EXTENSIBLE REINFORCEMENT ASSEMBLY CAPABLE OF BEING USED WITH A SURGICAL STAPLER THAT HAS A LONGITUDI

专利摘要:
Extendable Reinforcement Set for Surgical Stapler. the present invention relates to an extensible reinforcement assembly that is associated with surgical staples that can be positioned in organic tissue, the staples being from a surgical stapler that has a longitudinal geometric axis. the reinforcement set includes a flat textile product and a bioabsorbable adhesive. the flat textile product also includes fibers that are substantially offset with the longitudinal axis of the surgical stapler or substantially aligned with the longitudinal axis of the surgical stapler. the bioabsorbable adhesive is applied to the first and/or second side of the flat textile product and is configured to adhere the extensible reinforcement assembly to an end actuator of the surgical stapler. the reinforcement assembly is substantially extendable in one direction. in some versions, the reinforcement assembly is extendable in a direction parallel to the longitudinal axis. in some versions, the reinforcement assembly is extendable in a direction perpendicular to the longitudinal axis.
公开号:BR112018008619B1
申请号:R112018008619-3
申请日:2016-10-20
公开日:2021-09-08
发明作者:Victoria Dalessandro；Jason L. Harris；Michael J. Vendely
申请人:Ethicon Llc；
IPC主号:

专利说明:

