END ACTUATOR ASSEMBLY FOR USE WITH A SURGICAL INSTRUMENT

专利摘要:
releasable layer of material and surgical end actuator having the same. an end actuator assembly for use with a surgical instrument. the end actuator assembly may include a cartridge of fasteners, a plurality of fasteners, a first connector, a second connector, and a layer of material releasably secured to the cartridge of fasteners by the first connector and the second connector. the layer of material may have a crimp that extends into a slot or notch in the fastener cartridge between the first connector and the second connector when the layer of material is secured to the fastener cartridge. the material layer may be a reinforcing material and/or a fabric thickness compensator. additionally, the material layer may have a reinforcing feature and/or a scalloped edge around at least a portion of its perimeter.
公开号:BR112015018699B1
申请号:R112015018699-8
申请日:2014-02-04
公开日:2022-01-11
发明作者:Jeffrey S. Swayze；Frederick E. Shelton Iv；Katherine J. Schmid
申请人:Ethicon Endo-Surgery, Inc；
IPC主号:

专利说明:

CROSS REFERENCE TO RELATED REQUEST
[0001] This non-provisional patent application is a continuation patent application in part under 35 USC §120 of US Patent Application Serial No. 12/032,002 entitled Surgical End Actuator Having Buttress Retention Features, filed in February 15, 2008, now US Patent Publication No. 2009/0206143, the entire disclosure of which is incorporated by reference herein. BACKGROUND
[0002] The present invention relates to surgical instruments and, in various embodiments, surgical cutting and stapling instruments, and staple cartridges therefor, which are designed to cut and staple tissue. BRIEF DESCRIPTION OF THE DRAWINGS
[0003] The features and advantages of this invention, and the manner of achieving them, will become more apparent, and the invention itself will be better understood, by referring to the following description of exemplary embodiments of the invention, together with the drawings. attachments, where:
[0004] Figure 1 is a perspective view of an end actuator assembly attached to a distal end of a surgical instrument, in accordance with a non-limiting embodiment of the present invention.
[0005] Figure 2 is a perspective view of an end actuator assembly that includes at least one piece of buttress material, the end actuator assembly being in an open configuration in accordance with a non-limiting embodiment of the present invention;
[0006] Figure 3 is a perspective view of a staple cartridge of the end actuator assembly of Figure 2, the buttress material being releasably retained therewith;
[0007] Figure 4 is a partial perspective view of an end actuator assembly with some components removed, with the end actuator assembly including a retractable element configured to releasably retain at least one piece of buttress material ;
[0008] Figure 5 is a perspective view of an anvil of the end actuator assembly of Figure 2, the anvil having at least one piece of buttress material releasably retained relative thereto;
[0009] Figure 6 is an exploded view of an end actuator assembly that includes a staple cartridge and an anvil, in accordance with a non-limiting embodiment of the present invention.
[00010] Figure 7 is an exploded view of the end actuator assembly of Figure 6 with some components removed;
[00011] Figure 8 is an exploded perspective view of a staple cartridge and a piece of buttress material, the piece of buttress material including a plurality of members extending therefrom;
[00012] Figure 9 is a cross-sectional view of a piece of buttress material, including members engaged with staple cavities of a staple cartridge, in accordance with a non-limiting embodiment of the present invention;
[00013] Figure 10 is an exploded view of Figure 9 illustrating the separate members of the staple cavities of the staple cartridge, in accordance with a non-limiting embodiment of the present invention;
[00014] Figure 11 is an exploded perspective view of a handle assembly of a surgical stapling instrument;
[00015] Figure 12 is a side cross-sectional view of the surgical stapling instrument shown in Figure 11 illustrating the cable assembly in a non-actuated position;
[00016] Figure 13 is an exploded perspective view of a portion of the stapling instrument shown in Figure 11;
[00017] Figure 14 is an enlarged view of the indicated area of the detail shown in Figure 12;
[00018] Figure 15 is a perspective view of a non-hinged disposable loading unit that can be used with the surgical stapling instrument shown in Figure 11;
[00019] Figure 16 is a perspective view of a hinged disposable loading unit that can be used with the surgical stapling instrument shown in Figure 11;
[00020] Figure 17 is a perspective view of a disposable charging unit that can be used with the surgical stapling instrument of Figure 11;
[00021] Figure 18 is another perspective view of a disposable charging unit that can be used with the surgical stapling instrument of Figure 11;
[00022] Figure 19 is an exploded perspective view of an end actuator for use with the surgical stapling instrument of Figure 11;
[00023] Figure 20 is an enlarged perspective view of the distal end of a staple cartridge for use with the surgical stapling instrument shown in Figure 11;
[00024] Figure 21 is a side cross-sectional view taken along the section line indicated in Figure 20;
[00025] Figure 22 is a bottom perspective view of the staple cartridge shown in Figure 20;
[00026] Figure 23 is an enlarged perspective view of the drive rail, thrusters and fasteners shown in Figure 21;
[00027] Figure 24 is an enlarged perspective view of the disposable charging unit assembly shown in Figure 17 mounted to a distal end portion of the proximal housing portion;
[00028] Figure 25 is an enlarged perspective view of the proximal housing portion and assembly of the disposable charging unit shown in Figure 17 with the upper half of the housing removed;
[00029] Figure 26 is a perspective view of the proximal housing portion and assembly of the disposable charging unit shown in Figure 17 with the upper half of the housing removed;
[00030] Figure 27 is a perspective view with separate parts of an axial drive assembly;
[00031] Figure 28 is a perspective view of the surgical stapling apparatus shown in Figure 11 with the disposable loading unit of Figure 17 separated therefrom;
[00032] Figure 29 is another perspective view of the surgical stapling instrument of Figure 1;
[00033] Figure 30 is an exploded view of an end actuator assembly for use with the surgical stapling instrument of Figure 29;
[00034] Figure 31 is a perspective view of a staple cartridge portion of the end actuator assembly of Figure 30
[00035] Figure 32 is a partial perspective view of an end actuator for use with the surgical stapling instrument of Figure 29;
[00036] Figure 33 is a partial detail view of the end actuator of Figure 32;
[00037] Figure 33A is an exploded perspective view of an end actuator of a stapling instrument comprising a staple cartridge and a tissue thickness compensator, according to various embodiments;
[00038] Figure 34 is a perspective view of fabric thickness compensators attached to fabric, according to various embodiments;
[00039] Figure 35 is a partial cross-sectional view of a fabric thickness compensator including a plurality of openings and a plurality of cavities, according to various embodiments;
[00040] Figure 36 is a perspective view of a fabric thickness compensator that includes pyramid-shaped loops, in accordance with various embodiments;
[00041] Figure 37 is a cross-sectional view of the fabric thickness compensator of Figure 36;
[00042] Figure 38 is a perspective view of a corrugated fabric thickness compensator, according to various embodiments;
[00043] Figure 39 is a cross-sectional view of the fabric thickness compensator of Figure 38;
[00044] Figure 40 is a perspective view of a fabric thickness compensator including a scalloped outer edge, in accordance with various embodiments;
[00045] Figure 41 is a perspective view of a fabric thickness compensator including a scalloped outer edge, according to various embodiments;
[00046] Figure 42 is a perspective view of a fabric thickness compensator including a damping element, according to various embodiments;
[00047] Figure 43 is a cross-sectional view of the fabric thickness compensator of Figure 42;
[00048] Figure 44 is a cross-sectional view of the fabric thickness compensator of Figure 42 attached to fabric, in accordance with various embodiments;
[00049] Figure 45 is a perspective view of a fabric thickness compensator including a laminated outer edge, in accordance with various embodiments;
[00050] Figure 46 is a partial cross-sectional view of the laminated outer edge of Figure 45;
[00051] Figure 47 is an exploded perspective view of an end actuator of a stapling instrument comprising a staple cartridge and a tissue thickness compensator, according to various embodiments;
[00052] Figure 48 is a cross-sectional view of the fabric thickness compensator of Figure 47, according to various embodiments;
[00053] Figure 49 is a top view of a fabric thickness compensator including a plurality of circular pieces, according to various embodiments;
[00054] Figure 50 is a top view of a fabric thickness compensator including a plurality of circular pieces, according to various embodiments;
[00055] Figure 51 is a cross-sectional view of a fabric thickness compensator, according to various embodiments;
[00056] Figure 52 is a top view of a fabric thickness compensator, according to various embodiments;
[00057] Figure 53 is a top view of a fabric thickness compensator including a plurality of hexagonal pieces, according to various embodiments;
[00058] Figure 54 is a top view of an attached fabric thickness compensator including a plurality of parts, according to various embodiments;
[00059] Figure 55 is a top view of a fabric thickness compensator including a plurality of slits, according to various embodiments;
[00060] Figure 55A is an exploded perspective view of an end actuator of a stapling instrument comprising a staple cartridge and a tissue thickness compensator, according to various embodiments;
[00061] Figure 55B is a cross-sectional view of fabric thickness compensators attached to fabric, according to various embodiments;
[00062] Figure 56 is a perspective view of a fabric thickness compensator, according to various embodiments;
[00063] Figure 57 is a detail view of the fabric thickness compensator of Figure 56;
[00064] Figure 58 is a plan view of two layers at least partially overlapping one another;
[00065] Figure 59 is a perspective view of a staple cartridge using one of the layers illustrated in Figure 58;
[00066] Figure 60 is a perspective view of a layer configured to be used in connection with a staple cartridge;
[00067] Figure 60A is a perspective view of the layer of Figure 60 attached to a staple cartridge; Figure 60B is a detail view of two adjacent layers at least partially in overlap with each other;
[00068] Figure 61 is an exploded view of a staple cartridge assembly, including a cartridge body and a layer assembly that includes a first layer and a second layer;
[00069] Figure 62 is a side view of the fabric T captured between the staple-fired layer assemblies of the staple cartridge assembly of Figure 61;
[00070] Figure 63 is a cross-sectional view of the layer set of Figure 61 showing the first and second layers;
[00071] Figure 64 is a perspective view of a cartridge fastener assembly for use with an end actuator assembly, in accordance with various embodiments of the present disclosure, depicting a layer of material released from a cartridge body. the fastener cartridge assembly;
[00072] Figure 65 is an elevation view of the cartridge fastener assembly of Figure 64 with various elements removed therefrom, depicting the layer of material secured to the cartridge body by a proximal connector and a distal connector, and further depicting a firing assembly in a non-firing position;
[00073] Figure 66 is an elevation view of the cartridge fastener assembly of Figure 64 with various elements removed from it, depicting the layer of material attached to the cartridge body by a distal connector, and further depicting a firing assembly in a partially fired position;
[00074] Figure 67 is a perspective view of a cartridge fastener assembly for use with an end actuator assembly, in accordance with various embodiments of the present disclosure, depicting a layer of material released from a cartridge body. the fastener cartridge assembly;
[00075] Figure 68 is a perspective view of the fastener cartridge assembly of Figure 67, illustrating the layer of material secured to the cartridge body by a proximal connector and a distal connector;
[00076] Figure 69 is a perspective and cross-sectional view of the cartridge fastener assembly of Figure 67 taken along the plane indicated in Figure 68, depicting the layer of material secured to the cartridge body by the proximal connector;
[00077] Figure 70 is an elevational and cross-sectional view of the material layer of Figure 67 taken along the plane indicated in Figure 68;
[00078] Figure 71 is an elevational and cross-sectional view of a layer of material for use with an end actuator assembly, in accordance with various embodiments of the present disclosure;
[00079] Figure 72 is a perspective view of a cartridge fastener assembly for use with an end actuator assembly, in accordance with various embodiments of the present disclosure, depicting a layer of material released from a cartridge body. the fastener cartridge assembly;
[00080] Figure 73 is a perspective view of the cartridge fastener assembly of Figure 72, illustrating the layer of material secured to the cartridge body by a first connector and a second connector;
[00081] Figure 74 is a perspective and cross-sectional view of the cartridge fastener assembly of Figure 72 taken along the plane indicated in Figure 73, representing the layer of material secured to the cartridge body by the proximal connector of Figure 73 ;
[00082] Figure 75 is an elevational and cross-sectional view of the material layer of Figure 72 taken along the plane indicated in Figure 73;
[00083] Figure 76 is a perspective view of a cartridge fastener assembly for use with an end actuator assembly, in accordance with various embodiments of the present disclosure, depicting a layer of material released from a cartridge body. the fastener cartridge assembly;
[00084] Figure 77 is a perspective view of the fastener cartridge assembly of Figure 76, depicting the layer of material secured to the cartridge body by a proximal connector and a distal connector;
[00085] Figure 78 is a perspective view of a cartridge fastener assembly for use with an end actuator assembly, in accordance with various embodiments of the present disclosure, depicting a layer of material released from a cartridge body. the fastener cartridge assembly;
[00086] Figure 79 is a perspective and elevation view of the cartridge fastener assembly of Figure 78, illustrating the layer of material attached to the cartridge body;
[00087] Figure 80 is a perspective and elevation view of the cartridge fastener assembly of Figure 78, illustrating the layer of material attached to the cartridge body;
[00088] Figure 80A is a perspective view of a layer of material for use with an end actuator assembly, in accordance with various embodiments of the present disclosure;
[00089] Figure 80B is a perspective view of the material layer of Figure 80A;
[00090] Figure 81 is a perspective and partial view of a gripper of an end actuator assembly, in accordance with various embodiments of the present disclosure, depicting a layer of material secured to a cartridge body by a distal connector, and which additionally represents an actuator in a pre-actuated position;
[00091] Figure 82 is a perspective and partial view of the grip of Figure 81, representing a trigger assembly against an actuator release stop, representing the actuator in an actuated position, and also representing the distal connector ruptured by the actuator;
[00092] Figure 83 is a perspective and partial view of the grip of Figure 81, representing the actuator release stop broken by the trigger set, and further representing the distal trigger set foot in relation to the release stop;
[00093] Figure 84 is a perspective view and in detail of the release stop of Figure 83 broken by the trigger assembly;
[00094] Figure 85 is a perspective view of a jaw of an end actuator assembly, in accordance with various embodiments of the present disclosure, with the jaw having several elements removed therefrom, representing an actuator in a predetermined position. -actuated, and which additionally represents a distal connector;
[00095] Figure 86 is a perspective and partial view of the claw of Figure 85, representing the actuator in an actuated position, and also representing the distal connector broken by the actuator;
[00096] Figure 87 is an exploded view of a staple cartridge and a fabric thickness compensator, according to at least one embodiment;
[00097] Figure 88A is a cross-sectional view of the staple cartridge and tissue thickness compensator of Figure 87, showing unformed staples supported by staple drivers;
[00098] Figure 88B is a cross-sectional view of the fabric thickness compensator of Figure 87 captured by formed staples;
[00099] Figure 88 is a cross-sectional view of a fabric thickness compensator, according to at least one embodiment;
[000100] Figure 89 is a cross-sectional view of a fabric thickness compensator, according to at least one embodiment; and
[000101] Figure 90 is a cross-sectional view of a fabric thickness compensator, according to at least one embodiment. DETAILED DESCRIPTION
[000102] The Applicant of the present application also owns the rights of the US patent applications identified below, which are each incorporated herein by reference in their entirety:
[000103] US Patent Application Serial No. 12/894,311 entitled SURGICAL INSTRUMENTS WITH RECONFIGURABLE STEM SEGMENTS, now US Patent Publication No. 2012/0080496;
[000104] US Patent Application Serial No. 12/894,340 entitled STAPLER CARTRIDGES SUPPORTING NON-LINEARLY ARRAYED STAPLES AND SURGICAL STAPLING INSTRUMENT WITH COMMON CLAMP FORMING POCKETS, now US Patent Publication No. 2012/0080482;
[000105] US Patent Application Serial No. 12/894,327 entitled AW CLOSURE ARRANGEMENTS FOR SURGICAL INSTRUMENTS, now US Patent Publication No. 2012/0080499;
[000106] US Patent Application Serial No. 12/894,351 entitled SURGICAL INSTRUMENTS FOR CUTTING AND FIXING WITH SEPARATE AND DIFFERENT FASTENER POSITIONING AND TISSUE CUTTING SYSTEMS, now US Patent Publication No. 2012/0080502;
[000107] US Patent Application Serial No. 12/894,338 entitled IMPLANTABLE FASTENER CARTRIDGE HAVING A NON-UNIFORM ARRANGEMENT, now US Patent Publication No. 2012/0080481;
[000108] US Patent Application Serial No. 12/894,369 entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER, now US Patent Publication No. 2012/0080344;
[000109] US Patent Application Serial No. 12/894,312 entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING MULTI-LAYER, now US Patent Publication No. 2012/0080479;
[000110] US Patent Application Serial No. 12/894,377 entitled SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE, now US Patent Publication No. 2012/0080334;
[000111] US Patent Application Serial No. 12/894,339 entitled SURGICAL CLIPING INSTRUMENT WITH COMPACT JOINT CONTROL ARRANGEMENT, now US Patent Publication No. 2012/0080500;
[000112] US Patent Application Serial No. 12/894,360 entitled SURGICAL STAPLING INSTRUMENT WITH A VARIABLE STAPLING SYSTEM, now US Patent Publication No. 2012/0080484;
[000113] US Patent Application Serial No. 12/894,322 entitled SURGICAL STAPLING INSTRUMENT WITH INTERCHANGEABLE STAPLER CARTRIDGE ARRANGEMENTS, now US Patent Publication No. 2012/0080501;
[000114] US Patent Application Serial No. 12/894,350 entitled SURGICAL CLIP CARTRIDGES WITH SUPPORT STRUCTURES AND SURGICAL CLAPING INSTRUMENTS WITH SYSTEMS FOR PREVENTING ACTION MOVEMENTS WHEN A CARTRIDGE IS NOT PRESENT, now US patent publications No. 2012/0080478;
[000115] US Patent Application Serial No. 12/894,383 entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING BIOABSORBABBLE LAYERS, now US Patent Publication No. 2012/0080345;
[000116] US Patent Application Serial No. 12/894,389 entitled COMPRESSIBLE FASTENER CARTRIDGE, now US Patent Publication No. 2012/0080335;
[000117] US Patent Application Serial No. 12/894,345 entitled CLAMPS SUPPORTED BY A CLAMP CARTRIDGE SUPPORT, now US Patent Publication No. 2012/0080483;
[000118] US Patent Application Serial No. 12/894,306 entitled RETRACTABLE FASTENER CARTRIDGE, now US Patent Publication No. 2012/0080332 ;
[000119] US Patent Application Serial No. 12/894,318 entitled CLAMP SYSTEM COMPRISING A PLURALITY OF CONNECTED RETAINING MATRIX ELEMENTS, now US Patent Publication No. 2012/0080480;
[000120] US Patent Application Serial No. 12/894,330, entitled FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND AN ALIGNMENT MATRIX, now US Patent Publication No. 2012/0080503;
[000121] US Patent Application Serial No. 12/894,361 entitled FASTENER SYSTEM COMPRISING A RETENTION MATRIX, now US Patent Publication No. 2012/0080333;
[000122] US Patent Application Serial No. 12/894,367 entitled CLAMP INSTRUMENT FOR IMPLEMENTING A CLAMP SYSTEM COMPRISING A RETENTION MATRIX, now US Patent Publication No. 2012/0080485;
[000123] US Patent Application Serial No. 12/894,388 entitled CLAMP SYSTEM COMPRISING A RETENTION MATRIX AND A COVER, now US Patent Publication No. 2012/0080487;
[000124] US Patent Application Serial No. 12/894,376 entitled FASTENER SYSTEM COMPRISING A PLURALITY OF FASTENER CARTRIDGES, now US Patent Publication No. 2012/0080486;
[000125] US Patent Application Serial No. 13/097,865 entitled SURGICAL STAPLER ANUS COMPRISING A PLURALITY OF FORMING POCKETS, now US Patent Publication No. 2012/0080488;
[000126] US Patent Application Serial No. 13/097,936 entitled TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER, now US Patent Publication No. 2012/0080339;
[000127] US Patent Application Serial No. 13/097,954 entitled STAPLES CARTRIDGE COMPRISING A COMPRESSIBLE PORTION OF VARIABLE THICKNESS, now US Patent Publication No. 2012/0080340;
[000128] US Patent Application Serial No. 13/097,856 entitled STAPLES CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF, now US Patent Publication No. 2012/0080336;
[000129] US Patent Application Serial No. 13/097,928 entitled TISSUE THICKNESS COMPENSATOR COMPRISING REMOVABLE PORTIONS, now US Patent Publication No. 2012/0080490;
[000130] US Patent Application Serial No. 13/097,891 entitled TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER COMPRISING AN ADJUSTABLE ANVIS, now US Patent Publication No. 2012/0080489;
[000131] US Patent Application Serial No. 13/097,948 entitled STAPLES CARTRIDGE COMPRISING AN ADJUSTABLE DISTAL PORTION, now US Patent Publication No. 2012/0083836;
[000132] US Patent Application Serial No. 13/097,907 entitled COMPRESSIBLE CLAMP CARTRIDGE ASSEMBLY, now US Patent Publication No. 2012/0080338;
[000133] US Patent Application Serial No. 13/097,861 entitled TISSUE THICKNESS COMPENSATOR COMPRISING PORTIONS HAVING DIFFERENT PROPERTIES, now US Patent Publication No. 2012/0080337;
[000134] US Patent Application Serial No. 13/097,869 entitled STAPLE CARTRIDGE LOADING ASSEMBLY, now US Patent Publication No. 2012/0160721;
[000135] US Patent Application Serial No. 13/097,917 entitled COMPRESSIBLE CLAMP CARTRIDGE COMPRISING ALIGNMENT ELEMENTS, now US Patent Publication No. 2012/0083834;
[000136] US Patent Application Serial No. 13/097,873 entitled STAPLES CARTRIDGE COMPRISING A RELEASE PORTION, now US Patent Publication No. 2012/0083833 ;
[000137] US Patent Application Serial No. 13/097,938 entitled STAPLES CARTRIDGE INCLUDING DISTORTION-RESISTANT COMPRESSIBLE COMPONENTS, now US Patent Publication No. 2012/0080491;
[000138] US Patent Application Serial No. 13/097,924 entitled STAPLER CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSER, now US Patent Publication No. 2012/0083835;
[000139] US Patent Application Serial No. 13/242,029, entitled SURGICAL STAPLER WITH FLOATING ANNUS, now US Patent Publication No. 2012/0080493;
[000140] US Patent Application Serial No. 13/242,066 entitled CURVED END ACTUATOR FOR A CLAMPING INSTRUMENT, now US Patent Publication No. 2012/0080498;
[000141] US Patent Application Serial No. 13/242,086 entitled CLAMP CARTRIDGE INCLUDING A RETRACTABLE HOLDER;
[000142] US Patent Application Serial No. 13/241,912 entitled CLAMP CARTRIDGE INCLUDING AN ARRANGEMENT OF RETRACTABLE SUPPORTS;
[000143] US Patent Application Serial No. 13/241,922 entitled SURGICAL STAPLER WITH STATIONARY CLAMP ACTUATORS;
[000144] US Patent Application Serial No. 13/241,637 entitled SURGICAL INSTRUMENT SET WITH TRIGGER FOR GENERATING MULTIPLE ACTION MOVEMENTS, now US Patent Publication No. 2012/0074201;
[000145] US Patent Application Serial No. 13/241,629, entitled SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULABLE END ACTUATOR, now US Patent Publication No. 2012/0074200;
[000146] US Patent Application Serial No. 13/433,096 entitled TISSUE THICKNESS COMPENSATION COMPRISING A PLURALITY OF CAPSULES, now US Patent Publication No. 2012/0241496;
[000147] US Patent Application Serial No. 13/433,103 entitled TISSUE THICKNESS COMPENSATION COMPRISING A PLURALITY OF LAYERS, now US Patent Publication No. 2012/0241498;
[000148] US Patent Application Serial No. 13/433,098 entitled EXPANDABLE TISSUE THICKNESS COMPENSATOR, now US Patent Publication No. 2012/0241491;
[000149] US Patent Application Serial No. 13/433,102 entitled TISSUE THICKNESS COMPENSING COMPENSING A RESERVOIR, now US Patent Publication No. 2012/0241497;
[000150] US Patent Application Serial No. 13/433,114 entitled RETAINER ASSEMBLY INCLUDING A TISSUE THICKNESS COMPENSATOR, now US Patent Publication No. 2012/0241499;
[000151] US Patent Application Serial No. 12/433,136, entitled TISSUE THICKNESS COMPENSATOR COMPRISING AT LEAST ONE DRUG, now US Patent Publication No. 2012/0241492;
[000152] US Patent Application Serial No. 13/433,141 entitled TISSUE THICKNESS COMPENSATOR COMPRISING CONTROLLED RELEASE AND EXPANSION, now US Patent Publication No. 2012/0241493;
[000153] US Patent Application Serial No. 13/433,144 entitled FABRIC THICKNESS COMPENSATION COMPRISING FIBERS TO PRODUCE A RESILIENT LOAD, now US Patent Publication No. 2012/0241500;
[000154] US Patent Application Serial No. 13/433,148 entitled FABRIC THICKNESS COMPENSATOR COMPRISING STRUCTURE FOR PRODUCING A RESILIENT LOAD, now US Patent Publication No. 2012/0241501;
[000155] US Patent Application Serial No. 13/433,155 entitled TISSUE THICKNESS COMPENSATOR COMPRISING RESILIENT LIMBS, now US Patent Publication No. 2012/0241502;
[000156] US Patent Application Serial No. 13/433,163 entitled METHODS FOR FORMING TISSUE THICKNESS COMPENSATOR ARRANGEMENTS FOR SURGICAL STAPLERS, now US Patent Publication No. 2012/0248169;
[000157] US Patent Application Serial No. 13/433,167 entitled TISSUE THICKNESS COMPENSATORS, now US Patent Publication No. 2012/0241503;
[000158] US Patent Application Serial No. 13/433,175 entitled LAYER TISSUE THICKNESS COMPENSATOR, now US Patent Publication No. 2012/0253298 ;
[000159] US Patent Application Serial No. 13/433,179 entitled TISSUE THICKNESS COMPENSATOR FOR CIRCULAR SURGICAL STAPLERS, now US Patent Publication No. 2012/0241505;
[000160] US Patent Application Serial No. 13/433,115 entitled TISSUE THICKNESS COMPENSATOR COMPRISING CAPSULES DEFINE A LOW PRESSURE ENVIRONMENT;
[000161] US Patent Application Serial No. 13/433,118 entitled TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF MATERIALS;
[000162] US Patent Application Serial No. 13/433,135 entitled MOBILE MEMBER FOR USE WITH A COMPENSATION OF FABRIC THICKNESS;
[000163] US Patent Application Serial No. 13/433,140, entitled TISSUE THICKNESS COMPENSATOR AND METHOD FOR PRODUCTION THEREOF;
[000164] US Patent Application Serial No. 13/433,147 entitled TISSUE THICKNESS COMPENSATION COMPRISING CHANNELS;
[000165] US Patent Application Serial No. 13/433,126 entitled TISSUE THICKNESS COMPENSATOR COMPRISING INTERNAL TISSUE GROWTH ELEMENTS;
[000166] US Patent Application Serial No. 13/433,132 entitled DEVICES AND METHODS FOR ATTACHING TISSUE THICKNESS COMPENSATION MATERIALS TO SURGICAL STAPLING INSTRUMENTS, and
[000167] US Patent Application Serial No. 13/433,129 entitled TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF MEDICINES.
[000168] The Applicant of the present application also owns the rights to the US patent applications identified below which are each incorporated herein by reference in their entirety, respectively:
[000169] US Patent Application Serial No. 11/216,562 entitled CLAMP CARTRIDGES FOR FORMING CLAMPS HAVING DIFFERENT FORMED CLIP HEIGHTS, now US Patent Application Serial No. 7,669,746;
[000170] US Patent Application Serial No. 11/714,049 entitled SURGICAL STAPLING DEVICE WITH ANUS HAVING STAPLE FORMING POCKETS OF VARIOUS DEPTH, now US Patent Publication No. 2007/0194082;
[000171] US Patent Application Serial No. 11/711,979 entitled SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now US Patent Application Serial No. 8,317,070;
[000172] US Patent Application Serial No. 11/711,975 entitled SURGICAL CLIPING DEVICE WITH DIFFERENT HEIGHT CLAMP ACTUATORS, now US Patent Publication No. 2007/0194079;
[000173] US Patent Application Serial No. 11/711,977 entitled SURGICAL STAPLING DEVICE WITH CLAMP ACTUATOR SUPPORTING MULTI-DIAMETER WIRE CLAMPS, now US Patent Application Serial No. 7,673,781;
[000174] US Patent Application Serial No. 11/712,315 entitled SURGICAL CLAMPING DEVICE WITH ACTUATOR WEDGE CAMS FOR DRIVING CLAMP ACTUATORS, now US Patent Application Serial No. 7,500,979;
[000175] US Patent Application Serial No. 12/038,939 entitled CLAMP CARTRIDGES FOR FORMING CLAMPS HAVING DIFFERENT FORMED CLIP HEIGHTS, now US Patent Application Serial No. 7,934,630;
[000176] US Patent Application Serial No. 13/020,263 entitled SURGICAL STAPLING SYSTEMS THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now US Patent Publication No. 2011/0147434;
[000177] US Patent Application Serial No. 13/118,278, entitled ROBOTICLY CONTROLLED SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now US Patent Publication No. 2011/0290851;
[000178] US Patent Application Serial No. 13/369,629 entitled ROBOTICLY CONTROLLED AND CABLE-BASED SURGICAL END ACTUATORS, now US Patent Publication No. 2012/0138660;
[000179] US Patent Application Serial No. 12/695,359, entitled SURGICAL STAPLING DEVICES FOR FORMING STAPLES WITH DIFFERENT FORMED HEIGHTS, now US Patent Publication No. 2010/0127042; and
[000180] US Patent Application Serial No. 13/072,923 entitled CLAMP CARTRIDGES FOR FORMING CLAMPS HAVING DIFFERENT FORMED CLIP HEIGHTS, now US Patent Publication No. 2011/0174863;
