Adjustable compression staple and method for stapling with adjustable compression

专利摘要:
Adjustable Compression Staple and Method for Stapling with Adjustable Compression A compression-self-adjusting staple includes: a substantially U-shaped staple (1) having an internally disposed compression device (23), which has a bias portion that has a compression surface (25) movably disposed between legs (26) of the staple (1) and a compression resistor (220). The compression resistor (220) is connected to a bridge (22) of the staple (1) and to the compression surface (25), and is formed to resist movement of the compression surface (25) towards the bridge (22) with a force.
公开号:AU2013224717A1
申请号:U2013224717
申请日:2013-09-06
公开日:2013-09-26
发明作者:Derek Dee Deville；Korey Kline；Matthew A. Palmer；Kevin W. Smith
申请人:Ethicon Endo Surgery Inc；
IPC主号:A61B17-064

专利说明:
1 Adjustable Compression Staple and Method for Stapling with Adjustable Compression CROSS-REFERENCE TO RELATED APPLICATIONS [1] This application relates to U.S. Patent Application Serial No. 11/971,998, filed on January 10, 2008, which application claims the priority, under 35 U.S.C. § 119, to U.S. Provisional Application Serial No. 60/880,146, filed on January 12, 2007, the entire disclosures of which are hereby incorporated herein by reference herein in their entireties. FIELD OF THE INVENTION [2] The present invention lies in the field of staple fastening, in particular, staples and instruments capable of applying a single or a plurality of staples to a material and processes therefor. More particularly, the present invention relates to a staple capable of placing a load bearing force against the material being stapled and improvements in processes for stapling material. The device can be used, particularly, in the medical field for stapling tissue during surgical procedures, whether open, endoscopic, or laparoscopic. BACKGROUND OF THE INVENTION [3] Conventional staples are, typically, U-shaped and require a staple cartridge and anvil to fasten the staple onto a material. The U-shape of the staple can be considered relatively square-cornered because of the sharp angle at which the legs extend from the bridge. On activation of a stapling device, the staple legs are advanced forward so that they penetrate a material on both sides of a slit or opening. As a staple former is advanced further, the legs of the staple bend around the anvil causing the tips of the legs to advance along an arcuate path toward each other so that the staple ultimately assumes a generally rectangular shape, thereby compressing the material that has been trapped between the staple legs, which is tissue in surgical applications. This compression of the material is the mechanism by which a closure is effected. Depending on the length of the incision or opening, a series of staples will be delivered along its length, which can ensure a blood tight closure in surgical procedures. [4] Because the staple has two legs that pierce the material, they are well suited for fastening two or more layers of material together when used with the opposing anvil. Whether 2 used in an office or during a surgical procedure, most staples 1 have similar shapes - a bridge 2 connecting two relatively parallel legs 4, which legs are disposed approximately orthogonal to the bridge 2, which, depending on the material of the staple, results in a square-cornered U shape. In surgical stapling devices, it is beneficial to start the legs 4 in a slight outward orientation to assist retention of the staples within the cartridge. The staple illustrated in FIG. 1 is representative of conventional surgical staples. Such staples are compressed against an anvil to bend the tips of the legs 4 inward. For purposes sufficient in surgery, the final stapled configuration has a stapling range from a "least" acceptable orientation to a "greatest" acceptable orientation. The "least" acceptable staple range is a position where the tangent defined by the tip of each leg 4 is at a negative angle to a line parallel to the bridge 2 and touching the lower portions of both legs 4. The "greatest" acceptable staple range is a position where the legs 4 are bent into a shape similar to the letter "B." [5] The staple 1 of FIG. 1 is shown in an orientation where the tips of the legs 4 are bent slightly by an anvil on the way towards a final stapled form. (This slightly bent orientation is also present with respect to the staples illustrated hereafter.) The legs 4 of such slightly bent staples have three different portions: [6] a connecting portion 6 (at which the legs 4 are connected to the bridge 2); [7] an intermediate portion 8 (at which the staple is bent; of course it is also possible for the connection portion 6 to be bent for various fastening purposes); and [8] a piercing portion 10 (for projecting through the material to be fastened; this portion, too, is bent when fastening). [9] Many stapling devices exist to deploy such staples. Some surgical stapling instruments are described in U.S. Patent No. 5,465,895 to Knodel et al., and U.S. Patent Nos. 6,644,532 and 6,250,532 to Green et al. When the staple 1 is bent for fastening, the polygon formed by the interior sides of the bent staple 1 defines an envelope or a central region 14. The material to be fastened by the staple 1 resides in and is compressed within the central region 14 when stapling occurs. When the final staple orientation is B-shaped, there can be two regions in which the tissue is held and compressed. [10] One common feature associated with conventional staples is that there is no controllable way of adjusting the compressive force that is applied by the staple to the material being stapled. While items such as paper and cardboard can withstand a wide range of stapler compressive force without breaking or puncturing, living tissue, such as the tissue to be 3 fastened in a surgical procedure, has a limited range of compressive force and cannot withstand force greater than a upper limit within that range without causing tissue damage. In fact, the range of optimal stapling force for a given surgical stapling procedure is relatively small and varies substantially with the type of tissue being stapled. [11] While it may be true that the distance between the bending point of the legs and the bridge (see, e.g., span 12 in FIG. 1) can be increased to impart less force on material within the staple, this characteristic does not apply when living tissue having varying degrees of hardness, composition, and flexibility is the material being stapled. Even if the staple leg bending distance 12 is increased, if more or less or harder or softer tissue than expected is actually captured within the staple, the force applied to the captured tissue will not be controlled and will not be optimal for that tissue. [12] When one, two, or more layers of tissue are being stapled, it is desirable for the tissue to be at a desired compressive state so that a desirous medical change can occur, but not to be at an undesired compressive state sufficient to cause tissue necrosis. Because there is no way to precisely control the tissue that is being placed within the staple, it is not possible to ensure that the tissue is stapled within an optimal tissue compression range, referred to as an OTC range. Therefore, ruling out of tissue necrosis is difficult or not possible. Further, tissue presented within one staple may not be the same tissue that is presented within an adjacent staple or is within another staple that is fired during the same stapling procedure. Thus, while one or a few of a set of staples could actually fasten within the OTC range, it is quite possible for many other staples in the same stapling procedure to fasten outside the OTC range. [13] What is needed, therefore, is an improved staple and improved methods of stapling that allow automatic control of the staple compression force imparted upon the material being stapled so that compression of the material remains within a desired OTC range. While prior art surgical stapling instruments have utility, and may be successfully employed in many medical procedures, it is desirable to enhance their operation with the ability to deliver a staple that can automatically tailor the compression force delivered to the tissue without external mechanics or operations. [14] It is to be understood that, if any prior art information is referred to herein, such reference does not constitute an admission that the information forms part of the common general knowledge in the art, in Australia or any other country.
4 SUMMARY OF THE INVENTION [15] It is accordingly an object of the invention to provide an adjustable compression staple and methods for stapling with adjustable compression that overcome the hereinafore-mentioned disadvantages of the heretofore-known devices and methods of this general type and that automatically tailors the compression force delivered to the tissue. [16] When tissue is stapled, liquid is forced out of the tissue. The OTC range of the tissue is a compression range in which liquid is removed from the tissue (i.e., desiccates the tissue) without damaging or necrosing the tissue. As the liquid from the tissue exits the tissue due to compression exerted upon the tissue by the staple, however, the compressive force that is being imposed upon the tissue naturally reduces - because less mass is between the opposing staple portions. In some instances, this reduction can allow the imparted tissue compression to exit the OTC range. Staples according to the present invention each have a self-adjusting, pre tensioned compression device that keeps compression force on the interposed tissue within the OTC compression range even after being desiccated. [17] The prior art staple of FIG. 1 has a stapling range that is illustrated in FIG. 17. For purposes sufficient in surgery, the final stapled configuration of the OTC staples of the present invention has a stapling range that is illustrated, for example, in FIGS. 18 to 20. A "least" acceptable staple range is a position where the tangent T defined by the tip of each leg 4 is at a negative angle a to a line L parallel to the bridge 2. This orientation is illustrated with the left half of the staple in FIG. 17 merely for reasons of clarity. See also FIGS. 18 to 20. A "greatest" acceptable staple range is a position where the legs 4 are bent 180 degrees into a shape similar to the letter "B" (see the exemplary orientation illustrated in the right-half of FIG. 17) but, in comparison to the prior art staple range of FIG. 17, as described below in detail, the tips of the legs 4 of the staples according to the invention reach only up to a compressing portion and not further than this compressing portion as shown in FIG. 20, for example. In such an orientation, the stapled tips of the legs do not interfere with the OTC device present in the staples according to the invention. [18] The OTC devices for staples according to the invention take many forms. The OTC device can be integral with the legs of the staple and project into a central area or can be attached to the staple to project into the central area. The OTC device can be sinusoidal in shape with a compressing portion at the end of the OTC device or can have multiple cycles of bends between the bridge of the staple with the compressing portion at the end of the OTC device. The bending portion can be single or double, the double bends being in cycle, out of 5 cycle, mirror-symmetrical, to name a few. The bends can be double-sinusoidal as shown in FIGS. 8, 9, and 11 The OTC device can be contained entirely between the two legs of the staple or can encircle one or both of the legs and, thereby, use the legs as a guide, for example, a sliding guide. The leg encirclement by the OTC device can be single or multiple. Travel of the OTC device can be limited, for example, by a star washer. The OTC device can be a compression spring(s) and a plate(s), with the plate encircling the legs and sliding thereon. The OTC device can be a compressible material secured on the legs. This material can be in the shape of a plate or a pillow. [19] With the foregoing and other objects in view, there is provided, in accordance with the invention, a compression-self-adjusting staple including a substantially U-shaped staple that has an internally disposed compression device, which has a bias portion that has a compression surface movably disposed between legs of the staple and a compression resistor. The compression resistor is connected to a bridge of the staple and to the compression surface, and is formed to resist movement of the compression surface towards the bridge with a force. [20] In accordance with another mode of the invention, the bridge is substantially rod-shaped with ends; and a base end of each the legs is integral with a respective one of the ends. [21] In accordance with another mode of the invention, the bridge and legs define a bridge leg plane; and the legs extend from the bridge at an angle of between 80 and 100 degrees in the bridge-leg plane. [22] In accordance with another mode of the invention, the compression surface defines two orifices; and each of the legs extends through one of the two orifices. [23] In accordance with another mode of the invention, the compression resistor defines at least one orifice pair; the compression surface defines two orifices; and each of the legs extends through one of the two orifices and one of the at least one orifice pair. [24] In accordance with another mode of the invention, the compression resistor defines a plurality of orifice pairs; the compression surface defines two orifices; and each of the legs extends through one of the two orifices and one of each of the orifice pairs. [25] In accordance with another mode of the invention, the bridge and the legs define a compression axis; and the compression surface is movably disposed between the legs along the compression axis.
6 [26] In accordance with another mode of the invention, the compression device is connected to the bridge. [27] In accordance with another mode of the invention, the compression resistor connects the bridge to the compression surface. [28] In accordance with another mode of the invention, the bridge, the legs, the compression resistor, and the compression surface are integral. [29] In accordance with another mode of the invention, the compression resistor is at least partly disposed between the legs. [30] In accordance with another mode of the invention, the compression resistor is disposed between the bridge and the compression surface. [31] In accordance with another mode of the invention, the force comprises a pre-defined opposing force. [32] In accordance with another mode of the invention, the force comprises a substantially constant force. [33] In accordance with another mode of the invention, the force comprises a linearly increasing force. [34] In accordance with another mode of the invention, the compression resistor has an anti compressive spring constant imparting a substantially constant anti-compressive force over a pre-defined compression range. [35] In accordance with another mode of the invention, the staple and the compression device are of a biocompatible material. [36] In accordance with another mode of the invention, the compression surface and the legs define a central compression region in which is to be disposed a material to be compressed between the compression surface and stapling points when distal ends of the staple legs are deformed; and when the distal ends are deformed in a staple closing direction into the central compression region, the bias portion resists movement of the compression surface in the staple closing direction with a pre-defined, substantially constant force. [37] In accordance with another mode of the invention, the compression surface and the bias portion are shaped to impart a pre-defined, substantially constant bias force upon material disposed between the compression surface and stapling points when the stapling points are deformed.
7 [38] In accordance with another mode of the invention, when stapling points are deformed toward one another, material disposed between the compression surface and the stapling points is compressed between the stapling points and the compression surface; and the compression resistor maintains a substantially constant compressive force on the material within a pre defined range independent of a degree of compression between the stapling points and the compression surface. BRIEF DESCRIPTION OF THE DRAWINGS [39] Advantages of the embodiments of the present invention will be apparent from the following detailed description of the preferred embodiments thereof, which description should be considered in conjunction with the accompanying drawings in which: [40] FIG. 1 is a perspective view from above a side of an exemplary prior art surgical staple; [41] FIG. 2 is a perspective view from above a side of a first exemplary embodiment of an OTC staple according to the invention; [42] FIG. 3 is a perspective view from above a side of a second exemplary embodiment of an OTC staple according to the invention; [43] FIG. 4 is a perspective view from above a side of a third exemplary embodiment of an OTC staple according to the invention; [44] FIG. 5 is a perspective view from above a side of a fourth exemplary embodiment of an OTC staple according to the invention; [45] FIG. 6 is a perspective view from above a side of a fifth exemplary embodiment of an OTC staple according to the invention; [46] FIG. 7 is a perspective view from above a side of a sixth exemplary embodiment of an OTC staple according to the invention; [47] FIG. 8 is a perspective view from above a side of a seventh exemplary embodiment of an OTC staple according to the invention; [48] FIG. 9 is a perspective view from above a side of an eighth exemplary embodiment of an OTC staple according to the invention; [49] FIG. 10 is a perspective view from above a side of a ninth exemplary embodiment of an OTC staple according to the invention; 8 [50] FIG. 11 is a perspective view from above a side of a tenth exemplary embodiment of an OTC staple according to the invention; [51] FIG. 11A is a fragmentary, enlarged perspective view from below a side of the OTC staple of FIG. 11; [52] FIG. 12 is a perspective view from above a side of an eleventh exemplary embodiment of an OTC staple according to the invention; [53] FIG. 13 is a perspective view from above a side of a twelfth exemplary embodiment of an OTC staple according to the invention; [54] FIG. 14 is a perspective view from above a side of a thirteenth exemplary embodiment of an OTC staple according to the invention; [55] FIG. 15 is a perspective view from above a side of a fourteenth exemplary embodiment of an OTC staple according to the invention; [56] FIG. 16 is a perspective view from above a side of a fifteenth exemplary embodiment of an OTC staple according to the invention; [57] FIG. 17 is a side elevational view of the prior art surgical staple of FIG. 1 with the staple tips illustrating an exemplary range of stapling; [58] FIG. 18 is a side elevational view of the staple of FIG. 6 with the staple tips in a first intermediate position of an exemplary stapling range; [59] FIG. 19 is a side elevational view of the staple of FIG. 6 with the staple tips in a second intermediate position of an exemplary stapling range; [60] FIG. 20 is a side elevational view of the staple of FIG. 6 with the staple tips in a third intermediate position of an exemplary stapling range; and [61] FIG. 21 is a process flow diagram of an inventive stapling method in accordance with the presenting invention DETAILED DESCRIPTION OF THE INVENTION [62] Herein various embodiment of the present invention are described. In many of the different embodiments, features are similar. Therefore, to avoid redundancy, repetitive description of these similar features may not be made in some circumstances. It shall be understood, however, that description of a first-appearing feature applies to the later described 9 similar feature and each respective description, therefore, is to be incorporated therein without such repetition. [63] Referring now to the figures of the drawings in detail and first, particularly to FIG. 2 thereof, there is shown a first exemplary embodiment of an automatic optimal tissue compression (OTC) staple 20 according to the invention. In this first embodiment, the bridge 21 has an upper bridge portion 22 and an extension 23 that substantially increases the overall length of the bridge 21 -- as compared to the bridge 2 of the staple 1 of FIG. 1. As the upper bridge portion 22 transitions into the extension 23, it curves into and within the central region 24 of the staple 20. This extension 23 can be in any shape or of any material so long as it delivers a pre-set compressive force to the tissue at a compressing portion 25, and as long as it allows for absorption (within the area between the compressing portion 25 and the upper bridge portion 22) of forces greater than this pre-set force. Therefore, the shape can be trapezoidal, triangular, sinusoidal, or any other