BACKGROUND
[001] In some cases, endoscopic surgical instruments may be preferred over devices for traditional open surgery, as a smaller incision can reduce recovery time and postoperative complications. Consequently, some endoscopic surgical instruments may be suitable for placing a distal end actuator at a desired surgical site via the cannula of a trocar. These distal end actuators can engage tissue in a variety of ways to achieve a diagnostic or therapeutic effect (eg, endocutter, gripper, cutter, stapler, clip applicator, access device, drug delivery device/gene therapy device, and device for application of energy through the use of ultrasonic vibration, RF, laser, etc.). Endoscopic surgical instruments may include a drive shaft between the end actuator and a portion of handle, which is manipulated by the clinician. Such a drive shaft can enable insertion to a desired depth and rotation around the longitudinal axis of the drive shaft, thus facilitating the positioning of the extremity actuator on the patient. The positioning of an end actuator can be further facilitated by the inclusion of one or more swivel joints or features, allowing the end actuator to be selectively pivoted or otherwise deflected relative to the longitudinal axis of the drive shaft.
[002] Examples of endoscopic surgical instruments include surgical staplers. Some of these staplers function to secure layers of fabric, cut through the secured layers of fabric, and cause the staples to pass through the layers of fabric to substantially seal the cut layers of fabric together, near their cut ends. Merely exemplary surgical staplers are shown in US Patent No. 4,805,823 entitled "Pocket Configuration for Internal Organ Staplers", issued February 21, 1989; U.S. Patent No. 5,415,334 entitled "Surgical Stapler and Staple Cartridge", issued May 16, 1995; U.S. Patent No. 5,465,895 entitled "Surgical Stapler Instrument", issued November 14, 1995; US Patent No. 5,597,107 entitled "Surgical Stapler Instrument", issued January 28, 1997; US Patent No. 5,632,432 entitled "Surgical Instrument", issued May 27, 1997; US Patent No. 5,673,840 entitled "Surgical Instrument", issued October 7, 1997; US Patent No. 5,704,534 entitled "Articulation Assembly for Surgical Instruments", issued January 6, 1998; US Patent No. 5,814,055 entitled "Surgical Clamping Mechanism", issued September 29, 1998; US Patent No. 6,978,921 entitled "Surgical Stapling Instrument Incorporating an E-Beam Firing Mechanism", issued December 27, 2005; U.S. Patent No. 7,000,818 entitled "Surgical Stapling Instrument Having Separate Distinct Closing and Firing Systems", issued February 21, 2006; U.S. Patent No. 7,143,923 entitled "Surgical Stapling Instrument Having a Firing Lockout for an Unclosed Anvil", issued December 5, 2006; US Patent No. 7,303,108 entitled "Surgical Stapling Instrument Incorporating a Multi-Stroke Firing Mechanism with a Flexible Rack", issued December 4, 2007; US Patent No. 7,367,485 entitled "Surgical Stapling Instrument Incorporating a Multistroke Firing Mechanism Having a Rotary Transmission", granted May 6, 2008; U.S. Patent No. 7,380,695 entitled "Surgical Stapling Instrument Having a Single Lockout Mechanism for Prevention of Firing", issued June 3, 2008; US Patent No. 7,380,696 entitled "Articulating Surgical Stapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism", granted June 3, 2008; US Patent No. 7,404,508 entitled "Surgical Stapling and Cutting Device", issued July 29, 2008; U.S. Patent No. 7,434,715 entitled "Surgical Stapling Instrument Having Multistroke Firing with Opening Lockout", issued October 14, 2008; US Patent No. 7,721,930 entitled "Disposable Cartridge with Adhesive for Use with a Stapling Device", issued May 25, 2010; US Patent No. 8,408,439 entitled "Surgical Stapling Instrument with An Articulatable End Effector", issued April 2, 2013; and US Patent No. 8,453,914 entitled "Motor-Driven Surgical Cutting Instrument with Electric Actuator Directional Control Assembly", issued June 4, 2013. The description of each of the aforementioned US patents is incorporated herein by way of reference.
[003] Although the aforementioned surgical staplers are described as used in endoscopic procedures, it should be understood that these surgical staplers can also be used in open procedures and/or other non-endoscopic procedures. By way of example only, a surgical stapler can be inserted through a thoracotomy and thus between the patient's ribs to reach one or more organs in a thoracic surgical procedure that does not use a trocar as a conduit for the stapler. Such procedures may include using a stapler to cut and close a blood vessel leading to a lung. For example, the vessels leading to an organ can be cut and closed by a stapler before removing the organ from the chest cavity. Of course, surgical staplers can be used in many other scenarios and procedures.
[004] Examples of surgical staplers that may be particularly suitable for use by a thoracotomy are disclosed in US Patent Publication No. 2014/0243801, entitled "Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks", published August 28 2014; US Patent Publication No. 2014/0239041 entitled "Lockout Feature for Movable Cutting Member of Surgical Instrument", published August 28, 2014; US Patent Publication No. 2014/0239042 entitled "Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler", published August 28, 2014; US Patent Publication No. 2014/0239036 entitled "Jaw Closure Feature for End Effector of Surgical Instrument", published August 28, 2014; US Patent Publication No. 2014/0239040 entitled "Surgical Instrument with Articulation Lock having a Detenting Binary Spring", published August 28, 2014; US Patent Publication No. 2014/0239043 entitled "Distal Tip Features for End Effector of Surgical Instrument", published August 28, 2014; US Patent Publication No. 2014/0239037 entitled "Staple Forming Features for Surgical Stapling Instrument", published August 28, 2014; US Patent Publication No. 2014/0239038 entitled "Surgical Stapler with Multi-Diameter Shaft", published August 28, 2014; and/or US Patent Publication No. 2014/0239044 entitled "Installation Features for Surgical Instrument End Effector Cartridge", published August 28, 2014. The disclosure of each of the aforementioned US Patent Applications is incorporated in the present invention by way of reference.
[005] Additional surgical stapling instruments are disclosed in US Patent No. 8,801,735 entitled "Surgical Circular Stapler with Tissue Retention Arrangements", issued August 12, 2014; US Patent No. 8,141,762 entitled "Surgical Stapler Comprising a Staple Pocket", issued March 27, 2012; U.S. Patent No. 8,371,491 entitled "Surgical End Effector Having Buttress Retention Features", granted February 12, 2013; US publication No. 2014/0263563 entitled "Method and Apparatus for Sealing End-to-End Anastomosis", published September 18, 2014; US publication No. 2014/0246473 entitled "Rotary Powered Surgical Instruments with Multiple Degrees of Freedom", published September 4, 2014; US Publication No. 2013/0206813 entitled "Linear Stapler" published August 15, 2013; US publication No. 2008/0169328 entitled "Buttress Material for Use with a Surgical Stapler", published July 17, 2008; US Patent Application No. 14/300,804 entitled "Woven and Fibrous Materials for Reinforcing a Staple Line" filed June 10, 2014; US Patent Application No. 14/300,811 entitled "Devices and Methods for Sealing Staples in Tissue"; and US Patent Publication No. 14/498. 070, entitled "Radically Expandable Staple Line" filed September 26, 2014. The descriptions of each of the above-cited U.S. patents, U.S. patent publications, and U.S. Patent Applications are incorporated by reference into the present invention.
[006] In some cases, it may be desirable to equip a surgical stapling instrument with a reinforcing material to enhance the mechanical fixation of tissue provided by staples. Such reinforcement can prevent the applied staples from pulling through the fabric and may otherwise reduce a risk of fabric tearing at or near the site of applied staples.
[007] Although various types of surgical stapling instruments and associated components have been produced and used, it is believed that no one prior to the inventor(s) has produced or used the invention described in the appended claims. BRIEF DESCRIPTION OF THE DRAWINGS
[008] The attached drawings, which are incorporated into and form part of this descriptive report, illustrate embodiments of the invention and, together with the general description provided above, and the detailed description of the embodiments provided below, serve to explain the principles of the present invention.
[009] Figure 1 shows a perspective view of an exemplary surgical stapling instrument;
[0010] Figure 2 shows a perspective view of an end actuator of the instrument of Figure 1, with the end actuator in an open configuration;
[0011] Figure 3 shows an exploded perspective view of the end actuator of Figure 2;
[0012] Figure 4 shows a perspective view of an exemplary upper strut and an exemplary lower strut, each of which can be applied to the end actuator of Figure 2;
[0013] Figure 5A shows an end cross-sectional view of a portion of the end actuator of Figure 2 with a brace assembly formed by the braces of Figure 4 applied to the end actuator, with the fabric positioned between the braces on the actuator end, and with the anvil in an open position;
[0014] Figure 5B shows an end cross-sectional view of the combined end actuator and gusset assembly of Figure 5A, with the fabric positioned between the gussets in the end actuator, and with the anvil in a closed position;
[0015] Figure 5C shows a cross-sectional view of a clamp and reinforcement assembly of Figure 5A secured to the fabric by the end actuator of Figure 2;
[0016] Figure 6 shows a perspective view of clamps and the reinforcement assembly of Figure 5A secured to the fabric by the end actuator of Figure 2;
[0017] Figure 7 represents an enlarged schematic view of an exemplary flat textile product comprising knitted fibers in a knit pattern, suitable for incorporation in the reinforcement assemblies of Figure 4;
[0018] Figure 8 represents an enlarged schematic view of an exemplary flat textile product comprising knitted fibers in a weft insert pattern, suitable for incorporation in the reinforcement assemblies of Figure 4;
[0019] Figure 9 represents an enlarged schematic view of an exemplary flat textile product comprising knitted fibers in a weft pattern, suitable for incorporation in the reinforcement assemblies of Figure 4;
[0020] Figure 10 represents an enlarged schematic view of an exemplary flat textile product comprising mesh fibers, suitable for incorporation in the reinforcement assemblies of Figure 4;
[0021] Figure 11 represents two top plan views showing a flat textile woven in an extended state and the flat textile woven in a relaxed state; and
[0022] Figure 12 represents two top plan views showing a reinforcement body in an extended state and the reinforcement body in a relaxed state.
[0023] The drawings are in no way intended to be limiting and it is contemplated that various embodiments of the invention may be carried out in a variety of other ways, including those not necessarily represented in the drawings. The accompanying drawings incorporated and forming a part of the descriptive report illustrate various aspects of the present invention and, together with the description, serve to explain the principles of the invention; it being understood, however, that this invention is not specifically limited to the arrangements shown. DETAILED DESCRIPTION
[0024] The following description of specific examples of the invention should not be used to limit the scope of the present invention. Other examples, features, aspects, embodiments and advantages of the invention will become apparent to those skilled in the art from the following description, which is, by way of illustration, one of the best contemplated modes for carrying out the invention. As will be understood, the invention may have other different and obvious aspects, all without departing from the invention. Consequently, the drawings and descriptions are to be considered as illustrative and not restrictive in nature. I. Exemplifying Surgical Stapler
[0025] Figure 1 depicts an exemplary surgical stapling and cutting instrument 10 that includes a handle assembly 20, a drive shaft assembly 30, and an end actuator 40. The end actuator 40 and the distal portion of the assembly Drive shaft 30 are sized for insertion, in an unarticulated state as depicted in Figure 1, through a trocar cannula to a surgical site on a patient to perform a surgical procedure. As an example only, such a trocar may be inserted into the patient's abdomen, between two of the patient's ribs, or elsewhere. In some cases, instrument 10 is used without a trocar. For example, the end actuator 40 and the distal portion of the drive shaft assembly 30 can be inserted directly through a thoracotomy or other type of incision. It should be understood that terms such as "proximal" and "distal" are used in the present invention with reference to a physician holding the cable assembly 20 of the instrument 10. In this way, the end actuator 40 is distal to the cable assembly. 20 more proximal. It will be further understood that, for convenience and clarity, spatial terms such as "vertical" and "horizontal" are used in the present invention in relation to the drawings. However, surgical instruments are used in many orientations and positions, and such terms are not intended to be limiting and absolute. A. Exemplifying Cable Assembly and Drive Shaft Assembly
[0026] As shown in Figure 1, the cable assembly 20 of the present example comprises a pistol grip 22, a close trigger 24 and a firing trigger 26. Each trigger 24, 26 can be selectively pivoted towards and away of the pistol grip 22 as will be described in more detail below. Cable assembly 20 additionally includes a removable battery 28. These components will also be described in more detail below. Of course, the cable assembly 20 can have a variety of other components, features and functionality in addition to, or instead of, any of the elements mentioned above. Other suitable configurations for the cable assembly 20 will become apparent to those skilled in the art in light of the teachings of the present invention.