[000181] The Applicant of the present application also owns the US patent applications identified below, which were filed on the same date as the present application and which are each incorporated herein by reference in their respective entirety:
[000182] US Application Serial No., titled STAPLES CARTRIDGE WITH LAYER RETENTION FEATURES, (Attorney's Document No. END7104USCIP1/110606CIP1);
[000183] US Application Serial No., entitled ADHESIVE FILM LAMINATE, (Attorney's Document No. END6843USCIP19/100528CP19);
[000184] US Application Serial No., entitled ACTUATOR TO RELEASE A TISSUE THICKNESS COMPENSATOR FROM A FASTENER CARTRIDGE, (Attorney's Document No. END6848USCIP2/100533CIP2);
[000185] US application serial no., entitled FABRIC THICKNESS COMPENSATOR AND FASTENER CARTRIDGE HAVING THE SAME, (attorney's document no. END6848USCIP3/100533CIP3);
[000186] US Patent Application Serial No., entitled FASTENER CARTRIDGE COMPRISING A RELEASE TISSUE THICKNESS COMPENSATOR, (Attorney's Document No. END6848USCIP4/100533CIP4);
[000187] US Patent Application Serial No., entitled FASTENER CARTRIDGE COMPRISING A CUTTING MEMBER TO RELEASE A TISSUE THICKNESS COMPENSATOR, (Attorney's Document No. END6848USCIP5/100533CIP5);
[000188] US Patent Application Serial No., entitled FASTENER CARTRIDGE COMPRISING A RELEASELY FIXED TISSUE THICKNESS COMPENSER, (Attorney's Document No. END6848USCIP6/100533CIP6);
[000189] US Application Serial No., entitled CLAMP CARTRIDGE INCLUDING A RELEASE COVER, (attorney's document no. END7201USNP/120294);
[000190] US Application Serial No., entitled ANUS LAYER ATTACHED TO A PROXIMAL END OF AN END ACTUATOR, (Attorney's Document No. END7102USCIP2/110604CIP2);
[000191] US Application Serial No., entitled LAYER COMPRISING POSITIONING FIXING ELEMENTS, (attorney's document no. END7102USCIP3/110604CIP3);
[000192] US Application Serial No., entitled END ACTUATOR COMPRISING A DISTAL TISSUE MEMBER IN BOUNDARIES POSITION, (Attorney's Document No. END7102USCIP4/110604CIP4);
[000193] US Application Serial No., entitled LAYER PROVISIONS FOR SURGICAL CLAMP CARTRIDGES, (Attorney's Document No. END6232USCIP1/070348CIP1);
[000194] US Application Serial No., entitled IMPLANTABLE PROVISIONS FOR SURGICAL CLAMP CARTRIDGES, (attorney's document no. END6232USCIP2/070348CIP2);
[000195] US Application Serial No., entitled MULTIPLE THICKNESS IMPLANTABLE LAYERS FOR SURGICAL STAPLING DEVICES, (attorney's document no. END6840USCIP2/100525CIP2);
[000196] US Application Serial No., entitled ACTUATOR TO RELEASE A LAYER OF MATERIAL FROM A SURGICAL END ACTUATOR, (Attorney's Document No. END6232USCIP4/070348CIP4); and
[000197] US Application Serial No., entitled STAPLES CARTRIDGE INCLUDING A COMPRESSIBLE PORTION, (Attorney's Document No. END7200USNP/120302).
[000198] Certain exemplifying modalities will now be described to provide a general understanding of the principles of structure, function, fabrication and use of the devices and methods disclosed herein. One or more examples of such embodiments are illustrated in the accompanying drawings. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are exemplary and not limiting embodiments, and that the scope of the various embodiments of the present invention is defined solely by the claims. Features illustrated or described in connection with one exemplary embodiment may be combined with features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.
[000199] Throughout the specification, the terms "several modalities", "some modalities", "a modality" or "the modality", or similar, mean that a specific feature, structure or characteristic described together with the embodiment is included in at least one embodiment. In this way, the appearance of the phrases "in several modalities", "in some modalities", "in a modality" or "in the modality", or similar, in places throughout the descriptive report are not necessarily referring to the same modality. . In addition, particular features, structures or features may be combined in any suitable manner in one or more modalities. Therefore, the particular features, structures or features illustrated or described in conjunction with a modality may be combined, in whole or in part, with the structures, features or features of a or more other modalities, without limitation. Such modifications and variations are intended to be included within the scope of the present invention.
[000200] The terms "proximal" and "distal" are used in the present invention with reference to a physician who manipulates the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the physician, and the term "distal" refers to the portion located farthest from the physician. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "upwards" and "downwards" may be used in the present invention in connection with the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.
[000201] Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, those skilled in the art will readily understand that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications, including, for example, those in conjunction with open surgical procedures. As the present detailed description proceeds, those skilled in the art will further understand that the various instruments disclosed in the present invention may be inserted into a body in any manner, such as through a natural orifice, through an incision or perforation formed in tissue. , etc. The functional portions or end actuator portions of instruments may be inserted directly into a patient's body or may be inserted via an access device which has a working channel through which the end actuator and elongated stem of a surgical instrument can be advanced.
[000202] In various embodiments, a surgical stapling instrument, such as instrument 10, for example, may comprise a handle, a shaft extending from the handle, and an end actuator extending from the shaft that can be configured to treat a patient's tissue. Referring to Figure 1, the handle assembly 12 of the instrument 10 may be attached to a first, or proximal, end 13 of an instrument stem 16 and, in addition, an end actuator assembly 14 may be configured to be attached to a second, or distal, end 15 of instrument stem 16. In various embodiments, end actuator assembly 14 and at least a portion of instrument stem 16 may be configured to be positioned within, and inserted at least partially through, of a cannula or trocar into a patient's body during a minimally invasive surgical procedure. Various surgical instruments are described in further detail in US Patent Application Serial No. 11/329,020 entitled Surgical Instrument Having a Swivel End Actuator, filed January 10, 2006; in U.S. Patent Application Serial No. 11/343,321 entitled Surgical Instrument for Cutting and Fixation with Closing Trigger Lock Mechanism, filed January 31, 2006, and in U.S. Patent Application Serial No. 11/529,935 , titled Surgical Clamps Having Attached Triggers and Stapling Instruments for Installing The Same, filed September 29, 2006, the entire disclosures of which are incorporated herein by reference.
[000203] In various embodiments, in addition to those described above, the end actuator assembly 14 may include a first jaw member 20 and a second jaw member 424, wherein at least one of the first and second jaw members may be configured to be moved relative to the other gripper member so that a patient's tissue can be pinched therebetween. Referring to Figures 1 to 3 and 5, the first jaw member 20 may include the staple cartridge 422 and, additionally, the second jaw member 424 may include the anvil 426. In at least one embodiment, the staple cartridge 422 may include a support having a plurality of clamp cavities defined therein. The anvil 426 may include an anvil cover 427 and an anvil face, the anvil face may have a plurality of anvil pockets defined therein. In various embodiments, each clip cavity may be configured to detachably store a clip therein, and each anvil pocket may be configured to deform at least a portion of the clip when the clip is installed. In various embodiments, at least one of the staple cartridge and anvil may comprise one or more gripping features, or ridges, 435 that may be configured to hold tissue within the end actuator.
[000204] In addition to the above, the end actuator assembly 14 may include at least one piece of buttress material 436 and/or 436' which may be configured to be in an intermediate position between the first and second members jaw and can be releasably retained on one of the cartridge holder and/or anvil face, for example. In at least one embodiment, a surface on the piece of buttress material may be configured to contact the fabric as the fabric is pinched between the first and second gripper members. In such an embodiment, the buttress material surface can be used to distribute the compressive pinch force over the fabric, remove excess fluid from the fabric, and/or optimize gripping of the staples. In various embodiments, one or more pieces of buttress material may be positioned within the end actuator assembly. In at least one embodiment, a piece of buttress material 436 may be attached to the staple cartridge 422 and a piece of buttress material 436' may be attached to the anvil 426. In at least one other embodiment, two pieces of buttress material 436 can be positioned on the cartridge holder and a piece of buttress material 436' can be positioned on the anvil face, for example. In various other embodiments, any suitable amount of pieces of buttress material may be positioned within an end actuator assembly. However, in various embodiments, the piece(s) of buttress material may be comprised of materials such as bioabsorbable materials, biofragmentable materials and/or dissolvable materials, for example, so that the buttress material can be absorbed, fragmented and/or dissolved during the curing process. In at least one embodiment, the piece(s) of buttress material may be comprised at least partially of a therapeutic drug that may be configured to be released over time to help the tissue heal. be cured, for example. In various additional embodiments, the piece(s) of buttress material may include a non-absorbable and/or non-dissolvable material, for example.
[000205] In various embodiments, an end actuator assembly may include at least one fastener or connecting member, such as connecting members 38, for example, which can be used to releasably retain a piece of buttress material at at least least one of an anvil and a staple cartridge, for example. In various embodiments, connection members can be configured to release from an end actuator and install together with a piece of buttress material. In at least one embodiment, the head portions of the connecting members may be configured to be separate from the body portions of the connecting members, so that the head portions can be fitted with the piece of buttress material, while the body parts remain attached to the end actuator. In various other embodiments, the entirety of the connecting members may remain engaged with the end actuator when the piece of buttress material is detached from the end actuator. However, in at least one embodiment, the connecting members may be comprised at least partially of at least one of a bioabsorbable material, a biofragmentable material and a dissolvable material, so that the connecting members can be absorbed, fragmented and /or dissolved in the body. In various embodiments, the connecting members are comprised of a therapeutic drug that can be configured to be released over time to aid tissue in healing, for example. In various other embodiments, the connecting members may include a non-absorbable and/or non-dissolvable material, for example, such as a plastic.
[000206] In various embodiments, connection members can be arranged in any suitable pattern or configuration. In at least one embodiment, the connecting members may be located around the outer perimeter of the buttress material piece 436, for example. In at least one embodiment, the connecting members may be positioned in a position proximate to one or more sides and/or ends of the piece of buttress material, for example, to prevent, or at least assist in preventing, the buttress material from detach from staple cartridge holder and/or anvil face when end actuator is inserted through a trocar or engaged with tissue. In various embodiments, the connecting members may be used in conjunction with any suitable adhesive, such as cyanoacrylate, for example, to releasably retain the piece of buttress material, or at least a portion of the buttress material, on the end actuator. . In at least one embodiment, the adhesive may be applied to the connecting members before the connecting members are engaged with openings in the piece of buttress material, staple cartridge, and/or anvil.
[000207] Now referring to Figure 4, a retaining element can be configured to be moved within the end actuator between a first position and a second position to releasably retain a fabric thickness compensator in an end actuator. An end actuator assembly 214 may include a first jaw including staple cartridge 222 and a second jaw including anvil 226, retaining member 262 being movable relative to staple cartridge 222 and anvil 226 For example, the retaining member 262 can be moved between a first, or extended, position near the distal end 264, and a second, or retracted, position near the proximal end 263. In its extended position, the retaining member 262 may hold a tissue thickness compensator such as tissue thickness compensator 236 in position while end actuator 214 is inserted into a surgical site. Thereafter, the end actuator 214 can be closed over the fabric, for example, and the clips can be installed through the compensator 236 into the fabric. Retaining member 262 may be moved to its retracted position so that retaining member 262 can be operatively disengaged from trim tab 236. Alternatively, retaining member 262 may be retracted before the clamps are installed. Either way, as a result of the above, the end actuator 214 can be opened and withdrawn from the surgical site, leaving the stapled compensator 236 and tissue behind.
[000208] In various embodiments, with reference to Figures 6 and 7, at least one resilient member may be used to releasably retain a piece of buttress material in a staple cartridge and/or an anvil of an end actuator. Similar to the above, a first jaw 520 of the end actuator may comprise a staple cartridge 522 and a second jaw 524 may comprise an anvil 526. In at least one embodiment, at least one resilient member, such as resilient members 550 or 550', for example, may include a first end, such as first ends 552 or 552', configured to be secured to or integrally formed with at least one between the first and second jaw members 520 and 524. In at least one In one embodiment, each resilient member 550 may include a second end, such as second ends 554 or 554', for example, configured to contact and releasably retain a piece of buttress material, such as a piece of buttress material 536, for example, on at least one between the first and second claw members. In various embodiments, second end 554 may include prong 558 which may be configured to grip at least a portion of buttress material piece 536, for example. In various embodiments, point 558 may be contoured and/or configured to include a roughened or ribbed surface, for example, to frictionally engage the piece of buttress material. Similarly, each second end 554' may comprise a prong 558' configured to engage and secure a piece of buttress material to the anvil. In various embodiments, again with reference to Figures 6 and 7, a plurality of resilient members may be provided to at least two sides of a gripper member to retain lateral portions of the piece of buttress material in the gripper member. In at least one embodiment, the first ends 552 of each individual resilient member 550 may be secured together by a connected element, such as a connected element, or bar, 556 or 556', for example. In various embodiments, connected member 556 may be attached to second jaw member 524 so that attached member 556 can provide support to resilient members 550. In various other embodiments, a plurality of resilient members 550 may be attached to at least one between the first and second gripping members, without the use of a connected element. In such an embodiment, the first ends of the resilient members may be directly attached to one between the first and second gripping members, for example. In at least one embodiment, resilient members 550, for example, may be configured to release buttress material 536 after the clips are installed through the buttress material and/or when the buttress material is disengaged from the end actuator. In at least one embodiment, the resilient members may be comprised of an elastic material such as metal or plastic, for example.
[000209] As stated above, an end actuator assembly may include a staple cartridge, an anvil and at least one piece of buttress material in an intermediate position between the staple cartridge and anvil. In at least one embodiment, with reference to Figure 8, a piece of buttress material, such as buttress material 336, may be configured to be press fit into at least one of the staple cartridges 322 and/or an anvil to releasably retain the piece of buttress material within the end actuator. Staple cartridge 322 may include first sidewall 302 and second sidewall opposite first sidewall 302, at least one between the first and second walls may include a lip 306 extending therefrom. In various embodiments, the buttress material 336 may include the first edge, or side, 308, the second edge, or side, 310, and at least one shoulder 312 that extends at least partially along the length of edges 308 and 310. In at least one embodiment, the lips 312 may be configured to be snap-fitted with the lips 306 so as to releasably retain the buttress material 336 in the staple cartridge 322.
[000210] In addition to the foregoing, the buttress material 336 may include surface 316 which may be configured to be positioned adjacent to or against the support 328 of the staple cartridge 322. In at least one embodiment, the side edges 308 and 310 may comprise side walls that may extend in a direction transverse or perpendicular to the surface 316. In such embodiments, edges 312 may extend from these side walls so that edges 312 can be interlocked behind. from the lips 306 of the staple cartridge 322. In various embodiments, the lips 312 of the buttress material 336 may be disengaged from the lips 306 of the staple cartridge 322 when the staples are installed from the staple cartridge 322. More specifically, when the clamps are installed, the clamps may contact the buttress material 336, apply an upward force to the buttress material 336 and expelling the buttress material 336 from the staple cartridge 322. Advantageously, as a result, the buttress material 336 may be automatically disengaged from the staple cartridge 322 when the staples are installed therefrom and/or when the end is open as described above.
[000211] In various embodiments, a piece of buttress material may include at least one member extending therefrom, which may be configured to releasably retain the buttress material in the staple cartridge and/or anvil. In at least one embodiment, one or more members 318 may extend from buttress material 336 in a direction perpendicular to or transverse to surface 316. In various embodiments, each member 318 may be engaged with a clamp cavity 320 defined in the support. 328 by friction or press fit to releasably retain the piece of buttress material 336 in the staple cartridge. In certain embodiments, a piece of buttress material may comprise members that engage pockets on the anvil. Similar to the above, in various embodiments the clips installed from the clip recesses 320 may apply an upward force to the buttress material 336 and disengage the members 318 from the clip recesses 320. In various embodiments, the clips may pierce the projections 318 and/or the buttress material 336 for securing the buttress material to the fabric as described above.
[000212] As illustrated in Figure 8, a piece of buttress material may include more than one member, or projection, extending therefrom to retain a piece of buttress material in one between a staple cartridge and an anvil. In various embodiments, with reference to Figures 9 and 10, more than one member 318' may extend from the piece of buttress material 336', for example. In at least one embodiment, the members 318' may be snap-fitted into the staple cavities 320' of the staple cartridge 322', and/or into the anvil pockets of an anvil (not shown), so that the members can retain by friction the piece of buttress material on the staple cartridge and/or the anvil, as stated above. In various embodiments, a staple cartridge may include slots or openings therein, in addition to staple cavities defined in the staple cartridge that may be configured to frictionally receive the members 318'. Similarly, in various embodiments, an anvil may include slits or openings therein, in addition to the clip forming pockets defined therein that may be configured to frictionally receive members 318'.
[000213] Figures 11 and 28 illustrate an embodiment of a surgical stapling instrument. Briefly, the surgical stapling instrument includes a handle assembly 12 and an elongated rod 14. A disposable charging unit or DLU 16 is releasably attached to a distal end of the rod 14. The disposable charging unit 16 includes an assembly of tool 17 having a cartridge assembly 18 housing a plurality of surgical staples and an anvil assembly 20 movably secured with respect to cartridge assembly 18. Disposable loading unit 16 is configured to apply linear rows of staples measuring approximately from 30 mm to about 60 mm in length. Disposable loading units that have linear rows of staples of other lengths are also provided, for example 45 mm. Handle assembly 12 includes an immovable handle member 22, a movable handle member 24, and a cylinder portion 26. A pivoting member 28 is mounted to the forward end of the cylinder portion 26 to facilitate rotation of the elongate body 14 relative to to the handle assembly 12. A pivot lever 30 is also mounted at the front end of the cylinder portion 26 adjacent the knob 28 to facilitate pivoting of the tool assembly 17. A pair of retraction buttons 32 are movably positioned along the along cylinder portion 26 to return surgical stapler 10 to a retracted position, as will be described in detail below.
[000214] A cable assembly 12 includes a housing that is formed from molded housing midsections 36a and 36b, which form the immovable cable member 22 and cylinder portion 26 of the cable assembly 12 (see Figure 1). ). The movable cable member 24 is pivotally supported between the housing midsections 36a and 36b around the pivot pin 38. A tilting member 40, which is a torsional spring, tilts the movable cable 24 in the opposite direction to the cable. 22. An actuation rod 46 is supported on cylinder portion 26 of housing 36 and includes a toothed shelf 48. A drive pawl 42 having shelf engagement finger 43 with laterally extending tabs 43a and 43b is mounted hingedly to one end of the movable cable 24 around a pivot pin 44. A tilting member 50, which is also a torsional spring, is positioned to drive the engaging finger 43 of the drive pawl 42 towards the shelf 48 of actuation rod 46. Movable handle 24 is pivotable to move engagement finger 43 of actuation pawl 42 and bring it into contact with toothed shelf 48 of actuation rod 46 to advance the actuation rod linearly in the direction the distal. The forward end of actuation rod 46 pivotally receives the proximal end 49 of a control rod 52 such that linear advancement of actuation rod 46 causes a corresponding linear advance of control rod 52. A locking pawl 54 that has an engaging shelf member 55 is pivotally mounted to housing 36 around pivot pin 57 and is biased towards toothed shelf 48 by tilting member 56, which is also a torsional spring. The engaging member 55 of the locking pawl 54 can be moved into engagement with the toothed shelf 48 to secure the actuating rod 46 in a longitudinally fixed position.
[000215] A retractor mechanism 58, which includes a pair of retraction knobs 32, is connected to the proximal end of the actuating rod 46 by a coupling rod 60. The coupling rod 60 includes right and left coupling portions 62a and 62b to receive retractor buttons 32 and a central portion 62c which is sized and configured to translate within a pair of longitudinal slots 34a formed in the actuation rod 46 adjacent the proximal end thereof. A release plate 64 is operatively associated with the actuation rod 46 and is mounted for movement relative thereto in response to manipulation of the retract buttons 32. A pair of spaced pins 66 extend outward from the side face. of the actuation rod 46 to engage a pair of correspondingly angled cam slots 68 formed in the release plate 64. On rearward movement of the retractor knobs 32, the pins 66 may release the plate 64 downwardly with respect to the actuation rod 46 and to the toothed shelf 48 so that the lower portion of the release plate 64 extends below the toothed shelf 48 to disengage the engagement finger 43 of the drive pawl 42 from the toothed shelf 48. A transverse slot 70 is formed at the proximal end of the toothed shelf 48. release plate 64 to accommodate the center portion 62c of the coupling rod 60 and elongated slots 34 (see Figure 1) are defined in the cylinder portion 26 of the cable assembly 12 to accommodate the latch. Longitudinal adjustment of coupling rod 60 as retractor knobs 32 are pulled back to retract actuation rod 46 and thereby retract control rod 52 rearwardly. An actuation rod 46 is proximally biased by spring 72 which is secured at one end to the coupling rod portion 62 by connector 74 and at the other end to post 76 on actuation rod 46.
[000216] In addition to the foregoing, the cable assembly 12 includes a trigger lock assembly 80 that includes a plunger 82 and a pivot locking member 83. The plunger 82 is biased to a central position by tilt springs 84 and includes annular tapered cam surfaces 85. Each end of plunger 82 extends through housing 36 adjacent an upper end of immovable handle 22. Pivot locking member 83 is pivotally secured by its distal end between housing middle sections 36a and 36b around pivot pin 86 and includes a locking surface 88 and a proximal extension 90 which has a slot 89 formed therein. Pivoting locking member 83 is biased by spring 92 in a counterclockwise direction (as seen in Figure 11) to move locking surface 88 into a position to place the distal end of actuation rod 46 in a boundary position to prevent the advancement of the rod 46 and the subsequent firing of the stapling apparatus. The tapered annular cam surface 85 is positioned to extend into the tapered slot 89 at the proximal extension 90. Lateral movement of the plunger 82 in both directions against the bias of the two springs 84 moves the tapered cam surface 85 into engagement. on the side walls of the tapered slot 89 to revolve the locking member 83 clockwise around the pivot pin 86, as seen in Figure 11, to move the locking surface 88 into a position to allow advancement of the actuating rod 46 and thereby triggering the stapling apparatus 10. The locking surface 88 is retained in that position by the recesses which receive the tapered end of the cam surface 85 to lock the locking member 83 in a counterclockwise position. The operation of the trigger lock assembly 80 will be further illustrated below.
[000217] In addition to the foregoing, the cable mechanism 12 also includes an anti-reverse clutch mechanism that includes a first gear 94 rotatably mounted on a first rod 96 and a second gear 98 mounted on a second rod 100 , and a slide plate (not shown) slidably mounted to housing 36. The slide plate includes an elongated slot sized and configured to be slidably positioned around the locking pawl pivot pin 57, a gear plate configured to mesh with the teeth of the second gear 98 and a cam surface. In the retracted position, the cam surface of the slide plate engages the locking pawl 54 to prevent the locking pawl 54 from engaging the toothed shelf 48. The actuation rod 46 includes a distal series of spaced proximal series gear teeth. of gear teeth positioned to engage with the first gear 94 of the actuation rod 46 during the movement of the actuation rod 46. When the actuation rod 46 is advanced by rotating the movable cable 24 around the pivot pin 38, the teeth of the distal gear on the actuating rod 46 mesh and rotate the first gear 94 and the first rod 96. The first rod 96 is connected to the second rod 100 by the spring clutch assembly so that rotation of the first rod 96 causes the rotation corresponding to that of the second rod 100. The rotation of the second rod 100 causes the corresponding rotation of the second gear 98 which engages the gear plate on the sliding plate to cause advance sliding plate linear. The linear advance of the slide plate is limited to the length of the elongated slot. After the slide plate has advanced the length of the slot, the cam surface releases the locking pawl 54 so that it is moved to engage with the toothed shelf 48. Continued advancement of the actuating rod 46 eventually moves the teeth of the distal gear. for engagement with the gear plate. However, as the slide plate is fixed longitudinally in position, the spring clutch is forced to release, so that continued distal advancement of the actuation rod 46 is permitted.
[000218] When the actuating rod 46 is returned to the retracted position (by pulling the retraction knobs 34 proximally as discussed above) the teeth of the distal gear engage first gear 94 to rotate second gear 98 in the reverse direction to retract the slider proximally in the housing 36. Proximal movement of the slider advances the cam surface to the locking pawl 54 prior to engagement between the locking pawl 54 and the toothed shelf 48 to drive the pawl 54 into a position. position that allows the retraction of the actuating rod 46.
[000219] Referring again to Figure 11, the cable assembly 12 includes an emergency return button 112 pivotally mounted in the housing 36 around the pivot element 114 supported between the middle sections of the housing 36a and 36b. Return button 112 includes an externally positioned member 116 positioned at the proximal end of cylinder portion 26. Member 116 is movable about pivot element 114 and can be engaged with proximal end of locking pawl 54 to propel the element. rack 55 out of engagement with the toothed rack 48 to allow the actuation rod 46 to be retracted during the triggering stroke of the stapling apparatus 10.