configuration. An exemplary embodiment of relatively sinusoidal curves is shown in FIG. 2. These curves traverse two periods in the illustrated embodiment, however, the number of wave periods can be varied (smaller or larger). The extension 23 has two mirror symmetrical portions each starting from the upper bridge portion 22 and ending at respective ends of the compressing portion 25. Further, it is noted that neither the extension 23 nor the compressing portion 25 directly contacts the legs 26 in this exemplary configuration. [64] In the embodiment of FIG. 2, the extension 23 and the compressing portion 25 are integral with the upper bridge portion 22 and a base end 27 of the legs 26. The legs 26 are shown as relatively circular in cross-section. The bridge 21 and all of the compressing components 22, 23, 25 can also be circular in cross-section. Alternatively, as shown in FIG. 2, any portion of the extension 23 and/or the compressing portion 25 can have different cross sectional shapes, such as ovular, rectangular, or polygonal. In the embodiment shown, the cross-section of the extension 23 after the first curve away from the upper bridge portion 22 is shaped in a "racetrack" form (two relatively straight sides with two curved ends connecting each end of the sides). The upper bridge portion 22 can also have a different cross-sectional shape. The extension 23 and compressing portion 25 are, in this embodiment, even in cross-sectional area. Different portions of these parts can, however, have varying cross-sectional areas (i.e., varying thicknesses) as desired. [65] When the upper bridge 22, the extension 23, and the compressing portion 25 are shaped to deliver the pre-set compressive force to the tissue in a substantially longitudinal direction 28 of an unbent section of the leg portions 26 and to absorb forces greater than this 10 pre-set force, the overall effect is to create an OTC device having a given spring coefficient. In other words, the OTC device maintains the preset compressive force within the stapled area even after tissue changes states, such as expanding due to swelling and/or contracting during desiccation. Variation of the cross-section of any portion of the upper bridge 22, the extension 23, and the compressing portion 25 will allow for different OTC spring coefficients and, therefore, allows for adjustment of the compressive and reactive force constants of the OTC device within the staple 20. Variation of the material making up all of the staple 20 or any of its portions also permits adjustment of the OTC force. [66] FIG. 3 illustrates a second exemplary embodiment of the OTC staple 30 according to the invention. In this variation, as compared to the embodiment of FIG. 2, the OTC portion is not integral with the bridge 31 and the legs 32. Instead, the OTC device 33 is separate therefrom and is connected to these staple portions. Specifically, the OTC device 33 has a compressing portion 34 that directly contacts the tissue being compressed and an extension 36 for providing the load-bearing force when tissue is compressed within the central region 37 of the staple 30. The OTC device 33 also has a connecting portion 35 for attaching the OTC device 33 to the bridge 31. The extension 36 connects the upper and lower portions 34, 35 of the OTC device 33. The extension 36 and the compressing portion 34 are, in this embodiment, different in cross-sectional area. Here, the cross-sectional area of the compressing portion 34 is wider than the extension 36. Any portions of the extension 36 or the compressing portion 34 can be varied to have same or varying cross-sectional areas (i.e., varying thicknesses). [67] Connection of the OTC device 33 to the staple 30, for example, at the bridge 31, can occur by any fastening measure. One exemplary connection method is spot welding, which is indicated in FIG. 3 by reference numeral 38. Other exemplary methods of attaching suitable materials together include soldering and brazing. The type or types of material of the staple portions 31, 32 and the OTC device 33 will direct a preferable attachment method. In the case of attaching two materials together that are not suited to be welded, soldered or brazed, other attachment methods can be used such as crimping and adhesive bonding. Features can be added to one or both of the two components to facilitate the crimp or bond. These features could be configured to have the components snap together. In the case of dissimilar materials, for example, if the staple material is stainless steel and the OTC device 33 is of nickel titanium alloy, then preferred attachment measures include crimping, adhesive bonding, or snapping. [68] In this second embodiment, the OTC device 33 behaves similar to the OTC portions of the embodiment of FIG. 2 and can be shaped with the same variations of cross-section and 11 other spatial characteristics and can be formed with the same variations in material composition. Variation of any attribute of the OTC device 33 allows for adjustment of the compressive and reactive force constants thereof on the compressed tissue. The extension 36 can be any shape or material so long as it delivers a pre-set compressive force to the tissue at the compressing portion 34 and as long as it allows for absorption of forces greater than this pre-set force. An exemplary embodiment selected for this exemplary OTC device 33 is a relatively sinusoidal set of curves traversing less than two periods. The extension 36 has two mirror-symmetrical portions each starting from the bridge 31 and ending at respective ends of the compressing portion 34. In this exemplary embodiment, neither the extension 36 nor the compressing portion 34 directly contacts the legs 32. Most of the cross-section of the OTC device 33 has a racetrack form. Like the embodiment of FIG. 2, the cross-section can be varied in any desired way to deliver the pre-set compressive force to the tissue and to absorb forces greater than this pre-set force. [69] FIG. 4 illustrates a third exemplary embodiment of the OTC staple 40 according to the invention. In this variation, as compared to the embodiments of FIGS. 2 and 3, the OTC portion 43 is not symmetrical with respect to the bridge 41 or the legs 42. Also, like the embodiment of FIG. 3, the OTC portion is not integral with either the bridge 41 or the legs 42. The OTC device 43 is a separate part from the bridge 41 and the legs 42 and is fixedly connected to the bridge 41 at a connection location (for example, with a spot weld 48; other fixation/connection processes can be used). In particular, a connecting portion 45 of the OTC device 43 fixedly secures the OTC device 43 to the bridge 41. An extension 46 of the OTC device 43 provides the load-bearing force when tissue is compressed within the central region 47 of the staple 40 and a compressing portion 44 directly contacts the tissue being compressed. [70] Notably different from the embodiments of FIGS. 2 and 3 is the compressing portion 44. Here, the width of the compressing portion 44 (defined along the line between the two legs 42 of the staple 40) is greater than the separation distance of the two legs 42. The compressing portion 44 is provided with orifices 49 having a shape substantially corresponding to the cross sectional shape of the upper portion of the staple legs 42 but slightly larger. The legs 42 pass through and slidably rest within these orifices 49. In such a configuration, movement of the OTC device 43 out of the bridge-legs plane is substantially prevented. Because the orifices 49 are shaped to be slightly larger than the cross-section of the legs 42, the extension 46 acts as a compression spring in the bridge-legs plane as the compressing portion 44 moves up and down along the upper portion of the legs 42 (up being defined as the direction towards the bridge 41 12 from the piercing tips of the legs 42). Thus, the OTC device 43 of the third embodiment behaves different from the OTC devices of FIGS. 2 and 3 because of the form-locking and sliding connection between the connecting portion 44 and the legs 42. A form-locking connection is one that connects two elements together due to the shape of the elements themselves, as opposed to a force-locking connection, which locks the elements together by force external to the elements. [71] Like the previous embodiments, the OTC device 43 can be shaped with variations in cross-section and other spatial characteristics and can be formed with a variety of material compositions. The extension 46 and compressing portion 44 are, in this embodiment, different in cross-sectional area. Here, the cross-sectional area of the compressing portion 44 is wider than the extension 46. Any portions of the extension 46 or the compressing portion 44 can be varied to have same or varying cross-sectional areas (i.e., varying thicknesses). The extension 46 can be any shape or material so long as it delivers the pre-set compressive force to the tissue at the compressing portion 44 and as long as it allows for absorption of forces greater than this pre-set force. An exemplary embodiment selected for this OTC device 43 is a relatively sinusoidal curve traversing approximately one sinusoidal period. Virtually all of the cross-section of the OTC device 43 has a racetrack form, but can be changed as desired to other shapes (e.g., circular, ovular, polygonal, etc.). As described above, variation of any attribute of the OTC device 43 allows for adjustment of the compressive and reactive force constants thereof on the compressed tissue in the central region 47. [72] FIG. 5 illustrates a fourth exemplary embodiment of the OTC staple 50 according to the invention. This variation has some of the features of the above embodiments. In this variant, like the embodiment of FIG. 2, the OTC portion is symmetrical with respect to the bridge 51 and the legs 52 and the OTC device 53 is integral with the bridge 51. Like the embodiment of FIG. 4, the compressing portion 54 has a width greater than the separation distance of the two legs 52 and has ports 55 with a shape substantially corresponding to the cross-sectional shape of the upper portion of the legs 52, but slightly larger. The legs 52 pass through these ports 55. In this configuration, movement of the OTC device 53 out of the bridge-legs plane is substantially prevented. The extension 56 of the OTC device 53 traverses from the bridge 51 to the compressing portion 54. Because the ports 55 are shaped to be slightly larger than the cross section of the legs 52, the extension 56 acts as a compression spring in the bridge-legs plane as the compressing portion 54 moves up and down along the upper portion of the legs 52. It is the extension 56 that provides the load-bearing force when tissue is compressed within the 13 central region 57 of the staple 50. Because of the form-locking and sliding connection between the compressing portion 54 and the legs 52, the OTC device 53 of the fourth embodiment behaves similar to the OTC device of FIG. 4. [73] Here, the OTC device 53 is integral with the legs 52, the bridge 51, and the compressing portion 54. Because the two sides of the bridge 51 are not integral, they can separate from one another when the staple 50 is subjected to a twisting force. If desired, to substantially prevent such separation, the central portions of the bridge 51 can be fixedly connected to one another at a connection location (for example, with a spot weld 58; other connection processes can be used as well). [74] Like the previous embodiments, the OTC device 53 can be shaped with variations in cross-section and other spatial characteristics and can be formed with a variety of material compositions. Any portions of the extension 56 or the compressing portion 54 can be varied to have the same or varying cross-sectional areas (i.e., varying thicknesses). The extension 56 and compressing portion 54 are, in this embodiment, different in cross-sectional areas. Here, the cross-sectional area of the upper majority of the extension 56 is narrower than the lower portion of the extension 56 and the cross-section of the lower portion of the extension 56 gradually increases in width until it is equal to the cross-section of the compressing portion 54. [75] The extension 56 can be any shape or material so long as it delivers the pre-set compressive force to the tissue at the compressing portion 54 and as long as it allows for absorption of forces greater than this pre-set force. An exemplary embodiment selected for this OTC device 53 is a relatively sinusoidal curve traversing more than one sinusoidal period. Again, only for illustrative purposes, the cross-section of the OTC device 53 has a racetrack shape, but can be changed as desired to other shapes (e.g., circular, ovular, polygonal, etc.). As described above, variation of any attribute of the OTC device 53 allows for adjustment of the compressive and reactive force constants thereof on the compressed tissue in the central region 57. [76] FIG. 6 illustrates a fifth exemplary embodiment of the OTC staple 60 according to the invention. This variation has some of the features of the above embodiments. In this variant, like the embodiment of FIG. 3, the OTC portion is symmetrical with respect to the bridge 61 and the legs 62 and the OTC device 63 is a separate part from the bridge 61 and legs 62 of the staple 60. Like the embodiment of FIGS. 4 and 5, the compressing portion 64 has a width greater than the separation distance of the two legs 62 and has ports 65 with a shape substantially corresponding to the cross-sectional shape of the upper portion of the legs 62, but 14 slightly larger. The legs 62 pass through these ports 65. In this configuration, movement of the OTC device 63 out of the bridge-legs plane is substantially prevented. The extension 66 of the OTC device 63 traverses from the bridge 61 to the compressing portion 64. Because the ports 65 are shaped to be slightly larger than the cross-section of the legs 62, the extension 66 acts as a compression spring in the bridge-legs plane as the compressing portion 64 moves up and down along the upper portion of the legs 62. It is the extension 66 that provides the load bearing force when tissue is compressed within the central region 67 of the staple 60. Because of the form-locking and sliding connection between the compressing portion 64 and the legs 62, the OTC device 63 of the fifth embodiment behaves similar to the OTC devices of FIGS. 4 and 5. [77] Connection of the OTC device 63 to the staple 60, for example, at the bridge 61, can occur by any fastening measure. One exemplary connection method is spot welding, which is indicated in FIG. 6 by reference numeral 68. The type or types of material of the staple portions 61, 62 and the OTC device 63 will direct a preferable attachment method. In the case of attaching two materials together that are not suited to be welded, soldered or brazed, other attachment methods can be used such as crimping and adhesive bonding. Features can be added to one or both of the two components to facilitate the crimp or bond. These features could be configured to have the components snap together. In the case of dissimilar materials, for example, if the staple material is stainless steel and the OTC device 63 is of nickel titanium alloy, then preferred attachment measures include crimping, adhesive bonding, or snapping. [78] Like the previous embodiments, the OTC device 63 can be shaped with variations in cross-section and other spatial characteristics and can be formed with a variety of material compositions. Any portions of the extension 66 or the compressing portion 64 can be varied to have the same or different cross-sectional areas (i.e., varying thicknesses). The extension 66 and compressing portion 64 are, in this embodiment, different in cross-sectional areas. Here, the cross-sectional area of most of the extension 66 is narrower than the lowermost portion of the extension 66 and the cross-section of this lowermost portion of the extension 66 gradually increases in width until it is equal to the cross-section of the compressing portion 64, which is substantially wider. [79] The extension 66 can be any shape or material so long as it delivers the pre-set compressive force to the tissue at the compressing portion 64 and as long as it allows for absorption of forces greater than this pre-set force. An exemplary embodiment selected for this OTC device 63 is a relatively sinusoidal curve traversing more than one sinusoidal period.
15 Again, only for illustrative purposes, the cross-section of the OTC device 63 has a racetrack shape, but can be changed as desired to other shapes (e.g., circular, ovular, polygonal, etc.). As described above, variation of any attribute of the OTC device 63 allows for adjustment of the compressive and reactive force constants thereof on the compressed tissue in the central region 67. [80] FIG. 7 illustrates a sixth exemplary embodiment of the OTC staple 70 according to the invention. This variation has some of the features of the above embodiments. In this variant, like the embodiment of FIG. 3, the OTC portion is symmetrical with respect to the bridge 71 and the legs 72 and the OTC device 73 is a separate part from the bridge 71 and legs 72 of the staple 70. Like the embodiment of FIGS. 4 to 6, the compressing portion 74 has a width greater than the separation distance of the two legs 72 and has ports 75 with a shape substantially corresponding to the cross-sectional shape of the upper portion of the legs 72, but slightly larger. The legs 72 pass through these ports 75. In this configuration, movement of the OTC device 73 out of the bridge-legs plane is substantially prevented. The extension 76 of the OTC device 73 traverses from the bridge 71 to the compressing portion 74. Because the ports 75 are shaped to be slightly larger than the cross-section of the legs 72, the extension 76 acts as a compression spring in the bridge-legs plane as the compressing portion 74 moves up and down along the upper portion of the legs 72. It is the extension 76 that provides the load-bearing force when tissue is compressed within the central region 77 of the staple 70. Because of the form-locking and sliding connection between the compressing portion 74 and the legs 72, the OTC device 73 of the sixth embodiment behaves similar to the OTC devices of FIGS. 4 to 6. [81] Connection of the OTC device 73 to the staple 70, for example, at the bridge 71, can occur by any fastening measure. One exemplary connection method is spot welding, which is indicated in FIG. 7 by reference numeral 78. The type or types of material of the staple portions 71, 72 and the OTC device 73 will direct a preferable attachment method. In the case of attaching two materials together that are not suited to be welded, soldered or brazed, other attachment methods can be used such as crimping and adhesive bonding. Features can be added to one or both of the two components to facilitate the crimp or bond. These features could be configured to have the components snap together. In the case of dissimilar materials, for example, if the staple material is stainless steel and the OTC device 73 is of nickel titanium alloy, then preferred attachment measures include crimping, adhesive bonding, or snapping. [82] It is noted that the extensions (i.e., springs) in each of FIGS. 2, 3, 5, and 6 are in the same plane, which can be the bridge-legs plane (as shown) or out of that plane. In comparison 16 to these embodiments, the extension 76 has the springs residing in different planes (i.e., one next to the other. [83] Like the previous embodiments, the OTC device 73 can be shaped with variations in cross-section and other spatial characteristics and can be formed with a variety of material compositions. Any portions of the extension 76 or the compressing portion 74 can be varied to have the same or varying cross-sectional areas (i.e., varying thicknesses). The extension 76 and the compressing portion 74 are, in this embodiment, different in cross-sectional areas. Here, the cross-sectional area of most of the extension 76 is narrower than the lowermost portion of the extension 76 and the cross-section of this lowermost portion of the extension 76 gradually increases in width until it is equal to the cross-section of the compressing portion 74, which is substantially wider. [84] The extension 76 can be any shape or material so long as it delivers the pre-set compressive force to the tissue at the compressing portion 74 and as long as it allows for absorption of forces greater than this pre-set force. An exemplary embodiment selected for this OTC device 73 is a relatively sinusoidal curve traversing more than one sinusoidal period. Again, only for illustrative purposes, the cross-section of the OTC device 73 has a racetrack shape, but can be changed as desired to other shapes (e.g., circular, ovular, polygonal, etc.). As described above, variation of any attribute of the OTC device 73 allows for adjustment of the compressive and reactive force constants thereof on the compressed tissue in the central region 77. [85] FIG. 8 illustrates a seventh exemplary embodiment of the OTC staple 