[0027] As shown in Figures 1 and 2, the drive shaft assembly 30 of the present example comprises an outer closure tube 32, a pivot section 34 and a closure ring 36, which is further coupled to an end actuator 40. Closure tube 32 extends the length of drive shaft assembly 30. Closure ring 36 is positioned distal to pivot section 34. Closure tube 32 and closure ring 36 are configured to to translate longitudinally with respect to the cable assembly 20. The longitudinal translation of the closure tube 32 is communicated to the closure ring 36 through the hinge section 34. Exemplary features that can be used to provide longitudinal translation of the closure tube 32 and of the closure ring 36 will be described in more detail below.
[0028] The pivot section 34 is operable to laterally deflect the closure ring 36 and the end actuator 40 laterally in the direction opposite the longitudinal axis LA of the drive shaft assembly 30 at a desired angle α. In the present example, the articulation is controlled through a articulation control knob 35 which is located at the proximal end of the drive shaft assembly 30. The closure ring 36 and the end actuator 40 are pivoted about an axis. that is perpendicular to the longitudinal axis LA of the drive shaft assembly 30 in response to the rotation of the knob 35. The pivot section 34 is configured to communicate longitudinal translation from the closure tube 32 to the closure ring 36, independent of the possibility of the hinge section 34 being in a straight configuration or in a hinged configuration. By way of example only, the pivot section 34 and/or the pivot control knob 35 may be constructed and operable in accordance with at least some of the teachings of US Patent Publication No. 2014/0243801, entitled "Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks", published August 28, 2014, the description of which is incorporated herein by reference; and/or US Patent Application No. 14/314,125 entitled "Articulation Drive Features for Surgical Stapler", filed June 25, 2014, the description of which is incorporated herein by reference. and/or in accordance with the various teachings below. Other suitable shapes that the hinge section 34 and the hinge knob 35 may take will be apparent to those skilled in the art in view of the teachings of the present invention.
[0029] As shown in Figure 1, the drive shaft assembly 30 of the present example additionally includes a rotation knob 31. The rotation knob 31 is operable to rotate the entire drive shaft assembly 30 and the end actuator 40 , with respect to the cable assembly 20 around the longitudinal axis LA defined by the drive shaft assembly 30. Of course, the drive shaft assembly 30 may have a variety of other components, features and functionality in addition to or in instead, any of the elements mentioned above. By way of example only, at least part of the drive shaft assembly 30 is constructed in accordance with at least some of the teachings of US Patent Application No. 2014/0239038 entitled "Surgical Instrument with Multi-Diameter Shaft", published in August 28, 2014, the description of which is incorporated herein by reference. Other suitable configurations for drive shaft assembly 30 will be apparent to those skilled in the art in view of the teachings presented herein. B. Exemplifying End Actuator
[0030] As also depicted in Figures 1 to 3, the end actuator 40 of the present example includes a lower jaw 50 and a hinged anvil 60. The anvil 60 includes a pair of integral outwardly extending pins 66 that are disposed at corresponding curved slots 54 of lower jaw 50. Anvil 60 is pivotal toward and away from lower jaw 50 between an open position (shown in Figure 2) and a closed position (shown in Figure 1). The use of the term "pivoting" (and similar terms with "pivot" as the base) should not be read as necessarily requiring pivotal movement about a fixed geometric axis. For example, in the present example, anvil 60 rotates about a geometric axis that is defined by pins 66, which slide along curved slots 54 of lower jaw 50 as anvil 60 moves to lower jaw 50. In such versions, the pivot axis is translated along the path defined by the slots 54 while the anvil 60 simultaneously rotates around this axis. Additionally or alternatively, the pivot axis can slide along the slots 54, with the anvil 60 then pivoting about the pivot axis after the pivot axis has slid a certain distance along the slots 54 It should be understood that such pivoting sliding/returning movement is encompassed within terms such as "pivot", "pivots", "pivoting", "swivel", "pivot" and the like. Of course, some versions may provide pivotal movement of the anvil 60 around a geometric axis that remains fixed and untranslated within a slot or groove, etc.
[0031] As best seen in Figure 3, the lower jaw 50 of the present example defines a channel 52 that is configured to receive a staple cartridge 70. The staple cartridge 70 can be inserted into the channel 52, the end actuator 40 can be actuated and then the staple cartridge 70 can be removed and replaced with another staple cartridge 70. The lower jaw 50 thus releasably retains the staple cartridge 70 in alignment with the anvil 60 for the actuation of the end actuator 40. In some versions, the lower jaw 50 is constructed in accordance with at least some of the teachings of Patent Application No. 2014/0239044 entitled "Installation Features for Surgical Instrument End Effector Cartridge", published at 28 of August 2014, the description of which is incorporated herein by reference. Other suitable shapes that lower claw 50 may take will be apparent to those skilled in the art based on the teachings of the present invention.
[0032] As best seen in Figures 2 and 3, the staple cartridge 70 of the present example comprises a cartridge body 71 and a tray 76 secured to the underside of the cartridge body 71. The upper side of the cartridge body 71 presents a platform 73, against which tissue can be compressed when the anvil 60 is in a closed position. Cartridge body 71 further defines a longitudinally extending channel 72 and a plurality of clip pockets 74. A clip 90 is positioned in each clip pocket 74. A clip driver 75 is also positioned in each clip pocket 74, under a corresponding staple 90 and above the tray 76. As will be described in more detail below, the staple drivers 75 are operable to translate upward into staple pockets 74 to thereby drive staples 90 upward through the pockets of clamp 74 and for engagement with anvil 60. The clamp drivers 75 are moved upwardly by a wedge slider 78, which is captured between the cartridge body 71 and the tray 76, and which is translated longitudinally through the cartridge body 71 .
[0033] Wedge slider 78 includes a pair of obliquely angled cam surfaces 79, which are configured to engage clip drivers 75 and thereby drive clip drivers 75 upwards as wedge slider 78 it translates longitudinally through cartridge 70. For example, when wedge slider 78 is in a proximal position, clip drives 75 are in downward positions, and clips 90 are located in clip pockets 74. wedge 78 is driven to the distal position by a translation knife member 80, wedge slider 78 drives staple drivers 75 upward, thereby driving staples 90 out of staple pockets 74 and into pockets of forming staples 64 which are formed on the underside 65 of the anvil 60. In this way, the staple drivers 75 translate along a vertical dimension as the wedge slider 78 translates along a vertical dimension. that of a horizontal dimension.
[0034] In some versions, the staple cartridge 70 is constructed and operable in accordance with at least some of the instructions in US Patent Application No. 2014/0239042 entitled "Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler", published on August 28, 2014, the description of which is incorporated herein by reference. Additionally or alternatively, the staple cartridge 70 may be constructed and operable in accordance with at least some of the teachings of US Patent Application No. 2014/0239044, entitled "Installation Features for Surgical Instrument End Effector Cartridge", published at 28 of August 2014, the description of which is incorporated herein by reference. Other suitable shapes that staple cartridge 70 may take will be apparent to those skilled in the art in view of the teachings of the present invention.
[0035] As best seen in Figure 2, the anvil 60 of the present example comprises a longitudinally extending channel 62 and a plurality of clip forming pockets 64. The channel 62 is configured to align with the channel 72 of the staple cartridge 70 when anvil 60 is in a closed position. Each staple forming pocket 64 is positioned to lie over a corresponding staple pocket 74 of staple cartridge 70 when anvil 60 is in a closed position. The staple forming pockets 64 are configured to deform the staple legs 90 when the staples 90 are driven through the fabric and into the anvil 60. In particular, the staple forming pockets 64 are configured to flex the staple legs 90 to secure the staples 90 formed in the fabric. Anvil 60 can be constructed in accordance with at least some of the teachings of US Patent Application No. 2014/0239042 entitled "Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler", published August 28, 2014; at least some of the teachings of US Patent Application No. 2014/0239036 entitled "Jaw Closure Feature for End Effector of Surgical Instrument", published on August 28, 2014; and/or at least some of the teachings of US Patent Application No. 2014/0239037 entitled "Staple Forming Features for Surgical Stapling Instrument", published August 28, 2014, the description of which is incorporated herein by reference. Other suitable shapes that anvil 60 can acquire will be apparent to those skilled in the art in view of the teachings of the present invention.
[0036] In the present example, a knife member 80 is configured to translate through the end actuator 40. As best seen in Figure 3, a knife member 80 is secured to the distal end of a firing arm 82, which extends through a portion of the drive shaft assembly 30. As best seen in Figure 2, a knife member 80 is positioned in the channels 62, 72 of the anvil 60 and staple cartridge 70. The knife member 80 includes a distally presented cutting edge 84 that is configured to cut tissue that is compressed between anvil 60 and platform 73 of staple cartridge 70 as knife member 80 is moved distally through end actuator 40. As noted above , knife member 80 also drives wedge slider 78 distally as knife member 80 translates distally through end actuator 40, thus pushing clips 90 through tissue and against anvil 6 0 for training. C. Exemplary Actuation of the End Actuator
[0037] In the present example, the anvil 60 is driven to the lower jaw 50 by advancing the closure ring 36 distally to the end actuator 40. The closure ring 36 cooperates with the anvil 60 through a cam action. 60 toward lower jaw 50 in response to distal translation of closure ring 36 relative to end actuator 40. Likewise, closure ring 36 can cooperate with anvil 60 to open anvil 60 away from the lower jaw. 50 in response to proximal translation of closure ring 36 relative to end actuator 40. By way of example only, closure ring 36 and anvil 60 may interact in accordance with at least some of the teachings of US Patent Application No. 2014/0239036 entitled "Jaw Closure Feature for End Effector of Surgical Instrument", published August 28, 2014, the description of which is incorporated herein by reference; and/or can be configured in accordance with at least some of the teachings of US Patent Application No. 14/314,108 entitled "Jaw Opening Feature for Surgical Stapler", filed June 25, 2014, the description of which is incorporated herein by way of of reference.
[0038] As noted above, handle assembly 20 includes a pistol grip 22 and a closing trigger 24. As also noted above, the anvil 60 is closed toward the lower jaw 50 in response to the distal advancement of the closing ring 36 In the present example, the closing trigger 24 is pivotal toward the pistol grip 22 to actuate the closing tube 32 and the closing ring 36 distally. Various suitable components that can be used to convert the pivotal movement of the closure trigger 24 towards the pistol grip 22 to the distal translation of the closure tube 32 and closure ring 36 relative to the handle assembly 20 will be evident to those skilled in the art in view of the teachings contained herein.
[0039] Also in the present example, the instrument 10 provides motorized control of the firing arm 82. In particular, the instrument 10 includes motorized components that are configured to drive the firing arm 82 distally in response to the firing trigger 26 pivot at the direction of pistol grip 22. In some versions, a motor (not shown) is contained in pistol grip 22 and is powered by battery 28. This motor is coupled with a transmission assembly (not shown) that converts rotary motion of a motor drive shaft in linear translation of the firing arm 82. By way of example only, the features that are operable to provide motorized actuation of the firing arm 82 may be configured and operable in accordance with at least some of the teachings of US Patent No. 8,210,411 entitled "Motor-Driven Surgical Instrument", filed July 3, 2012, the description of which is incorporated herein by reference; US Patent No. 8,453,914 entitled "Motor-Driven Surgical Cutting Instrument with Electric Actuator Directional Control Assembly", issued June 4, 2013, the description of which is incorporated herein by reference; and/or US Patent Application No. 14/226,142, entitled "Surgical Instrument Comprising a Sensor System", published March 26, 2014, the description of which is incorporated herein by reference.
[0040] It should also be understood that other components or features of the instrument 10 may be configured and operated in accordance with the various references cited in the present invention. Additional exemplary modifications that may be provided for instrument 10 will be described in more detail below. Various suitable ways in which the teachings below can be incorporated into instrument 10 will be apparent to those skilled in the art. Similarly, various suitable ways in which the teachings below may be combined with the various teachings of the references cited in the present invention will be apparent to those skilled in the art. It should be understood, therefore, that the teachings below can be readily incorporated into the various instruments taught in the various references which are cited in the present invention. It is also to be understood that the teachings below are not limited to the instrument 10 or the devices taught in the references cited in the present invention. The teachings below can be readily applied to many other types of instruments, including instruments that would not be classified as surgical staplers. Various other suitable devices and settings to which the teachings below can be applied will be apparent to those skilled in the art based on the teachings of the present invention. II. Exemplifying Reinforcement Set for Surgical Stapler