[000220] As discussed above, during the pinching portion of the actuation rod 46 advance, the slide plate disengages the pawl 54 from the shelf 48 and thus the actuation of the return button 112 is not necessary to retract the actuation rod 46 Figures 12 to 14 illustrate the interconnection of elongate body 14 and cable assembly 12. Housing 36 includes an annular groove 117 configured to receive an annular rib 118 formed at the proximal end of pivot member 28, which is formed from of molded mid-sections 28a and 28b. Annular groove 117 and rib 118 allow relative rotation between rotation member 28 and housing 36. Elongate body 14 includes an inner housing 122 and an outer housing 124. Inner housing 122 is sized to be received within the housing 122. outer housing 124 and includes an inner hole 126 extending therethrough and sized to slidably receive a first pivot link 123 and control rod 52. The proximal end of housing 122 and housing 124 each include a pair of diametrically opposed apertures 130 and 128, respectively, which are sized to receive radial projections 132 formed at the distal end of pivot member 28. Projections 132 and apertures 128 and 130 fixedly hold pivot member 28 and the body elongated 14 with respect to each other, both longitudinally and rotatably. Rotation of turn knob 28 relative to handle assembly 12 thus results in corresponding rotation of elongate body 14 relative to handle assembly 12.
[000221] A pivot mechanism 120 is supported on the pivot member 28 and includes a pivot lever 30, a cam member 136, a translation member 138 and the first pivot link 123. A pivot lever 30 is mounted so that pivoted about pivot member 140 which extends outwardly from pivot member 28 and is integrally formed therewith. A projection 142 extends downward from the pivot lever 30 for engagement with the cam member 136. The distal end of the translation member 138 includes an arm 160 that includes an opening 162 configured to receive an extending finger 164. from the proximal end of the hinge link 123. A pin 166 having a housing 168 constructed of a non-abrasive material, e.g. Teflon, is secured to the translation member 138 and sized to be received on an uneven cam surface . In an assembly condition, the proximal and distal uneven portions 150 and 152 of the cam member 136 are positioned beneath flanges, such as the flange 170, formed on the pivot member 28 to constrain the cam member 136 to transverse movement in an assembly. relative to the longitudinal axis of the stapling apparatus 10. When the pivot lever 30 is revolved around the pivot member 140, the cam member 136 is moved transversely on the pivot member 28 to move the cam surface 148 unevenly. transversely of the pin 166, forcing the pin 166 to move proximally or distally along the uneven cam surface 148. As the pin 166 is fixedly secured to the translation member 138, the translation member 138 is moved proximally or distally to effect the corresponding distal or proximal movement of the first actuation link 123.
[000222] A disposable charging unit sensing mechanism extends within the stapling instrument from the elongate body 14 to the cable assembly 12. The sensing mechanism includes a sensor tube 176 that is slidably supported in the hole. 26 of the elongate body 14. The distal end of the sensor tube 176 is positioned toward the distal end of the elongate body 14, and the proximal end of the sensor tube 176 is secured within the distal end of a sensor cylinder 178 by a pair of lugs 180. The distal end of a sensor connection 182 is secured to the proximal end of the sensor cylinder 178. The sensor connection 182 has a bulbous end 184 that engages a cam surface on the pivot locking member 83. disposable charging unit is inserted into the distal end of the elongate body 14, the disposable charging unit engages the distal end of the sensor tube 176 to directing sensor tube 176 proximally and thereby directing sensor barrel 178 and sensor connection 182 proximally. Movement of sensor link 182 proximally causes bulbous end 184 of sensor link 182 to move distally from the cam surface to allow locking member 83 to pivot under spring 92 bias from a position that allows the triggering of the clipping apparatus 10 to a locking position, the locking member 83 being positioned to engage the actuating rod 46 and preventing the triggering of the clipping apparatus 10. The sensor connection 182 and the locking member 83 function to prevent the firing of the surgical clipping apparatus 10 after a disposable charging unit is attached to the elongate body 14, without first operating the firing lock assembly 80.
[000223] In addition to the foregoing, the cam member 136 may include a recess defined in the lower portion thereof. A locking ring 184, which has a protrusion portion 186 configured to be received in this recess, may be positioned around the sensor cylinder 178 between a portion of the control tab 188 and a portion of the proximal flange 190. A spring 192 positioned between flange portion 190 and locking ring 184 drives the locking ring distally around the sensor cylinder 178. When a hinged disposable charging unit having an extended insertion tip 193 (Figure 16) is inserted into the distal end of the elongate body 14 of the stapling apparatus 10, the insertion point 193 causes the tab portion 188 to move proximally into engagement with the locking ring 184 to drive the locking ring 184 and protrusion 186 in a manner proximal to the recess 154 in the cam member 136. With the boss 186 positioned proximal to the recess in the cam member 136, the cam member 136 is free to move t transverse to effect articulation of the stapling apparatus 10. A non-hinged disposable loading unit may not have an extended insertion tip. Thus, when a non-hinged disposable loading unit is inserted into the elongate body 14, the sensor cylinder 178 will not be proximally retracted a sufficient distance to move the boss 186 from the recess 154. Thus, the cam member 136 is prevented from moving transversely by the projection 186 of the locking ring 184 which is positioned in the recess defined in the cam member 136 and the pivot lever 30 is locked in its central position.
[000224] Referring to Figures 15 to 18, a disposable charging unit, such as disposable charging unit 16a and/or 16b, for example, includes a proximal housing portion 200 adapted to releasably engage the distal end of the portion 14. A mounting assembly 202 is pivotally secured to the distal end of housing portion 200, and is configured to receive the proximal end of tool assembly 17 so that pivoting movement of mounting assembly 202 about an axis perpendicular to the longitudinal axis of a housing portion 200 effectively pivots the tool assembly 17 around pivot pin 244. A housing portion 200 of disposable loading unit 16 may first include latching lugs 254 for latching. releasably the elongate rod 14 and, second, an insertion point 193. The protrusions 254 form a bayonet-like coupling with the distal end of the rod. and 14. A second hinge link is sized to be slidably positioned in a slot 258 formed between the housing halves of housing portion 200.
[000225] Referring to Figures 19 to 27, the tool assembly 17 includes an anvil assembly 20 and a cartridge assembly 18. A cartridge assembly 20 includes an anvil portion 204 having a plurality of staple-forming concavities 206 and a cover plate 208 secured to the top surface of an anvil portion 204 to define a cavity 210 therebetween. A cover plate 208 is provided to prevent tissue strangulation during clamping and firing of the surgical stapling apparatus. The cavity 210 is sized to receive a distal end of an axial drive assembly 212. A longitudinal slot 214 extends through an anvil portion 204 to facilitate passage of the retaining flange 284 of the axial drive assembly 212 into the anvil cavity. 210. A cam surface 209 formed in an anvil portion 204 is positioned to engage the axial drive assembly 212 to facilitate pinching of tissue 198. A pair of pivot elements 211 formed in an anvil portion 204 are positioned within the slots. 213 formed in vehicle 216 to guide the anvil portion between the open and clamped positions. A pair of stabilizing elements may engage a respective shoulder portion 217 formed on a carrier 216 to prevent the anvil portion 204 from sliding axially with respect to the staple cartridge 220 while the cam surface 209 is deformed.
[000226] The cartridge assembly 18 includes a carrier 216 that defines an elongate support channel 218. The elongate support channel 218 is sized and configured to receive a staple cartridge 220. Flaps 222 and corresponding slots 224 formed along the staple cartridge 220 and elongated support channel 218 function to secure staple cartridge 220 in support channel 218. A pair of support struts 223 formed in staple cartridge 220 are positioned to rest on the side walls of vehicle 216 to stabilize plus staple cartridge 220 in support channel 218. Staple cartridge 220 includes retaining slots 225 for receiving a plurality of fasteners 226 and thrusters 228. A plurality of separate longitudinal slots 230 extend through staple cartridge 220 to accommodate cam wedges 232 of actuation slider 234. A central longitudinal slot 282 extends the length of the cartridge. clamps 220 to facilitate passage of knife blade 280. During operation of the surgical stapler, actuation slider 234 translates through longitudinal slots 230 of staple cartridge 220 to advance cam wedges 232 into sequential contact with thrusters 228 , to cause the thrusters 228 to translate vertically in the slots 225 and to drive the fasteners 226 of the slots 225 into the clamp deforming cavities 206 of the anvil assembly 20.
[000227] In addition to the foregoing, the stem of the surgical stapling instrument may include upper and lower mounting portions 236 and 238. Each mounting portion includes a threaded hole 240 on each side thereof, sized to receive threaded pegs. 242 to secure the proximal end of the vehicle 216 thereto. A pair of centrally located pivot elements 244 extend between the upper and lower mounting portions by means of a pair of coupling members that engage the distal end of housing portion 200. Housing portion 200 of the disposable charging unit may include lower and upper housing halves contained within an outer housing 251. A second hinge connection 256 is sized to be slidably positioned within a slot formed between the housing halves. A pair of purge plates 254 are positioned adjacent the distal end of the housing portion 200 adjacent the distal end of the axial drive assembly 212 to prevent outward swelling of the drive assembly 212 during articulation of the tool assembly 17. The second hinge connection 256 includes at least one elongated metal plate. Preferably, two or more metal plates are stacked to form linkage 256. The proximal end of linkage link 256 includes a hook portion 258 configured to engage first linkage linkage 123 and the distal end includes a loop 260 sized to engage a projection 262 formed on mounting assembly 202. Projection 262 is laterally offset from pivot pin 244 so that linear movement of second pivot link 256 causes mounting assembly 202 to pivot about pivot pins 244 to articulate tool set 17.
[000228] The distal end of the drive beam 266 is defined by a vertical support strut 278 that supports a knife blade 280 and an adjoining surface 283 that engages the central portion of the sliding actuation support 234 during a stapling procedure. Surface 285 on surface base 283 is configured to receive a support member 287 slidably positioned along the underside of staple cartridge 220. Knife blade 280 is positioned to translate slightly behind sliding actuation support 234 through of a central longitudinal slot 282 in the staple cartridge 220 to form an incision between rows of stapled body tissue. A retaining flange projects distally from the vertical strut and supports a cylindrical cam cylinder 286 at its distal end. Cam cylinder 286 is sized and configured to engage cam surface 209 with anvil body 204 to engage anvil portion 204 against body tissue.
[000229] In various embodiments, now referring to Figures 30 and 31, an end actuator of a surgical stapling instrument may comprise a first jaw 680 that includes a staple cartridge assembly and a second jaw 670. The first jaw 680 may include a barrel 680a, a cartridge body 682 positionable on the barrel 680a, and a slider 690 which is movable through the cartridge body 682 to lift the drivers 692 towards the holder 682a of the cartridge body 682 and eject the stored staples 684 from removable mode in the clamp cavities defined there. Cartridge body 682 may further comprise a plurality of slots 682b which may each be configured to receive a cam from slider 690, such as cams 690a through 690c, for example, which may be configured to engage and lift actuators 692 The staple cartridge assembly may further comprise a layer B2 which may be attached to the cartridge body 682 using connectors S3 and S4. In various embodiments, each connector S3 and S4 may comprise a suture that joins layer B2 to cartridge body 682. For example, connector S3 may join the distal end of layer B2 to the distal end 682f of cartridge body 682 while the connector S4 can join the proximal end of layer B2 to the proximal end 682e of the cartridge body 682. In use, a cutting member, such as the cutting member 660, for example, can be advanced through the cartridge body 682 and make an incision. , or disable otherwise, on connectors S3 and S4. For example, cutting member 660 may comprise a body 662, flanges 664a and 664b which are configured to engage second jaw 670 and first jaw 680, respectively, and a cutting member 66 which is configured to traverse a longitudinal slot 682c defined in cartridge body 682a. Cutting member 660 may be advanced distally through cartridge body 682 by a triggering member assembly 650. The triggering member assembly 650 may comprise a rod 652 comprising a plurality of layers that include a distal end 654 engaged with the cutting member body 662 and a proximal end 656 configured to receive a triggering force applied thereto.
[000230] When triggering force is applied to triggering member 650, in addition to the above, flange 664a can engage second jaw 670 and pivot second jaw 670 down toward first jaw 680. The second jaw 670 may comprise an anvil assembly 623 which may include a frame 672 and an anvil plate including a plurality of anvil pockets defined therein. As the firing member 650 is advanced distally, the cutting member 660 can pass through a longitudinal slot 670b defined in the anvil plate. Similar to the above, the second jaw 670 may additionally comprise a layer B1 attached thereto by one or more connectors, such as connectors S1 and S2, for example. Also similarly, connectors S1 and S2 may each comprise a suture, wherein connector S1 may be configured to releasably secure the distal end of layer B1 to the distal end 670e of the anvil assembly 623 and that the connector S2 may be configured to releasably secure the distal end of layer B2 to the proximal end 670c of anvil assembly 623. In various embodiments, anvil assembly 623 may comprise a distal nose 676 along with frame 672 and may include a slot 676a defined there that is configured to receive connector S1. Similarly, the proximal end of frame 672 may include a slot 672a defined therein which is configured to receive connector S2. In both events, in various embodiments, connectors S1 and S2 may extend around the entirety of the anvil frame 672, while in other embodiments, connectors S1 and S2 may engage the sides of the anvil assembly 623. 660 is advanced distally through the anvil assembly 623, the cutting member 660 may transection, or otherwise disable, connectors S1 and S2 to release layer S1 from the anvil assembly 623. More particularly, in various In these modalities, layer B1 can be positioned on one side of the patient's tissue and layer B2 can be positioned on the opposite side of the patient's tissue, whereupon the staples 684 can then be fired through layer B2, the patient's tissue and the layer B1 when firing member 650 is advanced distally. While the triggering member 650 is being advanced distally, the cutting member 660 can progressively transection the connectors from S1 to S4, while layers B1 and B2 are progressively transected by the cutting member 660. For example, the cutting member 660 can transition connectors S2 and S4 at the beginning of the trigger and connectors S1 and S3 at the end of the trigger. In various embodiments, now referring to Figures 32 and 33, an end actuator 716 may comprise a first jaw 718 and a second jaw 720, with a connector 774 being embedded within a slot 770e defined in an anvil 772 of the second claw 720.
[000231] Referring to Figure 33A, an end actuator of a surgical stapling instrument may comprise a first jaw and a second jaw, at least one of the first jaw and the second jaw being configured to be moved relative to each other. the other. The end actuator may comprise a first jaw including a staple cartridge groove 1050 and a second jaw including an anvil, the anvil pivotable toward and/or away from the staple cartridge groove 1050 , for example. In various alternative embodiments, the first jaw including a cartridge of staples therein can be pivoted toward and/or opposite the direction of the second jaw including the anvil. In either event, the staple cartridge channel 1050 may be configured to receive a staple cartridge 1060, for example, which is removably retained within the staple cartridge channel 1050. The staple cartridge 1060 may comprise a cartridge body 1062, a cartridge holder 1064, and a fabric thickness compensator 1000, wherein, as illustrated in Figure 33A, the fabric thickness compensator 1000 may be removably positioned against or adjacent to the cartridge holder 1064. Similar to other embodiments described herein, now with reference to Figures 33A and 34, cartridge body 1062 may comprise a plurality of clip cavities 1066 and a staple 1002 positioned within each staple cavity 1066. Also similar to other embodiments herein described, the clamps 1002 may be supported by clamp drivers positioned within the cartridge body 1062 with a sliding support and/or a The trigger, for example, may be advanced through the staple cartridge 1060 to lift the staple drivers up into the staple cavities 1066 and eject the staples 1002 from the staple cavities 1066.
[000232] Referring to Figure 34, fabric thickness compensators, such as fabric thickness compensators 1000 and 1000', may be attached to fabric T in order, for example, to provide support to attached fabric T. illustrated in Figure 34, fabric thickness compensators 1000 and 1000' may be attached to opposite sides of the fabric T. A fabric thickness compensator such as, for example, fabric thickness compensator 1000, may comprise an inner portion 1004 and an outer portion 1006 that may form an outer perimeter at least partially surrounding the inner portion 1004. The outer portion 1006 may be more flexible than the inner portion 1004. In various circumstances, the outer portion 1006 may comprise sufficient flexibility to provide an atraumatic tissue contact surface for the tissue T, and the inner portion may comprise sufficient rigidity to provide adequate support to the trapped tissue T.
[000233] Again referring to Figure 34, the outer portion 1006 of the fabric thickness compensator 1000 may include an outer edge 1008. To optimize its flexibility, the outer portion 1006 may include multiple slots 1010. In addition, parts of the outer edge 1008 and outer portion 1006 may be cut or removed to optimize the flexibility of outer portion 1006. As illustrated in Figure 34, slots 1010 may start at outer edge 1008 and may follow several paths that terminate within outer portion 1006. For example, a slot, such as slot 1010A, may start at outer edge 1008 and then follow a path substantially perpendicular to outer edge 1008, ending at outer portion 1006. In another example, a slot, such as slot 1010B, may also start at outer edge 1006. outer edge 1008 and then follow a path at an acute angle to outer edge 1008, also ending at outer portion 1006. Fabric thickness compensator 100 0 may be manufactured with slots 1010 in outer portion 1006. Alternatively, fabric thickness compensator 1000 may be manufactured without slots 1010, which may be incorporated into outer portion 1006 prior to implantation thereof, for example.
[000234] As described above and as illustrated in Figure 34, staples 1002 can be configured to at least partially capture the fabric thickness compensator 1000 when staples 1002 are moved from their non-fired positions to their fired positions. In addition, staples 1002 may be fired in rows and each row may include multiple staples 1002. A row of staples 1002, for example row 1012, may be attached to outer portion 1006 of fabric thickness compensator 1000 such that slots 1010 may be positioned between clips 1002 of row 1012 to provide sufficient support for clips 1002 while maintaining adequate flexibility in outer portion 1006. Alternatively, in certain circumstances, slots 1010 may be positioned in clips 1002, for example, to provide flexibility in the 1002 clamps.
[000235] Referring now to Figure 35, the fabric thickness compensator 1000 may include a plurality of openings 1014 that extend therethrough. As illustrated in Figure 35, apertures 1014 may comprise generally cylindrical shapes. Alternatively, apertures 1014 may comprise cone shapes that may be narrow on one side and wider on the other side of fabric thickness compensator 1000. Other geometric shapes of apertures 1014 are contemplated within the scope of this disclosure. Fabric thickness compensator 1000 may also include multiple cavities 1016. As illustrated in Figure 35, cavities 1016 may comprise generally cylindrical shapes, sometimes with tapered outer portions. Other geometric shapes of 1016 cavities are contemplated within the scope of this disclosure. For example, cavities 1016 may include closed-ended cones. Apertures 1014 and/or cavities 1016 may provide regions of localized flexibility in fabric thickness compensator 1000 and may be positioned in outer portion 1006, inner portion 1004 and/or both portions 1004 and 1006 to improve the flexibility of the fabric thickness compensator. fabric thickness 1000. In addition, as illustrated in Figure 35, fabric thickness compensator 1000 may include combinations of slots 1010, apertures 1014, and/or recesses 1016 to provide the desired degree of flexibility.
[000236] Now referring to figures 36 to 39, to optimize its flexibility, the thickness of the fabric thickness compensator 1000 can include patterns that can provide regions of localized flexibility. Such patterns can be embossed patterns that can be molded or carved into fabric thickness compensator 1000. As illustrated in Figure 36, fabric thickness compensator 1000 can include a pattern 1020 comprising a plurality of pyramids 1018 that can be arranged, for example in rows. The pyramids 1018, as illustrated in Figure 37, can be separated from each other by a distance "D". The degree of flexibility of the fabric thickness compensator 1000 can, in part, be controlled by increasing or decreasing the distance "D" between the pyramids 1018. The pyramids 1018 can be arranged in other patterns, which are contemplated within the scope of the present revelation. In addition, other geometric shapes, such as cones, for example, and combinations thereof may also be used and are contemplated within the scope of the present disclosure. As illustrated in Figure 38, the fabric thickness compensator 1000 may comprise a corrugated pattern 1022. Figure 38 shows a cross-sectional view of the corrugated pattern 1022 of the fabric thickness compensator 1000 which may include multiple peaks 1024 and multiple valleys 1026 The various patterns illustrated herein and combinations thereof can be positioned on the outer portion 1006 and/or the inner portion 1004 to improve the flexibility of the fabric thickness compensator 1000.
[000237] In addition to the foregoing, with reference to Figures 40 and 41, the outer edge 1008 of the fabric thickness compensator 1000 may comprise a generally atraumatic profile that may minimize an impact on the fabric T, for example, during and/or after capturing the fabric T and the fabric thickness compensator 1000 by staples 1002. For example, as illustrated in Figures 40 and 41, the outer edge 1008 may comprise a generally cut profile. Other atraumatic profiles, such as chamfered profiles, for example, for the 1008 outer edge are also contemplated within the scope of the current disclosure. In addition, the tissue thickness compensator 1000 may also comprise an atraumatic nose portion 1028 and/or an atraumatic tail portion 1030. As illustrated in Figures 40 and 41, an atraumatic nose portion 1028 may comprise, for example, a generally curved shape, and the atraumatic tail portion 1030 may, for example, comprise a split tail with flexible ends 1032. Other atraumatic shapes for the nose portion 1028 and/or the tail portion 1030 are also contemplated within the scope of the current revelation.
[000238] Again with reference to Figures 40 and 41, the fabric thickness compensator 1000 may comprise a clamping member 1034, which can reduce slipping between the fabric thickness compensator 1000 and the cartridge holder 1064 when the thickness compensator 1064 Thick fabric 1000 is placed against cartridge holder 1064. As illustrated in Figure 40, a gripping member 1034 may comprise multiple cylindrical-shaped protuberances 1036, for example, which may be joined to corresponding recesses on cartridge holder 1064. The Clamping member 1034, as illustrated in Figure 41, may comprise an arrowhead-shaped protrusion 1038 that can be fitted into a corresponding recess in cartridge holder 1064. Other clamping means for clamping fabric thickness compensator 1000 in with respect to the 1064 cartridge holder are contemplated within the scope of the present disclosure. Gripping member 1034, as shown in Figures 40 and 41, may be positioned on nose portion 1028. Alternatively, gripping member 1034 may be positioned on other portions of tissue thickness compensator 1000 such as, for example, portion tail 1030.
[000239] Referring now to Figures 42 to 44, the outer portion 1006 of the fabric thickness compensator 1000 may comprise a padding member 1043 which may provide a pliable edge that contacts the fabric T, for example, during and /or after capturing the fabric T and fabric thickness compensator 1000 by staples 1002. In at least one embodiment, as illustrated in Figure 44, the padding member 1043 may comprise sufficient structural elasticity to contract and/or flex when compressed against fabric T. As illustrated in Figure 43, padding member 1043 may partially extend over outer edge 1008 and may be secured to outer edge 1008 by an adhesive, for example. Other attachment means for securing padding member 1043 to outer edge 1008 are contemplated within the scope of the current disclosure. Alternatively, padding member 1043 may be an integral part of fabric thickness compensator 1000 that may be manufactured therewith. The padding member 1043 may comprise a biocompatible foam which may be comprised of a biodegradable material such as, for example, PGA, PCL, PLLA and/or combinations thereof, for example. In addition, the padding member 1043 may be comprised, at least in part, of oxidized regenerated cellulose (ORC) and/or alginate. For example, the padding member 1043 may include a plurality of alginate and/or ORC capsules that can become soft after implantation in a patient, which can increase the softness of the padding member 1043.
[000240] The outer edge 1008 of the compensator 1000 may comprise a thickness greater than the thickness of the outer portion 1006. The increased thickness of the outer edge 1008 may provide an atraumatic surface that makes contact with tissue T. Referring to Figures 45 and 46 , the outer portion 1006 of the fabric thickness compensator 1000 may comprise a laminated outer edge 1046 that can be at least partially extended around the outer portion 1006 and laminated inwardly toward the inner portion 1004. Similar to the above, the Laminate outer edge 1046 may provide a pliable outer edge that contacts the T fabric, for example, during and/or after capturing the T fabric and fabric thickness compensator 1000 by staples 1002.
[000241] Referring to Figures 47 through 49, as described above, the staple cartridge channel 1050 may be configured to receive a staple cartridge 1060 which may comprise a cartridge body 1062, a cartridge holder 1064. In addition, a fabric thickness compensator such as a fabric thickness compensator 1100 may be removably positioned against or adjacent to the cartridge holder 1064, as illustrated in Figure 47.
[000242] Again with reference to Figures 47 to 49, a tissue thickness compensator can be configured to be absorbed after implantation in a patient. The absorption process may initially reduce the fabric thickness compensator to smaller pieces which may include rough edges which may have undesirable effects on the surrounding T fabric. To mitigate these effects, fabric thickness compensator 1100 can be at least partially assembled from a plurality of pieces 1140, each of which can have an atraumatic outer periphery and can be joined together to form a single structure, as illustrated in Figure 48. Pieces 1140 can be joined to form fabric thickness compensator 1100 so that the absorption process can first reduce fabric thickness compensator 1100 to pieces 1140, thus minimizing the presence of rough edges. For example, pieces 1140 may comprise circular profiles and may be thermowelded together to form fabric thickness compensator 1100. Other profiles and other methods of joining pieces 1140 are contemplated within the scope of the present disclosure. In one example, parts 1140 may be joined by an adhesive 1143 (see Figure 48) configured to absorb faster than parts 1140 to allow separation of parts 1140 at an early stage in the absorption process. As illustrated in Figure 48, the pieces 1140 can be arranged in an overlapping array in which an end portion of one of the pieces 1140 can overlap an end portion of another piece 1140 so that the two end portions of the pieces 1140 are releasably attached to each other, for example by an adhesive. Under certain circumstances, the pieces 1140 may be arranged in another superimposed matrix, with one of the pieces 1140 being positioned over and releasably secured to a plurality of pieces 1140, as illustrated in Figure 49.
