ES2683858T3 - Brachytherapy with support and integrated staple line markers for edge identification - Google Patents

Abstract

A surgical support (900) for use in a linear surgical stapling apparatus, the surgical support comprising: an elongated rectangular body portion (920) having a longitudinal axis and defining a width and being manufactured with at least one of a biocompatible or bioabsorbable material; wherein the surgical support is formed with a plurality of mark / s (928) provided in or on at least one of the body portion; wherein the marks (928) are spaced apart and extend along the body portion and are oriented orthogonally to the longitudinal axis of the body portion, the marks extending along a percentage or a totality of the width of the body portion and characterized in that at least one radioactive material (940) is disposed only along at least one side edge of the body portion (920).

Description

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DESCRIPTION

Brachytherapy with support and integrated staple line markers for edge identification Background

1. Technical field

The present description refers to a surgical stapling apparatus and, in particular, to a surgical stapling device that includes a removable surgical support for an anvil and a staple cartridge.

2. Background of the related technique

Surgical stapling instruments that are used sequentially or simultaneously apply one or more rows of fasteners to join segments of body tissue are well known in the art. Typically, the fasteners are in the form of surgical clips, but two-piece polymeric fixators can also be used. Such devices generally include a pair of jaws for compressing together the body tissues to be joined. Typically, one of the jaw members includes a staple cartridge that conforms to a plurality of staples arranged in at least two lateral rows, while the other jaw member has an anvil that defines a surface to form the staple legs to as the staples are driven from the staple cartridge.

When the stapling instrument is operated, the longitudinally moving cam comes into contact with staple drive members in one of the jaws which in turn acts on staple pushers to eject the staples from the staple cartridge simultaneously or simultaneously. . A sheet can move between the rows of staples to cut and / or longitudinally open the stapled tissue between the rows of staples. Such instruments are described, for example, in United States Patent No. 3,079,606 and United States Patent No. 3,490,675.

When relatively thin or fragile fabrics are stapled, it is important to seal the staple line effectively to avoid air or fluid seepage. In addition, it is often necessary to reinforce the staple line against the tissue to avoid tearing or tearing the tissue. One method of preventing tears or tears includes the placement of a biocompatible tissue reinforcement material or a "support" between the staple and the underlying tissue. With this method, a layer of support material is placed against the tissue and the tissue is stapled in a conventional manner. In more recent methods, the support layer is positioned on the stapling instrument itself before stapling the tissue. Some surgical staplers use fasteners or clips to temporarily connect support material to each of the staple jaws, that is, one arranged in the staple cartridge assembly and the other in the anvil assembly.

International publication WO 2008/109125 describes a surgical stapling apparatus that includes a cartridge assembly, an anvil assembly, and a surgical support fixed so that it can be released by an anchor. The anchor releases the surgical support during firing of the stapling device.

EP 2 305 135 describes articles in the form of films, bands, sheets, and / or tapes, which can be used as a support with a surgical stapling device or as reinforcement means for suture lines. Articles can be manufactured with biting. on at least a part of a surface of the article.

A desire of the present application is to provide a surgical stapling apparatus with a surgical support fixed thereto so as to minimize deviations from the surgical support, and tears or other damage to the surgical support during assembly. It would also be desirable to provide a single profile support that can be used in a surgical staple cartridge assembly and / or a surgical anvil cartridge assembly, as well as in cartridge and anvil assemblies of different sizes. Consequently, an object of this description is to fulfill the aforementioned wishes.

Compendium

The present invention is defined in the appended claims. The present invention relates to a surgical stapling apparatus that includes a surgical support.

According to one aspect of the present description, a surgical stapling apparatus is provided and includes a cartridge assembly defining a first tissue contact surface, the cartridge assembly housing a plurality of surgical fasteners therein, the cartridge assembly defining at least one distal clamping point and at least one proximal clamping point; an anvil assembly that defines a second tissue contact surface, the anvil assembly fixed so that it can move relative to the cartridge assembly, the anvil assembly that defines at least one distal attachment point and at least one point proximal clamping, where the at least one proximal clamping point of the anvil assembly is offset at an axial distance from the at least one proximal clamping point of the cartridge assembly; and a surgical support set so that you can

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Loose to each of the first tissue contact surface and the second tissue contact surface, the surgical support including a body portion configured to substantially coat at least one of the first and second tissue contact surface of either the First length and second length of cartridge assembly and anvil assembly.

Each surgical support defines a distal clamping feature to match the distal clamping point of the cartridge assembly and the anvil assembly; and a first proximal clamping characteristic and a second offset proximal clamping characteristic at an axial distance from the first proximal clamping characteristic. The first proximal clamping feature coincides with the proximal clamping point of the cartridge assembly; and the second proximal clamping feature coincides with the proximal clamping point of the anvil assembly.