[0041] In some cases, it may be desirable to equip an end actuator 40 with a reinforcement material to reinforce the mechanical fixation of the fabric provided by staples 90. Such reinforcement may prevent the applied staples 90 from pulling through the tissue, and can, otherwise, reduce a risk of fabric tearing at or near the applied staples 90. In addition to or as an alternative to providing structural support and integrity to a line of staples 90, a gusset can provide various other types of effects, such as spacing or gap filling, delivery of therapeutic agents, and/or other effects. In some cases, a gusset may be provided on the platform 73 of the staple cartridge 70. In some other cases, a gusset may be provided on the surface of the anvil 60 that faces the staple cartridge 70. It should also be understood that a first gusset may be provided on platform 73 of staple cartridge 70 while a second gusset is provided on anvil 60 of the same end actuator 40. Various examples of shapes that a gusset can take will be described in more detail below. Various ways in which a gusset can be attached to a staple cartridge 70 or an anvil 60 will also be described in more detail below. A. Exemplifying Composition of the Surgical Stapler Reinforcement Set
[0042] Figure 4 shows an exemplary pair of reinforcement sets 100, 110 with a basic composition. The reinforcement assembly 100 of the present example comprises a reinforcement body 102 and an upper adhesive layer 104. Similarly, the reinforcement assembly 110 comprises a reinforcement body 112 and a lower adhesive layer 114. gusset 102, 112 comprises a strong yet flexible material configured to structurally support a row of staples 90. By way of example only, each gusset 102, 112 may comprise a woven web of Polyglactin 910 material, supplied by Ethicon, Inc. of Somerville, New Jersey, USA. Alternatively, any other suitable materials or combinations of materials may be used additionally or alternatively to the Polyglactin 910 material to form each reinforcement body 102, 112. Each reinforcement body 102, 112 may be any other suitable shape and may be fabricated in any other suitable materials. By way of example only, each reinforcing body 102, 112 may comprise one or more of the following: NEOVEIL absorbable PGA (polyglycolic acid) felt, available from Gunze Limited, Kyoto, Japan; SEAMGUARD polyglycolic acid:trimethylene carbonate (PGA:TMC) reinforcing material, available from W.L. Gore & Associates, Inc., of Flagstaff, Arizona, USA; PERI-STRIPS DRY with VERITAS Collagen Matrix Reinforcement Material (PSDV), available from Baxter Healthcare Corporation of Deerfield, Illinois, USA; BIODESIGN biological graft material, available from Cook Medical, Bloomington, Indiana, USA; and/or SURGICEL NU-KNIT hemostatic material, available from Ethicon, Inc., of Somerville, New Jersey, USA. Still other suitable materials that can be used to form each bolster 102, 112 will be apparent to those skilled in the art in view of the teachings of the present invention.
[0043] Additionally or alternatively, each reinforcement body 102, 112 may comprise a material that includes, for example, a hemostatic agent, such as fibrin, to aid in blood clotting and reduce bleeding at the surgical site cut and/or stapled to the along tissue 90. As another merely illustrative example, each reinforcement body 102, 112 may comprise other auxiliary compounds or hemostatic agents that can be used, such as thrombin, so that each reinforcement body 102, 112 can help to clot the blood and reduce the amount of bleeding at the surgical site. Other auxiliary compounds or reagents that may be incorporated into each reinforcement body 102, 112 may additionally include, but are not limited to, matrix components or medical fluid. Merely illustrative examples of materials that can be used to form each reinforcement body 102, 112, as well as materials that may otherwise be incorporated into a reinforcement body 102, 112, are disclosed in US Patent Application No. 14/667,842 , entitled "Method of Applying a Buttress to a Surgical Stapler", filed March 25, 2015, the description of which is incorporated herein by reference. Alternatively, any other suitable materials can be used.
[0044] By way of additional example only, each reinforcement body 102, 112 can be constructed in accordance with at least some of the teachings of US patent publication No. 2012/0241493, entitled "Tissue Thickness Compensator Comprising Controlled Release and Expansion" , published September 27, 2012, the description of which is incorporated herein by reference. US Patent Publication No. 2013/0068816 entitled "Surgical Instrument and Buttress Material", published March 21, 2013, the description of which is incorporated herein by reference; US Patent Publication No. 2013/0062391, entitled "Surgical Instrument with Fluid Fillable Buttress", published March 14, 2013, the description of which is incorporated herein by reference; US Patent Publication No. 2013/0068820 entitled "Fibrin Pad Matrix with Suspended Heat Activated Beads of Adhesive", published March 21, 2013, the description of which is incorporated herein by reference; US Patent Publication No. 2013/0082086 entitled "Attachment of Surgical Staple Buttress to Cartridge", published April 4, 2013, the description of which is incorporated herein by reference; US Patent Publication No. 2013/0037596 entitled "Device for Applying Adjunct in Endoscopic Procedure", published February 14, 2013, the description of which is incorporated herein by reference; US Patent Publication No. 2013/0062393 entitled "Resistive Heated Surgical Staple Cartridge with Phase Change Sealant", published March 14, 2013, the description of which is incorporated herein by reference; US Patent Publication No. 2013/0075446 entitled "Surgical Staple Assembly with Hemostatic Feature", published March 28, 2013, the description of which is incorporated herein by reference; US Patent Publication No. 2013/0062394 entitled "Surgical Staple Cartridge with SelfDispensing Staple Buttress", published March 14, 2013, the description of which is incorporated herein by reference; US Patent Publication No. 2013/0075445 entitled "Anvil Cartridge for Surgical Fastening Device", published March 28, 2013, the description of which is incorporated herein by reference; US Patent Publication No. 2013/0075447 entitled "Adjunct Therapy for Applying Hemostatic Agent", published March 28, 2013, the disclosure of which is incorporated herein by reference. US Patent Publication No. 2013/0256367 entitled "Tissue Thickness Compensator Compensating a Plurality of Medicines", published October 3, 2013, the disclosure of which is incorporated herein by reference; U.S. Patent Application No. 14/300,954 entitled "Adjunct Materials and Methods of Using Same in Surgical Methods for Tissue Sealing", filed June 10, 2014, the description of which is incorporated herein by reference; US Patent Application No. 14/827,856 entitled "Implantable Layers for a Surgical Instrument", filed August 17, 2015, the description of which is incorporated herein by reference; U.S. Patent Application No. 14/840,613 entitled "Drug Eluting Adjuncts and Methods of Using Drug Eluting Adjuncts", filed August 31, 2015, the disclosure of which is incorporated herein by reference; US Patent Application No. 14/871,071, entitled "Compressible Adjunct with Crossing Spacer Fibers", filed September 30, 2015, the description of which is incorporated herein by reference; and/or US Patent Application No. 14/871,131 entitled "Method for Applying an Implantable Layer to a Fastener Cartridge", filed September 30, 2015, the description of which is incorporated herein by reference.
[0045] In the present example, adhesive layer 104 is provided on reinforcement body 102 for adhering reinforcement body 102 to the underside 65 of anvil 60. Similarly, adhesive layer 114 is provided on reinforcement body 112 to adhering the reinforcement body 112 to the platform 73 of the staple cartridge 70. The adhesion of the reinforcement body 102 to the underside 65 of the anvil 60 or to the platform 73 of the staple cartridge 70 can occur through a variety of mechanisms, including , but not limited to, a pressure sensitive adhesive. In some versions, each adhesive layer 104, 114 comprises a pressure sensitive adhesive material. Several examples of suitable materials that can be used to form adhesive layers 104, 114 are disclosed in US Patent Application No. 14/667,842 entitled "Method of Applying a Buttress to a Surgical Stapler", filed March 25, 2015 , the description of which is incorporated herein by reference. Alternatively, any other suitable materials can be used. It should be understood that the term "adhesive", as used herein, may include (but is not limited to) sticky materials as well as materials that are malleable or wax-like, and that adhere to a complex geometry through deformation and forming. . Some suitable adhesives can provide such elasticity to adhere to a complex geometry through deformation and forming without necessarily providing high initial tackiness. In some cases, adhesives with lower tackiness can be removed cleaner from surfaces. Various suitable materials that can be used to form adhesive layers 104, 114 will be apparent to those skilled in the art in view of the teachings of the present invention. B. Exemplifying Materials and Techniques for Providing Surgical Stapler Reinforcement Adhesion
[0046] As noted above, a reinforcement assembly 100, 110 may include a layer 104, 114 of adhesive material or other form of adhesive material that causes the reinforcement body 102, 112 to adhere to the underside 65 of the anvil 60 or to platform 73 of staple cartridge 70. Such adhesive material can provide proper positioning of backing body 102, 112 before and during actuation of end actuator 40; and then, enables the reinforcement body 102, 112 to separate from the end actuator 40 after the end actuator 40 has been actuated, without causing damage to the reinforcement body 102, 112 that is substantial enough to compromise subsequent proper operation. of the reinforcement body 102, 112.
[0047] Figures 5A to 5C show a sequence in which an end actuator 40 that has been loaded with stiffener assemblies 100, 110 is actuated to drive the staples 90 through two juxtaposed fabric layers T1, T2, with the stiffener assemblies gusset 100, 110 being secured to the same tissue layers T1, T2 by staples 90. In particular, Figure 5A shows tissue layers T1, T2 positioned between anvil 60 and staple cartridge 70, with anvil 60 in the open position . Reinforcement assembly 100 is adhered to underside 65 of anvil 60 by adhesive layer 104; while gusset assembly 110 is adhered to platform 73 of staple cartridge 70 by means of adhesive layer 114. Fabric layers T1, T2 are therefore interposed between gusset assemblies 100, 110. Then trigger 24 is pivoted toward pistol grip 22 to actuate closure tube 32 and closure ring 36 distally. This drives the anvil 60 to the closed position, as shown in Figure 5B. At this stage, fabric layers T1, T2 are compressed between anvil 60 and staple cartridge 70, with gusset assemblies 100, 110 engaging opposing surfaces of fabric layers T1, T2. End actuator 40 is then actuated, as described above, driving clamp 90 through gusset assemblies 100, 110 and tissue 90. As shown in Figure 5C, crown 92 of actuated clamp 90 captures and retains gusset assembly 110 against fabric layer T2. The deformed legs 94 of the clamp 90 capture and retain the reinforcement assembly 100 against the fabric layer T1.
[0048] It should be understood that a series of staples 90 will similarly capture and retain gusset assemblies 100, 110 against fabric layers T1, T2, thereby securing gusset assemblies 100, 110 to the fabric T1, T2, as shown in Figure 6. As the end actuator 40 is pulled out of the fabric 90 after deploying the clamps 90 and the brace assemblies 100, 110, the brace assemblies 100, 110 disengage the end effector, so that the reinforcement assemblies 100, 110 remain secured to the fabric T1, T2 with staples 90. The reinforcement fabric T1, T2 therefore provides structural reinforcement to the lines of the staples 90. As can be seen in Figure 6, the knife member 80 also cuts through a centerline of gusset fabric assemblies 100, 110, separating each gusset assembly 100, 110 into a corresponding pair of sections so that each section remains attached to a respective cut region of fabric. T1, T2.
[0049] In the aforementioned example, the brace assembly 100 is sized to extend over the entire width of the underside 65 so that the brace assembly 100 expands through the channel 62. Thus, the member knife 80 cuts through backing assembly 100 during actuation of end actuator 40 as described above. In some other examples, such as those described below, the reinforcement assembly 100 is provided in two separate and laterally spaced portions, with one portion being disposed on the underside 65 on one side of the channel 62 and another portion being disposed over the lower side 65 on the other side of the channel 62. In these versions, the brace assembly 100 does not expand through the channel 62, so the knife member 80 does not cut through the brace assembly 100 during actuation of the end actuator. 40.
[0050] Likewise, the reinforcement assembly 110 can be sized to extend along the entire width of the platform 73, so that the reinforcement assembly 110 extends along the channel 72, and so that the member 80 cuts through backing assembly 110 during actuation of end actuator 40 as described above. Alternatively, the reinforcement assembly 110 may be provided in two separate and laterally spaced portions, with one portion being disposed on the platform 73 on one side of the channel 72 and another portion being disposed on the platform 73 on the other side of the channel 72, so that the brace assembly 110 does not expand through the channel 72, and so that the knife member 80 does not cut through the brace assembly 110 during actuation of the end actuator 40. III. Exemplifier Extensible Reinforcement Set for Surgical Stapler