[000243] Referring to Figures 50 to 53, as described above, a tissue thickness compensator can be configured to be absorbed after implantation in a patient, and the absorption process can initially reduce the tissue thickness compensator to pieces random minors. Control of the absorption process to produce small parts with non-traumatic outer edges can be achieved, as described above, by starting with small parts that have atraumatic outer edges. Another approach may include modifying the tissue thickness compensator in a way that allows it to separate into smaller pieces that have atraumatic peripheries at an early stage in the absorption process. For example, as illustrated in Figure 50, a fabric thickness compensator 1200 may comprise a pattern such as pattern 1212, for example, which may be molded or carved into the fabric thickness compensator 1200 to produce, for example, a plurality of circular portions 1210. Portions 1210 can be defined by reducing the thickness of fabric thickness compensator 1200 along the circumferences 1214 of circular portions 1210, as illustrated in the cross-sectional view in Figure 51. As a result, an absorption faster along the circumferences 1214 of the circular portions 1210 may occur, which can lead to a separation of the circular portions 1210 from each other at an early stage of the absorption process. The patterns that comprise the portions with other geometric shapes with atraumatic external peripheries are contemplated in the scope of the current revelation. For example, as illustrated in Figure 52, the fabric thickness compensator 1200' may comprise a pattern 1216 comprising portions 1218 which may include profiles that extend longitudinally in a wave-like profile along a length of the thickness compensator of 1200' fabric. In another example, as illustrated in Figure 53, fabric thickness compensator 1200'' may comprise a pattern 1220 which may include hexagonal shaped portions 1222.
[000244] Referring to Figure 54, as described above, a fabric thickness compensator, such as the fabric thickness compensator 1250, may be captured together with the T fabric by staples, such as the staples 1002, for example, and may be configured to be reduced to non-traumatic parts, such as the 1226 parts, for example, at an early stage of the absorption process after implantation in a patient. After separation, the pieces 1226 can move and/or slide relative to each other, which can affect the surrounding T tissue. To minimize relative movement between pieces 1226, fired staples 1002 can be spatially arranged on fabric thickness compensator 1250 so that one staple 1002 can capture multiple pieces 1226, as illustrated in Figure 54. This can also help maintain a fabric thickness compensator 1250 in a substantially individual structure even after the pieces 1226 are separated from each other in the initial stage of the absorption process. In this way, the fabric thickness compensator 1250 can continue to provide support for the fabric T captured by staples 1002 after the pieces 1226 are separated from each other in the initial stage of the absorption process.
[000245] In addition to the above, now referring to Figure 55, yet another approach can be taken to guide the absorption process of a fabric thickness compensator to produce small parts with atraumatic outer edges. For example, as illustrated in Figure 55, a fabric thickness compensator such as fabric thickness compensator 1300 may comprise a plurality of slots 1310 that can be strategically positioned to optimize the flexibility of fabric thickness compensator 1300 as described above . Furthermore, the slits 1310 may partially divide the fabric thickness compensator 1300 into a plurality of portions 1312 which may separate from one another during an early stage of the absorption process. Slots 1312 can reduce the width of the fabric thickness compensator 1300 along the outer peripheries 1314 of the portions 1312, as illustrated in Figure 55. Such a reduction in width can lead to faster absorption along the outer peripheries 1314 of the portions 1312. , which can result in the fabric thickness compensator 1300 being reduced to separate portions 1312 during the initial stage of the absorption process.
[000246] With general reference to Figures 55A to 57, as described above, the staple cartridge channel 1050 may be configured to receive a staple cartridge 1060, for example, which may, in at least one embodiment, be securely retained. removable within the staple cartridge channel 1050. In various embodiments, the staple cartridge 1060 may comprise a cartridge body 1062, a cartridge holder 1064, and a fabric thickness compensator 1400, wherein, in at least one embodiment , as illustrated in Figure 55A, fabric thickness compensator 1400 may be removably positioned against or adjacent to cartridge holder 1064 and may comprise protrusions (not shown) as described above for snap-in engagement with recesses 1402.
[000247] Again with reference to Figures 55A through 57, the compensator 1400 may comprise a plurality of layers. For example, compensator 1400 may comprise a first layer 1400A and a second layer 1400B, which may be positioned over the first layer 1400A. Furthermore, an outer periphery 1418 of the second layer 1400B may be at least partially extended beyond the outer periphery 1420 of the first layer 1400A. Furthermore, the first layer 1400A and the second layer 1400B may comprise different degrees of hardness. For example, second layer 1400B can be configured to be more flexible than first layer 1400A. As illustrated in Figure 55B, such an arrangement may provide the fabric thickness compensator 1400 with a sufficiently rigid internal region, comprised of the first layer 1400A and the second layer 1400B, which may be suitable for providing support for the staples 1002, and a region flexible enough outer layer, comprised of the second layer 1400B, which may be suitable to provide sufficient flexibility to soften the impact on the T fabric, for example, during and/or after the capture of the T fabric and the fabric thickness compensator 1400 by the hairs clips 1002. Layers 1400A and 1400B may be joined, for example, by an adhesive. Other fastening means for securing the first layer 1400A to the second layer 1400B are contemplated within the scope of the current disclosure.
[000248] In addition to the above, again with reference to Figure 55A, the first layer 1400A may include an inner portion 1404 and an outer portion 1406 at least partially surrounding the inner portion 1404, with the outer portion 1406 being configured to be more flexible than the inner portion 1404. For example, as illustrated in Figure 55A, the outer portion 1404 may comprise a plurality of slots 1410, which, as described above, may increase the flexibility of the outer portion 1404. Furthermore, as described above, second layer 1400B can be configured to be more flexible than first layer 1400A. This arrangement can provide the fabric thickness compensator 1400 with three different stiffness regions that include a first inner region having the greatest stiffness, the inner region being comprised of the inner portion 1404 of the first layer 1400A and the second layer 1400B, a middle region having an intermediate stiffness, the middle region comprising the outer portion 1408 of the first layer 1400A and the second layer 1400B, and a third region having the lowest stiffness, the third region comprising only the second layer 1400B.
[000249] Referring now to Figures 56 and 57, the second layer 1400B of the fabric thickness compensator 1400 may comprise a fabric structure 1440, which may include a plurality of fibers 1442 that can be woven into the fabric structure 1440. A The fabric structure 1440 can provide the second layer 1400B with sufficient flexibility to cushion the impact on the T fabric, for example, during and/or after the capture of the T fabric and the fabric thickness compensator 1400 by staples 1002. outer periphery 1418 may be comprised of fibers 1042 which can provide an atraumatic surface for tissue contact to minimize impact on tissue T, as described above. The fabric structure 1440 and fibers 1042 may be comprised of biocompatible materials. Furthermore, the fabric structure 1040 and/or the fibers 1042 may be comprised of bioabsorbable materials such as PLLA, PGA, PCL and/or combinations thereof, for example.
[000250] Now referring to Figures 60 to 60B, as described in more detail below, a tissue thickness compensator 11050 may comprise a proximal end 11053 and a distal end 11055, with the proximal end 11053 and/or the 11055 may comprise one or more strain relief portions that may reduce the stiffness of the fabric thickness compensator 11050 and the stiffness of the fabric that is stapled. Distal end 11055 of fabric thickness compensator 11050 may comprise one or more slots 11058 defined therein. Slots 11058 may comprise cuts and/or notches, for example, defined in fabric thickness compensator 11050. Slots 11058 may define projections, or flaps, 11056 that may be configured to move and/or flex, at least partially , with respect to each other and/or the body portion of the fabric thickness compensator 11050. Stated another way, the slots 11058 can provide localized strain relief to the fabric thickness compensator 11050 and the underlying fabric. Under certain circumstances, tabs 11056 of a first fabric thickness compensator 11050 may be superimposed on a proximal end 11053 of a second fabric thickness compensator 11050. In various circumstances, slots 11058 may allow the first fabric thickness compensator to fabric 11050 and the second fabric thickness compensator revolve relative to each other. In certain circumstances, referring primarily to Figure 60B, the tabs 11056 of a first fabric thickness compensator 11050 may be superimposed on the tabs 11056 of a second fabric thickness compensator 11050. In various circumstances, the slits 11058 at the distal ends 11055 overlays can further reduce stiffness in the underlying tissue. While the illustrated embodiment of fabric thickness compensator 11050 comprises only an arrangement of tabs 11057 and slots 11058 at one end thereof, a fabric thickness compensator may comprise an arrangement of tabs 11056 and slots 11058 at both ends thereof , for example.
[000251] In certain embodiments, in addition to the above, each tab 11056 may comprise a tapered profile. For example, each flap 11056 may comprise a base attached to the fabric thickness compensator body 11050 which has a base width and a free end at its opposite end having an edge width, the base width may be wider. than the end width. In certain embodiments, the end width may be wider than the base width. Referring primarily to Figure 60B, an end 11055 may comprise a plurality of tabs 11056 having different configurations. For example, tabs 11056 can be of different lengths. As illustrated in Figure 60B , an endmost flap 11056a may have a first length, a second flap 11056b may have a second length that is longer than the first, a third flap 11056c may have a third length that is longer than the first. the second length, a fourth flap 11056d may have a fourth length that is longer than the third length, a fifth flap 11056e may have a fifth length that is longer than the fourth length, and a sixth flap 11056f may have a sixth length that is longer than the fifth length, for example. In such an embodiment, the flaps 11056 may become progressively shorter toward the distal end of the tissue thickness compensator 11050. In other embodiments, the lengths of the flaps 11056 may be arranged in any other suitable arrangement.
[000252] In various circumstances, in addition to the above, a layer may comprise edges that define the perimeter of the layer. These edges may be straight, substantially straight, linear and/or substantially linear under certain circumstances. In some of these circumstances, the edges of the layer can impact and/or otherwise affect the surrounding tissue. Also, in some circumstances the edges may be stiff and may rigidly support the fabric. In fact, certain portions of the fabric may not be supported by the layer adjacent to other portions of the fabric that are rigidly supported by the layer without transitioning between them. Referring to Figures 60 through 60B again, the perimeter of the fabric thickness compensator 11050 may include a contour configuration that may provide a region of transitional stiffness to the underlying fabric. The perimeter of the fabric thickness compensator 11050 may comprise a plurality of notches or recesses 11059 defined therein which may define the tabs 11057. Similar to the foregoing, the tabs 11057 may extend from the fabric thickness compensator body 11050 and can move in relation to it. Also similar to the above, each tab 11057 may comprise a base end attached to the fabric thickness compensator body 11050 and the free end which is movable with respect to the base end. In certain circumstances, the free end of a flap 11057 may have a width that is narrower than the width of the base end of the flap 11057, while, in other circumstances, the free end of a flap 11057 may have a width that is wider than the width of the base end of the flap 11057. The flaps 11057 may comprise any suitable configuration, such as a semicircular configuration or an at least partially arcuate configuration, for example. As a result of the above, the fabric underlying and/or attached to the body portion of the fabric thickness compensator 11050 may be rigidly supported by the body portion, the fabric underlying and/or attached to the tabs 11057 may be less than rigidly supported by flaps 11057, and fabric underlying flaps 11057, but not underlying flaps 11057, may be unsupported by fabric thickness compensator 11050.
[000253] Referring now to Figures 58 and 59, a staple cartridge assembly 11100 may comprise a cartridge body 11110 and a tissue thickness compensator 11150 secured to the cartridge body 11110. The cartridge assembly 11100 may additionally comprise a or more fasteners 11160 configured to releasably secure fabric thickness compensator 11150 to cartridge body 11110. In at least one instance, each fastener may comprise a strip extending around cartridge body 11110 and of the tissue thickness compensator 11150. In use, in addition to that described above, a triggering member 10030 may be advanced through the staple cartridge 11100 to make an incision in the tissue thickness compensator 11150, firing the staples at least partially stored in the cartridge body 11110 and separating fasteners 11160. Fabric thickness compensator 11150 may comprise an end and first, or proximal, 11157 and a second, or distal, end 11155. Distal end 11155 may comprise an elongated projection 11156 extending from a body portion 11153 of tissue thickness compensator 11150. As illustrated in Figure 58, the elongated projection 11156 may extend distally of the most distal attachment member 11160. At least in the illustrated embodiment, the cartridge body 11110 may comprise a holder 11113 within which the cartridge body's 11110 clip cavities may be defined. In various circumstances, the body 11153 of the fabric thickness compensator 11150 may be configured and arranged to cover the bracket 11113 and the clamp cavities defined in the cartridge body 11110. In at least some circumstances, as also illustrated in Figure 58 , elongated projection 11156 may extend distally from bracket 11113 and extend distally with respect to clip cavities defined in bracket 11113.
[000254] In use, in addition to the above, the fabric thickness compensator 11150 can be attached to the fabric and can provide fabric thickness compensator properties as described here. Similar to the above, the fabric underlying the fabric thickness compensator 11150 may be rigidly supported by the fabric thickness compensator 11150 and the clips securing the same, while the fabric surrounding the fabric thickness compensator 11150 may be unsupported by the compensator. fabric thickness 11150 and can be flexible. In such circumstances, the fabric between the flexible unsupported fabric and the rigidly supported fabric underlying the fabric thickness compensator 11150, i.e., the transitional fabric, can be subjected to an undesirable amount of tension. Such tension can negatively affect the transition tissue. For example, when a tissue thickness compensator is attached to lung tissue, or to the lungs, for example, the tissue immediately surrounding the perimeter of the tissue thickness compensator, i.e. the perimeter tissue, may tear under certain circumstances, especially the perimeter tissue adjacent and/or surrounding the distal end of the tissue thickness compensator, i.e. the perimeter tissue of the end. The distal projection 11156 of the fabric thickness compensator 11150, however, can support the fabric of the edge's perimeter. In other words, the distal projection 11156 can provide transitional support to the extremity perimeter tissue. Such transitional support may be less than the support provided by the body of the fabric thickness compensator 11150 and may mitigate the change in tension between the unsupported fabric and the fully supported fabric underlying the fabric thickness compensator 11150. In various circumstances, the distal projection 11156 can provide an enlarged area in which force can be transmitted between non-stapled tissue and stapled tissue. The distal projection 11156 can be configured to flex and move with the unsupported tissue and the tissue thickness compensator 11150. Under various circumstances, the distal projection 11156 can move relative to the body portion of the tissue thickness compensator 11150 and/or unsupported tissue.
[000255] The tissue thickness compensator, again with reference to Figures 58 and 59, may additionally comprise a notch 11157 defined at the proximal end 11153 thereof. The notch 11157 may be defined between two distally extending projections 11158. The notch 11157 may comprise any suitable shape, such as a parabolic shape, for example. Similar to the above, the distally extending projections 11158 can provide transitional support to the proximal end perimeter tissue. Such transitional support may be less than the support provided by the body of the 11150 fabric thickness compensator and may mitigate the change in tension between the unsupported fabric and the fully supported fabric underlying the 11150 fabric thickness compensator. proximal projections 11158 can provide an enlarged area in which force can be transmitted between non-stapled tissue and stapled tissue. The proximal projections 11158 can be configured to flex and move with the unsupported tissue and the tissue thickness compensator 11150. Under various circumstances, the proximal projections 11158 can move relative to the body portion of the tissue thickness compensator 11150 and/or unsupported tissue. Several alternative embodiments are envisaged, in which more than two projections extend from the proximal and/or distal end of a tissue thickness compensator.
[000256] As illustrated in Figure 59, two or more tissue thickness compensators 11150 may be deployed end-to-end along a path. In such circumstances, the distal end 11155 of a first tissue thickness compensator 11150 may overlap the proximal end 11153 of a second tissue thickness compensator 11150. Similarly, the distal end 11155 of the second tissue thickness compensator 11150 may overlap the proximal end 11153 of a third fabric thickness compensator 11150. In various circumstances, the distal projection 11156 of the first fabric thickness compensator 11150 may be aligned, or at least substantially aligned, with the recess 11157 of the second fabric thickness compensator 11150. tissue thickness 11150. Additionally, in various embodiments, distal projection 11156 and proximal recess 11558 may be configured so that they are substantially the same size and/or shape. In various circumstances, a distal projection 11156 may be configured to be positioned in a proximal recess 11157 of an adjacent tissue thickness compensator 11150.
[000257] In various embodiments, now referring to Figure 61, a staple cartridge assembly 16000 may comprise a cartridge body 16010 and a layer assembly 16020. The cartridge body 16010 may comprise a holder 16011 and a longitudinal slot 16012 defined in bracket 16011 which can be configured to slideably receive a cutting member 16030 therein. Cartridge body 16010 may further comprise a plurality of clip cavities defined therein which may each be configured to detachably store a clip therein. Clamp cavities can be part of two or more groups. For example, staple cavities can be divided into a first group of staple cavities 16015 and a second group of staple cavities 16016. In various circumstances, groups of staple cavities may be arranged in rows while in other circumstances, the groups of clamp cavities may overlap or be inter-dispersed with each other. In either event, layer assembly 16020 may comprise a plurality of layers that may extend over the clamp cavities. In use, as described in more detail below, the staples, when ejected from the staple cavities, can capture at least a portion of the layer assembly 16020 therein. The layers of the layer set 16020 can be configured so that only certain layers of the layer set 16020 extend over certain clamp cavities. For example, layer assembly 16020 can comprise a first layer 16050 that can extend over the first group of clip cavities 16015 and the second group of staple cavities 16016 and, in addition, a second layer 16040 that can extend over the second group of clamp cavities 16016 but may not extend over the first group of clamp cavities 16015.
[000258] In use, as a result of the above and referring primarily to Figure 62, certain staples installed from the staple cartridge 16000 can only capture the first layer 16050 of the layer set 16020 while other staples can only capture the second layer 16040 of layer set 16020. For example, one or more outer rows of staples 16061 can capture only the first layer 16050 while one or more inner rows of staples 16063 can capture both the first layer 16050 and the second layer 16040. In In various embodiments, one or more intermediate rows of staples 16062 may include some staples that capture only the first layer 16050 and other staples that capture both the first layer 16050 and the second layer 16040. In at least one embodiment, the second layer 16040 may comprise a plurality of tabs 16043 that can be configured to be captured on clips 16062 of the intermediate row. The flaps 16043 may be separated by slots 16044 which may allow the flaps 16043 to move and flex with respect to each other. For example, the arrangement of slots 16044 and flaps 16043 can introduce flexibility to the staple fabric. In certain embodiments, the tabs 16043 may be spaced far enough apart that some of the intermediate clips 16062 can capture a tab 16043 there while others cannot. Referring primarily to Figure 61 again, the second layer 16040 may include a longitudinal projection 16042 extending therefrom and which may be configured to extend to the longitudinal slot 16012 defined in the cartridge body 16010. In various circumstances, the longitudinal projection 16042 can be releasably secured in either longitudinal slot 16012. In at least one embodiment, longitudinal projection 16042 may fit securely in longitudinal slot 16012 by means of a snap engagement, for example. Either way, the engagement between the longitudinal slot 16012 and the longitudinal projection 16042 can maintain the alignment between the second layer 16040 and the cartridge body 16010. Furthermore, the first layer 16050 can be mounted on the second layer 16040 so that the projection 16042 can also hold the first layer 16050 in position.
[000259] In addition to the foregoing, the first layer 16050 of the set of layers 16020 may cover a first group of clip cavities, and the second layer 16040 may cover a second group of staple cavities. In other words, the first layer 16050 of the layer set 16020 may have a different projection area than the second layer 16040. In various embodiments, the first layer 16050 of the layer set 16020 and the second layer 16040 may be comprised of different materials. . In at least one such embodiment, the second layer 16040 may comprise a rigid material and may be configured to support the first layer 16050. The first layer 16050 may be comprised of a flexible material, or at least a material that is more flexible than than the material comprising the second layer 16050. Referring primarily to Figure 62, the first flexible layer 16050 may extend laterally beyond the second layer 16040. In such circumstances, the first layer 16050 may provide a more flexible side edge of the assembly of layers 16020. After layer assembly 16020 has been implanted against tissue T by staples and transected by cutting member 16030, referring primarily to Figure 62, second layer 16050 may support tissue T located adjacent to the transitional lineage while the first layer 16040 may extend laterally along the fabric T. In various circumstances, the first layer 16040 may provide a a flexible transition between the fabric T supported by the second layer 16050 and the fabric T not supported by the layer assembly 16020. In various circumstances, the first layer 16050 may comprise a fabric thickness compensator, and the second layer 16040 may comprise a material laminate, for example.
[000260] In several embodiments, referring primarily to Figure 61, the layer assembly 16020 may be attached to the cartridge body 16010. In at least one embodiment, the cartridge assembly 16000 may comprise at least one joint or connector, which may releasably secure the layer assembly 16020 to the cartridge body 16010. For example, the cartridge assembly 16000 may comprise a first connector releasably attaching a distal end 16021 of the layer assembly 16020 to the distal end of the cartridge body 16010, and a second connector that secures a proximal end 16022 of the layer assembly 16020 to a proximal end of the cartridge body 16010. As the firing member 16030 is advanced from the proximal end to the distal end of the cartridge body 16010 to deploy the clips therefrom and make an incision in the layer array 16020, the trigger member 16030 may also transect and/or otherwise overlap. air the connectors securing the 16020 layer assembly to the 16010 cartridge body.
[000261] Referring now to Figures 64 through 66, an end actuator assembly 5400 may include a first jaw, illustrated elsewhere, and a second jaw 5402. In various embodiments, the second jaw 5402 may include a cartridge body of fasteners 5450 and a layer of material 5458 releasably secured to the cartridge body of fasteners 5450 and/or the second jaw 5402. The cartridge body of fasteners 5450 and the layer of material 5458 releasably secured thereto may comprise a cartridge set of fasteners, for example. In various embodiments, the material layer 5458 may comprise a piece of buttress material and/or a fabric thickness compensator, for example. In certain embodiments, the layer of material 5458 may be a piece of buttress material releasably secured to the fastener cartridge body 5450, for example. The second jaw 5402 may have a proximal portion 5404 and a distal portion 5406. In various embodiments, the second jaw 5402 may have a proximal connector 5480a (Figures 65 and 66) on the proximal portion 5404 and a distal connector 5480b (Figure 66) on the distal portion 5406. Proximal connector 5480a and distal connector 5480b may secure layer of material 5458 relative to cartridge body 5450. Connectors 5480a, 5480b may comprise ribs and/or cords, for example.
[000262] Referring primarily to Figure 64, the cartridge body 5450 may include a support 5452. A slot 5456 may extend from the proximal portion 5404 toward the distal portion 5406 of the second jaw 5402, for example, and may be defined in a portion of the support 5452, for example. In various embodiments, fastener cavities 5454 may also be defined in bracket 5452. Additionally, second jaw 5402 may include fasteners, such as surgical staplers, for example, releasably positioned in fastener cavities 5454. For example, a fastener may be ejectably positioned in each fastener cavity 5454 of the cartridge body 5450. In various embodiments, the fasteners may be ejected from their respective fastener pockets 5454 by a slider 5434 (Figures 65 and 66) during a firing stroke.
[000263] Referring primarily to Figures 65 and 66, a trigger assembly 5430 may include a trigger bar 5432, a cutting edge 5436, and a base 5438. The cutting edge 5438 may cut the fabric and/or layer of material 5458, for example, and base 5438 can guide firing assembly 5430 along slot 5456 in cartridge body 5450 (Figure 64), for example. In various embodiments, the firing assembly 5430 may move along the slot 5456 in the cartridge body 5450 during a firing stroke. Firing assembly 5430 may engage slider 5434 in cartridge body 5430 and may drive slider 5434 at least partially through cartridge body 5450, for example. In certain embodiments, the slider 5434 may have a cam or ramp surface 5442, which can engage the drivers in the cavities of the fasteners 5454 during the firing stroke. When ramp 5442 engages a driver in a fastener cavity 5454, the ramp 5442 can cam with the driver and the corresponding fastener towards the cartridge holder 5452 and can eject the fastener from the fastener cavity 5454, for example. In certain embodiments, referring primarily to Figure 65, at the start of the trigger stroke, the trigger assembly 5430 may be positioned in a proximal portion 5404 of the second jaw 5402. In such embodiments, referring primarily to Figure 66, the 5432 firing bar can trigger the 5430 firing assembly distally during the firing stroke. In various embodiments, cutting edge 5436 can cut proximal connector 5480a and distal connector 5480b during the firing stroke. Cutting edge 5436 can cut proximal connector 5480a at or near the start of the trigger stroke, for example, and can cut distal connector 5480b at or near the end of the trigger stroke, for example.
[000264] Still referring to figures 76 and 66, the layer of material 5458 can be attached to the support 5452 of the cartridge body 5450 (Figure 64) by the proximal connector 5480a (Figure 65) and by the distal connector 5480b (Figures 65 and 66 ). In addition, material layer 5458 may include at least one bead 5460. Bezel 5460 may be integrally molded with material layer 5458, for example. In certain embodiments, when the layer of material 5458 is secured to the support 5452, the crimp 5460 may extend from the layer of material 5458 into the slot 5456 of the cartridge body 5450. Referring primarily to Figure 65, the crimp 5460 it may extend into the slot 5456 (Figure 64) between the proximal connector 5480a and the distal connector 5480b, for example. In other words, the bezel 5460 may extend from an intermediate portion 5468 of the layer of material 5458. In various embodiments, the bezel 5460 may be sized to fit into the slot 5456 when the layer of material 5458 is positioned on the support 5452 of the 5450 cartridge. In addition, the crimp 5460 may be sized for non-forced removal of the slot 5456 when the layer of material 5458 is lifted and/or peeled off the cartridge body 5458. For example, the crimp 5460 may not be frictionally engaged in slot 5456 and, in certain embodiments, when bead 5460 is positioned in slot 5456, a distance or gap may exist between bezel 5460 and slot 5456. The distance may be approximately 0.12 mm, for example. In certain embodiments, the distance may be up to approximately 0.24 mm, for example. In some embodiments, an interference of approximately 0.01 mm to approximately 0.12 mm may exist between the crimp 5460 and the slot 5456, for example, so that the crimp 5460 is compacted when positioned in the slot 5456, for example.