The surgical support may be disposed against the tissue contact surface of the cartridge assembly and the surgical support may be disposed against the tissue contact surface of the anvil assembly has substantially the same length.

Each surgical support can have the same configuration. Each surgical support can be made of a biocompatible and bioabsorbable material.

The surgical stapling apparatus may also include sutures that retain the surgical supports against the tissue contact surface of the cartridge assembly and the anvil assembly.

The surgical stapling apparatus may further include a suture that retains a distal end portion of the surgical support against one of the cartridge assembly and the respective anvil assembly, wherein the suture maintains the distal clamping feature of the surgical support in coincidence with the distal clamping point of one of the cartridge assembly and the respective anvil assembly.

The surgical stapling apparatus may further include a suture that retains a proximal end portion of the surgical support against one of the cartridge assembly and the respective anvil assembly, wherein a suture maintains the first proximal clamping feature of the surgical support in coincidence with the proximal clamping point of the cartridge assembly and the respective anvil assembly, and where a suture maintains the second proximal clamping feature of the surgical support in coincidence with the proximal clamping point of the anvil assembly.

According to another aspect of the present description, a surgical stapling apparatus is provided and includes a cartridge assembly defining a first tissue contact surface, the cartridge assembly housing a plurality of surgical fasteners therein, the cartridge assembly which is either a first length or a second length longer than the first length; an anvil assembly that defines a second tissue contact surface, the anvil assembly that is fixed so that it can move relative to the cartridge assembly, the anvil assembly that is either the first length or the second length each one corresponding to the length of the cartridge assembly; and a surgical support that is fixed so that it can be released to at least one of the first tissue contact surface and the second tissue contact surface, including the surgical support a head portion, a neck portion, and a portion of body. The head portion is connected to a distal end of the body portion by the neck portion. The surgical support is configured to substantially coat at least one of the first and second tissue contact surface of either the first length and second length of the anvil cartridge and assembly.

The body portion of the surgical support can define a recess formed on a proximal edge thereof, the recess by longitudinally sectioning the proximal edge. The recess can be a notch that has a V-shaped profile.

The body portion of the surgical support may define at least one pair of opposite proximal recesses, and each of the at least one pair of opposite proximal recesses may be formed on an opposite lateral side of the body portion near a proximal edge of the support surgical. The at least one pair of opposite proximal recesses may be a notch that has a V-shaped profile.

The body portion of the surgical support may further define a pair of opposing distal recesses, and each of the pair of opposing distal recesses may be formed on an opposite lateral side of the body portion close to a distal edge of the body portion.

The pair of opposite distal recesses can be longitudinally frustoconical. A distal edge of the body portion of the surgical support can be arched. A distal edge of the body portion of the surgical support may have a transverse width dimension that is smaller than that of the rest of the body portion. The head portion may have a substantially rectangular shape.

Each surgical support can be made of a biocompatible and bioabsorbable material.

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According to an additional aspect of the present description, surgical support is provided for use in a surgical stapling apparatus. Surgical support includes a body portion, a neck portion; and a head portion connected to a distal end of the body portion by the neck portion, wherein the body portion defines at least one pair of opposite proximal recesses, each of the at least one pair of opposite proximal recesses is formed on an opposite side of the body portion near a proximal edge of the body portion.

Each of the at least one pair of opposite proximal recesses may be a notch having a V-shaped profile. The body portion may further define a pair of opposite distal recesses, each of the pair of opposite distal recesses may be formed on an opposite side of the body portion near a distal edge of the body portion.

The body portion of the surgical support can also define a proximal edge recess formed on a proximal edge thereof, the proximal edge recess by longitudinally sectioning the proximal edge. A distal edge of the body portion of the surgical support can be arched. A distal edge of the body portion of the surgical support may have a dimension of transverse width smaller than that of the rest of the body portion. The head portion may have a substantially rectangular shape.

The surgical support can be made of a biocompatible and bioabsorbable material.

According to yet another aspect of the present description, surgical support is provided for use with a surgical stapling apparatus that has a cartridge assembly of any number of lengths and an anvil assembly of any number of lengths corresponding to the lengths of the assembly. cartridge, wherein each of the cartridge assembly and the anvil assembly defines respective juxtaposed tissue contact surfaces, and wherein the cartridge assembly includes a plurality of staples stored in staple slots thereof to form against the forming bags of anvil set staples. Surgical support includes a body portion configured and sized to cover all staple slots of the cartridge assembly for any length of cartridge assembly, and / or coat all staple formation bags of the anvil assembly for any length of assembly. of anvil. The surgical support also includes a neck portion that extends from the body portion; and a head portion connected to a neck portion and opposite a distal end of the body portion, wherein the body portion defines at least one pair of opposite proximal recesses, each of at least one pair of opposite proximal recesses it is formed on an opposite side of the body portion near a proximal edge of the body portion.