80 according to the invention. This variation has some of the features of the above embodiments. In this variant, like the embodiment of FIG. 3, the OTC portion is symmetrical with respect to the bridge 81 and the legs 82, and the OTC device 83 is a separate part from the bridge 81 and legs 82 of the staple 80. Like the embodiment of FIGS. 4 to 7, the compressing portion 84 has a width greater than the separation distance of the two legs 82 and has ports 85 with a shape substantially corresponding to the cross-sectional shape of the upper portion of the legs 82, but slightly larger. The legs 82 pass through these ports 85. In this configuration, movement of the OTC device 83 out of the bridge-legs plane is substantially prevented. The extension 86 of the OTC device 83 traverses from the bridge 81 to the compressing portion 84. Because the ports 85 are shaped to be slightly larger than the cross-section of the legs 82, the extension 86 acts as a compression spring in the bridge-legs plane as the compressing portion 84 moves up and down along the upper portion of the legs 82. It is the extension 86 that provides the load- 17 bearing force when tissue is compressed within the central region 87 of the staple 80. Because of the form-locking and sliding connection between the compressing portion 84 and the legs 82, the OTC device 83 of the seventh embodiment behaves similar to the OTC devices of FIGS. 4 to 7. [86] Like the previous embodiments, the OTC device 83 can be shaped with variations in cross-section and other spatial characteristics and can be formed with a variety of material compositions. Any portions of the extension 86 or the compressing portion 84 can be varied to have the same or varying cross-sectional areas (i.e., varying thicknesses). The extension 86 and the compressing portion 84 are, in this embodiment, different in cross-sectional areas. Here, the cross-sectional area of most of the extension 86 is smaller and narrower than the lowermost portion of the extension 86 and the cross-section of this lowermost portion gradually increases in width until it is equal to the cross-section of the compressing portion 84, which is substantially wider. Also, the cross-sectional area of this extension 86 is smaller than previous embodiments (but it need not be). [87] The extension 86 can be any shape or material so long as it delivers the pre-set compressive force to the tissue at the compressing portion 84 and as long as it allows for absorption of forces greater than this pre-set force. An exemplary embodiment selected for this OTC device 83 is a relatively sinusoidal curve traversing a more than two periods and also having a second "interior" curve that traverses sinusoidal periods. In this embodiment, the OTC device 83 has an uppermost portion that is, in contrast to the embodiments of FIGS. 3, 6, and 7 a single bar extending along a majority of the bridge 81. [88] Connection of the OTC device 83 to the staple 80, for example, at the bridge 81, can occur by any fastening measure. One exemplary connection method is spot welding, which is indicated in FIG. 8 by reference numeral 88. Because there is contact over most of the bridge 81, the OTC device 83 can be welded over the entire length thereof. The type or types of material of the staple portions 81, 82 and the OTC device 83 will direct a preferable attachment method. In the case of attaching two materials together that are not suited to be welded, soldered or brazed, other attachment methods can be used such as crimping and adhesive bonding. Features can be added to one or both of the two components to facilitate the crimp or bond. These features could be configured to have the components snap together. In the case of dissimilar materials, for example, if the staple material is stainless steel and the OTC device 83 is of nickel titanium alloy, then preferred attachment measures include crimping, adhesive bonding, or snapping.
18 [89] Only for illustrative purposes, the cross-section of the OTC device 83 has a racetrack shape, but can be changed as desired to other shapes (e.g., circular, ovular, polygonal, etc.). As described above, variation of any attribute of the OTC device 83 allows for adjustment of the compressive and reactive force constants thereof on the compressed tissue in the central region 87. [90] FIG. 9 illustrates an eighth exemplary embodiment of the OTC staple 90 according to the invention. This variation has some of the features of the above embodiments. In this variant, like the embodiment of FIG. 3, the OTC portion is symmetrical with respect to the bridge 91 and the legs 92, and the OTC device 93 is a separate part from the bridge 91 and legs 92 of the staple 90. Like the embodiment of FIGS. 4 to 8, the compressing portion 94 has a width greater than the separation distance of the two legs 92 and has ports 95 with a shape substantially corresponding to the cross-sectional shape of the upper portion of the legs 92, but slightly larger. The legs 92 pass through these ports 95. In this configuration, movement of the OTC device 93 out of the bridge-legs plane is substantially prevented. The extension 96 of the OTC device 93 traverses from the bridge 91 to the compressing portion 94. Because the ports 95 are shaped to be slightly larger than the cross-section of the legs 92, the extension 96 acts as a compression spring in the bridge-legs plane as the compressing portion 94 moves up and down along the upper portion of the legs 92. It is the extension 96 that provides the load-bearing force when tissue is compressed within the central region 97 of the staple 90. Because of the form-locking and sliding connection between the compressing portion 94 and the legs 92, the OTC device 93 of the eighth embodiment behaves similar to the OTC devices of FIGS. 4 to 8. [91] Like the previous embodiments, the OTC device 93 can be shaped with variations in cross-section and other spatial characteristics and can be formed with a variety of material compositions. Any portion(s) of the extension 96 or the compressing portion 94 can be varied to have the same or varying cross-sectional areas (i.e., varying thicknesses). The extension 96 and the compressing portion 94 are, in this embodiment, different in cross-sectional areas. Here, the cross-sectional area of most of the extension 96 is smaller and narrower than the lowermost portion of the extension 96 and the cross-section of this lowermost portion gradually increases in width until it is equal to the cross-section of the compressing portion 94, which is substantially wider. Also, the cross-sectional area of this extension 96 is smaller than previous embodiments (but need not be). With such a relatively smaller cross-sectional shape, the curves of the extension 96 might tend to deform or move out of the bridge-legs plane, which tendency can increase or decrease depending upon the material of the extension 96. To 19 prevent such deformation and/or movement, a plurality of guiding tabs 99 are disposed at one or more of the outside ends of each periodic curve adjacent the legs 92. These guiding tabs 99 are shaped in a similar manner to the ends of the compressing portion 94, in that they have ports with a cross-sectional shape substantially corresponding to the cross-sectional shape of the upper portion of the legs 92 but slightly larger. The embodiment illustrated in FIG. 9 provides each guiding tab 99 with two relatively parallel plates each having one of the two ports through which the respective leg 92 is disposed. Like the lower portion of the extension 96, the cross-sectional area of the extension gradually increases in width until it is equal to the larger cross-section of the plate of the guiding tab 99. Another alternative of the guiding tab 99 is to have only a single plate with a single port. In such an embodiment (assuming the material was the same as a dual-plate embodiment), the curves of the extension 96 would be slightly stiffer because of the absence of the exterior curve of the guiding tab 99. [92] The extension 96 can be any shape or material so long as it delivers the pre-set compressive force to the tissue at the compressing portion 94 and as long as it allows for absorption of forces greater than this pre-set force. An exemplary embodiment selected for this OTC device 93 is a relatively sinusoidal curve having a second interior curve that traverses a few sinusoidal periods and, in this embodiment, has an uppermost portion that is, like the embodiment of FIG. 8, a single bar extending along a majority of the bridge 91. Connection of the OTC device 93 to the staple 90, for example, at the bridge 91, can occur by any fastening measure. One exemplary connection method is spot welding, which is indicated in FIG. 9 by reference numeral 98. Alternatively, the weld can be over the entire span contacting the bridge 91. The type or types of material of the staple portions 91, 92 and the OTC device 93 will direct a preferable attachment method. In the case of attaching two materials together that are not suited to be welded, soldered or brazed, other attachment methods can be used such as crimping and adhesive bonding. Features can be added to one or both of the two components to facilitate the crimp or bond. These features could be configured to have the components snap together. In the case of dissimilar materials, for example, if the staple material is stainless steel and the OTC device 93 is of nickel titanium alloy, then preferred attachment measures include crimping, adhesive bonding, or snapping. [93] Again, only for illustrative purposes, the cross-section of the OTC device 93 has a racetrack shape, but can be changed as desired to other shapes (e.g., circular, ovular, polygonal, etc.). As described above, variation of any attribute of the OTC device 93 allows for 20 adjustment of the compressive and reactive force constants thereof on the compressed tissue in the central region 97. [94] FIG. 10 illustrates a ninth exemplary embodiment of the OTC staple 100 according to the invention. This variation has some of the features of the above embodiments. In this variant, like the embodiment of FIG. 3, the OTC portion is symmetrical with respect to the bridge 101 and the legs 102, and the OTC device 103 is a separate part from the bridge 101 and legs 102 of the staple 100. The compressing portion 104, however, is unlike all of the previous embodiments. Here, the compressing portion 104 is formed from two compressing plates, each of these plates being attached to a respective lower end of two halves of the OTC device 103. The shape of the compressing portion 104 need not be a plate. It can be cylindrical, for example. Like previous embodiments, the lowermost end of the extension 106 gradually increases in cross-section until it is equal to the compressing portion 104. Each compressing plate, then, extends towards a respective one of the legs 102 and defines a respective port 105 for receiving therein the leg 102. The port 105 has a shape substantially corresponding to the cross-sectional shape of the upper portion of the legs 102, but is slightly larger. The legs 102 pass through each port 105 to form the OTC device 103. In this configuration, movement of the OTC device 103 out of the bridge-legs plane is substantially prevented. The extension 106 of the OTC device 103 traverses from the bridge 101 to the plates of the compressing portion 104. Because the ports 105 are shaped to be slightly larger than the cross-section of the legs 102, the extension 106 acts as a compression spring in the bridge-legs plane as the compressing portion 104 moves up and down along the upper portion of the legs 102. It is the extension 106 that provides the load-bearing force when tissue is compressed within the central region 107 of the staple 100. [95] In this embodiment, as compared to previous OTC device embodiments, the two sides of the OTC device 103 move independent from one another. Thus, if tissue varies in any characteristic within the central portion 107 (e.g., hardness, thickness, density), the optimal tissue compression force can be delivered independently and differently for each of the two differing tissue segments contacting the respective one of the sides of the OTC device 103. [96] Connection of the OTC device 103 to the staple 100, for example, at the bridge 101, can occur by any fastening measure. One exemplary connection method is spot welding, which is indicated in FIG. 10 by reference numeral 108. As the upper portion contacts almost all of the bridge 101, the weld 108, instead, can span any amount of the bridge 101. The type or types of material of the staple portions 101, 102 and the OTC device 103 will direct a preferable 21 attachment method. In the case of attaching two materials together that are not suited to be welded, soldered or brazed, other attachment methods can be used such as crimping and adhesive bonding. Features can be added to one or both of the two components to facilitate the crimp or bond. These features could be configured to have the components snap together. In the case of dissimilar materials, for example, if the staple material is stainless steel and the OTC device 103 is of nickel titanium alloy, then preferred attachment measures include crimping, adhesive bonding, or snapping. [97] Like the previous embodiments, the OTC device 103 can be shaped with variations in cross-section and other spatial characteristics and can be formed with a variety of material compositions. Any portions of the extension 106 or the compressing portion 104 can be varied to have the same or varying cross-sectional areas (i.e., varying thicknesses). The extension 106 and the plates of the compressing portion 104 are, in this embodiment, different in cross sectional areas. Here, the cross-sectional area of most of the extension 106 is smaller and narrower than the lowermost portion of the extension 86 and the cross-section of this lowermost portion gradually increases in width until it is equal to the cross-section of the respective plate of the compressing portion 104, which is substantially wider. [98] The extension 106 can be any shape or material so long as it delivers the pre-set compressive force to the tissue at the compressing portion 104 and as long as it allows for absorption of forces greater than this pre-set force. An exemplary embodiment selected for this OTC device 103 is a relatively sinusoidal curve having almost two sinusoidal periods and, in this embodiment, has an uppermost portion that is (like the embodiments of FIGS. 8 and 9) a single bar extending along a majority of the bridge 101. For illustrative purposes, the cross-section of the OTC device 103 has an ovular shape, but can be changed as desired to other shapes (e.g., circular, racetrack, polygonal, etc.). As described above, variation of any attribute of the OTC device 103 allows for adjustment of the compressive and reactive force constants thereof on the compressed tissue in the central region 107. [99] FIGS. 11 and 11A illustrate a tenth exemplary embodiment of the OTC staple 110 according to the invention. This variation has some of the features of the above embodiments. In this variant, like the embodiment of FIG. 3, the OTC portion is symmetrical with respect to the bridge 111 and the legs 112, and the OTC device 113 is a separate part from the bridge 111 and legs 112 of the staple 110. The compressing portion 114 is like the embodiment of FIG. 10 - it is formed from two compressing plates, each of these plates being attached to a respective lower end of two halves of the OTC device 113. The lowermost end of the extension 116 22 gradually increases in cross-section until it is equal in area to the compressing portion 114. Each compressing plate, then, extends towards a respective one of the legs 112 and defines a respective port 115 for receiving therein one of the legs 112. In FIG. 11, the ports 115 cannot be seen because of the presence of one-way washers 119 (described below), but the port 115 is visible in FIG. 11 A. [100] As set forth above, each port 115 has a shape substantially corresponding to the cross sectional shape of the upper portion of the legs 112 but is slightly larger. The legs 112 pass through each port 115 to form the OTC device 113. Because the ports 115 are shaped to be slightly larger than the cross-section of the legs 112, the extension 116 acts as a compression spring in the bridge-legs plane as the compressing portion 114 moves up and down along the upper portion of the legs 112. In this configuration, movement of the OTC device 113 out of the bridge-legs plane is substantially prevented. It is the extension 116 that provides the load bearing force when tissue is compressed within the central region 117 of the staple 110. In this embodiment (like the embodiment of FIG. 10), the two sides of the OTC device 113 move independent from one another. Thus, if tissue varies in any characteristic within the central portion 117 (e.g., hardness, thickness, density), the optimal tissue compression force can be delivered independently and differently for each of the two differing tissue segments contacting the two plates of the compressing portion 114. [101] Introduced for the first time in this embodiment are one-way devices 119 (one exemplary embodiment being a star washer that is illustrated in FIGS. 11 and 11 A) disposed on the leg 112 between the bridge 111 and the compressing portion 114. These devices 119 are shaped to freely move on the leg 112 upwards towards the bridge 111 but not to move in the opposite direction. Thus, as tissue is being compressed within the central region 117 as the distal ends of the legs 112 are curved in the stapling action, the tissue presses against the compressing portion 114 and moves the compressing portion 114 up towards the bridge 111. Once the stapling force is removed from the staple 110 (after stapling is complete), the tissue will most likely not press the washers 119 any further without any additionally supplied outside force. Thus, the washers 119 limit further movement of the compressing portion 114 from the then current location of the washers 119 towards the first bend of the legs 112. These washers also add some friction when the first stapling movement occurs, which friction may be used to add to and make up the compression coefficients of the OTC device 113. If the stapled tissue swells, it is possible for the washers 119 to be moved if the force is sufficient. After such swelling ends 23 and desiccation of the tissue occurs, the compressing portions 114 will be limited in further compression by these washers 119. [102] Like the previous embodiments, the OTC device 113 can be shaped with variations in cross-section and other spatial characteristics and can be formed with a variety of material compositions. Any portions of the extension 116 or the compressing portion 114 can be varied to have the same or varying cross-sectional areas (i.e., varying thicknesses). The extension 116 and the plates of the compressing portion 114 are, in this embodiment, different in cross sectional areas. Here, the cross-sectional area of most of the extension 116 is smaller and narrower than the lowermost portion of the extension 116 and the cross-section of this lowermost portion gradually increases in width until it is equal to the cross-section of the respective plate of the compressing portion 114, which is substantially wider. [103] The extension 116 can be any shape or material so long as it delivers the pre-set compressive force to the tissue at the compressing portion 114 and as long as it allows for absorption of forces greater than this pre-set force. An exemplary embodiment selected for this OTC device 113 is a relatively sinusoidal curve traversing more than two sinusoidal periods and having a second "interior" curve. In this embodiment, the OTC device 113 has an uppermost portion that is (like the embodiments of FIGS. 8 to 10) a single bar extending along a majority of the bridge 111. Connection of the OTC device 113 to the staple 110, for example, at the bridge 111, can occur by any fastening measure. One exemplary connection method is spot welding, which is indicated in FIG. 11 by reference numeral 118. This process can be changed if desired. The type or types of material of the staple portions 111, 112 and the OTC device 113 will direct a preferable attachment method. In the case of attaching two materials together that are not suited to be welded, soldered or brazed, other attachment methods can be used such as crimping and adhesive bonding. Features can be added to one or both of the two components to facilitate the crimp or bond. These features could be configured to have the components snap together. In the case of dissimilar materials, for example, if the staple material is stainless steel and the OTC device 113 is of nickel titanium alloy, then preferred attachment measures include crimping, adhesive bonding, or snapping. [104] For illustrative purposes, the cross-section of the OTC device 113 has a racetrack shape, but can be changed as desired to other shapes (e.g., circular, ovular, polygonal, etc.). As described above, variation of any attribute of the OTC device 113 allows for adjustment of the compressive and reactive force constants thereof on the compressed tissue in the central region 117.