[000265] Still referring to figures 64 to 66, the engagement between the slot and the bezel can prevent and/or limit the lateral displacement and/or warping of the intermediate portion 5468 of the layer of material 5458. For example, when the assembly of the end actuator 5400 is positioned and/or moved relative to tissue at a surgical site, the bead 5460 may remain positioned within the slot 5456 (Figure 64) to secure the intermediate portion 5458 in position relative to the cartridge holder 5452. Some displacement in the material layer 5458 is possible due to the gap defined between the crimp 5460 and the slot 5456, for example. In various embodiments, the crimp 5460 may not resist lifting and/or peeling of the layer of material 5458 from the cartridge body 5450. For example, the crimp 5460 may not be frictionally engaged in the slot 5456, and the crimp 5460 may be easily removed from slot 5456 when material layer 5458 is lifted from support 5452 of cartridge body 5450, for example after cutting edge 5436 cuts proximal connector 5680a and distal connector 5680b. For example, while the trigger assembly 5430 is driven distally during the trigger stroke, an element of the trigger assembly 5430 may contact the crib 5460 in the slot 5456. Referring primarily to Figure 66, the slider 5434 may enter contact the 5460 bezel when the 5434 slide is driven distally by the 5430 trigger assembly. Additionally, the 5434 slide can flex the 5460 bezel out of the path of the slide and out of the slot 5456. In other words, the 5434 slide can flex bezel 5460 to remove bezel 5460 from slot 5456.
[000266] In various embodiments, the layer of material 5458 may include multiple cribs 5460, which may extend from the layer of material 5458 into the slot 5456 (Figure 64) in the cartridge body 5450. The cribs 5460 may be spaced along at least a portion of the length of slot 5456, for example. In certain embodiments, at least one bead 5460 may be positioned in the proximal portion 5404 of the second jaw 5402, and at least one bead 5460 may be positioned in the distal portion 5406 of the second jaw 5402. Additionally, the bezels 5460 may be in an intermediate position. between proximal and distal connectors 5480a, 5480b (Figure 65), for example. As the trigger assembly 5430 (Figures 65 and 66) is triggered distally during the trigger stroke, the slider 5434 may sequentially engage each crib 5460 in the slot 5456 to flex and remove each crib 5460 from the slot 5456. 5460 is released from slot 5456 and the proximal and distal connectors 5480a, 5480b are cut or otherwise overlapped, the layer of material 5458 may be released relative to the support 5452 of the cartridge body 5450.
[000267] Still referring to Figures 64 to 66, a crimp 5460 can include a flexible rod 5462 and a head 5464. The flexible rod 5462 of the crimp 5460 can flex when an element of the firing assembly 5430, such as the slider 5434, exerts pressure against the 5464 head during the firing stroke. In certain embodiments, head 5464 may be rounded and enlarged in size to minimize the distance between head 5464 and slot 5456 of cartridge body 5450. In various embodiments, head 5464 may fit slot 5456, and may be smooth and easily removed from slot 5456 when material layer 5458 is lifted and/or peeled off cartridge body 5450.
[000268] Referring now to Figures 67 through 70, an end actuator assembly 5500 may include a first jaw, illustrated elsewhere, and a second jaw 5502. In various embodiments, the second jaw 5502 may include the cartridge body 5450 and a layer of material 5558 releasably secured to the cartridge body 5450 and/or the second jaw. The cartridge body 5450 and the layer of material 5558 releasably secured thereto may comprise a cartridge assembly of fasteners, for example. In various embodiments, the material layer 5558 may comprise a piece of buttress material and/or a fabric thickness compensator, for example. In certain embodiments, the layer of material 5558 may be a piece of buttress material releasably secured to the cartridge body 5450. Additionally, the second jaw 5502 may have a proximal portion 5504 and a distal portion 5506. In various embodiments, the second jaw 5502 may have a proximal portion 5504 and a distal portion 5506. second jaw 5502 may have a proximal connector 5580a (Figures 68 and 69) at the proximal portion 5504 and a distal connector 5580b (Figure 68) at the distal portion 5506. The proximal connector 5580a and the distal connector 5580b may hold the layer of material 5558 in relative to cartridge body 5450. In various embodiments, the material layer 5558 may include a ridge 5560. The ridge 5560 may be integrally molded with the material layer 5558, for example. Referring primarily to Figure 67, the ridge 5560 may extend longitudinally along at least a portion of the length of the material layer 5558.
[000269] Referring mainly to Figure 69, when the layer of material 5558 is attached to the cartridge body 5460, the ridge 5560 may extend into the slot 5456 in the cartridge body 5450. The ridge 5560 may extend into the slot 5456 between the proximal connector 5580a and the distal connector 5580b, for example. In various embodiments, the crib 5560 can be sized to fit the slot 5456 when the layer of material 5558 is positioned on the cartridge body 5450. In addition, the ridge 5560 can be sized for unforced removal of the slot 5456 when the layer of material 5558 is lifted and/or detached from cartridge body 5458. For example, ridge 5560 may not be frictionally engaged in slot 5456, and in certain embodiments, when ridge 5560 is positioned in slot 5456, a distance or gap may exist between crest 5560 and slot 5456. The distance may be approximately 0.08 mm, for example. In certain embodiments, the distance may be up to approximately 0.24 mm, for example. In some embodiments, an interference of approximately 0.01 mm to approximately 0.06 mm may exist between crest 5560 and slot 5456, for example, so that crest 5560 is compacted when positioned in slot 5456, for example.
[000270] In various embodiments, the engagement between the crest and the slot can prevent and/or limit the displacement and/or lateral warping of the layer of material 5558 with respect to the support 5452 of the cartridge body 5450. For example, when the End actuator assembly 5500 is positioned and/or moved relative to tissue at a surgical site, crest 5560 may remain positioned in slot 5456 to hold material layer 5558 in position relative to cartridge holder 5452. Some displacement of layer of material 5558 in relation to the cartridge body 5450 is possible due to the gap defined between the ridge 5560 and the slot 5456, for example. In various embodiments, the ridge 5560 may not resist lifting and/or detachment of the layer of material 5558 from the cartridge body 5450. For example, the ridge 5560 may not be friction fit in the slot 5456, and the ridge 5560 may be smooth. and easily removed from slot 5456 when layer of material 5550 is lifted from support 5452 of cartridge body 5450, for example, after cutting edge 5436 cuts proximal connector 5680a and distal connector 5680b. In various embodiments, cutting edge 5436 of firing assembly 5430 can cut material layer 5558 as well as ridge 5560, for example, when cutting edge 5436 is driven distally during the firing stroke.
[000271] Referring primarily to Figures 68 through 70, the material layer 5558 may include a reinforcement feature 5570, which may extend along at least a portion of the length of the material layer 5558. The reinforcement feature 5570 can extend from a proximal portion 5504 of the second jaw 5502 towards the distal portion 5506 of the second jaw 5502, for example. Reinforcement feature 5570 can be integrally molded with material layer 5558, for example. In various embodiments, the reinforcing feature 5570 can increase the moment of inertia of the layer of material 5558 so that the reinforcing feature 5570 can reinforce, support and/or stiffen the layer of material 5558. For example, when the cutting edge 5436 (figures 65 and 66) passes through the 5558 material layer during the firing stroke, the 5570 reinforcement feature can prevent and/or limit the displacement and/or warping of the 5558 material layer relative to the 5450 cartridge body. Additionally , the bolster feature 5570 can engage the pinched tissue between the first jaw and the second jaw 5502 of the end actuator assembly 5500. In certain embodiments, the gusset feature 5570 can prevent and/or limit displacement of the pinched tissue relative to to the 5450 cartridge body, for example. In various embodiments, the material layer 5558 may include multiple reinforcement features 5570, which can extend along at least a portion of the length of the material layer 5558. The reinforcement features 5570 may be parallel, for example, and may extend on either or both sides of the 5560 ridge, for example. In various embodiments, the reinforcement feature 5570 and/or the ridge 5560 may extend along the length portion of the material layer 5558 and may be interrupted before reaching the distal portion thereof. The absence of the gusset 5570 and/or the ridge 5560 in the distal portion may provide flexibility to the distal portion of the 5558 material layer.
[000272] Now referring to Figure 71, a layer of material 5588 for use with an end actuator assembly may have a longitudinal crest 5590, similar to crest 5560, for example. In various embodiments, the layer of material 5588 and/or the crest 5590 can be a piece of buttress material and/or a fabric thickness compensator, for example. The ridge 5590 may extend along at least a portion of the length of the layer of material 5588. Additionally, the ridge 5590 may be received in the slot in the end actuator, like the slot 5456 in the cartridge body 5450 (Figure 67), for example. In certain embodiments, the ridge 5590 can provide sufficient reinforcement, support, and rigidity to the material layer 5588, without the addition of additional reinforcement features, for example.
[000273] Referring now to Figures 72 through 75, an end actuator assembly 5600 may include a first jaw, illustrated elsewhere, and a second jaw 5602. In various embodiments, the second jaw 5602 may include the cartridge body 5450 and a layer of material 5658 releasably attached to the cartridge body 5450 and/or the second jaw 5602. In various embodiments, the cartridge body 5450 and the layer of material 5458 releasably attached thereto may comprise a set of fastener cartridge, for example. The layer of material 5658 may comprise a piece of buttress material and/or a fabric thickness compensator, for example. In certain embodiments, the layer of material 5658 may be a piece of buttress material releasably secured to the cartridge body 5450, for example. Additionally, the second jaw 5602 may have a proximal portion 5604 and a distal portion 5606. In various embodiments, the second jaw 5602 may have a proximal connector 5680a (Figures 73 and 74) at the proximal portion 5604 and a distal connector 5680b (Figure 73). ) at distal portion 5606. Proximal connector 5680a and distal connector 5680b may secure layer of material 5658 with respect to cartridge body 5450. In various embodiments, layer of material 5658 may include a ridge 5660. Crest 5660 may be integrally molded with the 5658 material layer, for example. Referring primarily to Figure 72, ridge 5660 may extend longitudinally along at least a portion of the length of material layer 5658. In various embodiments, ridge 5660 may be a folded portion of material layer 5658. For example , the material layer 5658 may be crimped, creased, and/or folded over itself to form a thicker portion, which may be the ridge 5660. Referring primarily to Figures 74 and 75, the ridge 5660 may be folded into shape. of U, for example, and may include a rounded tip 5662.
[000274] Referring primarily to Figure 74, when the layer of material 5658 is attached to the cartridge body 5460, the ridge 5660 may extend into the slot 5456 in the cartridge body 5450. In certain embodiments, the slot 5456 may be structured to receive the ridge 5660. The ridge 5660 can be sized to fit the slot 5456 when the layer of material 5658 is positioned on the cartridge body 5450. In addition, the ridge 5660 can be sized for unforced removal of the slit 5456 when the layer of material 5658 is lifted and/or peeled from the cartridge body 5458. For example, the ridge 5660 may not be frictionally engaged in the slot 5456 and, in certain embodiments, when the ridge 5660 is positioned in the slot 5456, a distance or gap may exist between crest 5660 and slot 5456. The distance may be approximately 0.12 mm, for example. In certain embodiments, the distance may be up to approximately 0.24 mm, for example. In some embodiments, an interference of approximately 0.01 mm to approximately 0.18 mm may exist between crest 5660 and slot 5456, for example, so that crest 5660 is compacted when positioned in slot 5456, for example.
[000275] In various embodiments, the engagement between the crest and the slot can prevent and/or limit displacement and/or lateral warping of the 5658 material layer. For example, when the 5600 end actuator assembly is positioned and/or or moved relative to tissue at a surgical site, ridge 5660 may remain positioned in slot 5456 to hold material layer 5658 in position relative to cartridge holder 5452. Displacement of material layer 5658 relative to cartridge body 5450 can be limited by clearance. For example, some displacement of material layer 5658 is possible due to the gap defined between crest 5660 and slot 5456. In various embodiments, crest 5660 may not resist lifting and/or detachment of material layer 5658 from the cartridge body 5450. For example, the ridge 5660 may not be frictionally fitted to the slot 5456, and the ridge 5660 may be easily removed from the slot when the layer of material 5658 is lifted from the support 5452 of the cartridge body 5450, for example, after cutting edge 5436 cuts proximal connector 5680a and distal connector 5680b. In various embodiments, when firing assembly 5430 (figures 65 and 66) is fired along slot 5456 during a firing stroke, slider 5434 and/or other element of firing assembly 5430 can smoothly and easily release crest 5660 of slot 5456, for example, to release material layer 5658 from cartridge body 5450. Cutting edge 5436 of firing assembly 5430 can cut material layer 5658 as well as ridge 5660, for example, when the cutting edge 5436 is triggered distally during the firing stroke.
[000276] Referring primarily to Figures 73 through 75, the material layer 5658 may include a reinforcement feature 5670, which may extend along at least a portion of the length of the material layer 5658. The reinforcement feature 5670 can extend from the proximal end of the second jaw 5602 to the distal end of the second jaw 5602, for example. Reinforcement feature 5670 can be integrally molded with material layer 5658, for example. In various embodiments, reinforcement feature 5670 may be a folded portion of material layer 5658. For example, material layer 5658 may be creased, crimped, and/or folded over itself to form a thicker portion, which may form the 5670 reinforcement feature. Referring primarily to Figures 74 and 75, the 5670 reinforcement feature may be crimped in a V-shape and may include a pointed tip 5672, for example. In various embodiments, the reinforcement feature 5670 can reinforce, support and/or stiffen the layer of material 5658. In some embodiments, the reinforcement feature 5670 can be configured to flex along the tip 5672 thereof to resist applied lateral force along the edge of the material layer 5658 so that the material layer 5658 remains positioned on the cartridge body 5450. For example, when the cutting edge 5436 (Figures 65 and 66) passes through the material layer 5658 during the firing stroke , the reinforcing feature 5670 can prevent and/or limit the displacement and/or warping of the layer of material 5658 relative to the cartridge body 5450. Additionally, the reinforcing feature 5670 can engage the pinched fabric between the first jaw and the second jaw 5602 of the 5600 end actuator assembly. For example, the 5670 reinforcement feature can prevent and/or limit the displacement of the pinched tissue relative to the 5450 cartridge body. to engage the fabric and hold it in place with respect to the 5658 material layer during the firing stroke, for example. In various embodiments, the layer of material 5658 may include multiple reinforcement features 5670 that can extend along at least a portion of the length of the layer of material 5658. The reinforcement features 5670 may be parallel, for example, and may intersect. extend on either or both sides of the 5660 ridge, for example.
[000277] Referring now to Figures 76 and 77, an end actuator assembly 5700 may include a first jaw, illustrated elsewhere, and a second jaw 5702. In various embodiments, the second jaw 5702 may include a cartridge body 5750 and a layer of material 5758 releasably attached to the cartridge body 5750 and/or the second jaw 5702. In various embodiments, the cartridge body 5750 and the layer of material 5758 releasably attached thereto may comprise a set of fastener cartridge, for example. The layer of material 5758 may comprise a piece of buttress material and/or a fabric thickness compensator, for example. In certain embodiments, the layer of material 5758 may be a piece of buttress material releasably secured to the cartridge body 5750, for example. The second jaw 5702 may have a proximal portion 5704 and a distal portion 5706. In various embodiments, the second jaw 5702 may have a proximal connector 5780a (Figure 77) at the proximal portion 5704 and a distal connector 5780b (Figure 77) at the distal portion. 5706. Proximal connector 5780a and distal connector 5780b can secure layer of material 5758 relative to cartridge body 5750.
[000278] Referring to Figure 76, the cartridge body 5750 may include a support 5752. A slot 5756 may extend from the proximal portion 5704 toward the distal portion 5706 of the second jaw 5702, for example, and may be defined in a support portion 5752, for example. In various embodiments, fastener cavities 5754 may be defined in bracket 5752. Second jaw 5702 may also include fasteners such as surgical staplers detachably positioned in fastener cavities 5754. For example, a fastener may be ejectably positioned in each fastener cavity 5754 of the cartridge body 5750. In various embodiments, the fasteners may be ejected from their respective fastener cavities 5754 in the cartridge body 5750 by a slider, similar to slider 5434 (Figures 65 and 66) during a strike. shot.
[000279] Still referring to figures 76 and 77, a firing assembly, such as the firing assembly 5430 (figures 65 and 66), can move along the slot 5756 in the cartridge body 5750 during the firing stroke. As previously described, the firing assembly 5430 may include a firing bar 5432, a cutting edge 5436, and a base 5438 (Figures 65 and 66), for example. In various embodiments, the firing assembly 5430 may engage the slider in the cartridge body 5730 and may direct the slider at least partially through the cartridge body 5750 during the firing stroke. In certain embodiments, the slider may have a cam or ramp surface, which may engage the drivers in the fastener cavities 5754 during the firing stroke. When the ramp engages a driver in a fastener cavity 5754, the ramp can cam with the driver and corresponding fastener towards the cartridge holder 5752 and can eject the fastener from the fastener cavity 5754, for example. In various embodiments, cutting edge 5436 can cut proximal connector 5780a and distal connector 5780b (Figure 77) during the firing stroke. Cutting edge 5436 can cut proximal connector 5780a at or near the start of the trigger stroke, for example, and can cut distal connector 5780b at or near the end of the trigger stroke, for example.
[000280] Still referring to Figures 76 and 77, the layer of material 5758 can be releasably secured to the support 5752 of the cartridge body 5750 by the proximal connector 5780a and the distal connector 5780b (Figure 77). In various embodiments, cartridge body 5750 may include at least one notch 5748a (Figure 76), which may be defined in holder 5752, for example. Notch 5748a may be positioned between proximal connector 5780a and distal connector 5780b, for example. Additionally, in various embodiments, material layer 5758 may include a crimp 5760a (Figure 76), which may be integrally molded with material layer 5758, for example. In certain embodiments, when the layer of material 5758 is secured to the holder 5752, the bead 5760a may extend from the layer of material 5758 into the groove 5748a of the cartridge body 5750. The bead 5760a may remain positioned in the groove 5748a to secure the layer of material 5758 relative to the support 5752 of the cartridge body 5750. The bezel 5760a is sized to fit the notch 5748a when the layer of material 5758 is positioned on the cartridge body 5750. In addition, the bezel 5760a is sized for non-forced removal of the notch 5748a when the layer of material 5758 is lifted and/or detached from the cartridge body 5758. For example, the crimp 5760 may not be frictionally engaged in the notch 5748a and, in certain embodiments, when the crimp 5760a is positioned in the notch 5748a, a distance or gap may exist between the notch 5760a and the notch 5748a. The distance can be approximately 0.08 mm, for example. In certain embodiments, the distance may be up to approximately 0.24 mm, for example. In some embodiments, an interference of approximately 0.01 mm to approximately 0.06 mm may exist between the notch 5760a and the notch 5748a, for example, so that the notch 5760a is compacted when positioned in the notch 5748, for example.
[000281] In various embodiments, the engagement between the notch and the notch can prevent and/or limit displacement and/or lateral warping of the 5758 material layer relative to the 5750 cartridge body. For example, when the actuator assembly 5700 is positioned and/or moved relative to tissue at a surgical site and/or when cutting edge 5436 (Figures 65 and 66) cuts material layer 5758, bead 5760a may remain positioned in notch 5748a to secure the layer of material 5758 in position with respect to cartridge holder 5752. In certain embodiments, displacement of layer of material 5758 with respect to cartridge body 5750 may be limited by the clearance defined between crimp 5760a and notch 5748a. For example, some displacement of the 5758 material layer is possible due to the gap. Additionally, after cutting edge 5436 cuts proximal connector 5780a and distal connector 5780b, crimp 5760a may smoothly disengage and/or be removed from notch 5748a while material layer 5758 is lifted and/or detached from cartridge body 5750.
[000282] Referring primarily to Figure 76 , cartridge body 5750 may include at least a pair of notches 5748a, 5748b, and material layer 5758 may include a pair of notches 5760a, 5760b. The first notch 5748a can be positioned on a first longitudinal side of the cartridge body 5750, for example, and the second notch 5748b can be positioned on a second longitudinal side of the cartridge body 5750, for example. In other words, each notch of the pair of notches 5748a, 5748b may be positioned on opposite sides of the slot 5756 in the cartridge body 5750. In certain embodiments, the second notch 5748b may be a mirror image reflection of the first notch 5748a by the slit. 5756, for example. Additionally, when the layer of material 5758 is attached to the cartridge body 5750, each notch of the pair of notches 5760a, 5760b may be aligned with a notch of the pair of notches 5748a, 5748b so that the first notch 5760a extends into the interior of the first notch 5748b and the second notch 5760b extends into the second notch 5748b In various embodiments, the pair of notches 5748a, 5748b on cartridge body 5750 may be positioned at the perimeter of cartridge body 5750. Additionally, in certain In embodiments, the pair of crimps 5760a, 5760b may be positioned on the perimeter of the material layer 5758.
[000283] In various embodiments, the engagement between the notch and the notch on both sides of the 5750 cartridge body can further prevent and/or limit displacement and/or lateral warping on both longitudinal sides of the 5758 material layer. For example, when the cutting edge 5436 of the firing assembly 5430 (Figures 65 and 66) cuts the layer of material 5758, the pair of notches 5760a, 5760b may remain positioned in the pair of notches 5748a, 5748b to maintain the perimeter of the layer of material. 5758 in position with respect to the perimeter of the cartridge holder 5752. In other words, the pair of notches 5760a, 5760b can prevent at least a portion of the layer of material 5758 from sliding laterally relative to the cartridge holder 5752. layer of material 5758 is lifted and/or peeled off from cartridge body 5750, for example, after cutting edge 5436 cuts proximal and distal connectors, pair of cribs 5760a, 5760b can be smoothly and easily removed from the pair of notches 5748a, 5748b. In various embodiments, the material layer 5758 may include multiple pairs of notches 5760a, 5860b and the cartridge body 5750 may include multiple pairs of notches 5748a, 5748b. When the layer of material 5758 is attached to the cartridge body 5750, each pair of notches 5760a, 5760b of the layer of material 5758 can be aligned with the pair of notches 5748, for example. In such embodiments, engagement between the bezel and the notch along a length of the perimeter of the lower jaw 5702 may further prevent and/or limit displacement and/or lateral warping of a length of material layer 5758 relative to the body. cartridge 5750.
[000284] Referring now to Figures 78 through 80, an end actuator assembly 5800 may include a first jaw, illustrated elsewhere, and a second jaw 5802. In various embodiments, the second jaw 5802 may include a cartridge body 5850 and a layer of material 5858 releasably attached to the cartridge body 5850 and/or the second jaw 5802. In various embodiments, the cartridge body 5850 and the layer of material 5858 releasably attached thereto may comprise a set of fastener cartridge, for example. The layer of material 5858 may comprise a piece of buttress material and/or a fabric thickness compensator, for example. In certain embodiments, the layer of material 5858 may be a piece of buttress material releasably secured to the cartridge body 5850, for example. The second jaw 5802 may have a proximal portion 5804 and a distal portion 5806. In various embodiments, the second jaw 5802 may have a proximal connector, similar to the proximal connector 5780a (Figure 77), at the proximal portion 5804 and a distal connector, similar to to the distal connector 5880b (Figure 77), at the distal portion 5406. The proximal connector and the distal connector can hold the layer of material 5858 relative to the cartridge body 5850.
[000285] Referring primarily to Figure 78, the cartridge body 5850 may include a holder 5852. A slot 5856 may extend from the proximal portion 5804 toward the distal portion 5806 of the second jaw 5802, for example, and may be defined on a portion of the 5852 bracket, for example. In various embodiments, fastener cavities 5854 may be defined in holder 5852. The second jaw 5802 may also include fasteners, such as surgical staplers removably positioned in fastener cavities 5854. For example, a fastener may be ejectably positioned in each fastener cavity 5854 of cartridge body 5850. In various embodiments, fasteners may be ejected from their respective fastener cavities 5854 in cartridge body 5850 by a slider, similar to slider 5434 (Figures 65 and 66) during a firing stroke. .
[000286] A firing assembly, such as the firing assembly 5430 (figures 65 and 66), can move along the slot 5856 in the cartridge body 5850 during the firing stroke. The firing assembly 5430 may include a firing bar 5432, a cutting edge 5436 and a base 5438, for example. In various embodiments, the firing assembly 5430 may engage the slider in the cartridge body 5850 and may direct the slider at least partially through the cartridge body 5850 during the firing stroke. In certain embodiments, the slider may have a cam or ramp surface, which can engage the drivers in the fastener cavities 5854 during the firing stroke. When the ramp engages a driver in a fastener cavity 5854, the ramp can cam with the driver and corresponding fastener towards the cartridge holder 5852 and can eject the fastener from the fastener cavity 5854, for example. In various embodiments, the 5436 cutting edge can cut the proximal and distal connectors during the trigger stroke. The 5436 cutting edge can cut the proximal connector at or near the start of the trigger stroke, for example, and can cut the distal connector at or near the end of the trigger stroke, for example.
[000287] Still referring to figures 78 to 80, cartridge body 5850 may include at least one notch 5848, which may be defined in holder 5852 (Figure 78), for example. The 5848 notch can be positioned between the proximal connector and the distal connector, for example. Additionally, in various embodiments, the material layer 5858 may include a pair of crimps 5860a, 5860b. The pair of crimps 5860a, 5860b may be integrally molded with the material layer 5858, for example. In certain embodiments, when the layer of material 5858 is secured to the support 5852, the pair of notches 5860a, 5860b may extend from the layer of material 5858 into the recess 5848 of the cartridge body 5850. The pair of notches 5860a, 5860b may be positioned in notch 5848 to secure layer of material 5858 with respect to support 5852 of cartridge body 5850. In various embodiments, pair of recesses 5860a, 5860b may be sized to fit slot 5848 when layer of material 5858 is positioned on cartridge body 5850. Additionally, the pair of recesses 5860a, 5860b may be sized for non-forced removal of notch 5848 when material layer 5858 is lifted and/or peeled off cartridge body 5858. In certain embodiments, when a pair of notch 5860a, 5860b is positioned in notch 5848, a distance or gap may exist between each notch 5860a, 5860b and notch 5848. The distance may be approximately 0.12 mm, for example . In certain embodiments, the distance may be up to approximately 0.24 mm, for example. In some embodiments, an interference of approximately 0.01 mm to approximately 0.18 mm may exist between each notch 5860a, 5860b and the notch 5848, for example, so that each notch 5860a, 5860b is compacted when positioned in the notch 5848, for example.