According to yet another aspect of the present description, surgical support is provided for use in a surgical stapling apparatus and includes an elongated rectangular body portion defining a width; a neck portion integrally formed and extending from a distal end of the body portion, the neck portion defining a width; a head portion integrally formed and connected to a distal end of the neck portion, the head portion defining a width; and a posterior portion integrally formed and extending from a proximal end of the body portion, the posterior portion defining a width. The width of the posterior portion is smaller than the width of the body portion, and the surgical support is formed of a material containing filaments.

In certain embodiments, the width of the neck portion is smaller than the width of the body portion, or the width of the neck portion is smaller than the width of the posterior portion, or the width of the neck portion is larger than half the width of the body portion.

A length of the head portion may be greater than a length of the posterior portion. A length of the head portion may be greater than a length of the neck portion.

The rear portion may define at least one pair of opposite proximal recesses, each of the at least one pair of opposite proximal recesses being formed on an opposite side side of the posterior portion.

The body portion may further define a pair of opposing distal recesses, each of the pair of opposing distal recesses being formed on an opposite lateral side of the body portion close to a distal edge of the body portion.

The posterior portion of the surgical support may define a proximal edge recess formed at a proximal edge thereof, wherein the proximal edge recess longitudinally section the proximal edge.

The surgical support is preferably made of a biocompatible and bioabsorbable material.

The surgical support may be made of a material selected from the group consisting of polyglycolic acid, trimethylene glycolide carbonate, glycolic acid trimethylene carbonate, and mixtures thereof. The surgical support may be formed as a non-spun material.

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According to a further aspect of the present description, surgical support is provided for use with a surgical stapling apparatus that has a cartridge assembly of any number of lengths and an anvil assembly of any number of lengths corresponding to the lengths of the assembly. cartridge, wherein each of the cartridge assembly and the anvil assembly defines respective juxtaposed tissue contact surfaces, and wherein the cartridge assembly includes a plurality of staples stored in staple slots thereof to form against the forming bags of anvil set staples. The surgical support includes an elongated rectangular body portion that defines a length and width; a neck portion integrally formed and extending from a distal end of the body portion, the neck portion defining a length and width; a head portion integrally formed and connected to a distal end of the neck portion, the head portion defining a length and a width; and a posterior portion integrally formed and extending from a proximal end of the body portion, the posterior portion defining a length and width. The width of the posterior portion is smaller than the width of the body portion. The body portion and the rear portion are configured and sized to cover all staple slots of the cartridge assembly for any length of cartridge assembly, and / or coat all staple formation bags of the anvil assembly for any length of anvil set.

The width of the neck portion may be smaller than the width of the body portion. The width of the neck portion may be smaller than the width of the posterior portion. The width of the neck portion may be greater than half the width of the body portion.

The length of the head portion may be greater than the length of the posterior portion. The length of the head portion may be greater than the length of the neck portion.

The posterior portion may define at least one pair of opposite proximal recesses. Each of the at least one pair of opposite proximal recesses may be formed on an opposite side side of the rear portion.

The body portion can also define a pair of opposite distal recesses. Each of the pair of opposing distal recesses may be formed on an opposite side of the body portion close to a distal edge of the body portion.

The posterior portion of the surgical support may define a proximal edge recess formed in a proximal edge thereof. The proximal edge recess can longitudinally section the proximal edge.

The surgical support can be made of a biocompatible and bioabsorbable material. The surgical support may be made of a material selected from the group consisting of polyglycolic acid, trimethylene glycolide carbonate, glycolic acid trimethylene carbonate, and mixtures thereof. The surgical support can be made of a non-spun material.

According to another additional aspect of the present description, surgical support is provided for use in a surgical stapling apparatus. The surgical stapling apparatus includes an elongated rectangular body portion defining a width; a tip portion integrally formed and extending from a distal end of the body portion, the tip portion defining a width that is smaller than the width of the body portion; a neck portion integrally formed and extending from a distal end of the body portion, the neck portion defining a width; a head portion integrally formed and connected to a distal end of the neck portion, the head portion defining a width; and a posterior portion integrally formed and extending from a proximal end of the body portion, the posterior portion defining a width that is smaller than the width of the body portion. The surgical support is formed by a material that contains filaments.

The width of the neck portion may be smaller than the width of the tip portion. The width of the neck portion may be smaller than the width of the posterior portion. The width of the neck portion may be greater than half the width of the body portion.

The rear portion may define at least one pair of opposite proximal recesses, each of the at least one pair of opposite proximal recesses being formed on an opposite side side of the posterior portion.