24 [105] FIG. 12 illustrates an eleventh exemplary embodiment of the OTC staple 120 according to the invention. This variation is significantly different from the above embodiments. The OTC device 123 is, as above, a separate part from the bridge 121 and legs 122 of the staple 120. Here, however, the compressing portion 124 is a C-beam having ports 125 that permit passage of a respective one of the legs 122 therethrough. Each port 125 has a shape substantially corresponding to the cross-sectional shape of the upper portion of the legs 122 but is slightly larger. The legs 122 pass through each port 125 to form the OTC device 123. In this configuration, movement of the OTC device 123 out of the bridge-legs plane is substantially prevented. [106] The C-beam shape is useful for a variety of reasons. First, the C-shape provides a central cavity in which a distal end of a compression device 126 can be held or fastened. Next, the C-shape also increases resistance to bending forces as compared to a simple rectangular plate, as is known in construction. Finally, orienting the open portion of the "C" away from the tissue presents a flat compressing plate to the tissue to be compressed. With such a shape, the tissue can be compressed evenly, with no singular pressure points. Of course, the C-shape is not the only possible cross-sectional shape. The compressing portion 124 can be a rectangular plate, an I-beam, an L-beam, or any other desired shape. [107] The compression device 126 can take any form (see, e.g., FIG. 13). The exemplary embodiment of FIG. 12 illustrates the compression device 126 as a conically expanding compression spring. Connection of the spring 126 and compressing portion 124 to the staple 120, for example, at the bridge 121, can occur by any fastening measure. The illustrated exemplary proximal connection method is a ring of the spring material wrapping around the bridge 121. This proximal end is secured at the center of the bridge 121 and held in place there by placing protuberances 128 on the bridge 121. These protuberances prevent lateral movement of the proximal ring towards either of the two legs 122. Of course, this ring can be welded or fastened to the bridge 121 by any fastening process. The distal end of the spring is a relatively circular coil lying in the same plane as the interior cavity of the C-beam and having an outer diameter just slightly less than the interior diameter of the C-shaped cavity of the compressing portion 124. Thus, the ends of the C-shape can be used to retain the distal end of the spring 126 within the cavity. Of course, other fastening measures can be used to secure the spring distal ends to the compressing portion 124. [108] It is the spring 126 that provides the load-bearing force when tissue is compressed within the central region 127 of the staple 120. Like the previous embodiments, the OTC device 25 123 can be shaped with variations in cross-section, winding, and other spatial characteristics and can be formed with a variety of material compositions. Any portions of the spring 126 or the compressing portion 124 can be varied. In particular, the spring 126 can be any shape or material so long as it delivers the pre-set compressive force to the tissue through the compressing portion 124 and as long as it allows for absorption of forces greater than this pre set force. As described above, variation of any attribute of the OTC device 123 allows for adjustment of the compressive and reactive force constants thereof on the compressed tissue in the central region 127. [109] FIG. 13 illustrates a twelfth exemplary embodiment of the OTC staple 130 according to the invention. This variation is similar to the embodiment of FIG. 12. The OTC device 133 is, as above, a separate part from the bridge 131 and legs 132 of the staple 130 and the compressing portion 134 is a C-beam having ports 135 that permit passage of a respective one of the legs 132 therethrough. Each port 135 has a shape substantially corresponding to the cross-sectional shape of the upper portion of the legs 132 but is slightly larger. The legs 132 pass through each port 135 to form the OTC device 133. In this configuration, movement of the OTC device 133 out of the bridge-legs plane is substantially prevented. [110] The C-beam shape has the same benefits as described in the eleventh embodiment of FIG. 12. Like that embodiment, the C-shape is not required; the compressing portion 134 can be a rectangular plate, an I-beam, an L-beam, or any other desired shape. [111] The compression device 136 can take any form. In the exemplary embodiment of FIG. 13, the compression device 136 is a pair of compression springs 136. Connection of these springs 136 and the compressing portion 134 to the staple 130, for example, at the bridge 131, can occur by any fastening measure. The illustrated exemplary proximal connection method is a narrowing of the spring diameter to be equal or less than the diameter of the legs 132 at the connection point to the bridge 131. Thus, the springs 136 can be held by the force imparted on the legs 132 by press-fitting the narrower spring rings onto a desired location on the legs 132. Alternatively and/or additionally, the almost ninety degree bend at the legs-bridge intersection forms a stop preventing further upward movement of the distal ends of each spring 136. Of course, the upper ring(s) can be fastened to the staple 130 by any measure, such as welding, crimping, etc. [112] Like the embodiment of FIG. 12, the distal end of the springs 136 in FIG. 13 is formed by a relatively circular coil lying in the same plane as the interior cavity of the C-beam and having an outer diameter just slightly less than the interior diameter of the C-shaped cavity of the 26 compressing portion 134. Thus, the ends of the C-shape can be used to retain the distal end of the spring 136 within the cavity. The coils can be welded to the C-beam, for example. Of course, other fastening measures and coil configurations can be used to secure the distal ends of the springs 136 to the compressing portion 134. [113] It is the springs 136 that provide the load-bearing force when tissue is compressed within the central region 137 of the staple 130. Like the previous embodiments, the OTC device 133 can be shaped with variations in cross-section and other spatial characteristics and can be formed with a variety of material compositions. Any portions of the springs 136 or the compressing portion 134 can be varied. In particular, the spring 136 can be any shape or material so long as it delivers the pre-set compressive force to the tissue through the compressing portion 134 and as long as it allows for absorption of forces greater than this pre set force. As described above, variation of any attribute of the OTC device 133 allows for adjustment of the compressive and reactive force constants thereof on the compressed tissue in the central region 137. [114] The spring 136 shown in FIG. 12 floats between the legs 132 and does not touch either leg 132. In contrast, the springs 135 of FIG. 13 wrap around the legs throughout the entire length. This orientation presents the possibility of resistance (i.e., friction) imparted upon the springs 136 by the legs 132 when the springs 136 are compressed. This resistance may be desirable depending upon the desired OTC device compression coefficient. If resistance is to be reduced, then sleeves 138 can be inserted onto the legs 132 such that they "lubricate" or reduce resistance of spring compression. These sleeves 138 can be made of polytetrafluoroethylene (PTFE), for example. [115] FIG. 14 illustrates a thirteenth exemplary embodiment of the OTC staple 140 according to the invention. This variation is similar to the embodiments of FIGS. 12 and 13. The OTC device 143 is, as above, a separate part from the bridge 141 and legs 142 of the staple 140 and the compressing portion 144 is a C-beam having non-illustrated ports that permit passage of a respective one of the legs 142 therethrough (in the view of FIG. 14, the ports are blocked from view by the C-beam). Each port has a shape substantially corresponding to the cross-sectional shape of the upper portion of the legs 142 but is slightly larger. The legs 142 pass through each port to form the OTC device 143. In this configuration, movement of the OTC device 143 out of the bridge-legs plane is substantially prevented.
27 [116] The C-beam shape has the same benefits as described in the eleventh embodiment of FIG. 12. Like that embodiment, the C-shape is not required; the compressing portion 144 can be a rectangular plate, an I-beam, an L-beam, or any other desired shape. [117] The compression device 146 can take any form. The exemplary embodiment of FIG. 14 is a pair of compression springs 146. Like the single spring 136 shown in FIG. 12, the compression springs 146 of this embodiment float between the legs 142 and do not touch either leg 142. Connection of these springs 146 to the staple 140, for example, at the bridge 141, can occur by any fastening measure. The illustrated exemplary proximal connection method is a second C-beam disposed against the bridge 141 and connected thereto by any fastening measure, such as spot welds 148, for example. With such a connection configuration, each of the springs 146 can be formed with a relatively circular coil lying in the same plane as the interior cavity of each C-beam and having an outer diameter just slightly less than the interior diameter of the respective C-shaped cavity of the compressing portion 144. Thus, the ends of the C-shape can be used to retain the distal end of the spring 146 within the cavity. These end coils can be press-fit or slid into the C-beam cavity for connection thereto. Alternatively and/or additionally, these lower and upper loops can be fastened to the beams by welding, crimping, etc. The respective interior cavities of the two C-beams can be of different or of equal size. [118] It is the springs 146 that provide the load-bearing force when tissue is compressed within the central region 147 of the staple 140. Like the previous embodiments, the OTC device 143 can be shaped with variations in cross-section, winding, and other spatial characteristics and can be formed with a variety of material compositions. Any portions of the springs 146 or the compressing portion 144 can be varied. In particular, the spring 146 can be any shape or winding or of any material so long as it delivers the pre-set compressive force to the tissue through the compressing portion 144 and as long as it allows for absorption of forces greater than this pre-set force. As described above, variation of any attribute of the OTC device 143 allows for adjustment of the compressive and reactive force constants thereof on the compressed tissue in the central region 147. [119] FIG. 15 illustrates a fourteenth exemplary embodiment of the OTC staple 150 according to the invention. The OTC device 153 is, as above, a separate part from the bridge 151 and legs 152 of the staple 150. Here, however, this variation differs from the previous embodiments because the OTC device 153 is a cushion made of a compressible material. Examples of such material include, but are not limited to, closed cell polyethylene foam, expanded polytetrafluoroethylene (PTFE), silicone rubber, silicone rubber foam, urethane, and electro- 28 spun thermoplastic elastomers. This cushion 153 defines two channels 154 for receiving therethrough a respective one of the legs 152. Because the staple legs 152 taper inwards slightly in a direction from the intermediate portion 155 of the staple 150 to the ends of the bridge 151 (although this taper is not a requirement), the cross-sectional area of the channels 154 are larger than the cross-section of a portion of the legs 152 disposed inside the channels 154. By passing the legs 152 through each channel 154, the OTC device 153 is formed. [120] It is this pillow 153 that provides the load-bearing force when tissue is compressed within the central region 157 of the staple 150. Like the previous embodiments, the OTC device 153 can be shaped with variations in cross-section and other spatial characteristics and can be formed with a variety of material compositions. The exemplary embodiment illustrated in FIG. 15 is a pillow having a racetrack cross-sectional shape in the transverse direction. However, the pillow can be circular, ovular, rectangular, and polygonal in its outer transverse shape. [121] Any portion of the pillow 153 can be varied so long as it delivers the pre-set compressive force to the tissue at the distal end of the pillow 153 and as long as it allows for absorption of forces greater than this pre-set force. As described above, variation of any attribute of the OTC device 153 allows for adjustment of the compressive and reactive force constants thereof on the compressed tissue in the central region 157. [122] FIG. 16 illustrates a fifteenth exemplary embodiment of the OTC staple 160 according to the invention. This variation is different from the previous embodiments. The OTC device 163 is, as above, a separate part from the bridge 161 and legs 162 of the staple 160. The OTC device is a plate 163 made of a semi-compressible material having properties that will be described in detail below. Examples of such a material include, but are not limited to, polyurethane and silicone rubber. The plate 163 defines two channels 164 for receiving therethrough a respective one of the legs 162. Because the legs 162 taper inwards slightly in the bridge-legs plane in a direction from the intermediate portion 165 of the staple 160 to the ends of the bridge 161 (although this taper is not a requirement), the cross-sectional area of each of the channels 164 in the bridge-legs plane is larger than the cross-section of the legs 162 that are to be disposed inside the channels 164. This larger area is defined by a hole that is longer in the bridge-legs plane than in the plane orthogonal thereto along the axis of the leg 162. In the exemplary embodiment shown in FIG. 16, the cross-sectional shape of the channels 164 are ovular or racetrack shaped. By passing the legs 162 through each channel 164, the OTC device 163 is formed.
29 [123] It is noted that the staple 160 shown in FIG. 16 is different from the prior art staple of FIG. 1. Specifically, the connecting portion 166 of the legs 162 tapers in width outwardly in the direction beginning from the intermediate portion towards the bridge 161 in a plane that is orthogonal to the bridge-legs plane. Because the channels 164 have a fixed width in the plane of the widening (which plane is orthogonal to the bridge-legs plane), and due to the fact that the fixed width is close in size to the lower-most portion of the connecting portion 166 (nearest to the intermediate portion 165), the plate 163 will not be able to move upwards towards the bridge 161 unless the material of the plate 163 is semi-compressible. Knowledge about the material's ability to compress and the resistance it provides to upward movement as the plate 163 progresses upward along the outwards taper of the leg widening can be used to set or adjust the compressive and reactive force constants thereof on the compressed tissue in the central region 167. Any portion of the plate 163 and of the upper leg taper can be varied so long as the OTC system (plate 163 and taper of the legs 162) delivers the pre-set compressive force to the tissue at the distal end of the plate 163 and as long as it allows for absorption of forces greater than this pre-set force. [124] The OTC device of this embodiment can be shaped with variations in cross-section, taper, and other spatial characteristics and can be formed with a variety of material compositions. The exemplary embodiment illustrated in FIG. 16 is a plate 163 having a racetrack cross-sectional shape in the transverse direction. However, the pillow can be circular, ovular, rectangular, and polygonal in its outer transverse shape, for example. [125] The OTC staple according to the invention is applied in the same manner as a conventional staple, that is: [126] the staple is loaded into a staple cartridge; [127] material to be stapled with the staple is placed between the staple cartridge and an anvil; and [128] the anvil and staple are brought together to press the lower portion of the legs against the anvil and bend the lower portions inward to capture the material in the central region and compress it between the bent portions and the compressing portion of the staple. [129] Because the material to be stapled has a length less than the distance between the bent lower portions and the bridge, the captured material partially compresses the OTC device inside the staple to, thereby, effect the optimal tissue compression feature. When the staple and material are released from the staple cartridge and anvil, the OTC device is imparting a pre-set 30 compressive force against the compressed material. Significantly, the OTC device is able to move while the material is going through its compression and expansion cycle(s) until it finally reaches a steady state size. Even after reaching the steady state, the OTC device imparts the desired compressive force (within an acceptable minimum range) so that the material is not permanently damaged due to overcompression. [130] For example, if the material is human tissue, when tissue is stapled, liquid is forced out of the tissue. During the desiccation period, the tissue compresses further and further. The OTC device compensates by enlarging to follow the tissue compression. At some point in time, the tissue begins to swell (due to the puncturing and compressing forces imparted thereon). During the swelling period, the OTC device compensates by reducing to follow the tissue swelling. [131] FIG. 21 is a process flow diagram showing the inventive method for applying and maintaining optimal tissue compression with a staple according to the invention, in this exemplary embodiment, the staple described is staple 20 of FIG. 2. The process starts at step 2100 and moves directly to step 2102 where tissue is pierced with deformable distal ends 29 of two staple legs 26. Each distal end 29 of the staple legs 26 defines a stapling point shaped to pierce material to be stapled. The two staple legs 26 are coupled to each other at base ends 27 thereof by a bridge 21, the two staple legs 26 and the bridge 21 form a substantially U-shaped staple body. In step 2104, the two staple legs 26 are caused to enter the tissue until the tissue applies a compressive force to a compression device 23 disposed at least partly between the two staple legs 26. The compression device 23 has a compression surface 25 movably disposed between the two staple legs 26 and a compression resistor 220 connected to the bridge 22 and to the compression surface 25 and is formed to resist movement of the compression surface 25 towards the bridge 22 with a force. In step 2106, the two staple legs are deformed by bending the stapling points toward one another to compress the tissue between the compression surface 25 and the stapling points 29 and to maintain the compressive force between the tissue and the compression device 23. In step 2108, the compressed tissue changes from a first state to a second state. For instance, the tissue swells and then desiccates. Throughout step 2108, however, the inventive staple 20 maintains, with the compression resistor 220, a substantially constant compressive force on the tissue within a pre-defined range independent of a distance between the stapling points 29 and the bridge 22. The flow ends at step 2110.
31 [132] The foregoing description and accompanying drawings illustrate the principles, preferred embodiments and modes of operation of the invention. However, the invention should not be construed as being limited to the particular embodiments discussed above. Additional variations of the embodiments discussed above will be appreciated by those skilled in the art. [133] Therefore, the above-described embodiments should be regarded as illustrative rather than restrictive. Accordingly, it should be appreciated that variations to those embodiments can be made by those skilled in the art without departing from the scope of the invention as defined by the following claims. [134] In the claims which follow and in the preceding description of the invention, except where the context requires otherwise due to express language or necessary implication, the word "comprise" or variations such as "comprises" or "comprising" are used in an inclusive sense, i.e. to specify the presence of the stated features but not to preclude the presence or addition of further features in various embodiments of the invention. [135] Any one of the terms: including or which includes or that includes as used herein is also an open term that also means including at least the elements/features that follow the term, but not excluding others. Thus, including is synonymous with and means comprising.