[000288] In several embodiments, the engagement between the bezel and the notch can prevent and/or limit the displacement and/or lateral warping of the layer of material 5858. For example, when the cutting edge 5436 (figures 65 and 66) cuts the layer of material 5858, the pair of grooves 5860a, 5860b may remain positioned in the notch 5848 to hold the layer of material 5858 in position with respect to the cartridge holder 5852. The displacement of the layer of material 5858 relative to the cartridge body 5850 may be limited by the clearance defined between each crimp 5860a, 5860b and the notch 5848, for example. For example, some displacement of the 5858 material layer is possible due to the gap. In various embodiments, the cribs 5860a, 5860b may not resist lifting and/or detachment of the layer of material 5858 from the cartridge body 5850. For example, the cribs 5860a, 5860b may not be frictionally engaged in the notch 5848, and the cribs 5860a, 5860b can be smoothly and easily removed from the notch 5848 when the layer of material is lifted from the cartridge body holder 5850, for example after the cutting edge 5436 cuts the proximal and distal connectors.
[000289] Referring primarily to Figure 78, notch 5848 may extend from slot 5856 in cartridge body 5850 and may intersect slot 5856, for example. In such embodiments, when the pair of bezels 5860a, 5860b extend into the groove 5848, the bezel 5860a may be positioned on a first side of the slot 5856 and the bezel 5860b may be positioned on a second side of the slot 5856, for example. In certain embodiments, the bezel 5860b may be a mirror image reflection of the bezel 5860b by the slot 5856, for example. Also, referring primarily to Figure 79, the pair of cribs 5860a, 5860b may not overlap the slot 5856, for example. In such embodiments, the cutting edge 5436 of the firing assembly 5430 (Figs. 65 and 66) can transection the layer of material 5858 during the firing stroke without cutting the bezels 5860a, 5860b, for example. In other words, the trigger assembly 5430 can pass between the pair of sockets 5860a, 5860b during the trigger stroke. In such embodiments, the engagement between the crimp and the notch on either side of the slot 5856 may additionally prevent and/or limit displacement and/or lateral warping of both longitudinal sides of the material layer 5858, for example. Referring primarily to Figure 78 , cartridge body 5850 may include multiple notches 5848 spaced along the length portion of cartridge body 5850. Additionally, material layer 5858 may include multiple pairs of crimps 5860a, 5860b. When material layer 5858 is secured to cartridge body 5850, pairs of crimps 5860a, 5860b of material layer 5758 may be aligned with notches 5748, for example. In such embodiments, engagement between the crimp and the notch along a portion of the length of the lower jaw 5802 may further prevent and/or limit displacement and/or lateral warping of a length of material layer 5858.
[000290] Now referring to Figures 80A and 80B, a layer of material 5958 for use with an end actuator may have a perimeter 5970 that defines the edge of the layer of material 5958. In various embodiments, the layer of material 5958 may be a piece of buttress material or a fabric thickness compensator, for example. Additionally, perimeter 5970 may include contours 5974 and indentations 5972. In various embodiments, an indentation 5972 may be at an intermediate position between each contour 5974 to form a scalloped edge along at least a portion of the perimeter 5970. In some embodiments, the perimeter can be a clipped perimeter. In certain embodiments, a portion of the perimeter 5970 can be a scalloped perimeter and a portion of the perimeter can be an uncropped perimeter. The scalloped edge of the perimeter 5970 can prevent and/or limit abrasions and/or other injuries to the tissue that contacts the perimeter 5970 while the layer of material 5958 is positioned relative to the surgical site.
[000291] Still referring to Figures 80A and 80B, the material layer 5958 may include an upper surface 5962 (Figure 80A) and a lower surface 5966 (Figure 80B). The top surface 5962 may be positioned relative to the first jaw or anvil of an end actuator, for example, and the bottom surface 5966 may be positioned relative to the second jaw or fastener cartridge of the end actuator, for example. In various embodiments, the layer of material 5958 may include a proximal portion 5904 and a distal portion 5906. In certain embodiments, the layer of material 5958 may include a bead 5960, 5964 extending from the top surface 5962 and/or of the bottom surface 5966 thereof. In various embodiments, the crimp 5960, 5964 may be positioned in an indentation or notch in the end actuator 5902, such as a notch in the cartridge body and/or anvil. In certain embodiments, the crimp 5960, 5964 may support, reinforce and/or stiffen the material layer 5958. For example, when the cutting edge 5436 (Figures 65 and 66) passes through the material layer 5958 during a firing stroke, the crimp 5960 can prevent and/or limit displacement and/or warping of material layer 5958 relative to the cartridge body. Additionally, one of the cribs 5960, 5964 may engage the fabric clamped between the first jaw and the second jaw of the end actuator 5902, for example. In such embodiments, the crimp 5960, 5964 can prevent and/or limit displacement of the pinched tissue relative to the cartridge body, for example. Referring primarily to Figure 80A, bezel 5960 may be at distal portion 5906 of material layer 5958. Bezel 5960 may include multiple projections or buttons extending from top surface 5962, for example. In various embodiments, the buttons on the 5960 bezel can be arranged in a triangle, for example. Referring primarily to Figure 80B, the bezel 5964 may extend into the bottom surface 5966 of the material layer 5958, for example. The crimp 5964 may be in the distal portion 5906 of the material layer 5958, and may be V-shaped, for example.
[000292] Referring now to Figures 81 through 84, an end actuator assembly 5000 may include a first jaw, illustrated elsewhere, and a second jaw 5002. In various embodiments, the second jaw 5002 may include a cartridge assembly. of fasteners comprising a fastener cartridge body 5050 and a layer of material 5058 releasably secured to the fastener cartridge body 5050. In various embodiments, the material layer 5058 may comprise a fabric thickness compensator and/or a piece of buttress material. For example, the layer of material 5058 may be a piece of buttress material releasably secured to the fastener cartridge body 5050. Referring primarily to Figure 81, the fastener cartridge body 5050 may have defined fastener cavities 5054. the same. Additionally, the second jaw 5002 and/or cartridge body of fasteners 5050 may include fasteners, such as surgical staplers, for example, that can be removably positioned in fastener cavities 5054. For example, a fastener may be positioned releasably. ejectable into each fastener cavity 5054 of cartridge body 5050. In certain embodiments, cartridge body 5050 may include a slot 5056, which may extend from a proximal portion 5004 of the second jaw 5002 toward a distal portion 5006 of the second jaw 5002. In various embodiments, a firing assembly 5030 can translate along slot 5056 of cartridge body 5050. For example, firing assembly 5030 can translate into slot 5056 during a firing stroke and can eject the fasteners of the 5054 fastener cavities during the firing stroke.
[000293] Still referring to figures 81 to 84, the firing assembly 5030 can include a firing bar, a cutting edge 5036 (figures 81 and 82), a cross bar 5038 (figures 81 and 82), a nose 5040 ( Figure 81) and a base 5034. Cutting edge 5036 can cut fabric and/or cut material layer 5058 as firing assembly 5030 is fired through second jaw 5002 during a firing stroke. Crossbar 5038 may engage the first jaw, as a slot in the anvil thereof, to secure the first jaw with respect to the cartridge body 5050, and the base 5034 may engage the second jaw 5002, such as the slot 5056 (Figure 81). in the cartridge body 5050, to secure the firing assembly 5030 in relation to the cartridge body 5050, for example. In various embodiments, the firing assembly 5030 may engage a slider in the cartridge body 5050 during the firing stroke. An element of the firing assembly 5030, such as the nose 5040, for example, may engage the slider and drive the slider distally during the firing stroke to eject fasteners from fastener cavities 5054, for example.
[000294] Referring primarily to Figure 81, the material layer 5058 may be releasably secured to the cartridge body 5050 by at least one connector. In certain embodiments, multiple connectors may secure the layer of material 5058 to the cartridge body 5050. For example, a proximal connector may secure a layer of material 5058 to the cartridge body 5050 at the proximal portion 5004 of the second jaw 5002, and a distal connector 5080 may secure the layer of material 5058 to the cartridge body 5050 at the distal portion 5006 of the second jaw 5002. In various embodiments, a bead 5064 may extend from the layer of material 5058 into the distal portion of the second jaw 5002. The distal connector 5080 can extend or encircle at least part of the second jaw 5002 and/or the cartridge body 5050, as well as the crimp 5064 for securing the layer of material 5058 to the cartridge body 5050, for example. In certain embodiments, additional connectors may secure the layer of material 5058 to the cartridge body 5050. In such embodiments, the additional connectors may be spaced along at least a portion of the length of the cartridge body 5050 and may be positioned between the connector proximal and distal connector 5080, for example. In various embodiments, a connector may be a band, a joint and/or a suture, and may include braided and/or interwoven fibers, for example. The end of a severed and/or detached connector may be sharp, for example, and may puncture and/or lacerate adjacent tissue while the surgeon removes the end actuator assembly from the patient's tissue. However, the end of a twisted connector may be less sharp than the end of a non-twisted connector. For example, the cut end of a braided connector can fray, which can result in a less sharp end. With braided connectors, tissue puncture and/or tearing by the severed and/or severed connector end can be reduced and/or substantially eliminated. In various embodiments, a braided connector may have at least substantially the same grip tensile strength as a non-braided connector, for example. Additionally, in certain embodiments, when cut and/or separated, a braided connector may have substantially less compressive strength than a non-braided connector, for example.
[000295] Still referring primarily to Figure 81, the distal connector 5080 can clamp the material layer 5058 with respect to the cartridge body 5050. The material layer 5058 can be released from the cartridge body 5050 when the distal connector 5080, as well as any additional connector, is torn, cut, dislocated or otherwise overcome. In certain embodiments, the trigger assembly 5030 may overtake the distal connector 5080 as the trigger assembly 5030 translates along the slot 5056 in the fastener cartridge 5050 during a trigger stroke. For example, during the firing stroke, the firing assembly 5030 can cut the pinched tissue between the first claw and the second claw 5002, and can also move the fasteners from fastener cavities 5054 into the pinched fabric and the layer of material 5058. In various embodiments, the trigger assembly 5030 can propel the slider distally during the trigger stroke. The slider may have a cam or ramp surface, for example, that can engage the drivers in the cavities of fasteners 5054. When the ramp engages a driver, the ramp can propel the driver toward the layer of material 5058 to eject the fastener from the slider. fastener cavity 5054. Additionally, trigger assembly 5030 can cut material layer 5058 and/or distal connector 5080 during the trigger stroke.
[000296] Still referring to Figures 81 to 84, in various embodiments, the second jaw 5002 can overcome the connector or connectors, such as, or including, the distal connector 5080, at or near the start of the firing stroke. In other words, an element of the second jaw 5002 may overtake the distal connector 5080 at or near the start of the trigger stroke. The second jaw 5002 and/or cartridge assembly of fasteners may include an actuator 5010, for example, that can override the distal connector 5080 before the fasteners are ejected from the fastener cavities 5054. The actuator 5010 may overcome the distal connector 5080 , and the layer of material 5058 can be released from the cartridge body 5050 even when the firing stroke is prematurely stopped, i.e., before the firing assembly 5030 reaches the distal portion 5006 of the second jaw 5002, for example. In various embodiments, actuator 5010 can include a bottom side 5016, side walls 5018, and/or edges 5026. Side walls 5018 can extend from the bottom side 5016 and around at least a portion of the cartridge body. 5050. Edges 5026 may extend from side walls 5018 and around at least a portion of cartridge body 5050. In various embodiments, edges 5026 may extend into slots 5052 in cartridge body 5050, for example. Bottom side 5016, side walls 5018 and/or edges 5026 may extend beyond and/or around cartridge body 5050 and fasteners positioned in fastener cavities 5054 thereof. Additionally, the actuator 5010 can be movably secured with respect to the cartridge body 5050. For example, the actuator 5010 can move from a pre-actuated position (Figure 81) to a actuated position (Figure 82). In certain embodiments, edges 5026 of actuator 5010 may slide into slots 5052 in cartridge body 5050 as actuator 5010 moves relative to cartridge body 5050. When actuator 5010 moves relative to cartridge body 5050, actuator 5010 can slide relative to fasteners positioned in fastener cavities 5054 of cartridge body 5050. For example, actuator 5010 can slide past and/or around fasteners positioned in cartridge body 5050.
[000297] Referring primarily to Figures 81 to 84, the actuator 5010 may include a slot 5012, which may extend from the proximal portion 5004 toward the distal portion 5006 of the second jaw 5002 when the actuator 5010 is positioned relative to to cartridge body 5050. Slot 5012 on actuator 5010 may match and/or be aligned with slot 5056 (Figure 81) on cartridge body 5050, for example. Additionally, the trigger assembly 5030 can translate within the slot 5012 in the actuator 5010 as the trigger assembly 5030 translates within the slot 5056 in the cartridge body 5050 during the trigger stroke. In various embodiments, the trigger assembly 5030 may engage the actuator 5010 to move the actuator 5010 distally when the trigger assembly 5030 is at or near the beginning of the trigger stroke. In such embodiments, the trigger assembly 5030 may activate the actuator 5010 at the proximal portion 5004 of the second jaw 5002. When the actuator 5010 is activated and moves distally, a distal end of the actuator 5010 may cut, or otherwise overcome, the 5080 distal connector, for example. In other words, proximal actuation of actuator 5010 can effect distal release of material layer 5058 from cartridge body 5050. In various embodiments, actuator 5010 may merely displace distally to overcome distal connector 5080. In at least one embodiment , the 5010 actuator can travel approximately 1.0 mm before overcoming the 5080 distal connector. In certain embodiments, the 5010 actuator may travel approximately 0.5 mm to 5.0 mm before overcoming the 5180 distal connector.
[000298] Referring primarily to figures 81 and 82, the 5010 actuator can move from the pre-activated position (Figure 81) to the activated position (Figure 82) when the 5030 trigger assembly moves between a non-triggered and a partially fired position during part of the firing stroke. In various embodiments, slot 5012 in actuator 5010 may include a release lock 5014. Release lock 5014 may include a frangible bridge crossing slot 5012, for example. Referring primarily to Figure 82, an element of the trigger assembly 5030 can exert pressure against the release lock 5014 as the trigger assembly 5030 translates along the slot 5056 (Figure 81) during the trigger stroke. The trigger assembly 5030 can exert pressure against the release lock 5014 at or near the beginning of the trigger stroke, for example. In certain embodiments, the release lock 5014 may be near the proximal end of the slot 5012, and an element of the trigger assembly 5030, such as the nose 5040, may be in a boundary position with respect to the release lock 5014 at the start of the kick-off. shot. When nose 5040 is positioned against release lock 5014, nose 5040 can exert pressure against actuator 5010 and move actuator 5010 distally. In certain embodiments, with reference primarily to Figure 82, actuator 5010 may be moved distally to reach a rigid lock 5060, for example. Rigid lock 5060 may be on distal portion 5006 of second jaw 5002, and may prevent further distal movement of actuator 5010, for example. In various embodiments, the actuator 5010 may be in a boundary position with respect to the rigid lock 5060 before the trigger assembly 5030 ejects the fasteners from the fastener cavities 5054. In certain embodiments, the actuator may be in a boundary position with respect to the rigid lock. 5060 while firing assembly 5030 ejects at least one fastener from fastener cavity 5054 and/or after firing assembly 5030 ejects at least one fastener from fastener cavity 5054.
[000299] Still referring to Figure 82, when actuator 5010 is driven distally by trigger assembly 5030, actuator 5010 may cut through, or otherwise overcome, distal connector 5080 to release material layer 5058 from the cartridge body 5050 in the distal portion 5006 of the second jaw 5002. In certain embodiments, the actuator 5010 may include a notch 5024 for receiving and securing the distal connector 5080. The notch 5024 may secure the distal connector 5080 as the actuator 5010 moves distally toward the rigid lock 5060. Additionally, actuator 5010 may include a cutting edge 5020, for example, along a portion of notch 5024. In certain embodiments, when actuator 5010 moves toward rigid lock 5060, distal connector 5080 may be driven between the rigid lock 5060 and the cutting edge 5020 of the 5010 actuator. In various embodiments, the cutting edge 5020 can cut the distal connector 5080 when the cutting edge 5020 is driven 5060. In such embodiments, the distal connector 5080 may be cut by the cutting edge 5020 of the actuator 5010 at or near the beginning of the trigger stroke and before the fasteners are fired from the fastener cavities 5054. In various embodiments, the 5010 actuator can outperform the 5080 distal connector without cutting it. For example, actuator 5010 may displace or extend distal connector 5080 out of position so that distal connector 5080 no longer holds material layer 5058 relative to cartridge body 5050. In various embodiments, distal movement of the actuator 5010 can overcome or unlock a constraint, such as a cam lock, that locks and/or tensions the distal connector 5080 around the layer of material 5058. For example, with reference to Figure 30, a constraint 694 can be positioned in the lower jaw 680 and, for example, may be positioned between barrel 680a and cartridge body 682. In various embodiments, constraint 694 may be used when mounting the end actuator, and connector S3 may be connected thereto. When constraint 694 is pushed and held in place, constraint 694 can tension connector S3 around layer B2 and can be adjustablely positioned to adjust the compressibility of connector S3 around layer B2. In various embodiments, referring again to Figure 82, actuator 5010 may unlock a constraint, such as constraint 694 (Figure 30), for example. The 5010 actuator can cam with the restraint so that the restraint loosens and/or releases the 5080 Distal Connector.
[000300] In various embodiments, additional connectors along the length of the 5050 cartridge body may be cut, or otherwise overcome, by the 5010 actuator at or near the start of the firing stroke. For example, a proximal cutting edge on actuator 5010 can cut an additional proximal connector and/or an intermediate cutting edge on actuator 5010 can cut an additional immediate connector. The various cutting edges and/or portions of the 5010 actuator may cut, or otherwise overcome, each of the connectors at the beginning of, and/or close to, the triggering stroke. In addition or alternatively, the cutting edge 5036 of the firing assembly 5030 may cut, or otherwise overcome, the additional connectors. For example, the cutting edge 5036 of the trigger assembly 5030 can cut a connector at the proximal portion 5004 of the second jaw 5002 and the cutting edge 5020 of the actuator 5010 can cut the distal connector 5080 before the fasteners are ejected from the fastener cavities 5054 of the cartridge body 5050. In certain embodiments, actuator 5010 may overtake distal connector 5080 while at least one fastener is ejected from fastener cavity 5054 and/or after at least one fastener is ejected from fastener cavity 5054.
[000301] Referring mainly to figures 83 and 84, when the actuator 5010 is blocked from further distal movement by the rigid block 5060, the trigger assembly 5030 can slide the release block 5014 into the slot 5012 of the actuator 5010. For example, the nose 5040 of the trigger assembly 5030 may break the frangible bridge of the release lock 5014 to continue to move distally along the slot 5012 during the trigger stroke. The frangible bridge can be rigid enough to withstand the force of the 5030 trigger assembly as the 5010 actuator moves distally toward the 5060 rigid lock, and can be frangible enough to break when the 5010 actuator reaches the 5060 rigid lock without requiring force overload of an engine and/or an operator. The 5010 actuator and/or frangible bridge thereof may comprise stainless steel, titanium, liquid crystal polymer (LCP) aluminum, nylon and/or ultem, for example. In certain embodiments, the actuator 5010 may comprise stainless steel and the frangible bridge may comprise a thin piece of stainless steel. In certain embodiments, the frangible bridge may include a perforation, which may increase the frangibility thereof. The size and shape of the perforation can be selected so that the frangible bridge is properly breakable. In various embodiments, the actuator 5010 may override the distal connector 5080 before a fastener is fired from the cartridge of fasteners 5050. In certain embodiments, at least one fastener may be fired from a fastener cavity before or while the actuator 5010 overshoots the connector. 5080. After breaking through release lock 5014, trigger assembly 5030 can continue to move distally along slot 5056 (Figure 81) in cartridge body 5050 and along slot 5012 in actuator 5010 to eject fasteners from the 5050 fastener cartridge during the remaining portion of the firing stroke. In other words, the trigger assembly 5030 may activate the actuator during a first stage or portion of the trigger stroke and may trigger fasteners from fastener cavities 5054 and/or cut the fabric and/or material layer 5058 for a second. stage or portion of the firing stroke.
[000302] Now referring to Figures 85 and 86, an end actuator assembly may include a first jaw 5102 and a second jaw, illustrated elsewhere. In various embodiments, the first jaw 5102 may include an anvil structure 5170 and a layer of material releasably secured to the anvil structure 5170. The material layer may comprise a fabric thickness compensator and/or a piece of fabric material. buttress, for example, similar to material layer 5058 (figures 81 to 84). For example, the layer of material may be a piece of buttress material releasably secured to the anvil structure 5170. In certain embodiments, the anvil structure 5170 may include a slot 5172, which may extend from a proximal portion 5104 of the anvil structure 5170. first jaw 5102 toward distal portion 5106 of first jaw 5102. In various embodiments, a trigger assembly 5130 may translate along slot 5172 of anvil structure 5170. For example, trigger assembly 5130 may translate along slot 5172 during a firing hit. The translation of the trigger assembly 5130 along the slot 5172 may correspond to the translation of a trigger element through the second jaw of the end actuator assembly. As the first trigger element translates through the second jaw, for example, the trigger element may eject the fasteners of the second jaw into the layer of material and tissue pinched between the first jaw 5102 and the second jaw. Referring primarily to Figure 85, the trigger assembly 5130 may include a trigger bar 5132 and a nose 5136. In various embodiments, the nose 5136 of the trigger assembly 5130 may include a cutting edge for cutting tissue and the layer of material. material clamped between the first jaw 5102 and the second jaw.
[000303] Referring primarily to Figure 85, the layer of material may be releasably secured to the anvil structure 5170 by at least one connector. In certain embodiments, multiple connectors may secure the layer of material to the anvil structure 5170. For example, a proximal connector may secure the layer of material to the anvil structure 5170 at the proximal portion 5104 of the first jaw 5102, and a distal connector 5180 may secure the layer of material to the anvil structure 5170 at the distal portion 5106 of the first jaw 5102. In certain embodiments, additional connectors may secure the layer of material to the anvil structure 5170. In such embodiments, the additional connectors may be spaced along at least a portion of the length of the anvil structure 5170 and may be positioned between the proximal connector and the distal connector 5180, for example.
[000304] Still referring primarily to Figure 85, the distal connector 5180 can clamp the layer of material relative to the anvil structure 5170. The layer of material can be released from the anvil structure 5170 when the distal connector 5180, and any additional connectors, are torn, cut, dislodged or otherwise overcome. In certain embodiments, the trigger assembly 5130 may overtake the distal connector 5180 as the trigger assembly 5130 translates along the slot 5172 in the anvil structure 5170 during a trigger stroke. In various embodiments, an element of the first jaw 5102 may overtake the connector or connectors, such as or including the distal connector 5180, at or near the beginning of the firing stroke. In other words, the first jaw 5102 may overtake the distal connector 5180 at or near the beginning of the firing stroke and before a fastener is ejected into the pinched tissue. In various embodiments, the first jaw 5102 may include an actuator 5110, for example, which may overtake the distal connector 5080 at or near the beginning of the trigger stroke. The actuator 5110 can overcome the distal connector 5180, and the layer of material 5158 can be released from the anvil structure 5170 even when the firing stroke is prematurely stopped, that is, before the firing assembly 5130 reaches the distal portion 5106 of the first claw 5102, for example. In various embodiments, actuator 5110 may comprise a longitudinal plate that extends along a length of anvil structure 5170. In certain embodiments, the plate may include a longitudinal portion on one side of anvil slot 5172, another longitudinal portion on the other side of the anvil slot 5172, and a distal bridge 5174 extending between the longitudinal portions to reinforce the distal end of the actuator 5110. The actuator 5110 may extend through the first jaw 5102 and may be positioned between the a gripper and an outer surface of the first jaw 5102, for example. Additionally, the actuator 5110 can be movably secured with respect to the anvil frame 5170. For example, the actuator 5110 can move from a pre-activated position (Figure 85) to an activated position (Figure 86).
[000305] Referring primarily to Figure 85, the actuator 5110 may include a slot 5112, which may extend from the proximal portion 5104 towards the distal portion 5106 of the first jaw 5102 when the actuator 5110 is positioned relative to the frame of anvil 5170. Slot 5112 on actuator 5110 may match and/or be aligned with slot 5172 on anvil frame 5170, for example. Additionally, the trigger assembly 5130 can translate along the slot 5112 in the actuator 5110 as the trigger assembly 5130 translates along the slot 5172 in the anvil structure 5170 during the trigger stroke. In various embodiments, the trigger assembly 5130 may engage the actuator 5110 to move the actuator 5110 distally when the trigger assembly 5130 is at or near the beginning of the trigger stroke. In such embodiments, the trigger assembly 5130 may activate the actuator 5110 at the proximal portion 5104 of the first jaw 5102. When the actuator 5110 is activated and moves distally, a distal end of the actuator 5110 may cut, or otherwise overcome, the 5180 distal connector, for example. In other words, proximal activation of actuator 5110 can effect distal release of the layer of material from anvil structure 5172. In several embodiments, actuator 5110 may merely travel distally to overcome distal connector 5180. In at least one embodiment, the 5110 actuator may travel approximately 1.0 mm before overcoming the 5180 distal connector. In certain embodiments, the 5110 actuator may travel approximately 0.5 mm to 5.0 mm before overcoming the 5180 distal connector.
[000306] Still referring to figures 85 and 86, the 5110 actuator can move from the pre-activated position (Figure 85) to the activated position (Figure 86) when the 5130 trigger assembly moves between a non-triggered position and a partially fired position during part of the firing stroke. In various embodiments, slot 5112 in actuator 5110 may include a release lock 5114. Release lock 5114 may have a narrower width than portions of slot 5112 adjacent to release lock 5114, for example. Referring primarily to Figure 85, an element of trigger assembly 5130 can push release lock 5114 as trigger assembly 5130 translates along slot 5172 during the trigger stroke. The 5130 trigger assembly can push the 5114 release lock at or near the beginning of the trigger stroke, for example. In certain embodiments, the release lock 5114 may be near the proximal end of the slot 5112, and an element of the trigger assembly 5130, such as the nose 5136, may be in a boundary position with respect to the release lock 5114 at the start of the strike. shot. When nose 5136 is positioned against release lock 5114, nose 5136 can push actuator 5110 and move actuator 5110 distally. In certain embodiments, actuator 5110 may move distally until it reaches a rigid lock 5160, for example. Rigid lock 5160 may be on distal portion 5106 of first jaw 5102 and/or anvil structure 5170, and may prevent further distal movement of actuator 5110, for example.