The at least one pair of opposite proximal recesses may include a first pair of opposite proximal recesses; and a second pair of opposite proximal recesses, wherein the first pair of opposite proximal recesses is disposed proximal to the second pair of opposite proximal recesses.

Each of the second pair of opposing proximal recesses can extend to a longitudinal axis of the support an amount greater than each of the first pair of opposite proximal recesses.

A side edge of the rear portion, disposed between the first pair of opposite proximal recesses and the pair of opposite proximal recesses, can be tapered towards a longitudinal axis of the support from a proximal end to a distal end.

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Each of the first pair of opposite proximal recesses and each of the second pair of opposite proximal recesses may have a V-shaped profile. A distal edge of each of the first pair of opposite proximal recesses and each of the second pair of proximal recesses. Opposites may be oriented orthogonally to a longitudinal axis of the support.

The body portion can also define a pair of opposite distal recesses. Each of the pair of opposite distal recesses may be formed on opposite side sides of the tip portion.

The posterior portion of the surgical support can define a proximal edge recess formed in a proximal edge thereof, where the proximal edge recess can longitudinally section the proximal edge.

The surgical support can be made of a biocompatible and bioabsorbable material. The surgical support may be made of a material selected from the group consisting of polyglycolic acid, trimethylene glycolide carbonate, glycolic acid trimethylene carbonate, and mixtures thereof. The surgical support may be formed as a non-spun material.

According to even another aspect of the present description, surgical support is provided for use with a surgical stapling apparatus. The surgical stapling apparatus includes a cartridge assembly of any number of lengths and an anvil assembly of any number of lengths corresponding to the lengths of the cartridge assembly, wherein each of the cartridge assembly and anvil assembly defines respective surfaces of juxtaposed tissue contact, and wherein the cartridge assembly includes a plurality of staples stored in staple slots thereof to form against the staple-forming bags of the anvil assembly.

The surgical stapling apparatus includes an elongated rectangular body portion defining a width; a tip portion integrally formed and extending from a distal end of the body portion, the tip portion defining a width that is smaller than the width of the body portion; a neck portion integrally formed and extending from a distal end of the body portion, the neck portion defining a width; a head portion integrally formed and connected to a distal end of the neck portion, the head portion defining a width; and a posterior portion integrally formed and extending from a proximal end of the body portion, the posterior portion defining a width that is smaller than the width of the body portion.

The body portion and the rear portion are configured and sized to cover at least one of all the staple slots of the cartridge assembly for any length of cartridge assembly, and / or coat all the staple formation bags of the anvil assembly for any length of anvil set.

The width of the neck portion may be smaller than the width of the tip portion.

The posterior portion may define at least one pair of opposite proximal recesses. Each of the at least one pair of opposite proximal recesses may be formed on an opposite side side of the rear portion.

The at least one pair of opposite proximal recesses may include a first pair of opposite proximal recesses; and a second pair of opposite proximal recesses, wherein the first pair of opposite proximal recesses is disposed proximal to the second pair of opposite proximal recesses.

Each of the second pair of opposing proximal recesses can extend to a longitudinal axis of the support an amount greater than each of the first pair of opposite proximal recesses.

A side edge of the rear portion, disposed between the first pair of opposite proximal recesses and the pair of opposite proximal recesses, can be tapered towards a longitudinal axis of the support from a proximal end to a distal end.

Each of the first pair of opposite proximal recesses and each of the second pair of opposite proximal recesses may have a V-shaped profile. A distal edge of each of the first pair of opposite proximal recesses and each of the second pair of proximal recesses. Opposites may be oriented orthogonally to a longitudinal axis of the support.

The body portion can also define a pair of opposite distal recesses. Each of the pair of opposite distal recesses may be formed on opposite side sides of the tip portion.

The posterior portion of the surgical support may define a proximal edge recess formed at a proximal edge thereof, wherein the proximal edge recess longitudinally section the proximal edge.

The surgical support may be formed as a non-spun material.

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According to another additional aspect of the present description, surgical support is provided for use in a surgical stapling apparatus. The surgical support includes an elongated rectangular body portion that defines a width and is made of at least one of a biocompatible or bioabsorbable material. The surgical support is formed with at least one mark provided on or on at least one of the body portion.

The at least one mark may be formed as a notch.

The at least one brand may include biocompatible and bioabsorbable materials.

The at least one brand may include a biocompatible ink.

The at least one mark may be sewn on the surgical support.

The body portion may define at least one pair of notch markers on opposite side sides of the surgical support.

The body portion may include a plurality of marks. The plurality of marks may be formed by physical notches and ink. The plurality of marks may vary in length. The plurality of marks may be uniformly separated along a length of the surgical support.