[0051] In some cases, it may be desirable to equip the end actuator 40 with a backing assembly 100, 110 comprising an adhesive layer 104, 114 in combination with a backing body 102, 112 constructed from an elastic material that it is substantially extensible in at least one direction and that it will substantially regain its original shape. The resulting reinforcement assemblies 100, 110 can advantageously reinforce the mechanical fixation of tissue provided by the clamps 90, while moving with the underlying tissue rather than constraining it. Such gussets 100, 110 may be particularly useful in applications where the fabric that is closed may subsequently expand and/or contract. For example, the extendable bracing assemblies 100, 110 can be used to reinforce the mechanical attachment of a retracted lung which is then re-expanded, and which expand and contract with the lung during the breathing process.
[0052] In illustrative examples of extensible gussets 100, 110, the gusset bodies 102, 112 may comprise a flat fibrous textile product. "Fiber" for use in the present invention refers to continuous fibers, which are sometimes referred to in the art as "substantially continuous filaments", "filaments", or "yarns", or to textile fibers having an average length that is sufficient for that the textile fibers can be knitted and/or woven together. Fibers that are useful can be selected from the group consisting of monocomponent fibers; multicomponent fibers; bicomponent fibers; bi-constituent fibers; and their combinations.
[0053] "One-component fiber" for use in the present invention refers to a fiber formed using one or more extruders from a single polymer; this is not intended to exclude fibers formed from a polymer to which small amounts of additives have been added. Additives may be added to the polymer for the purpose of providing color, antistatic properties, lubricity, hydrophilic capacity and/or other properties to the resulting fiber. Monocomponent fibers can be multifilament or monofilament fibers.
[0054] "Multicomponent fiber" for use in the present invention refers to a fiber formed from two or more different polymers that are extruded into separate extruders and spun together to form a fiber.
[0055] "Bicomponent fibers" are a type of multicomponent fiber and are formed from two different polymers. Bicomponent fibers can sometimes be referred to in the technique as "conjugated fibers". Bicomponent fibers can consist of polymers that are positioned substantially continuously in distinct zones, both across the cross section of the bicomponent fibers and along their length. Some non-limiting examples of such bicomponent fibers include, but are not limited to, sheath/core arrangements, with one polymer being surrounded by another; side-by-side arrangements; "sliced pie" provisions; or even "islands-at-sea" provisions. Each of the aforementioned polymer arrangements is known in the multi-component (including bi-component) fiber art.
[0056] Bicomponent fibers can be divisible fibers. Such fibers can be split longitudinally before or during processing into multiple fibers, each of the multiple fibers having a smaller cross-sectional dimension than that of the original bicomponent fiber. Split fibers can provide softer textile products due to their reduced cross-sectional dimensions.
[0057] "Bi-constituent fibers" for use in the present invention refers to fibers that have been formed from at least two starting polymers extruded as a blend from the same extruder. Bi-constituent fibers can have the various polymeric components disposed in distinct zones positioned relatively constantly across the cross-sectional area of the fiber, and the various polymers are generally not continuous along the entire length of the fiber. Alternatively, the bi-constituent fibers may comprise a blend, which may or may not be homogeneous, of the at least two starting polymers. For example, a bicomponent fiber can be formed from starting polymers that differ only in molecular weight.
[0058] Bi-constituent fibers can form fibrils, which can start and end randomly along the length of the fiber. Bi-constituent fibers can sometimes be called multi-constituent fibers.
[0059] In the illustrative examples of extensible gusset sets 100, 110, flat textile products that are useful for producing extensible gusset sets 100, 110 comprise fibers that are substantially aligned in one or more preferred directions, such as in the machine direction, cross-machine direction, or combinations thereof. Useful textiles can be distinguished from textiles that comprise fibers in random orientations, including, but not limited to, melt blown, hydroentangled and electrospun textiles. In the following text, several merely illustrative examples of fiber arrangements are provided that can be readily incorporated into the reinforcement assemblies 100, 110. It should be understood that the teachings below can be readily combined with the teachings above. A. Exemplifying Extensible Reinforcement Assemblies that Do Not Substantially Extend along the Longitudinal Geometric Axis of an End Actuator
[0060] In some surgical applications, it may be desirable to use strut assemblies 100, 110 comprising strut bodies 102, 112 that do not substantially extend along the longitudinal axis LA of the end actuator 40 along which the length of each gusset 102, 112 extends but extends laterally along the plane defined by each gusset 102, 112. In other words, it may be desirable to provide gusset bodies 102, 112 that extend along the dimension of the width of the reinforcement bodies 102, 112. For example, a surgeon may wish to staple an anatomical structure that is not intended to stretch once secured with an extendable staple line. However, the surgeon may not wish to stop midway through surgery and change instrument 10 and/or drive shaft assembly 30. Applying to the anatomical structure a reinforcement assembly 100, 110 that does not extend substantially along the axis LA length of end actuator 40, clamp line stretch can be minimized or even eliminated. In an illustrative example, during a lobectomy, a surgeon may wish to apply an extendable staple line (for example, as taught in US Patent Application Publication No. 14/498,145 entitled "Method for Creating a Flexible Staple Line", filed on September 26, 2014, the description of which is incorporated herein by reference; and/or US Patent Application No. 14/498,070 entitled "Radically Expandable Staple Line", filed September 26, 2014, the description of which is incorporated herein. for reference) to the lung parenchyma, but apply a line of staples that does not extend to the bronchi. In such configurations, the surgeon can apply an extendable staple line without the bolster assembly 100, 110 to the parenchyma, and then apply an extendable staple line with the bolster assembly 100, 110 to the bronchi. The presence of the longitudinally applied inextensible reinforcement assembly 100, 110 will essentially convert an otherwise extensible staple line to an inextensible staple line when applied to the bronchi.
[0061] The following examples refer to various mesh or weft configurations that can be provided in textile products that are used to form reinforcement bodies 102, 112. reinforcement 102, 112 formed of flat textile product that is constructed from fibers that are substantially misaligned with the longitudinal axis LA of the end actuator 40. 1. Exemplifying Reinforcement Sets Comprising Warp Mesh Flat Textile Product
[0062] The flat textile product can comprise loop fiber structures that are obtained through the woven warp. In addition to being substantially stretchable in one direction, warp knit fabrics may tend not to come apart or curl, particularly compared to weft knit fabrics (discussed below). In some versions, the flat textile product which is warp knitted comprises fibers which are applied to the knitted area of the fabric in parallel with each other and with the edge of the fabric. The fabric edge is created as a result of the fibers being distributed in the fabric machine direction (i.e., the "lateral movement") to form loops, the edge being formed by the fibers as they move laterally. In addition to moving laterally along the machine direction, the fibers can move in front of and behind the fabric plane (ie, the "back-and-forth") or between multiple textile product planes (as in a construction of spacer textile product) to connect dots and form textile product ties.
[0063] In some examples, the warp knit flat textile product may preferably comprise one-component fibers that are monofilament or monofilament and relatively fine denier with a low denier per filament (DPF). In some examples, both multifilament and monofilament fibers can be used in the same woven reinforcement body 102, 112. In some examples, two or more monocomponent fibers of different polymeric compositions can be used to obtain the properties of reinforcement body 102, 112 desired.
[0064] In some illustrative examples, the warp knit fabric is weaved using knitting and/or Raschel knitting machines that use needle support and guide bar configurations known to those skilled in the art to provide a fabric warp mesh that comprises one or more mesh patterns. When using one or more of the aforementioned machines, the resulting warp knit fabric can be formed from a series of overlapping and underlying loops that can be arranged in various combinations. Additionally or alternatively, open and closed stitches may be formed as a result of the direction of the overlapping and underlying loops. Useful loop patterns include, but are not limited to, loop on pillar, loop 1x1 (knit loop), loop 2x1, loop 3x1, loop 4x1, loop atlas, and combinations thereof. As some Raschel knitting machines comprise a greater number of guide bars than knitting machines, they can provide a greater number of possible knit patterns. In some instances where spacer textile products are desired, a double needle bar Raschel machine can be used so that a single layer of secondary knit fabric is simultaneously produced and connected to a first layer of textile product.
[0065] Figure 7 is a diagram representing a knit pattern of an exemplary 750 flat textile product comprising 751 knitted fibers in a knit pattern using two guide bars, although up to four guide bars can be used for increase the complexity of the knitting pattern. As seen in Figure 7, fibers 751 zigzag intertwine along the cross-machine direction of the fabric to connect stitches and form fiber loops 752. The resulting flat textile product may be substantially extensible in the cross-machine direction of the fabric. fabric, but may not be substantially stretchable in the machine direction of the fabric. In some cases, after being rolled out, the resulting flat textile product can substantially regain its original shape.
[0066] The warp mesh flat textile product 750, 850 can be formed into reinforcement bodies 102, 112 so that the reinforcement bodies 102, 112 do not substantially stretch along the longitudinal axis LA of the end actuator 40 However, such reinforcement bodies 102, 112 can be stretched in directions that are transverse to the longitudinal geometric axis LA of the end actuator 40 along the planes defined by the reinforcement bodies 102, 112. useful when a surgeon wishes to staple an anatomical structure that will naturally extend in directions that are transverse to the longitudinal axis of the staple line. It may also be beneficial to enable stretching in directions that are transverse to the longitudinal axis of the staple line in cases where there is a series of staple lines generally arranged from one end to the other, where the longitudinal axes of the staple lines are not perfectly aligned with each other. 2. Exemplifying Reinforcement Assemblies Comprising Flat Weft Mesh Textile Product
[0067] The flat textile product can comprise loop fiber structures that are obtained through weft interweaving. Compared to warp knit fabrics, weft knit fabrics can be characterized by greater stretch and resilience, and can also be produced by using fewer spools of fiber, even a single spool of fiber. In some versions, the flat textile product which is weft knitted comprises fibers which are applied to the knitted area of the fabric in a horizontal, cross-machine and circular direction. In some versions, the weft knit fabric is woven in a ribbed pattern.
[0068] In some examples, the weft knit flat textile product may preferably comprise monocomponent fibers that are multifilament or monofilament and relatively fine medium denier with a low average denier per filament (DPF). In some examples, both multifilament and monofilament fibers can be used in the same woven reinforcing body construction 102, 112. In some examples, two or more monocomponent fibers of different polymer composition can be used to obtain the reinforcing body properties. 102, 112 desired.
[0069] Figure 8 is a diagram depicting an exemplary weft knit 850 flat textile product comprising fibers 851 woven into a weft insert pattern using a Raschel knitting machine. As can be seen in Figure 8, fibers 851 zigzag intertwine along the cross machine direction of the fabric to connect stitches and form fiber loops 852. The resulting flat textile product 850 may be substantially extensible in the cross machine direction. of the fabric, but may not be substantially stretchable in the machine direction of the fabric. In some cases, after being rolled out, the resulting flat textile product can substantially regain its original shape.
[0070] Figure 9 is a diagram representing a knit pattern of another exemplary flat textile product 950 comprising fibers 951 woven into a weft pattern. As can be seen in Figure 9, each fiber loop 952 is formed from the previous fiber loop 952. The resulting 950 flat textile product can be characterized by its extensibility in the cross-machine direction of the fabric and good resilience to its original shape.
[0071] Weft knit flat textiles 950 can be formed into reinforcing bodies 102, 112 so that the reinforcing bodies 102, 112 do not substantially extend along the longitudinal axis LA of the end actuator 40. , such reinforcement bodies 102, 112 may be stretched in directions that are transverse to the longitudinal geometric axis LA of the end actuator 40 along the planes defined by the reinforcement bodies 102, 112. Such reinforcement bodies 102, 112 may be useful when a surgeon wants to staple an anatomical structure that will naturally extend in directions that are transverse to the longitudinal axis of the staple line. It may also be beneficial to enable stretching in directions that are transverse to the longitudinal axis of the staple line in cases where there is a series of staple lines generally arranged from one end to the other, where the longitudinal axes of the staple lines are not perfectly aligned with each other. 3. Exemplifying Reinforcement Sets comprising Flat Woven Textile Product