[000307] Referring primarily to Figure 86, when actuator 5110 is driven distally by trigger assembly 5130, actuator 5110 may cut through, or otherwise overcome, distal connector 5180 to release the layer of material from the anvil structure 5172 in the distal portion 5106 of the first jaw 5102. In certain embodiments, the actuator 5110 may include a notch 5124 for receiving and securing the distal connector 5180. The notch 5124 may secure the distal connector 5180 as the actuator 5110 moves distally toward the rigid lock 5160. Additionally, actuator 5110 may include a cutting edge 5120, for example, along notch 5124. In certain embodiments, when actuator 5110 moves toward rigid lock 5160, distal connector 5180 may be driven between the rigid lock 5160 and the cutting edge 5120 of the actuator 5110. In various embodiments, the cutting edge 5120 can cut the distal connector 5180 when the cutting edge 5120 is driven towards the rigid lock 5160. In such embodiments, the distal connector 5080 may be cut by the cutting edge 5120 of the actuator 5110 at or near the beginning of the trigger stroke. In various embodiments, the 5110 actuator can outperform the 5180 distal connector without cutting it. For example, actuator 5110 can displace or extend distal connector 5180 out of position so that distal connector 5180 no longer traps the layer of material relative to anvil structure 5170.
[000308] In various embodiments, additional connectors along the length of the anvil structure 5170 may be cut, or otherwise overcome, by the actuator 5110 at or near the beginning of the trigger stroke. For example, a proximal cutting edge on actuator 5110 can cut an additional proximal connector and/or an intermediate cutting edge on actuator 5110 can cut an additional intermediate connector. The various cutting edges and/or portions of the 5110 actuator may cut or otherwise overcome each of the connectors at, and/or close to, the triggering stroke. Additionally or alternatively, a cutting edge of the firing assembly 5130 may cut, or otherwise overcome, the additional connectors. For example, the cutting edge of the firing assembly can cut a connector at the proximal portion 5104 of the first jaw 5102 and the cutting edge 5120 of the actuator 5110 can cut the distal connector 5180 before the fasteners are ejected from the cartridge body of the second jaw. In certain embodiments, actuator 5110 may overtake distal connector 5180 while at least one fastener is ejected from the fastener cavity and/or after at least one fastener has been ejected from a fastener cavity. When the 5110 actuator is blocked from further distal movement by the 5160 rigid lock, the 5130 trigger assembly can thread the 5114 release lock into the 5110 actuator slot 5112. When the 5130 trigger assembly threads the 5114 release lock, the 5114 trigger 5130 may widen the width of slot 5112 to allow trigger assembly 5130 to pass therethrough. For example, the nose 5136 of the trigger assembly 5130 can extend the release lock 5114 so that the trigger bar 5132 can extend through the release lock 5114 and translate along the slot 5112. In various embodiments, the trigger lock 5114 release can be rigid enough to withstand the force of the 5130 trigger assembly as the 5110 actuator moves distally toward the 5160 rigid lock, and can be flexible enough to widen when the 5110 actuator reaches the 5160 rigid lock without requiring excessive force of an engine and/or an operator. The actuator 5110 and/or the release lock 5114 thereof may comprise stainless steel, titanium, liquid crystal polymer (LCP) aluminum, nylon and/or ultem, for example. In various embodiments, actuator 5110 may overtake distal connector 5180 before a fastener is fired from the second jaw fastener cartridge. In certain embodiments, distal connector 5180 may be bypassed after and/or while at least one fastener is ejected from the fastener cavity. By extending through release lock 5114, trigger assembly 5130 can continue to move distally along slot 5172 in anvil structure 5172 and along slot 5112 in actuator 5110.
[000309] In various embodiments, an actuator may move proximally when activated by the trigger assembly. The proximal displacement actuator can overcome a proximal connector, for example. In certain embodiments, a first part of an actuator may displace distally when activated and a second part of an actuator may displace proximally when activated. The first and second parts of the actuator can simultaneously overcome the connectors. For example, the first part of the actuator can overcome a proximal connector while the second part of the actuator overcomes the distal connector.
[000310] In various embodiments, an end actuator assembly may include a first jaw and a second jaw. In certain embodiments, one layer of material may be releasably secured to the first jaw and another layer of material may be releasably secured to the second jaw. For example, a first layer of material may be releasably secured to a first jaw and/or anvil structure, and a second layer of material may be releasably secured to a second jaw and/or a set of fastener cartridge. In certain embodiments, an actuator, such as actuator 5010, for example, may release the first layer of material from the first jaw, and a second actuator, such as actuator 5110, for example, may release the second layer of material from the second jaw. The release of the first layer of material by the first actuator and the second layer of material by the second actuator can be timed. For example, actuators can be arranged and/or configured so that the first and second layers of material can be released from the end actuator assembly simultaneously and/or consecutively.
[000311] With general reference to Figures 87 to 90, an end actuator of a surgical stapling instrument may comprise a first jaw and a second jaw, at least one of the first jaw and the second jaw may be configured to be moved relative to the other. The end actuator may comprise a first jaw including a staple cartridge groove and a second jaw including an anvil such as, for example, anvil 2030 (Figure 88A), which may include a plurality of forming pockets 2032 (Figure 88A). ), whereby the anvil 2030 can be pivoted towards and/or away from the staple cartridge groove. The staple cartridge channel may be configured to receive a staple cartridge 2010 (Figure 87) which is removablely retained within the staple cartridge channel. T-fabric can be captured between the anvil 2030 and the staple cartridge 2010, for example, when the anvil 2030 is pivoted toward the staple cartridge groove.
[000312] Referring primarily to Figure 87, a staple cartridge assembly such as the staple cartridge assembly 2000 may comprise a fabric thickness compensator such as a fabric thickness compensator 2020 and a staples, such as staple cartridge 2010, for example, which may comprise a cartridge body 2012 and a multistage cartridge holder 2014. As shown in Figure 87, cartridge holder 2014 may comprise a longitudinally extending slot 2016 therethrough, the slot 2016 being configurable to receive a cutting member which can be slidably moved through the slot 2016.
[000313] In addition to the above, as illustrated in Figure 87, the cartridge holder 2014 may comprise a plurality of surfaces 2018a-c that extend longitudinally along the slot 2016, with the surface 2018a being closer to the slot 2016 than than surface 2018b, which may be closer to crack 2016 than surface 2018c. For example, surface 2018b can be laterally shifted from surface 2018a in a direction away from slot 2016, and surface 2018c can be shifted laterally from surface 2018b also in a direction away from slot 2016. In addition, surfaces 2018a-c can be offset vertically from each other. For example, each surface 2018a-c can be, or at least be substantially, in a separate plane, whereby the planes of the surfaces 2018a-c can be offset vertically from one another.
[000314] In addition to the foregoing, with reference again to Figures 87 to 88B, the cartridge 2010 may comprise a plurality of clip cavities 2022 in the cartridge body 2012, wherein the staple cavities 2022 may comprise openings in the surfaces 2018a-c of the cartridge holder 2014. A staple can be positioned within each staple cavity 2022. For example, staples 2024a-c can be positioned in cavities 2022 and can be supported by staple drivers 2026a-c on cartridge body 2012. A slider and/or trigger member, for example, can be advanced through staple cartridge 2010 to lift staple drivers 2026a-c up into staple cavities 2022 and eject staples 2024a-c from cavities 2022 through openings. on surfaces 2018a-c, respectively. Clamps 2024a-c may be formed by advancing clamps 2024a-c against corresponding forming pockets 2032 on anvil 2030 while anvil 2030 is in the closed position.
[000315] As illustrated in Figure 88A , actuators 2026a-c can be positioned at different unfired distances from corresponding forming pockets 2032 set on anvil 2030 when anvil 2030 is in the closed position. For example, as illustrated in Figure 88A, triggers 2026a may be positioned a first unfired distance from their corresponding forming pockets 2032, triggers 2026b may be positioned a second unfired distance from their corresponding forming pockets 2032, and the triggers 2026c can be positioned a third unfired distance from their corresponding formation pockets 2032, the first distance being shorter than the second distance, and the second distance being shorter than the third distance, for example . Referring now to Figure 88B, the staple drivers 2026a can direct the staples 2024a resting thereon to a first formed height 2021a, the staple drivers 2026b can direct the staples 2024b resting thereon to a second formed height 2021b, and the drivers of clips 2026c can direct the clips 2024c resting thereon to a third formed height 2021c, wherein the first formed height 2021a may be shorter than the second formed height 2021b and the second formed height 2021b may be shorter than the third formed height 2021c, for example. Clamps 2024a-c may comprise the same, or substantially the same, unformed or unfired height. Alternatively, drivers 2026a-c may support clamps that have different unformed heights. Additionally, as illustrated in Figure 88A, the tips of unformed clips 2024a-c may be, or be substantially, in different planes in their unfired positions. Alternatively, the staple cartridge 2010 can include unformed staples that comprise staple tips that can be, or at least be substantially, in a single plane. Other embodiments are envisaged, in which the clips 2024a-c can be formed to any suitable formed height and/or to any relative formed height.
[000316] Referring again to Figures 87 to 88B, the fabric thickness compensator 2020 may include a plurality of portions, such as portions 2020a-c (refer to Figure 87) that may be captured by clips 2024a-c, respectively . Portions 2020a-c, as illustrated in Figure 88A, can be moved laterally from each other. For example, portions 2020b can be shifted laterally from portions 2020a in a direction away from slot 2016 and portions 2020c can be shifted laterally from portions 2020b also in a direction away from slot 2016. In addition, portions 2020a -c, as illustrated in Figure 88A, may include the mating surfaces of support 2036a-c, whereby compensator 2020 can be positioned against cartridge support 2014 so that the contacting surfaces of support 2036a-c can be positioned detachably against or adjacent to surfaces 2018a-c of support 2014, respectively. Similar to surfaces 2018a-c, the contact surfaces of support 2036a-c can be offset vertically from each other. For example, as illustrated in Figure 88A , each surface 2036a-c can be, or at least be substantially, in a separate plane, whereby the planes of the surfaces 2036a-c can be offset vertically from one another. In other words, surface 2036a can be in a foreground, surface 2036b can be in a background, and surface 2036c can be in a third plane, with the foreground being closer than the background to a plane reference plane and the second plane is closer than the third plane of a reference plane such as reference plane 2031 on anvil 2030. As illustrated in Figure 88A, reference plane 2031 may comprise a plane passing through by an anvil 2030 when the anvil 2030 is in the closed position, wherein the reference plane 2031 may be parallel, or substantially parallel, to the surfaces 2036a-c.
[000317] In addition to the above, as illustrated in Figure 88A, the distance between the planes of surfaces 2036a and 2036b can be the same distance, or at least substantially the same, between the planes of surfaces 2036b and 2036c. Alternatively, the distance between the planes of surfaces 2036a and 2036b may be different from the distance between the planes of surfaces 2036b and 2036c. For example, the distance between the planes of surfaces 2036a and 2036b may be less than the distance between the planes of surfaces 2036b and 2036c.
[000318] Referring again to Figures 87 to 88B, portions 2020a-c may comprise fabric contacting surfaces 2034a-c which may be positioned against or adjacent to fabric T. Similar to surfaces 2018a-c as illustrated in Figure 88A, the fabric contacting surfaces 2034a-c can be offset vertically from one another. For example, as illustrated in Figure 88A, each surface 2034a-c can be, or at least be substantially, in a separate plane, whereby the planes of the surfaces 2034a-c can be offset vertically from one another. In other words, surface 2034a can be in a foreground, surface 2034b can be in a background, and surface 2034c can be in a third plane, where the foreground is closer than the background to a plane reference plane and the second plane is closer than the third plane to a reference plane 2031, wherein the reference plane 2031 may be parallel, or substantially parallel, to surfaces 2036a-c.
[000319] In addition to the above, the distance between the planes of surfaces 2034a and 2034b can be the same distance, or at least substantially the same, between the planes of surfaces 2034b and 2034c. Alternatively, the distance between the planes of surfaces 2034a and 2034b may be different from the distance between the planes of surfaces 2034b and 2034c. For example, the distance between the planes of surfaces 2034a and 2034b may be less than the distance between the planes of surfaces 2034b and 2034c.
[000320] Referring to Figures 88 to 90, portions 2020a-c of compensator 2020 may comprise a uniform, or substantially uniform, non-compressed thickness. For example, as illustrated in the cross-sectional view in Figure 88, portions 2020a may comprise an uncompressed first thickness between surfaces 2034a and 2036a, and portions 2020b may comprise a second uncompressed thickness between surfaces 2034b and 2036b, with that the first uncompressed thickness may be equal to, or substantially equal to, the second uncompressed thickness. In addition, portions 2020c may comprise a third uncompressed thickness between surfaces 2034c and 2036c, wherein the third uncompressed thickness may be equal to, or substantially equal to, the first uncompressed thickness and/or the second uncompressed thickness.
[000321] Alternatively, the compensator 2020 may comprise portions having different uncompressed thicknesses, all or some of the portions 2020a-c may comprise different uncompressed thicknesses. For example, as illustrated in Figure 89, the uncompressed third thickness of the portions 2020c may be greater than the second uncompressed thickness of the portions 2020a, while the first uncompressed thickness of the portions 2020a may comprise the same, or substantially the same, thickness. uncompressed than the second uncompressed thickness of portions 2020b. Under certain circumstances, the uncompressed thickness may be greater than the first uncompressed thickness, and the third uncompressed thickness may be greater than the second uncompressed thickness, thus forming a thickness gradient. Accordingly, the compensator 2020 may comprise a thickness gradient, whereby the uncompressed thickness of certain portions of the compensator 2020 may depend on the relative position of those portions. For example, compensator 2020 can comprise central portions that have a minimum uncompressed thickness, peripheral portions that have maximum uncompressed thickness, and intermediate portions that have average uncompressed thickness. Alternatively, the central portions may comprise a maximum uncompressed thickness and the peripheral portions may comprise a minimum uncompressed thickness. The reader will appreciate that the thickness of the portions 2020a-c and their relative positions on the compensator 2020 can be configured to provide a desired thickness compensation for the fabric T in the formed staples 2024a-c.
[000322] In addition to the above, as illustrated in Figure 88B, the formed staples 2024a-c can capture the T fabric and/or the compensator 2020, with the captured T fabric and the captured compensator 2020 being able to compete for space in the formed staples 2024a -ç. Consequently, the fabric T and/or the compensator 2020 may be compressed under compressive forces applied thereto by the formed clips 2024a-c, which may depend, at least in part, on the formed heights of the clips 2024a-c, the compressibility of the T fabric, the compressibility of the compensator 2020, the thickness of the fabric T and/or the thickness of the compensator 2020. Consequently, some or all of these parameters can be manipulated to produce a desired compression of the T fabric in the formed staples 2024a-c .
[000323] In addition to the above, the compressibility of the fabric T may depend, at least in part, on the modulus of elasticity of the fabric T, and the compressibility of the compensator 2020 may depend, at least in part, on the modulus of elasticity of the compensator 2020 , with a higher modulus of elasticity resulting in higher compressibility. For example, as illustrated in Figure 88B, staples 2024a may capture corresponding portions 2020a of compensator 2020 and corresponding T fabric, which can result in a competition for space between portions 2020a and corresponding T fabric in formed staples 2024a. In the example illustrated in Figure 88B, the fabric T may comprise a modulus of elasticity greater than the corresponding portions 2020a. Accordingly, the formed clips 2024a can compress the fabric T to a greater degree than the corresponding portions 2020a. Furthermore, as described above and as illustrated in Figure 88B, the formed height 2021a of the clips 2024a may be less than the formed height 2021b of the clips 2024b, and the formed height 2021b may be less than the formed height 2021c of the clips 2024c. Accordingly, the space available in the formed staples 2024a may be less than the space available in the formed staples 2024b which may be less than the space available in the formed staples 2024c. As a result, the T fabric in the formed staples 2024a can be compacted to a greater degree than the T fabric in the formed staples 2024b which can be compacted to a greater degree than the T fabric in the formed staples 2024c.
[000324] In addition to the above, portions 2020a-c of compensator 2020 may comprise different modulus of elasticity which may result in different degrees of compressibility by compensator 2020. For example, portions 2020a may comprise a greater modulus of elasticity than portions 2020b and portions 2020b may comprise a greater modulus of elasticity than portions 2020c. As a result, a gradient of modulus of elasticity may exist in compensator 2020, whereby a central portion, for example one of the portions 2020a, may comprise a greater modulus of elasticity than a peripheral portion, for example one of the portions 2020c. Furthermore, an intermediate portion, for example one of the portions 2020b, may comprise a modulus of elasticity greater than the peripheral portion and a modulus of elasticity less than the central portion. Accordingly, the fabric T in the formed staples 2024a-c can be configured to undergo a desirable compaction force by manipulating the modulus of elasticity of the corresponding portions 2020a-c.
[000325] Referring again to Figure 88B, as described above, the compressive forces experienced by the T fabric and the compensator 2020 may depend, at least in part, on the heights 2021a-c of the formed clips 2024a-c, which may determine the availability of total space in the formed staples 2024a-c for the fabric T and the corresponding portions 2020a-c of the compensator 2020 to compete therein. For example, as illustrated in Figure 88B , the space available in the formed staples 2024c can be greater than the space available in the formed staples 2024b and the space available in the formed staples 2024b can be greater than the space available in the formed staples 2024a. In the result, the fabric T and corresponding portions 2020a may experience greater compressive forces on the staples 2024a than those experienced by the fabric T and corresponding portions 2020b on the formed staples 2024b. Furthermore, the fabric T and corresponding portions 2020b may experience greater compressive forces on the formed staples 2024b than those experienced by the fabric T and corresponding portions 2020c on the formed staples 2024c. Consequently, a gradient of tissue compression can be established, whereby the T tissue in the formed staples 2024a can experience greater compression than the T tissue in the formed staples 2024b and the T tissue in the staples 2024b can experience greater compression than the T tissue on the 2024c clamps. Other embodiments are envisaged, in which a fabric thickness compensator and formed staples can be made to induce adequate compaction through the T fabric in the formed staples.
[000326] In addition to the above, with reference to Figure 89, the fabric thickness compensator 2020' may comprise a plurality of portions 2020'a-c. The compressive forces experienced by the fabric T and the tab 2020' as they are captured by the clips 2024a-c may depend, at least in part, on the thickness of the portions 2020'a-c of the tab 2020'. The portions 2020'a-c may comprise different uncompressed thicknesses. For example, as illustrated in Figure 89, portions 2020'c may comprise a greater uncompressed thickness than portions 2020'a and 2020'b which may result in greater compaction in the T fabric captured by the staples 2024c than the captured T fabric. by clamps 2024a and 2024b. Under certain circumstances, the compressive forces experienced by the captured T fabric and the captured compensator 2020' may be directly proportional to the thickness of the compensator 2020'.
[000327] Referring now to Figure 90, a fabric thickness compensator composite such as composite 2060 may comprise multiple fabric thickness compensators. For example, composite 2060 may comprise fabric thickness compensator 2020 and fabric thickness compensator 2080, wherein compensator 2080 may be positioned, at least in part, adjacent to or against compensator 2020. For example, compensator 2080 2080 may be selectively positioned over certain portions of the compensator 2020 to provide, for example, desirable thickness and/or compliance. As illustrated in Figure 90, the trimmer 2080 may comprise portions 2080c which can be positioned over, for example, portions 2020c of the trimmer 2020.
[000328] In addition to the above, the compensator 2080 and the compensator 2020 can be joined, for example, by an adhesive. Other fastening means for securing trim tab 2020 to trim tab 2080 are contemplated within the scope of the present disclosure. Similar to compensator 2020, portions of compensator 2080 may comprise various thicknesses, various modulus of elasticity and/or various relative spatial arrangements. In addition, portions of compensator 2080 and corresponding portions of compensator 2020 may comprise equal or different uncompressed thicknesses and/or modulus of elasticity. For example, portions 2080c may comprise a higher modulus of elasticity than portions 2020c to provide and may provide a surface for contacting the pliable fabric in a peripheral region of the composite 2080.
[000329] In addition to the above, the buffer 2020 and/or the buffer 2080 may comprise of biocompatible materials. Furthermore, the buffer 2020 and/or the buffer 2080 may be comprised of biodegradable materials such as, for example, PGA, PCL and PLLA, and/or combinations thereof, for example. Compensator 2020 and compensator 2080 may comprise the same or different materials to produce desirable localized compressibility through composite 2080.
[000330] As described herein, a fabric thickness compensator can compensate for variations in the thickness of fabric that is captured in staples ejected from a staple cartridge and/or contained in a row of staples, for example. In other words, certain staples in a staple line can capture thick pieces of fabric, while other staples in the staple line can capture thin pieces of fabric. Under such circumstances, the fabric thickness compensator can assume different heights or thicknesses on the staples and apply a compressive force to the tissue captured by the staples regardless of whether the captured tissue is thick or thin. In various embodiments, a fabric thickness compensator can compensate for variations in fabric hardness. For example, certain staples in a staple line can capture highly compressible portions of tissue, while other staples in the staple line can capture portions of tissue that are less compressible. Under such circumstances, the fabric thickness compensator may be configured to assume a lower height on staples that have captured tissue that has a lower compressibility or higher hardness, and correspondingly a greater height on staples that have captured tissue. that has a higher compressibility or lower hardness, for example. In any case, a fabric thickness compensator, regardless of whether it compensates for variations in fabric thickness and/or variations in fabric hardness, for example, may be called a "fabric compensator" and/or "compensator", for example.
[000331] The devices disclosed herein may be designed for disposal after a single use, or they may be designed to be used multiple times. In either case, however, the device may be refurbished for reuse after at least one use. Overhaul may include any combination of the steps of disassembling the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, the device may be dismantled, and any number of particular parts or parts of the device may be selectively exchanged or removed, in any combination. When cleaning and/or replacing specific parts, the device can be reassembled for subsequent use at the refurbishment facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that refurbishing a device can use a variety of disassembly, cleaning/replacement and reassembly techniques. The use of such techniques and the resulting refurbished device are within the scope of this application.
[000332] Preferably, the present invention described herein will be processed prior to surgery. First, a new or used instrument is obtained and, if necessary, cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, X-rays, or high-energy electrons. Radiation kills bacteria on the instrument and container. The sterilized instrument can then be stored in a sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.
[000333] Various embodiments described in the present invention are described in the context of staples releasably stored within a staple cartridge for use with surgical stapling instruments. In some circumstances, staples may include wires that are deformed when they come into contact with a surgical stapler anvil. Such wires may be comprised of metal, such as stainless steel, for example, and/or any other suitable material. These embodiments, and their teachings, can be applied to embodiments that include fasteners removably stored in fastener cartridges for use with any suitable fastening instrument.
[000334] Various embodiments described herein are described in the context of fabric thickness compensators attached to staple cartridges and/or fastener cartridges, and/or for use therewith. Such tissue thickness compensators can be used to compensate for variations in tissue thickness from one end of a staple cartridge to the other, or variations in the thickness of tissue captured within one staple, or fastener, compared to another. Such fabric thickness compensators can also be used to compensate for variations in fabric thickness from one side of a staple cartridge to the other. Such embodiments, and the teachings thereof, can be applied to embodiments that include a layer or layers of material affixed to, and/or use with, staple cartridges and/or fastener cartridges. A layer may include a buttress material.
[000335] Various embodiments described in the present invention are described in the context of linear end actuators and/or linear fastener cartridges. These embodiments, and the teachings thereof, can be applied to non-linear end actuators and/or non-linear fastener cartridges, such as, for example, circular and/or contoured end actuators. For example, a number of end actuators, including non-linear end actuators, are featured in US Patent Application Serial No. US No. 2011/0226837, which is incorporated in its entirety by the present invention by reference. Additionally, US Patent Application Serial No. 12/893,461, filed on September 29, 2012, entitled STAMP CARTRIDGE, now US Patent Application Publication No. 2012/0074198, which is incorporated in its entirety into the present invention by way of reference. US Patent Application Serial No. 12/031,873, filed on February 15, 2008, entitled END ACTUATORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT, now US Patent No. 7,980,443, is also incorporated in its entirety herein. invention by way of reference.
[000336] Any patent, publication or other descriptive material, in whole or in part, which is said to be incorporated by reference into the present invention is incorporated into the present invention only to the extent that the incorporated materials do not come into conflict with existing definitions, statements or other descriptive material disclosed in this description. Accordingly, and to the extent necessary, the disclosure as explicitly presented herein supersedes any conflicting material incorporated herein by reference. Any material, or portions thereof, which is incorporated herein by reference, but which conflicts with existing definitions, statements, or other descriptive materials presented herein, is incorporated herein only to the extent that there is no conflict between the material embedded and existing description material.
[000337] While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses or adaptations of the invention using its general principles. Additionally, this application is intended to cover deviations from the present disclosure that may occur with known or customary practice in the art to which this invention relates.