The surgical support may also include a radioactive material incorporated into the body portion. The radioactive material may be at least one brachytherapy seed.

The body portion may include a plurality of pores or bags. The at least one pore may contain a brachytherapy seed.

According to even another aspect of the present description, surgical support is provided for use in a surgical stapling apparatus. Surgical support includes a body portion; and radioactive material provided in or on at least one of the body portion.

The body portion may include biocompatible and bioabsorbable materials.

The radioactive material may be at least one brachytherapy seed.

The body portion may include a plurality of pores. At least one pore may contain a brachytherapy seed.

The surgical support may be formed with at least one mark provided on or on at least one of the body portion.

According to even another aspect of the present description, a method of incorporating radioactive material into a surgical support is provided. The method includes providing surgical support; provide a screed capable of supporting the radioactive material; insert the radioactive material into the hearth; attach the hearth to the surgical supports; and incorporate the radioactive material in the surgical support.

The method may also include providing surgical support comprising a plurality of pores or bags.

The method may also include providing a hearth that is capable of receiving at least one brachytherapy seed.

The method may also include inserting brachytherapy seeds.

The method may also include incorporating the radioactive material into at least 10% of a surface area of the support.

The method may also include incorporating the radioactive material at a distal end of the surgical support.

The method may also include incorporating the radioactive material at a proximal end of the surgical support.

The method may also include incorporating the radioactive material in a uniform manner along a surface area of the surgical support.

Brief description of the drawings

This description will be described in greater detail with reference to the accompanying drawings, in which the same reference numbers will designate equal parts of the different views and where:

Figure 1 is a perspective view of a surgical stapling apparatus according to an embodiment of the present description;

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Figure 2 is a top, exploded and perspective view of a distal end of a DLU (disposable loading unit) of the surgical stapling apparatus of Figure 1;

Figure 3 is a top plan view of a support according to an embodiment of the present description; Figure 4 is a top perspective view of a half cartridge section of the DLU of Figure 2; Figure 5 is a perspective view of a cartridge assembly of the DLU of Figure 2; Figure 6 is an enlarged perspective view of a distal end of the cartridge assembly of Figure 5; Figure 7 is an enlarged view of the indicated area of detail of Figure 5; Figure 8 is an enlarged view of the indicated area of detail of Figure 7;

Figure 9 is a perspective view of an anvil assembly of the DLU of Figure 2, illustrating the support of Figure 3 attached thereto;

Figure 10 is a plan view of the DLU cartridge assembly of Figures 4-8 and the DLU anvil assembly of Figure 9, illustrating the support of the support of Figure 3 at different attachment points of a cartridge assembly and respective anvil assembly;

Figure 11 is a top plan view of a support according to another embodiment of the present description;

Figure 12 is a top plan view of a support according to even another embodiment of the present description;

Figure 13 is an enlarged view of the indicated area of detail of Figure 12;

Figure 14 is an enlarged view of the indicated area of detail of Figure 12;

Figure 15 is a top plan view of a support according to another embodiment of the present description;

Figure 16 is a top plan view of a support according to another embodiment of the present description;

Figure 17 is a top plan view of a support according to another embodiment of the present description;

Figure 18 is a top plan view of a support according to another embodiment of the present description;

Figure 19 is a top plan view of a support according to another embodiment of the present description;

Figure 20 is a cross-sectional view taken through 20-20 of Figure 19; Figure 21 is an enlarged view of the indicated area of detail of Figure 19;

Figure 22 is a top plan view of a support according to another embodiment of the present description;

Figure 23 is a top plan view of a surgical support according to certain embodiments of the present description;

Figure 24 is a perspective view of a staple cartridge assembly having a surgical support attached thereto according to the embodiments of the present description; Y

Figure 25 is a detailed perspective view of one of the bags of a surgical support according to certain embodiments of the present description.

Detailed description of the achievements

The embodiments of the anvil staple line reinforcement and the cartridge of a loading unit of a surgical stapling device described herein will be described in detail below in reference to the drawings, in which the same reference numbers designate identical or corresponding elements in each of the different views. In the drawings and in the description that follows, the term "proximal", as normal, will refer to the end of the stapling apparatus that is closer to the operator, while the term "distal" will refer to the end of the stapling apparatus which is further from the operator.

Referring to FIG. 1, a linear surgical stapling apparatus is described, generally referred to as 10. For the sake of brevity, this description will mainly focus on a support used in a loading unit 100, e.g. eg, a single-use charging unit (SULU) or a disposable charging unit (DLU). To simplify, from this moment, SULU or DLU will be called as DLU, but it should be understood that

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It will include both a DLU and a SULU. An example of this type of surgical stapling instrument is described in US Patent No. 7,128,253.