[0072] The flat textile product may comprise woven fiber structures. Woven fiber structures comprise cross warp and weft fibers. The warp and weft fibers are perpendicular to each other so that they cross at a 90° angle.
[0073] In some examples, woven fiber structures may preferably comprise monocomponent fibers that are multifilament or monofilament and relatively fine denier with a low denier per filament (DPF). In some examples, both multifilament and monofilament fibers can be used in the same woven reinforcing body construction 102, 112. In some examples, two or more monocomponent fibers of different polymer composition can be used to obtain the reinforcing body properties. 102, 112 desired.
[0074] Useful flat textile products may be woven into any pattern that provides substantial extensibility in at least one direction and substantial recovery of the textile product's original shape after being drawn. By way of example only, the flat textile product may be woven in a pattern selected from the group consisting of twill weave; simple plot; and their combinations. In further examples, the flat textile product may comprise more than one woven pattern, in fact, while the twill pattern, plain weft pattern, etc. comprise basic warp and fill yarn arrangements, any number of desirable designs can be produced by changing the location and frequency of interlacing.
[0075] Figure 10 is a diagram depicting an exemplary flat textile product 1050 having a Raschel weft insert fiber pattern. Flat textile product 1050 comprises warp fibers 1051a that have been formed into columns of pillars produced by interdepending the warp fibers 1051a to form a chain stitch, and attaching the weft fibers 1051b to connect the pillar columns and form the fabric design. The resulting flat textile product 1050 may be substantially stable in both the DM machine direction and the cross machine direction DT, unless the weft fibers 1051b are elastomeric, in which case the resulting flat textile product 1050 extends substantially in the cross direction. to the DT machine. In other words, if the weft fibers 1051b are elastomeric, the stretch axis SA of the flat textile 1050 can be perpendicular to the DM machine direction of the fabric. In some versions, the 1050 flat textile product can substantially recover its original shape after being extended. In still other variations of the flat textile product 1050 shown in Figure 10, an inelastic fiber is wound around an elastic fiber to form a coil like a spring around an extensible center. The resulting combination of fibers can then be used as the 1051b weft fibers that are arranged to form the design and connect the 1051a warp fiber pillar columns together, as shown in Figure 10.
[0076] An illustrative example of the extensibility of the woven flat textile product is shown in Figure 11. In particular, a woven flat textile product 1150 comprises warp fibers 1151a and weft fibers 1151b that intersect at angles of about 90°. The woven flat textile product 1150 is oriented such that the longitudinal geometric axis of the textile product 1150 is about an angle of 45° to the warp fibers 1151a and the weft fibers 1151b. When the flat textile product is in its unextended or relaxed state 1150a, the warp fibers and the weft fibers intersect at a first angle, A1, and the textile product is characterized by a first width, W1, and a first length , L1. When the flat textile product is in its stretched state 1150b, the warp fibers and the weft fibers intersect at a second angle, A2, which is greater than A1, but which is not yet equal to 90°. Furthermore, when the flat textile product is in its extended state 1150b, it is further characterized by a width, W2, which is greater than W1, and a length, L2 which is greater than L1. When forces causing the flat textile product to be in its extended state 1150b are removed, the flat textile product may substantially return to its relaxed state 1150a, or to a state that is midway between the extended state 1150a and the state. relaxed 1150b.
[0077] The woven flat textile product 1050, 1150 can be formed into a reinforcing body 102, 112 so that the flat textile product does not substantially extend along the longitudinal axis LA of the end actuator 40. However, such bodies struts 102, 112 can be stretched in directions that are transverse to the longitudinal geometric axis LA of the end actuator 40 along the planes defined by struts 102, 112. Such struts 102, 112 may be useful when a surgeon desires staple an anatomical structure that will naturally extend in directions that are transverse to the longitudinal axis of the staple line. It may also be beneficial to enable stretching in directions that are transverse to the longitudinal axis of the staple line in cases where there is a series of staple lines generally arranged from one end to the other, where the longitudinal axes of the staple lines are not perfectly aligned with each other.
[0078] An illustrative example of a reinforcing body 1202 comprising the flat woven textile product 1150 of Figure 11 is shown in Figure 12. The reinforcing body 1202 is shown in a relaxed state 1202a and in an extended state 1202b. B. Exemplifying Extensible Reinforcement Assemblies Extending Substantially Along the Longitudinal Geometric Axis of an End Actuator
[0079] In some other surgical applications, it may be desirable to use bracing assemblies 100, 110 comprising bracing bodies 102, 112 that extend along the longitudinal axis LA of the end actuator 40, but which do not extend substantially laterally along the plane defined by each reinforcement bodies 102, 112. In other words, it may be desirable to provide reinforcement bodies 102, 112 that extend along the length dimension of the reinforcement bodies 102, 112. Again with reference to the example of a pulmonary lobectomy, the lung may be in a retracted state when the surgeon actuates the end actuator 40 on the lung parenchyma. When the lung is then re-expanded, the resulting expansion of the lung will apply tension to the parenchyma, thus causing extension along the staple line. A line of extensible staples (for example, as taught in US Patent Application Publication No. 14/498,145 entitled "Method for Creating a Flexible Staple Line", filed September 26, 2014, the description of which is incorporated herein by title and/or US Patent Application No. 14/498,070 entitled "Radically Expandable Staple Line", filed September 26, 2014, the description of which is incorporated herein by reference) may thus accommodate such extension. In configurations where the surgeon desires the staple line to be reinforced by a brace assembly 100, 110, it may be necessary for the brace assembly 100, 110 to be extensible along the longitudinal axis to accommodate the lung swelling during re-expansion. Otherwise, an inextensible reinforcement assembly 100, 110 can create tension in the staple line during re-expansion, possibly tear the tissue and compromise the integrity of the staple line, causing leakage and/or other adverse results. Thus, reinforcing bodies 102, 112 extending substantially along the longitudinal axis LA of the end actuator 40 may be required.
[0080] In some versions, the extensibility of the reinforcement bodies 100, 110 can be manipulated based on the choice of fiber material, the orientation of the fibers, the tension on the fibers during the production of the textile product, and combinations of these options. Fiber orientation can refer to how the warp fibers are spun through the needles (called a spinning pattern - each guide bar can be fully spun or partially spun), which can affect the density of the textile and, therefore, its extensibility. In warp and weft weaving constructions, the elasticity or "stretch" of the textile can be affected by tension in both the fiber and textile systems (being collected in a reel after weaving) during the product formation process textile. Tension can affect the size of the loops that are formed. Slight tension adjustments and the resulting impact on fiber loop size can enable greater extensibility and recovery.
[0081] Elastic fibers can be used in the construction of flat textile product. By way of example only, the flat textile product may comprise elastic fibers produced from copolymers selected from the group consisting of poly(caprolactone)-co-poly(glycolide) (PCL/PGA); poly(caprolactone)-poly(lactide) (PCL/PLA); poly(lactide)-trienmethylene diacene co-carbonate (PCL/TMC); and their combinations.
[0082] In some examples, elastic fibers can be used that comprise multifilament or monofilament fibers (depending on the degree of hardness, strength and elongation of the textile product that is desired). In some examples, elastic fibers are bicomponent fibers comprising inelastic fibers that are wound around elastic fibers to form a coil like a spring around an extensible center. The flat textile product comprising elastic fibers can be formed into a reinforcing body 102, 112 so that the flat textile product extends substantially along the longitudinal axis LA of the end actuator 40.
[0083] In addition to the foregoing, it should also be understood that any of the various reinforcement assemblies described herein may still be constructed and operated in accordance with at least some of the teachings of US patent application No. 14/667,842, entitled " Method of Applying a Buttress to a Surgical Stapler", filed March 25, 2015, the description of which is incorporated herein by reference. IV. Exemplifying Combinations
[0084] The following examples refer to various non-exhaustive ways in which the teachings of the present invention can be combined or applied. It should be understood that the following examples are not intended to restrict coverage of any claims that may be made at any time in this order or in deposits subsequent to this order. No waiver of rights is intended. The following examples are provided for illustrative purposes only. It is contemplated that the various teachings of the present invention can be arranged and applied in a variety of other ways. It is also contemplated that some variations may omit certain features referred to in the examples below. Therefore, none of the aspects or features referred to below should be considered critical, unless explicitly stated otherwise at a later date made by the inventors or a successor in the interest of the inventors. If any claims are filed in this application or in subsequent filings relating to this application that include additional features beyond those noted below, it is not presumed that such additional features have been added for any reason relating to patentability. Example 1
[0085] An extensible reinforcement assembly associated with surgical staples capable of positioning in organic tissue, the staples coming from a surgical stapler that has a longitudinal geometric axis, the reinforcement assembly comprising: (a) a textile product plan having a first side and a second side opposite the first side, the flat textile product comprising fibers that are: (i) substantially misaligned with the longitudinal axis of the surgical stapler, or (ii) substantially aligned with the geometric axis longitudinal of the surgical stapler; and (b) a bioabsorbable adhesive, wherein the bioabsorbable adhesive is applied to the first side and/or the second side of the flat textile and is configured to adhere the extensible reinforcement assembly to an end actuator of the surgical stapler; the brace assembly being substantially extendable in one direction. Example 2
[0086] The extensible reinforcement assembly of Example 1, wherein the flat textile product comprises fibers that are substantially misaligned with the longitudinal geometric axis of the surgical stapler, the flat textile product being selected from the group consisting of knitted fabric of warp; weft knit fabric; textile fabric product; and their combinations. Example 3
[0087] The extensible reinforcement assembly of any one or more of Examples 1 and 2, wherein the fibers are monocomponent fibers selected from the group consisting of multifilament monocomponent fibers; monocomponent fibers of monofilaments; and their combinations. Example 4
[0088] The extensible reinforcement assembly of any one or more of Examples 1 to 3, wherein the textile is woven textile and is woven in a pattern selected from the group consisting of twill; simple plot; and their combinations. Example 5
[0089] The extensible reinforcement assembly of any one or more of Examples 1 to 4, wherein the textile is a warp knit fabric comprising loop patterns selected from the group consisting of loop on pillar; 1x1 loop (knit loop); 2x1 loop; 3x1 loop; 4x1 loop; atlas loop; and their combinations. Example 6
[0090] The extensible reinforcement assembly of any one or more of Examples 1 to 5, the flat textile product comprising fibers that are substantially aligned with the longitudinal geometric axis of the surgical stapler. Example 7
[0091] The extensible reinforcement set of any one or more of Examples 1 to 6, the flat textile product comprising elastic fibers produced from copolymers selected from the group consisting of poly(caprolactone)-poly(glycolide) ( PCL/PGA); poly(caprolactone)-poly(lactide) (PCL/PLA); poly(lactide)-trienmethylene diacene co-carbonate (PCL/TMC); and their combinations. Example 8
[0092] The extensible reinforcement assembly of any one or more of Examples 1 to 7, further comprising a staple cartridge having a platform, wherein the flat textile product is secured to the staple cartridge platform through the bioabsorbable adhesive . Example 9
[0093] The extensible reinforcement assembly of Example 8, the platform including a plurality of openings, the staple cartridge further comprising a plurality of staples, the staples being configured to pass through the openings and the textile product plan is positioned over the openings. Example 10