权利要求:
Claims (3)
[0001]
1. End actuator assembly (5700) for use with a surgical instrument, wherein the end actuator assembly (5700) comprises: a cartridge of fasteners (5750) comprising: a plurality of fasteners detachably positioned on the cartridge of fasteners (5750; 5850), each of the fasteners being configured to move from a non-fired position to a fired position; a support (5752); a longitudinal slot (5756), a first notch (5748a) in a first side of the fastener cartridge (5750); and a second notch (5748b) on a second side of the fastener cartridge (5750), wherein the first notch (5748a) and the second notch (5748b) are positioned on opposite sides of the longitudinal slot (5756); a layer of material (5758) removably attached to the cartridge of fasteners (5750), wherein the layer of material (5758) is at least partially captured by the fasteners as the fasteners move from the unfired position to the fired position, and wherein the layer of material (5758) comprises: a first bead (5760a) on a first side; and a second bezel (5760b) on a second side, wherein the first bezel (5760a) extends into the first notch (5748a) and the second bezel (5760b) extends into the second notch (5748b) when the layer of material (5758) is attached to the fastener cartridge (5750); characterized in that the first notch (5748a) and the second notch (5748b) being defined in the holder (5752), wherein the first notch (5748a) is positioned at an edge of the fastener cartridge (5750), and wherein the second notch (5748b) is positioned on an opposite edge of the fastener cartridge (5750); and a first connector (5780a) and a second connector (5780b), wherein the first connector (5780a) and the second connector (5780b) are configured to secure the layer of material (5758) to the fastener cartridge (5750), and wherein the first notch (5748a) and the second notch (5748b) are intermediate between the first connector and the second connector.
[0002]
2. End actuator assembly (5700), according to claim 1, characterized in that the first bezel (5760a) and the second bezel (5760b) are integrally molded with the layer of material (5758).
[0003]
3. End actuator assembly (5700), according to claim 1, characterized in that the layer of material (5758) comprises one of a buttress material or a fabric thickness compensator.

类似技术:

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公开号 | 公开日 | 专利标题

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BR112015018757B1|2021-11-30|END EFFECTOR ASSEMBLY FOR USE WITH A SURGICAL INSTRUMENT

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BR112015018796B1|2021-11-30|STAPLER CARTRIDGE FOR USE WITH A SURGICAL STAPLER INCLUDING AN ANN

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CA3080444A1|2014-08-14|Implantable arrangements for surgical staple cartridges

同族专利:

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公开号 | 公开日

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RU2661143C2|2018-07-11|

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BR112015018699A2|2017-07-18|

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RU2015138132A|2017-03-16|

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US20190090871A1|2019-03-28|

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JP6293793B2|2018-03-14|

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JP2016509523A|2016-03-31|

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MX2015010214A|2016-05-09|

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法律状态:
2018-11-13| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

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2020-01-21| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2021-11-03| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2022-01-11| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 04/02/2014, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

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申请号 | 申请日 | 专利标题

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US13/763,161|2013-02-08|

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US13/763,161|US20130153641A1|2008-02-15|2013-02-08|Releasablelayer of material and surgical end effector having the same|

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PCT/US2014/014604|WO2014123865A2|2010-09-30|2014-02-04|Releasable layer of material and surgical end effector having the same|

---