The surgical stapling apparatus 10 generally includes a handle assembly 12 and an elongated body 14 that extends distally from the handle assembly 12. A DLU 100 is fixed so that it can be released to the distal end of the elongated body 14. A DLU 100 includes a cartridge assembly 200 that houses a plurality of surgical fasteners or clips 223 (see Figure 2) and an anvil assembly 300 that is secured so that it can move relative to the cartridge assembly 200. The handle assembly 12 includes a fixed handle member 22, a movable handle member 24, and a cylindrical portion 26. An articulation lever 30 is mounted at the front end of the cylindrical portion 26 adjacent to the rotary member 28 to facilitate articulation of the DLU 100. A pair of knobs 32 are positioned so that they can move along the cylindrical portion 26. The knobs 32 advance distally to approximate or close the cartridge and / or anvil assembly 200, 300, and fold back proximally to move away or open the cartridge and / or anvil assembly 200, 300. The drive of the movable handle member 24 applies staple lines 223 to the fabric. In order to properly orient the cartridge and anvil assembly 200, 300 with respect to the tissue to be stapled, the surgical stapling apparatus 10 is additionally provided with a rotating member 28 at the front end of the cylindrical portion 26. The rotation of the member Rotary 28 with respect to the handle assembly 12 rotates the elongated body 14 and the load unit 100 with respect to the handle assembly 12 in order to properly orient the cartridge assembly 200 and the anvil assembly 300 with respect to the tissue to be stapled.

As seen in Figure 2, the cartridge assembly 200 includes a carrier 210 that defines an elongated support channel 212. The elongated support channel 212 of the carrier 210 is sized and configured to selectively receive a staple cartridge 220 inside. The staple cartridge 220 includes retention slots 222 formed therein to receive a plurality of fasteners 223 and pushers 226. A plurality of longitudinal grooves spaced apart from each other extends through the staple cartridge 220 to fit the vertical cam wedges. of a drive skate 228. A central longitudinal groove 234 is formed and extends along the length of the staple cartridge 220 to facilitate passage of the scalpel blade 156 of the drive shaft 150 therethrough. During operation of the surgical stapler 10, the drive skate 228 moves through the staple cartridge 220 to advance the cam wedges towards sequential contact with the pushers 226, to cause the pushers 226 to move vertically within the retaining slots 222 and that the staples 223 are forced from the slots 222 to the staple cavities of the anvil plate 310 of the anvil assembly 300.

As can be seen in Figure 2, the cartridge assembly 200 includes a surgical cartridge support 500 functionally fixed to an upper surface of the staple cartridge 220, by means of the "S1, S2" sutures, to cover at least some of the retention grooves 222 and / or at least a portion of a length of the longitudinal groove 234. A first suture "S1" is threaded through each of a distal pair of recesses or fastening points 238 and around / over a portion distal of cartridge support 500 and, a second suture "S2" is screwed through each of a proximal pair of recesses or fastening points 236 and around / on a proximal portion of cartridge support 500. A first end of each Suture "S1, S2" may be anchored or fixed in a respective recess of the proximal and distal pair of recesses or fastening points 236, 238 while a second end of each suture "S1, S2" passes transversely through the distal portions and proximal respective of the cartridge support 500 and is anchored or fixed in a respective recess other than the proximal and distal pair of recesses or fastening points 236, 238. As seen in Figure 10, the cartridge assembly 200 defines an axial distance "D1" between the distal pair of recesses or attachment points 238 and the proximal pair of recesses or attachment points 236.

Still in reference to Figure 2, the anvil assembly 300 includes an anvil plate 310 having a plurality of staple deformation bags / cavities 310a (see Figure 9) and a cover plate 320 fixed to an upper surface of the anvil plate 310. An anvil assembly 300 further includes a scalpel blade 330 functionally interposed within the defined cavity between an anvil plate 310 and a cover plate 320.

The anvil plate 310 defines a proximal pair of recesses or fastening points 316 formed near a proximal end of the anvil plate 310 and each arranged on opposite sides of the longitudinal groove 314. The anvil plate 310 defines a distal pair of recesses or fastening points 318 formed near a distal end of the anvil plate 310 and each arranged on opposite sides of the longitudinal groove 314. At least one recess of each of the proximal pair of recesses or points clamping 316 and the distal pair of recesses or clamping points 318 is in the form of a groove or notch having a narrowing profile in order to engage by friction and / or tighten a "S" suture. The anvil assembly 300 further includes a surgical anvil support 500 functionally fixed to a lower surface of anvil plate 310, by means of the "S3, S4" sutures, to cover at least some of the anvil bags 310a and / or at least a portion of a length of the longitudinal groove 314.