[0094] A method for operating a surgical stapler to apply staples to organic tissue, wherein the surgical stapler has a longitudinal axis and comprises an end actuator, wherein the end actuator comprises an anvil and a staple cartridge, the method comprising the steps of providing: (i) an extensible reinforcement assembly comprising a flat textile product having a first side and a second side opposite the first side and comprising fibers that are: (a) substantially misaligned with the longitudinal axis of the surgical stapler, or (b) substantially aligned with the longitudinal axis of the surgical stapler, and (ii) a bioabsorbable adhesive, with the bioabsorbable adhesive being applied to the first side and/or second side of the flat textile product and is configured to adhere the extensible stiffener assembly to the anvil or staple cartridge; (b) adhering the extensible reinforcement assembly to the anvil or staple cartridge; (c) engaging the organic tissue between the anvil and the end actuator staple cartridge; (d) deploying the staple cartridge staples through the extensible reinforcement assembly and organic tissue; and (e) disengaging the end actuator so that the extensible brace assembly remains secured to the organic tissue by the clamps. Example 11
[0095] The method of Example 10, wherein the flat textile product comprises fibers that are substantially misaligned with the longitudinal geometric axis of the surgical stapler, wherein the flat textile product is selected from the group consisting of warp knit fabric; weft knit fabric; textile fabric product; and their combinations. Example 12
[0096] The method of any one or more of Examples 10 and 11, wherein the fibers are monocomponent fibers selected from the group consisting of multifilament monocomponent fibers; monocomponent fibers of monofilaments; and their combinations. Example 13
[0097] The method of any one or more of Examples 10 to 12, wherein the textile is woven textile and is woven in a pattern selected from the group consisting of twill; simple plot; and their combinations. Example 14
[0098] The method of any one or more of Examples 10 to 13, wherein the textile is warp knit fabric comprising loop patterns selected from the group consisting of loop on pillar; 1x1 loop (knit loop); 2x1 loop; 3x1 loop; 4x1 loop; atlas loop; and their combinations. Example 15
[0099] The method of any one or more of Examples 10 to 14, wherein the flat textile product is configured to extend in directions transverse to the longitudinal geometric axis of the surgical stapler. Example 16
[00100] The method of any one or more of Examples 10 to 15, wherein the flat textile product comprises elastic fibers produced from copolymers selected from the group consisting of poly(caprolactone)-poly(glycolide) (PCL/PGA) ); poly(caprolactone)-poly(lactide) (PCL/PLA); poly(lactide)-trienmethylene diacene co-carbonate (PCL/TMC); and their combinations. Example 17
[00101] The method of any one or more of Examples 10 to 16, further comprising: (a) removing the staple cartridge from the end actuator; (b) attach a new staple cartridge to the end actuator; and (c) adhering a new extensible gusset assembly to the anvil or the new staple cartridge. Example 18
[00102] An extensible reinforcement assembly to supplement the mechanical fixation of organic tissue by positionable surgical staples from a surgical stapler having a primary axis, the reinforcement assembly comprising: (a) a flat textile product having a the first side and a second side opposite the first side, the flat textile product comprising fibers which are substantially misaligned with the primary axis of the surgical stapler, the flat textile product being selected from the group consisting of warp knit fabric; weft knit fabric; textile fabric product; and their combinations; and (b) a bioabsorbable adhesive, wherein the bioabsorbable adhesive is applied to the first side and/or the second side of the flat textile and is configured to adhere the extensible reinforcement assembly to an end actuator of the surgical stapler; Example 19
[00103] The extensible reinforcement assembly of Example 18, wherein the fibers are monocomponent fibers selected from the group consisting of monocomponent multifilament fibers; monocomponent fibers of monofilaments; and their combinations. Example 20
[00104] The extensible reinforcement set of any one or more of Examples 18 and 19, the flat textile product comprising elastic fibers produced from copolymers selected from the group consisting of poly(caprolactone)-poly(glycolide) ( PCL/PGA); poly(caprolactone)-poly(lactide) (PCL/PLA); poly(lactide)-trienmethylene diacene co-carbonate (PCL/TMC); and their combinations. V. Other components
[00105] It should be understood that any one or more of the teachings, expressions, modalities, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, modalities, examples, etc. which are described in the present invention. The teachings, expressions, modalities, examples, etc. described above should therefore not be seen in isolation from one another. Various suitable ways in which the teachings of the present invention may be combined will become readily apparent to those skilled in the art in view of the teachings of the present invention. These modifications and variations are intended to be included within the scope of the appended claims.
[00106] In addition to the foregoing, it should also be understood that any of the various reinforcement assemblies described herein may further be constructed and operated in accordance with at least some of the teachings of US patent application No. 14/667,842, entitled " Method of Applying a Buttress to a Surgical Stapler", filed March 25, 2015, the description of which is incorporated herein by reference; US Patent Application No. 14/827,856 entitled "Implantable Layers for a Surgical Instrument", filed August 17, 2015, the description of which is incorporated herein by reference; US Patent Application No. 14/871,071, entitled "Compressible Adjunct with Crossing Spacer Fibers", filed September 30, 2015, the description of which is incorporated herein by reference; and US Patent Application No. 14/871,131 entitled "Method for Applying an Implantable Layer to a Fastener Cartridge", filed September 30, 2015, the description of which is incorporated herein by reference. Furthermore, in addition to the methods described herein, any of the various bracing assemblies described herein can be applied to the end actuator 40 in accordance with at least some of the teachings of provisional US Patent Application No. 62/209,041, entitled "Method and Apparatus for Applying a Buttress to End Effector of a Surgical Stapler," filed August 24, 2015, the description of which is incorporated herein by reference; and/or US Patent Application No. 14/871,131 entitled "Method for Applying an Implantable Layer to a Fastener Cartridge", filed September 30, 2015, the description of which is incorporated herein by reference. Various suitable ways in which the teachings of the present invention can be combined with the various teachings of the references cited above will be apparent to those skilled in the art.
[00107] It should be understood that any patent, publication, or other descriptive material incorporated herein by reference, in whole or in part, is incorporated into the present invention only to the extent that the incorporated material does not conflict with the definitions, statements or other disclosed material presented in this description. Accordingly, and to the extent necessary, the description as explicitly set forth herein supersedes any conflicting material incorporated into the present invention by way of reference. Any material, or portion thereof, incorporated herein by reference but which conflicts with the existing definitions, statements, or other descriptive material presented herein will be incorporated herein only to the extent that there is no conflict between the material. incorporated and the existing description material.
[00108] Versions of the devices described above may have application in conventional medical treatments and procedures conducted by a medical professional, as well as application in robotic-assisted medical treatments and procedures. By way of example only, various teachings of the present invention can be readily incorporated into a robotic surgical system such as the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, California, USA. Similarly, those skilled in the art will recognize that the various teachings herein may be readily combined with the various teachings of any of the following: US Patent No. 5,792,135 entitled "Articulated Surgical Instrument For Performing Minimally Invasive Surgery With Enhanced Dexterity and Sensitivity" , issued August 11, 1998, the disclosure of which is incorporated herein by reference; US Patent No. 5,817,084 entitled "Remote Center Positioning Device with Flexible Drive", issued October 6, 1998, the description of which is incorporated herein by reference; U.S. Patent No. 5,878,193 entitled "Automated Endoscope System for Optimal Positioning", issued March 2, 1999, the description of which is incorporated herein by reference; U.S. Patent No. 6,231,565 entitled "Robotic Arm DLUS for Performing Surgical Tasks", issued May 15, 2001, the disclosure of which is incorporated herein by reference; US Patent No. 6,783,524 entitled "Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument", issued August 31, 2004, the disclosure of which is incorporated herein by reference; US Patent No. 6,364,888 entitled "Alignment of Master and Slave in a Minimally Invasive Surgical Apparatus", issued April 2, 2002, the description of which is incorporated herein by reference; US Patent No. 7,524,320 entitled "Mechanical Actuator Interface System for Robotic Surgical Tools", issued April 28, 2009, the description of which is incorporated herein by reference; US Patent No. 7,691,098 entitled "Platform Link Wrist Mechanism", issued April 6, 2010, the description of which is incorporated herein by reference; US Patent No. 7,806,891 entitled "Repositioning and Reorientation of Master/Slave Relationship in Minimally Invasive Telesurgery," issued October 5, 2010, the description of which is incorporated herein by reference; US Publication No. 2013/0012957 entitled "Automated End Effector Component Reloading System for Use with a Robotic System", published January 10, 2013, the description of which is incorporated herein by reference; US Publication No. 2012/0199630 entitled "Robotically-Controlled Surgical Instrument with ForceFeedback Capabilities", published August 9, 2012, the description of which is incorporated herein by reference; US Publication No. 2012/0132450 entitled "Shiftable Drive Interface for Robotically-Controlled Surgical Tool", published May 31, 2012, the description of which is incorporated herein by reference; US Publication No. 2012/0199633, entitled "Surgical Stapling Instruments with Cam-Driven Staple Deployment Arrangements", published August 9, 2012, the description of which is incorporated herein by reference; US Publication No. 2012/0199631, entitled "Robotically-Controlled Motorized Surgical End Effector System with Rotary Actuated Closure Systems Having Variable Actuation Speeds", published August 9, 2012, the description of which is incorporated herein by reference; US Publication No. 2012/0199632, entitled "Robotically-Controlled Surgical Instrument with Selectively Articulatable End Effector", published August 9, 2012, the description of which is incorporated herein by reference; US Publication No. 2012/0203247 entitled "Robotically-Controlled Surgical End Effector System", published August 9, 2012, the description of which is incorporated herein by reference; US Publication No. 2012/0211546 entitled "Drive Interface for Operably Coupling a Manipulatable Surgical Tool to a Robot", published August 23, 2012; US Publication No. 2012/0138660 entitled "Robotically-Controlled Cable-Based Surgical End Effectors", published June 7, 2012, the description of which is incorporated herein by reference; and/or US Publication No. 2012/0205421 entitled "Robotically-Controlled Surgical End Effector System with Rotary Actuated Closure Systems", published August 16, 2012, the description of which is incorporated herein by reference.
[00109] Versions of the above may be designed to be discarded after a single use, or they may be designed to be used multiple times. Versions can, in either or both cases, be reconditioned for reuse after at least one use. Refurbishment can include any combination of the steps of disassembling the device, followed by cleaning or replacing specific parts, and subsequent reassembly. Specifically, some versions of the device can be disassembled into any number of particular parts or parts of the device can be selectively replaced or removed in any combination. With cleaning and/or replacement of particular parts, some versions of the device can be reassembled for subsequent use in a reconditioning facility or by a user immediately prior to a surgical procedure. Those skilled in the art will understand that reconditioning 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 order.
[00110] Just as an example, the versions described here can be sterilized before and/or after a procedure. In a sterilization technique, the device is placed in a closed, sealed container such as a plastic or TYVEK bag. The container and device can then be placed in a radiation field, such as gamma radiation, X-rays or high energy electrons, which can penetrate the container. Radiation can kill bacteria in the device and container. The sterilized device can then be stored in a sterile container for later use. The device may also be sterilized using any other known technique, including, but not limited to, beta or gamma radiation, ethylene oxide, or water vapor.
[00111] Having shown and described various embodiments of the present invention, other adaptations of the methods and systems described in the present invention can be carried out by means of suitable modifications by a person skilled in the art without departing from the scope of the present invention. Several of these possible modifications have been mentioned, and others will be evident to those skilled in the art. For example, the examples, modalities, geometry, materials, dimensions, proportions, steps and the like discussed above are illustrative and not mandatory. Accordingly, the scope of the present invention is to be considered in accordance with the terms of the following claims and it is understood that the same is not limited to the details of structure and operation shown and described in the specification and drawings.