权利要求:
Claims (20)
[1] 1. A compression-self-adjusting staple, comprising: a substantially U-shaped staple having an internally disposed compression device: having a bias portion with: a compression surface movably disposed between legs of the staple; and a compression resistor: connected to a bridge of the staple and to the compression surface; and being formed to resist movement of the compression surface towards the bridge with a force.
[2] 2. The staple according to claim 1, wherein: the bridge is substantially rod-shaped with ends; and a base end of each said legs is integral with a respective one of said ends.
[3] 3. The staple according to claim 1, wherein: said bridge and legs define a bridge-leg plane; and said legs extend from said bridge at an angle of between 80 and 100 degrees in said bridge-leg plane.
[4] 4. The staple according to claim 1, wherein: said compression surface defines two orifices; and each of said legs extends through one of said two orifices.
[5] 5. The staple according to claim 1, wherein: said compression resistor defines at least one orifice pair; said compression surface defines two orifices; and 33 each of said legs extends through one of said two orifices and one of said at least one orifice pair.
[6] 6. The staple according to claim 1, wherein: said compression resistor defines a plurality of orifice pairs; said compression surface defines two orifices; and each of said legs extends through one of said two orifices and one of each of said orifice pairs.
[7] 7. The staple according to claim 1, wherein: said bridge and said legs define a compression axis; and said compression surface is movably disposed between said legs along said compression axis.
[8] 8. The staple according to claim 1, wherein said compression device is connected to said bridge.
[9] 9. The staple according to claim 8, wherein said compression resistor connects said bridge to said compression surface.
[10] 10. The staple according to claim 8, wherein said bridge, said legs, said compression resistor, and said compression surface are integral.
[11] 11. The staple according to claim 1, wherein said compression resistor is at least partly disposed between said legs.
[12] 12. The staple according to claim 1, wherein said compression resistor is disposed between said bridge and said compression surface.
[13] 13. The staple according to claim 1, wherein the force comprises a pre-defined opposing force.
[14] 14. The staple according to claim 1, wherein the force comprises a substantially constant force.
[15] 15. The staple according to claim 1, wherein the force comprises a linearly increasing force. 34
[16] 16. The staple according to claim 1, wherein said compression resistor has an anti compressive spring constant imparting a substantially constant anti-compressive force over a pre-defined compression range.
[17] 17. The staple according to claim 1, wherein said staple and said compression device are of a biocompatible material.
[18] 18. The staple according to claim 1, wherein: said compression surface and said legs define a central compression region in which is to be disposed a material to be compressed between said compression surface and stapling points when distal ends of the staple legs are deformed; and when said distal ends are deformed in a staple closing direction into said central compression region, said bias portion resists movement of said compression surface in said staple closing direction with a pre-defined, substantially constant force.
[19] 19. The staple according to claim 1, wherein said compression surface and said bias portion are shaped to impart a pre-defined, substantially constant bias force upon material disposed between said compression surface and stapling points when said stapling points are deformed.
[20] 20. The staple according to claim 1, wherein: when stapling points are deformed toward one another, material disposed between said compression surface and said stapling points is compressed between said stapling points and said compression surface; and said compression resistor maintains a substantially constant compressive force on the material within a pre-defined range independent of a degree of compression between said stapling points and said compression surface.