Still in reference to Figure 2, the anvil support 500 is fixed to a lower surface of anvil plate 310, by means of the "S3, S4" anchors, to cover at least some of the anvil bags and / or at least one portion of

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a length of the longitudinal groove 314. In particular, an anchor "S3" is screwed along a distal portion of the anvil support 500 and each of the corresponding distal pair of recesses and fastening points 318, and an anchor "S4 "it is screwed along a proximal anvil support portion 500 and each of the corresponding proximal pair of recesses and fastening points 316. As seen in Figure 10, the anvil assembly 300 defines an axial distance" D2 "between the distal pair of recesses or attachment points 318 and the proximal pair of recesses or attachment points 316.

Reference may be made to Patent Application Serial No. 12 / 342,400, filed on December 23, 2008 (United States Patent No. 8,011,555), for a detailed description of the construction and operation of the surgical stapling apparatus 10, the cartridge assembly 200 and / or the anvil assembly 300.

It can be considered that the cartridge support and / or anvil support can be held by other means. For example, in any of the embodiments described herein, the supports can be fastened using adhesives, welds and / or fastening characteristics incorporated in the support material.

Support 500 is provided for each cartridge assembly 200 and anvil assembly 300 to reinforce and seal the staple lines applied to the tissue by the surgical stapling apparatus 10. The cartridge assembly 200 and the anvil assembly 300 are particularly configured to allow the surgical supports 500 to be located on surfaces that face the inside of the cartridge assembly 200 and the anvil assembly 300 in order to facilitate the passage of the surgical stapling apparatus 10 towards the body of a patient without risk of tears or Wrinkles of the respective braces as the surgical stapling apparatus 10 is inserted and manipulated into a patient's body. The material from which the support 500 is manufactured can be bioabsorbable or non-bioabsorbable. It is to be understood that any combination of natural, synthetic, bioabsorbable or non-bioabsorbable materials can be used to manufacture the support material. The support material may be porous or non-porous, or a combination of porous and non-porous layers. The non-porous support material can be used to retard or prevent the internal growth of surrounding tissues, thus acting as a non-stick barrier and preventing the formation of unwanted scar tissue.

Additional examples of materials for surgical braces 500 for use in surgical stapling devices set forth herein are shown in United States patents of shared property No. 5,542,594; 5,908,427; 5,964,774; and 6,045,560, and in the United States application for shared ownership with publication numbers 2006/0085034, filed April 20, 2006; and 2006/0135992, filed June 22, 2006.

In one embodiment, surgical braces 500 may be made of an appropriate biocompatible and bioabsorbable material. Surgical braces 500 can also be manufactured from non-absorbent material that does not retain fluid, for example, surgical braces 500 can be manufactured with "BIOSYN ™" (a synthetic polyester, commercially available through the Tyco Healthcare Group, LP, trade name COVIDIEN, North Haven, CT), which is manufactured from "GLYCOMER 631" (a block copolymer), which is a synthetic polyester composed of glycolide, dioxanone and trimethylene carbonate.

A block of the resulting copolymer contains randomly combined units derived from p-dioxanone (1,4-dioxane-2-one) and trimethylene carbonate (1,3-dioxane-2-one). A second block of the copolymer contains randomly combined units derived from glycolide and p-dioxanone. The resulting polyester is an ABA triblock terpolymer having approximately 60% glycolide, approximately 14% dioxanone, and approximately 26% trimethylene carbonate.

The anvil support and / or cartridge support 500 may be pre-loaded (ie by the manufacturer) in the anvil assembly 300 or the cartridge assembly 200. Additional or replacement supports 500 may be fixed for the anvil assembly 300 and / or for the cartridge assembly 200 either to the anvil assembly 300 or to the cartridge assembly 200 as needed or desired.

During operation, with the DLU 100 coupled to a distal end of the elongated body 14 of the surgical stapling apparatus 10, and with the anvil and cartridge supports 500 previously loaded in the anvil assembly 300 and the cartridge assembly 200, respectively, surgical stapling apparatus 10 is used according to methods known to those skilled in the art. Once the anvil assembly 300 and the cartridge assembly 200 are crimped to the tissue, the surgical stapling apparatus 10 is fired. When the surgical stapling apparatus 10 is fired, the drive shaft 150 advances from a maximum proximal position to a maximum distal position of the DLU 100. In doing so, the scalpel blade 156 of the drive shaft 150 enters the support notch 528 500, thus facilitating the division of the support 500 and reducing any incident of thrust or stacking of supports 500 by the blade 156. As the drive shaft 150 begins to move distally, the scalpel blade 156 cuts substantially simultaneously through of a central section of the proximal anchors "S2, S4" of the anvil assembly 300 and cartridge assembly 200, thus releasing respectively the proximal ends of anvil and cartridge supports 500 thereof. As the scalpel blade 156 moves distally, the scalpel blade 156 slices or cuts lengthwise through both the anvil support 500 and the cartridge support 500, thus dividing the supports 500 substantially in half.