权利要求:
Claims (20)
[0001]
1. Extendable reinforcement assembly capable of being used with a surgical stapler having a longitudinal geometric axis, the reinforcement assembly being characterized by the fact that it comprises: (a) a flat textile product having a first side and a second opposite side to the first side, the flat textile product comprising fibers that are: (i) out of alignment with the longitudinal axis of the surgical stapler, or (ii) aligned with the longitudinal axis of the surgical stapler; and (b) a bioabsorbable adhesive, wherein the bioabsorbable adhesive is applied to the first side and/or the second side of the flat textile and is configured to adhere the extensible reinforcement assembly to an end actuator of the surgical stapler; wherein the reinforcement assembly is extendable in only one direction.
[0002]
2. Extensible reinforcement assembly, according to claim 1, characterized in that the flat textile product comprises fibers that are misaligned with the longitudinal geometric axis of the surgical stapler, and the flat textile product is selected from the group consisting of : warp mesh fabric; weft knit fabric; textile fabric product; and their combinations.
[0003]
3. Extensible reinforcement set, according to claim 1, characterized in that the fibers are monocomponent fibers selected from the group consisting of: monocomponent multifilament fibers; monocomponent fibers of monofilaments; and their combinations.
[0004]
4. Extendable reinforcement set, according to claim 1, characterized in that the textile product is a woven textile product and is woven in a pattern selected from the group consisting of: twill; simple plot; and their combinations.
[0005]
5. Extensible reinforcement set, according to claim 1, characterized in that the textile product is a warp knit fabric comprising loop patterns selected from the group consisting of: pillar loop; 1x1 loop (knit loop); 2x1 loop; 3x1 loop; 4x1 loop; atlas loop; and their combinations.
[0006]
6. Extensible reinforcement set, according to claim 1, characterized in that the flat textile product comprises fibers that are aligned with the longitudinal geometric axis of the surgical stapler.
[0007]
7. Extensible reinforcement set, according to claim 1, characterized in that the flat textile product comprises elastic fibers produced from copolymers selected from the group consisting of: poly(caprolactone)-poly(glycolide) (PCL/ PGA); poly(caprolactone)-poly(lactide) (PCL/PLA); poly(lactide)-trienmethylene diacene co-carbonate (PCL/TMC); and their combinations.
[0008]
8. Extendable reinforcement assembly, according to claim 1, characterized in that it further comprises a staple cartridge that has a platform, whereby the flat textile product is attached to the staple cartridge platform through the bioabsorbable adhesive.
[0009]
9. Extendable reinforcement assembly according to claim 8, characterized in that the platform includes a plurality of openings, the staple cartridge further comprising a plurality of staples, wherein the staples are configured to pass through the openings, in which the flat textile product is positioned over the openings.
[0010]
10. Method for operating a surgical stapler to apply staples to organic tissue, wherein the surgical stapler has a longitudinal geometric axis and comprises an end actuator, the end actuator comprising an anvil and staple cartridge, method is characterized in that it comprises the steps of: (a) providing an extensible reinforcement assembly that is configured to stretch from its original shape and recovering its original shape, the reinforcement assembly comprises: (i) a flat textile product that has a first side and a second side opposite the first side and comprising fibers that are: (A) misaligned with the longitudinal axis of the surgical stapler, or (B) aligned with the longitudinal axis of the surgical stapler, and (ii) a bioabsorbable adhesive, wherein the bioabsorbable adhesive is applied to the first side and/or the second side of the flat textile product and is configured to adhere to the reinforcement assembly. extendable to the anvil or staple cartridge; (b) adhering the extensible reinforcement assembly to the anvil or staple cartridge; (c) engaging the organic tissue between the anvil and the end actuator staple cartridge; (d) deploying the staple cartridge staples through the extensible reinforcement assembly and organic tissue; and (e) disengaging the end actuator so that the extensible brace assembly remains secured to the organic tissue by the clamps.
[0011]
11. Method according to claim 10, characterized in that the flat textile product comprises fibers that are misaligned with the longitudinal geometric axis of the surgical stapler, wherein the flat textile product is selected from the group consisting of: warp mesh; weft knit fabric; textile fabric product; and their combinations.
[0012]
12. Method according to claim 10, characterized in that the fibers are monocomponent fibers selected from the group consisting of: monocomponent multifilament fibers; monocomponent fibers of monofilaments; and their combinations.
[0013]
13. Method according to claim 10, characterized in that the textile product is a woven textile product and is woven in a pattern selected from the group consisting of: twill; simple plot; and their combinations.
[0014]
14. Method according to claim 10, characterized in that the textile product is warp knit fabric comprising loop patterns selected from the group consisting of: loop in pillar; 1x1 loop (knit loop); 2x1 loop; 3x1 loop; 4x1 loop; atlas loop; and their combinations.
[0015]
15. Method according to claim 10, characterized in that the flat textile product is configured to extend in directions transverse to the longitudinal geometric axis of the surgical stapler.
[0016]
16. The method of claim 15, further comprising: (a) removing the staple cartridge from the end actuator; (b) attach a new staple cartridge to the end actuator; and (c) adhering a new extensible gusset assembly to the anvil or the new staple cartridge.
[0017]
17. Method according to claim 10, characterized in that the flat textile product comprises elastic fibers produced from copolymers selected from the group consisting of: poly(caprolactone)-poly(glycolide) (PCL/PGA); poly(caprolactone)-poly(lactide) (PCL/PLA); poly(lactide)-trienmethylene diacene co-carbonate (PCL/TMC); and their combinations.
[0018]
18. Extendable reinforcement assembly capable of being used with a surgical stapler with a primary axis, the reinforcement assembly being characterized by the fact that it comprises: (a) a flat textile product consisting of a single layer of flat textile product that it has a first side and a second side opposite the first side, the flat textile product comprising fibers that are misaligned with the primary axis of the surgical stapler, the flat textile product being selected from the group consisting of warp knit fabric ; weft knit fabric; textile fabric product; and their combinations; and (b) a bioabsorbable adhesive, wherein the bioabsorbable adhesive is applied to the first side and/or the second side of the flat textile and is configured to adhere the extensible reinforcement assembly to an end actuator of the surgical stapler.
[0019]
19. Extensible reinforcement set, according to claim 18, characterized in that the fibers are monocomponent fibers selected from the group consisting of: monocomponent multifilament fibers; monocomponent fibers of monofilaments; and their combinations.
[0020]
20. Extendable reinforcement set according to claim 18, characterized in that the flat textile product comprises elastic fibers produced from copolymers selected from the group consisting of poly(caprolactone)-poly(glycolide) (PCL/PGA ); poly(caprolactone)-poly(lactide) (PCL/PLA); poly(lactide)-trienmethylene diacene co-carbonate (PCL/TMC); and their combinations.

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同族专利:

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公开号 | 公开日

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RU2743406C2|2021-02-18|

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RU2018119472A3|2020-02-28|

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RU2018119472A|2019-11-29|

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CN108348648B|2021-09-07|

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BR112018008619A2|2018-10-30|

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EP3162388A1|2017-05-03|

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JP2018536465A|2018-12-13|

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WO2017074782A1|2017-05-04|

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EP3162388B1|2020-01-01|

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CN108348648A|2018-07-31|

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JP6938490B2|2021-09-22|

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法律状态:
2019-10-29| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2021-06-29| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2021-09-08| 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 20/10/2016, 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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US14/926,194|US10085745B2|2015-10-29|2015-10-29|Extensible buttress assembly for surgical stapler|

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US14/926,194|2015-10-29|

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PCT/US2016/057859|WO2017074782A1|2015-10-29|2016-10-20|Extensible buttress assembly for surgical stapler|

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