类似技术:

---

公开号 | 公开日 | 专利标题

---

US10568620B2|2020-02-25|Adjustable compression staple and method for stapling with adjustable compression

---

AU2013224717B2|2016-01-14|Adjustable compression staple and method for stapling with adjustable compression

---

US10383623B2|2019-08-20|Surgical fastener

---

EP1333762B1|2009-03-18|Surgical staple

同族专利:

---

公开号 | 公开日

---

AU2013224717B2|2016-01-14|

---

AU2011218702A1|2011-09-22|

---

AU2011218702B2|2013-06-06|

引用文献:

---

公开号 | 申请日 | 公开日 | 申请人 | 专利标题

---

US4278091A|1980-02-01|1981-07-14|Howmedica, Inc.|Soft tissue retainer for use with bone implants, especially bone staples|

---

US4532927A|1983-06-20|1985-08-06|Ethicon, Inc.|Two-piece tissue fastener with non-reentry bent leg staple and retaining receiver|

---

US5393184A|1993-09-20|1995-02-28|Beeuwkes, Iii; Reinier|Self retained stapled construction|

---

IES20010547A2|2001-06-07|2002-12-11|Christy Cummins|Surgical Staple|

---

US20030069603A1|2001-10-10|2003-04-10|Little James S.|Medical tack with a variable effective length|

---

CA2549224A1|2005-06-02|2006-12-02|Tyco Healthcare Group Lp|Expandable backspan staple|

---

US20060282084A1|2005-06-03|2006-12-14|Ken Blier|System and method for sealing tissue|US20070084897A1|2003-05-20|2007-04-19|Shelton Frederick E Iv|Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism|

---

US9060770B2|2003-05-20|2015-06-23|Ethicon Endo-Surgery, Inc.|Robotically-driven surgical instrument with E-beam driver|

---

US8215531B2|2004-07-28|2012-07-10|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument having a medical substance dispenser|

---

US9237891B2|2005-08-31|2016-01-19|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical stapling devices that produce formed staples having different lengths|

---

US7934630B2|2005-08-31|2011-05-03|Ethicon Endo-Surgery, Inc.|Staple cartridges for forming staples having differing formed staple heights|

---

US11246590B2|2005-08-31|2022-02-15|Cilag Gmbh International|Staple cartridge including staple drivers having different unfired heights|

---

US7669746B2|2005-08-31|2010-03-02|Ethicon Endo-Surgery, Inc.|Staple cartridges for forming staples having differing formed staple heights|

---

US10159482B2|2005-08-31|2018-12-25|Ethicon Llc|Fastener cartridge assembly comprising a fixed anvil and different staple heights|

---

US20070106317A1|2005-11-09|2007-05-10|Shelton Frederick E Iv|Hydraulically and electrically actuated articulation joints for surgical instruments|

---

US11207064B2|2011-05-27|2021-12-28|Cilag Gmbh International|Automated end effector component reloading system for use with a robotic system|

---

US20120292367A1|2006-01-31|2012-11-22|Ethicon Endo-Surgery, Inc.|Robotically-controlled end effector|

---

US7845537B2|2006-01-31|2010-12-07|Ethicon Endo-Surgery, Inc.|Surgical instrument having recording capabilities|

---

US8186555B2|2006-01-31|2012-05-29|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting and fastening instrument with mechanical closure system|

---

US7753904B2|2006-01-31|2010-07-13|Ethicon Endo-Surgery, Inc.|Endoscopic surgical instrument with a handle that can articulate with respect to the shaft|

---

US8708213B2|2006-01-31|2014-04-29|Ethicon Endo-Surgery, Inc.|Surgical instrument having a feedback system|

---

US8820603B2|2006-01-31|2014-09-02|Ethicon Endo-Surgery, Inc.|Accessing data stored in a memory of a surgical instrument|

---

US11224427B2|2006-01-31|2022-01-18|Cilag Gmbh International|Surgical stapling system including a console and retraction assembly|

---

US20110295295A1|2006-01-31|2011-12-01|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical instrument having recording capabilities|

---

US8992422B2|2006-03-23|2015-03-31|Ethicon Endo-Surgery, Inc.|Robotically-controlled endoscopic accessory channel|

---

US8322455B2|2006-06-27|2012-12-04|Ethicon Endo-Surgery, Inc.|Manually driven surgical cutting and fastening instrument|

---

US8348131B2|2006-09-29|2013-01-08|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument with mechanical indicator to show levels of tissue compression|

---

US10568652B2|2006-09-29|2020-02-25|Ethicon Llc|Surgical staples having attached drivers of different heights and stapling instruments for deploying the same|

---

US8652120B2|2007-01-10|2014-02-18|Ethicon Endo-Surgery, Inc.|Surgical instrument with wireless communication between control unit and sensor transponders|

---

US8684253B2|2007-01-10|2014-04-01|Ethicon Endo-Surgery, Inc.|Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor|

---

US8827133B2|2007-01-11|2014-09-09|Ethicon Endo-Surgery, Inc.|Surgical stapling device having supports for a flexible drive mechanism|

---

US11039836B2|2007-01-11|2021-06-22|Cilag Gmbh International|Staple cartridge for use with a surgical stapling instrument|

---

US20090005809A1|2007-03-15|2009-01-01|Hess Christopher J|Surgical staple having a slidable crown|

---

US8893946B2|2007-03-28|2014-11-25|Ethicon Endo-Surgery, Inc.|Laparoscopic tissue thickness and clamp load measuring devices|

---

US8931682B2|2007-06-04|2015-01-13|Ethicon Endo-Surgery, Inc.|Robotically-controlled shaft based rotary drive systems for surgical instruments|

---

US7753245B2|2007-06-22|2010-07-13|Ethicon Endo-Surgery, Inc.|Surgical stapling instruments|

---

US7819298B2|2008-02-14|2010-10-26|Ethicon Endo-Surgery, Inc.|Surgical stapling apparatus with control features operable with one hand|

---

US8636736B2|2008-02-14|2014-01-28|Ethicon Endo-Surgery, Inc.|Motorized surgical cutting and fastening instrument|

---

US8573465B2|2008-02-14|2013-11-05|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical end effector system with rotary actuated closure systems|

---

US9179912B2|2008-02-14|2015-11-10|Ethicon Endo-Surgery, Inc.|Robotically-controlled motorized surgical cutting and fastening instrument|

---

US7866527B2|2008-02-14|2011-01-11|Ethicon Endo-Surgery, Inc.|Surgical stapling apparatus with interlockable firing system|

---

RU2493788C2|2008-02-14|2013-09-27|Этикон Эндо-Серджери, Инк.|Surgical cutting and fixing instrument, which has radio-frequency electrodes|

---

US8758391B2|2008-02-14|2014-06-24|Ethicon Endo-Surgery, Inc.|Interchangeable tools for surgical instruments|

---

US9585657B2|2008-02-15|2017-03-07|Ethicon Endo-Surgery, Llc|Actuator for releasing a layer of material from a surgical end effector|

---

US9005230B2|2008-09-23|2015-04-14|Ethicon Endo-Surgery, Inc.|Motorized surgical instrument|

---

US9386983B2|2008-09-23|2016-07-12|Ethicon Endo-Surgery, Llc|Robotically-controlled motorized surgical instrument|

---

US8210411B2|2008-09-23|2012-07-03|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting instrument|

---

US8608045B2|2008-10-10|2013-12-17|Ethicon Endo-Sugery, Inc.|Powered surgical cutting and stapling apparatus with manually retractable firing system|

---

US8517239B2|2009-02-05|2013-08-27|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument comprising a magnetic element driver|

---

US8444036B2|2009-02-06|2013-05-21|Ethicon Endo-Surgery, Inc.|Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector|

---

US20110024477A1|2009-02-06|2011-02-03|Hall Steven G|Driven Surgical Stapler Improvements|

---

US8220688B2|2009-12-24|2012-07-17|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting instrument with electric actuator directional control assembly|

---

US10945731B2|2010-09-30|2021-03-16|Ethicon Llc|Tissue thickness compensator comprising controlled release and expansion|

---

US9629814B2|2010-09-30|2017-04-25|Ethicon Endo-Surgery, Llc|Tissue thickness compensator configured to redistribute compressive forces|

---

US9364233B2|2010-09-30|2016-06-14|Ethicon Endo-Surgery, Llc|Tissue thickness compensators for circular surgical staplers|

---

CN104321024B|2012-03-28|2017-05-24|伊西康内外科公司|Tissue thickness compensator comprising a plurality of layers|

---

RU2644272C2|2012-03-28|2018-02-08|Этикон Эндо-Серджери, Инк.|Limitation node with tissue thickness compensator|

---

US9295464B2|2010-09-30|2016-03-29|Ethicon Endo-Surgery, Inc.|Surgical stapler anvil comprising a plurality of forming pockets|

---

US9517063B2|2012-03-28|2016-12-13|Ethicon Endo-Surgery, Llc|Movable member for use with a tissue thickness compensator|

---

JP6026509B2|2011-04-29|2016-11-16|エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ．|Staple cartridge including staples disposed within a compressible portion of the staple cartridge itself|

---

US9320523B2|2012-03-28|2016-04-26|Ethicon Endo-Surgery, Llc|Tissue thickness compensator comprising tissue ingrowth features|

---

US9282962B2|2010-09-30|2016-03-15|Ethicon Endo-Surgery, Llc|Adhesive film laminate|

---

US8695866B2|2010-10-01|2014-04-15|Ethicon Endo-Surgery, Inc.|Surgical instrument having a power control circuit|

---

US9072535B2|2011-05-27|2015-07-07|Ethicon Endo-Surgery, Inc.|Surgical stapling instruments with rotatable staple deployment arrangements|

---

US9044230B2|2012-02-13|2015-06-02|Ethicon Endo-Surgery, Inc.|Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status|

---

RU2639857C2|2012-03-28|2017-12-22|Этикон Эндо-Серджери, Инк.|Tissue thickness compensator containing capsule for medium with low pressure|

---

US9101358B2|2012-06-15|2015-08-11|Ethicon Endo-Surgery, Inc.|Articulatable surgical instrument comprising a firing drive|

---

US20140001231A1|2012-06-28|2014-01-02|Ethicon Endo-Surgery, Inc.|Firing system lockout arrangements for surgical instruments|

---

US9289256B2|2012-06-28|2016-03-22|Ethicon Endo-Surgery, Llc|Surgical end effectors having angled tissue-contacting surfaces|

---

US20140005718A1|2012-06-28|2014-01-02|Ethicon Endo-Surgery, Inc.|Multi-functional powered surgical device with external dissection features|

---

US11202631B2|2012-06-28|2021-12-21|Cilag Gmbh International|Stapling assembly comprising a firing lockout|

---

RU2636861C2|2012-06-28|2017-11-28|Этикон Эндо-Серджери, Инк.|Blocking of empty cassette with clips|

---

US9408606B2|2012-06-28|2016-08-09|Ethicon Endo-Surgery, Llc|Robotically powered surgical device with manually-actuatable reversing system|

---

JP6382235B2|2013-03-01|2018-08-29|エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ．|Articulatable surgical instrument with a conductive path for signal communication|

---

JP6345707B2|2013-03-01|2018-06-20|エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ．|Surgical instrument with soft stop|

---

US9687230B2|2013-03-14|2017-06-27|Ethicon Llc|Articulatable surgical instrument comprising a firing drive|

---

US9629629B2|2013-03-14|2017-04-25|Ethicon Endo-Surgey, LLC|Control systems for surgical instruments|

---

US9826976B2|2013-04-16|2017-11-28|Ethicon Llc|Motor driven surgical instruments with lockable dual drive shafts|

---

JP6416260B2|2013-08-23|2018-10-31|エシコン エルエルシー|Firing member retractor for a powered surgical instrument|

---

US9283054B2|2013-08-23|2016-03-15|Ethicon Endo-Surgery, Llc|Interactive displays|

---

US9839428B2|2013-12-23|2017-12-12|Ethicon Llc|Surgical cutting and stapling instruments with independent jaw control features|

---

US9585662B2|2013-12-23|2017-03-07|Ethicon Endo-Surgery, Llc|Fastener cartridge comprising an extendable firing member|

---

US9724092B2|2013-12-23|2017-08-08|Ethicon Llc|Modular surgical instruments|

---

US20150173756A1|2013-12-23|2015-06-25|Ethicon Endo-Surgery, Inc.|Surgical cutting and stapling methods|

---

US9962161B2|2014-02-12|2018-05-08|Ethicon Llc|Deliverable surgical instrument|

---

JP6462004B2|2014-02-24|2019-01-30|エシコン エルエルシー|Fastening system with launcher lockout|

---

US9804618B2|2014-03-26|2017-10-31|Ethicon Llc|Systems and methods for controlling a segmented circuit|

---

US9750499B2|2014-03-26|2017-09-05|Ethicon Llc|Surgical stapling instrument system|

---

US11259799B2|2014-03-26|2022-03-01|Cilag Gmbh International|Interface systems for use with surgical instruments|

---

US20150272557A1|2014-03-26|2015-10-01|Ethicon Endo-Surgery, Inc.|Modular surgical instrument system|

---

US10299792B2|2014-04-16|2019-05-28|Ethicon Llc|Fastener cartridge comprising non-uniform fasteners|

---

BR112017004361A2|2014-09-05|2017-12-05|Ethicon Llc|medical overcurrent modular power supply|

---

US9737301B2|2014-09-05|2017-08-22|Ethicon Llc|Monitoring device degradation based on component evaluation|

---

US10206677B2|2014-09-26|2019-02-19|Ethicon Llc|Surgical staple and driver arrangements for staple cartridges|

---

MX2017003960A|2014-09-26|2017-12-04|Ethicon Llc|Surgical stapling buttresses and adjunct materials.|

---

US10076325B2|2014-10-13|2018-09-18|Ethicon Llc|Surgical stapling apparatus comprising a tissue stop|

---

US9924944B2|2014-10-16|2018-03-27|Ethicon Llc|Staple cartridge comprising an adjunct material|

---

US11141153B2|2014-10-29|2021-10-12|Cilag Gmbh International|Staple cartridges comprising driver arrangements|

---

US10517594B2|2014-10-29|2019-12-31|Ethicon Llc|Cartridge assemblies for surgical staplers|

---

US9844376B2|2014-11-06|2017-12-19|Ethicon Llc|Staple cartridge comprising a releasable adjunct material|

---

US10736636B2|2014-12-10|2020-08-11|Ethicon Llc|Articulatable surgical instrument system|

---

US9844374B2|2014-12-18|2017-12-19|Ethicon Llc|Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member|

---

US9844375B2|2014-12-18|2017-12-19|Ethicon Llc|Drive arrangements for articulatable surgical instruments|

---

US10004501B2|2014-12-18|2018-06-26|Ethicon Llc|Surgical instruments with improved closure arrangements|

---

US10188385B2|2014-12-18|2019-01-29|Ethicon Llc|Surgical instrument system comprising lockable systems|

---

US10085748B2|2014-12-18|2018-10-02|Ethicon Llc|Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors|

---

US9987000B2|2014-12-18|2018-06-05|Ethicon Llc|Surgical instrument assembly comprising a flexible articulation system|

---

US10180463B2|2015-02-27|2019-01-15|Ethicon Llc|Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band|

---

US10045779B2|2015-02-27|2018-08-14|Ethicon Llc|Surgical instrument system comprising an inspection station|

---

US11154301B2|2015-02-27|2021-10-26|Cilag Gmbh International|Modular stapling assembly|

---

US10052044B2|2015-03-06|2018-08-21|Ethicon Llc|Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures|

---

US9924961B2|2015-03-06|2018-03-27|Ethicon Endo-Surgery, Llc|Interactive feedback system for powered surgical instruments|

---

US9993248B2|2015-03-06|2018-06-12|Ethicon Endo-Surgery, Llc|Smart sensors with local signal processing|

---

US10245033B2|2015-03-06|2019-04-02|Ethicon Llc|Surgical instrument comprising a lockable battery housing|

---

US10617412B2|2015-03-06|2020-04-14|Ethicon Llc|System for detecting the mis-insertion of a staple cartridge into a surgical stapler|

---

US9901342B2|2015-03-06|2018-02-27|Ethicon Endo-Surgery, Llc|Signal and power communication system positioned on a rotatable shaft|

---

US10687806B2|2015-03-06|2020-06-23|Ethicon Llc|Adaptive tissue compression techniques to adjust closure rates for multiple tissue types|

---

US9808246B2|2015-03-06|2017-11-07|Ethicon Endo-Surgery, Llc|Method of operating a powered surgical instrument|

---

US10213201B2|2015-03-31|2019-02-26|Ethicon Llc|Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw|

---

US10835249B2|2015-08-17|2020-11-17|Ethicon Llc|Implantable layers for a surgical instrument|

---

US10517599B2|2015-08-26|2019-12-31|Ethicon Llc|Staple cartridge assembly comprising staple cavities for providing better staple guidance|

---

MX2018002386A|2015-08-26|2018-08-01|Ethicon Llc|Surgical staples comprising features for improved fastening of tissue.|

---

MX2018002388A|2015-08-26|2018-08-01|Ethicon Llc|Surgical staple strips for permitting varying staple properties and enabling easy cartridge loading.|

---

US11213295B2|2015-09-02|2022-01-04|Cilag Gmbh International|Surgical staple configurations with camming surfaces located between portions supporting surgical staples|

---

US10238390B2|2015-09-02|2019-03-26|Ethicon Llc|Surgical staple cartridges with driver arrangements for establishing herringbone staple patterns|

---

US10327769B2|2015-09-23|2019-06-25|Ethicon Llc|Surgical stapler having motor control based on a drive system component|

---

US10105139B2|2015-09-23|2018-10-23|Ethicon Llc|Surgical stapler having downstream current-based motor control|

---

US10238386B2|2015-09-23|2019-03-26|Ethicon Llc|Surgical stapler having motor control based on an electrical parameter related to a motor current|

---

US10363036B2|2015-09-23|2019-07-30|Ethicon Llc|Surgical stapler having force-based motor control|

---

US10299878B2|2015-09-25|2019-05-28|Ethicon Llc|Implantable adjunct systems for determining adjunct skew|

---

US10327777B2|2015-09-30|2019-06-25|Ethicon Llc|Implantable layer comprising plastically deformed fibers|

---

US10980539B2|2015-09-30|2021-04-20|Ethicon Llc|Implantable adjunct comprising bonded layers|

---

US10433846B2|2015-09-30|2019-10-08|Ethicon Llc|Compressible adjunct with crossing spacer fibers|

---

US10368865B2|2015-12-30|2019-08-06|Ethicon Llc|Mechanisms for compensating for drivetrain failure in powered surgical instruments|

---

US10265068B2|2015-12-30|2019-04-23|Ethicon Llc|Surgical instruments with separable motors and motor control circuits|

---

US10292704B2|2015-12-30|2019-05-21|Ethicon Llc|Mechanisms for compensating for battery pack failure in powered surgical instruments|

---

US10588625B2|2016-02-09|2020-03-17|Ethicon Llc|Articulatable surgical instruments with off-axis firing beam arrangements|

---

US11213293B2|2016-02-09|2022-01-04|Cilag Gmbh International|Articulatable surgical instruments with single articulation link arrangements|

---

US10448948B2|2016-02-12|2019-10-22|Ethicon Llc|Mechanisms for compensating for drivetrain failure in powered surgical instruments|

---

US10258331B2|2016-02-12|2019-04-16|Ethicon Llc|Mechanisms for compensating for drivetrain failure in powered surgical instruments|

---

US11224426B2|2016-02-12|2022-01-18|Cilag Gmbh International|Mechanisms for compensating for drivetrain failure in powered surgical instruments|

---

US10617413B2|2016-04-01|2020-04-14|Ethicon Llc|Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts|

---

US10376263B2|2016-04-01|2019-08-13|Ethicon Llc|Anvil modification members for surgical staplers|

---

US10492783B2|2016-04-15|2019-12-03|Ethicon, Llc|Surgical instrument with improved stop/start control during a firing motion|

---

US10828028B2|2016-04-15|2020-11-10|Ethicon Llc|Surgical instrument with multiple program responses during a firing motion|

---

US10426467B2|2016-04-15|2019-10-01|Ethicon Llc|Surgical instrument with detection sensors|

---

US10456137B2|2016-04-15|2019-10-29|Ethicon Llc|Staple formation detection mechanisms|

---

US10357247B2|2016-04-15|2019-07-23|Ethicon Llc|Surgical instrument with multiple program responses during a firing motion|

---

US11179150B2|2016-04-15|2021-11-23|Cilag Gmbh International|Systems and methods for controlling a surgical stapling and cutting instrument|

---

US10405859B2|2016-04-15|2019-09-10|Ethicon Llc|Surgical instrument with adjustable stop/start control during a firing motion|

---

US10335145B2|2016-04-15|2019-07-02|Ethicon Llc|Modular surgical instrument with configurable operating mode|

---

US10368867B2|2016-04-18|2019-08-06|Ethicon Llc|Surgical instrument comprising a lockout|

---

USD850617S1|2016-06-24|2019-06-04|Ethicon Llc|Surgical fastener cartridge|

---

USD826405S1|2016-06-24|2018-08-21|Ethicon Llc|Surgical fastener|

---

US10893863B2|2016-06-24|2021-01-19|Ethicon Llc|Staple cartridge comprising offset longitudinal staple rows|

---

USD847989S1|2016-06-24|2019-05-07|Ethicon Llc|Surgical fastener cartridge|

---

US10617414B2|2016-12-21|2020-04-14|Ethicon Llc|Closure member arrangements for surgical instruments|

---

US10517595B2|2016-12-21|2019-12-31|Ethicon Llc|Jaw actuated lock arrangements for preventing advancement of a firing member in a surgical end effector unless an unfired cartridge is installed in the end effector|

---

US10675026B2|2016-12-21|2020-06-09|Ethicon Llc|Methods of stapling tissue|

---

US10492785B2|2016-12-21|2019-12-03|Ethicon Llc|Shaft assembly comprising a lockout|

---

US10993715B2|2016-12-21|2021-05-04|Ethicon Llc|Staple cartridge comprising staples with different clamping breadths|

---

US10426471B2|2016-12-21|2019-10-01|Ethicon Llc|Surgical instrument with multiple failure response modes|

---

US10639034B2|2016-12-21|2020-05-05|Ethicon Llc|Surgical instruments with lockout arrangements for preventing firing system actuation unless an unspent staple cartridge is present|

---

US10779823B2|2016-12-21|2020-09-22|Ethicon Llc|Firing member pin angle|

---

US20180168647A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical stapling instruments having end effectors with positive opening features|

---

US10945727B2|2016-12-21|2021-03-16|Ethicon Llc|Staple cartridge with deformable driver retention features|

---

CN110087565A|2016-12-21|2019-08-02|爱惜康有限责任公司|Surgical stapling system|

---

US10588632B2|2016-12-21|2020-03-17|Ethicon Llc|Surgical end effectors and firing members thereof|

---

US11134942B2|2016-12-21|2021-10-05|Cilag Gmbh International|Surgical stapling instruments and staple-forming anvils|

---

US10499914B2|2016-12-21|2019-12-10|Ethicon Llc|Staple forming pocket arrangements|

---

US20180168625A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical stapling instruments with smart staple cartridges|

---

US20180168608A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical instrument system comprising an end effector lockout and a firing assembly lockout|

---

US10687810B2|2016-12-21|2020-06-23|Ethicon Llc|Stepped staple cartridge with tissue retention and gap setting features|

---

US10568625B2|2016-12-21|2020-02-25|Ethicon Llc|Staple cartridges and arrangements of staples and staple cavities therein|

---

US10758229B2|2016-12-21|2020-09-01|Ethicon Llc|Surgical instrument comprising improved jaw control|

---

US10327767B2|2017-06-20|2019-06-25|Ethicon Llc|Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation|

---

US10390841B2|2017-06-20|2019-08-27|Ethicon Llc|Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation|

---

US11071554B2|2017-06-20|2021-07-27|Cilag Gmbh International|Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements|

---

US10307170B2|2017-06-20|2019-06-04|Ethicon Llc|Method for closed loop control of motor velocity of a surgical stapling and cutting instrument|

---

US10624633B2|2017-06-20|2020-04-21|Ethicon Llc|Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument|

---

US11090046B2|2017-06-20|2021-08-17|Cilag Gmbh International|Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument|

---

US10813639B2|2017-06-20|2020-10-27|Ethicon Llc|Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions|

---

US10779820B2|2017-06-20|2020-09-22|Ethicon Llc|Systems and methods for controlling motor speed according to user input for a surgical instrument|

---

US10888321B2|2017-06-20|2021-01-12|Ethicon Llc|Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument|

---

US10881396B2|2017-06-20|2021-01-05|Ethicon Llc|Surgical instrument with variable duration trigger arrangement|

---

USD879808S1|2017-06-20|2020-03-31|Ethicon Llc|Display panel with graphical user interface|

---

USD890784S1|2017-06-20|2020-07-21|Ethicon Llc|Display panel with changeable graphical user interface|

---

US10368864B2|2017-06-20|2019-08-06|Ethicon Llc|Systems and methods for controlling displaying motor velocity for a surgical instrument|

---

US10646220B2|2017-06-20|2020-05-12|Ethicon Llc|Systems and methods for controlling displacement member velocity for a surgical instrument|

---

USD879809S1|2017-06-20|2020-03-31|Ethicon Llc|Display panel with changeable graphical user interface|

---

US10980537B2|2017-06-20|2021-04-20|Ethicon Llc|Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations|

---

US10881399B2|2017-06-20|2021-01-05|Ethicon Llc|Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument|

---

US10856869B2|2017-06-27|2020-12-08|Ethicon Llc|Surgical anvil arrangements|

---

US10772629B2|2017-06-27|2020-09-15|Ethicon Llc|Surgical anvil arrangements|

---

US11090049B2|2017-06-27|2021-08-17|Cilag Gmbh International|Staple forming pocket arrangements|

---

US10993716B2|2017-06-27|2021-05-04|Ethicon Llc|Surgical anvil arrangements|

---

USD854151S1|2017-06-28|2019-07-16|Ethicon Llc|Surgical instrument shaft|

---

US11259805B2|2017-06-28|2022-03-01|Cilag Gmbh International|Surgical instrument comprising firing member supports|

---

US10903685B2|2017-06-28|2021-01-26|Ethicon Llc|Surgical shaft assemblies with slip ring assemblies forming capacitive channels|

---

US20190000477A1|2017-06-28|2019-01-03|Ethicon Llc|Surgical instrument comprising a shaft including a housing arrangement|

---

US10716614B2|2017-06-28|2020-07-21|Ethicon Llc|Surgical shaft assemblies with slip ring assemblies with increased contact pressure|

---

US10765427B2|2017-06-28|2020-09-08|Ethicon Llc|Method for articulating a surgical instrument|

---

US10211586B2|2017-06-28|2019-02-19|Ethicon Llc|Surgical shaft assemblies with watertight housings|

---

US11246592B2|2017-06-28|2022-02-15|Cilag Gmbh International|Surgical instrument comprising an articulation system lockable to a frame|

---

USD906355S1|2017-06-28|2020-12-29|Ethicon Llc|Display screen or portion thereof with a graphical user interface for a surgical instrument|

---

USD851762S1|2017-06-28|2019-06-18|Ethicon Llc|Anvil|

---

US10786253B2|2017-06-28|2020-09-29|Ethicon Llc|Surgical end effectors with improved jaw aperture arrangements|

---

US10398434B2|2017-06-29|2019-09-03|Ethicon Llc|Closed loop velocity control of closure member for robotic surgical instrument|

---

US11007022B2|2017-06-29|2021-05-18|Ethicon Llc|Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument|

---

US10898183B2|2017-06-29|2021-01-26|Ethicon Llc|Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing|

---

US10258418B2|2017-06-29|2019-04-16|Ethicon Llc|System for controlling articulation forces|

---

US10932772B2|2017-06-29|2021-03-02|Ethicon Llc|Methods for closed loop velocity control for robotic surgical instrument|

---

USD907647S1|2017-09-29|2021-01-12|Ethicon Llc|Display screen or portion thereof with animated graphical user interface|

---

US10743872B2|2017-09-29|2020-08-18|Ethicon Llc|System and methods for controlling a display of a surgical instrument|

---

USD917500S1|2017-09-29|2021-04-27|Ethicon Llc|Display screen or portion thereof with graphical user interface|

---

US10796471B2|2017-09-29|2020-10-06|Ethicon Llc|Systems and methods of displaying a knife position for a surgical instrument|

---

US10765429B2|2017-09-29|2020-09-08|Ethicon Llc|Systems and methods for providing alerts according to the operational state of a surgical instrument|

---

USD907648S1|2017-09-29|2021-01-12|Ethicon Llc|Display screen or portion thereof with animated graphical user interface|

---

US11134944B2|2017-10-30|2021-10-05|Cilag Gmbh International|Surgical stapler knife motion controls|

---

US11090075B2|2017-10-30|2021-08-17|Cilag Gmbh International|Articulation features for surgical end effector|

---

US10842490B2|2017-10-31|2020-11-24|Ethicon Llc|Cartridge body design with force reduction based on firing completion|

---

US10779903B2|2017-10-31|2020-09-22|Ethicon Llc|Positive shaft rotation lock activated by jaw closure|

---

US10743875B2|2017-12-15|2020-08-18|Ethicon Llc|Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member|

---

US10743874B2|2017-12-15|2020-08-18|Ethicon Llc|Sealed adapters for use with electromechanical surgical instruments|

---

US10779826B2|2017-12-15|2020-09-22|Ethicon Llc|Methods of operating surgical end effectors|

---

US10966718B2|2017-12-15|2021-04-06|Ethicon Llc|Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments|

---

US10869666B2|2017-12-15|2020-12-22|Ethicon Llc|Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument|

---

US11033267B2|2017-12-15|2021-06-15|Ethicon Llc|Systems and methods of controlling a clamping member firing rate of a surgical instrument|

---

US11197670B2|2017-12-15|2021-12-14|Cilag Gmbh International|Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed|

---

US10828033B2|2017-12-15|2020-11-10|Ethicon Llc|Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto|

---

US11006955B2|2017-12-15|2021-05-18|Ethicon Llc|End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments|

---

US10687813B2|2017-12-15|2020-06-23|Ethicon Llc|Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments|

---

US10779825B2|2017-12-15|2020-09-22|Ethicon Llc|Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments|

---

US11071543B2|2017-12-15|2021-07-27|Cilag Gmbh International|Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges|

---

US11020112B2|2017-12-19|2021-06-01|Ethicon Llc|Surgical tools configured for interchangeable use with different controller interfaces|

---

US10835330B2|2017-12-19|2020-11-17|Ethicon Llc|Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly|

---

US10729509B2|2017-12-19|2020-08-04|Ethicon Llc|Surgical instrument comprising closure and firing locking mechanism|

---

US10716565B2|2017-12-19|2020-07-21|Ethicon Llc|Surgical instruments with dual articulation drivers|

---

USD910847S1|2017-12-19|2021-02-16|Ethicon Llc|Surgical instrument assembly|

---

US11045270B2|2017-12-19|2021-06-29|Cilag Gmbh International|Robotic attachment comprising exterior drive actuator|

---

US11076853B2|2017-12-21|2021-08-03|Cilag Gmbh International|Systems and methods of displaying a knife position during transection for a surgical instrument|

---

US11129680B2|2017-12-21|2021-09-28|Cilag Gmbh International|Surgical instrument comprising a projector|

---

US20190192151A1|2017-12-21|2019-06-27|Ethicon Llc|Surgical instrument having a display comprising image layers|

---

US11207065B2|2018-08-20|2021-12-28|Cilag Gmbh International|Method for fabricating surgical stapler anvils|

---

US10842492B2|2018-08-20|2020-11-24|Ethicon Llc|Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system|

---

US11045192B2|2018-08-20|2021-06-29|Cilag Gmbh International|Fabricating techniques for surgical stapler anvils|

---

US10779821B2|2018-08-20|2020-09-22|Ethicon Llc|Surgical stapler anvils with tissue stop features configured to avoid tissue pinch|

---

US10856870B2|2018-08-20|2020-12-08|Ethicon Llc|Switching arrangements for motor powered articulatable surgical instruments|

---

US11083458B2|2018-08-20|2021-08-10|Cilag Gmbh International|Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions|

---

USD914878S1|2018-08-20|2021-03-30|Ethicon Llc|Surgical instrument anvil|

---

US11253256B2|2018-08-20|2022-02-22|Cilag Gmbh International|Articulatable motor powered surgical instruments with dedicated articulation motor arrangements|

---

US11039834B2|2018-08-20|2021-06-22|Cilag Gmbh International|Surgical stapler anvils with staple directing protrusions and tissue stability features|

---

US10912559B2|2018-08-20|2021-02-09|Ethicon Llc|Reinforced deformable anvil tip for surgical stapler anvil|

---

US11147553B2|2019-03-25|2021-10-19|Cilag Gmbh International|Firing drive arrangements for surgical systems|

---

US11172929B2|2019-03-25|2021-11-16|Cilag Gmbh International|Articulation drive arrangements for surgical systems|

---

US11147551B2|2019-03-25|2021-10-19|Cilag Gmbh International|Firing drive arrangements for surgical systems|

---

US11253254B2|2019-04-30|2022-02-22|Cilag Gmbh International|Shaft rotation actuator on a surgical instrument|

---

US11229437B2|2019-06-28|2022-01-25|Cilag Gmbh International|Method for authenticating the compatibility of a staple cartridge with a surgical instrument|

---

US11219455B2|2019-06-28|2022-01-11|Cilag Gmbh International|Surgical instrument including a lockout key|

---

US11259803B2|2019-06-28|2022-03-01|Cilag Gmbh International|Surgical stapling system having an information encryption protocol|

---

US11051807B2|2019-06-28|2021-07-06|Cilag Gmbh International|Packaging assembly including a particulate trap|

---

US11224497B2|2019-06-28|2022-01-18|Cilag Gmbh International|Surgical systems with multiple RFID tags|

---

US11246678B2|2019-06-28|2022-02-15|Cilag Gmbh International|Surgical stapling system having a frangible RFID tag|

---

US11234698B2|2019-12-19|2022-02-01|Cilag Gmbh International|Stapling system comprising a clamp lockout and a firing lockout|

法律状态:
2016-05-12| FGA| Letters patent sealed or granted (standard patent)|

优先权:

---

申请号 | 申请日 | 专利标题

---

US60/880,146||2007-01-12||

---

US11/971,998||2008-01-10||

---

AU2011218702A|AU2011218702B2|2007-01-12|2011-09-01|Adjustable compression staple and method for stapling with adjustable compression|

---

AU2013224717A|AU2013224717B2|2007-01-12|2013-09-06|Adjustable compression staple and method for stapling with adjustable compression|AU2013224717A| AU2013224717B2|2007-01-12|2013-09-06|Adjustable compression staple and method for stapling with adjustable compression|