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Additionally, as drive shaft 150 approaches the maximum distal position, drive shaft 150 and / or scalpel blade 156 engages a suture cut assembly or suture release assembly, as described in the US Patent Application with No. of series 12 / 342.400, presented on December 23, 2008, in order to cut or release the "S1 or S3" sutures and thus release a distal end of the support 500.

Referring to Figure 3, an embodiment of a surgical support 500 having a uniform profile according to the present description is illustrated. The support 500 includes a head portion 510, a body portion 520, a neck portion 530 that interconnects the head portion 510 and the body portion 520, and a rear portion 532 extending proximally from the portion of body 520.

The support 500 is configured to be fixed so that it can be released to any anvil assembly 300 and / or sized cartridge assembly 200, as described above. The support body portion 520 defines a pair of opposing distal recesses 524 at transverse edges near a distal location 522 thereof. The pair of opposing distal recesses 524 can be used to fix a body portion 520 to a distal end of an anvil assembly 300 and / or cartridge assembly 200, either through the use of suture "S1 or S3" or any other type of attachment, eg, staple. The distal portion 522 of the body portion 520 has a reduced cross-sectional dimension, e.g. eg, corner, arched, in order to be appropriate for various types of anvil and cartridge assemblies that have different shapes.

The rear support portion 532 500 defines two proximal pairs of opposite recesses 526a, 526b formed therein. Each of the pair of proximal recesses 526a, 526b is disposed on a transverse side of the rear portion 532 near the proximal edge thereof. Said proximal pair of recesses 526a, 526b serve to fix so that the rear support portion 532 500 can be released to a proximal end of anvil assembly 300 and / or cartridge assembly 200. In order to fit various types of profiles , the rear support portion 532 500 is preferably provided with two pairs of opposite recesses, a first proximal pair of recesses 526a, and a second proximal pair of recesses 526b (located distally to the first proximal pair of recesses 526a). Each of the proximal pair of recesses 526a, 526b has a substantially V-shaped profile.

In particular, when the support 500 is to be used with an anvil assembly 300 and / or relatively longer cartridge assembly 200, then a "S2 or S4" suture extends along the rear portion 532 of support 500, passes through the most proximal pair of recesses 526a of support 500, and is fixed to respective recesses 316 of anvil assembly 300 and / or recesses 236 of cartridge assembly 200. Also, when the support 500 is to be used with a set of anvil 300 and / or relatively shorter cartridge assembly 200, then a "S2 or S4" suture extends along the rear support portion 532 500, passes through the distal pair of recesses 526b of the proximal pair of recesses of support 500, and is fixed to respective recesses 316 of anvil assembly 300 and / or recesses 236 of cartridge assembly 200.

According to another aspect of the present description, a single profile or support configuration 500 may be used in connection with the cartridge assembly 200 and / or anvil assembly 300. For example, the supports 500 that are used in connection with the assembly of cartridge 200 and anvil assembly 300, each can have the same total length, width, thickness, perimeter profile and construction material.

In particular, as shown in Figure 10, when the support 500 is used in connection with the cartridge assembly 200, a suture "S1" can be extended transversely along a distal end portion of the cartridge assembly 200 and it is imprisoned or otherwise fixed to the distal pair of recesses or fastening points 238 of the cartridge assembly 200, where the suture "S1" coincides with distal recesses 524 fixing to a distal end of body portion 520 of support 500. In addition, when the support 500 is used in connection with the cartridge assembly 200, a suture "S2" can be extended transversely along a proximal end portion of the cartridge assembly 200 and imprisoned or, of another form, fixed to each of a pair of recesses or fastening points 236 proximal of cartridge assembly 200, wherein the suture "S2" is in coincidence with the pair of recesses 526a more proximal of the pair of proximal recesses of rear portion 532 500 support.

Even with reference to Figure 10, when the support 500 is used in connection with the anvil assembly 300, a suture "S3" can be extended transversely along a distal end portion of anvil assembly 300 and imprisoned or , otherwise, fixed to the distal pair of recesses or fastening points 318 of anvil assembly 300, where the suture "S3" coincides with distal recesses 524 fixing to a distal end of body portion 520 of support 500 In addition, when the support 500 is used in connection with the anvil assembly 300, a suture "S4" can be extended transversely along a proximal end portion of the anvil assembly 300 and imprisoned or otherwise fixed to each of a proximal pair of recesses or fastening points 316 of the anvil assembly 300, wherein the suture "S4" coincides with the distal pair 526b of the proximal pair of recesses of the rear portion 532 of the support 500.

The neck portion 530 connects the head portion 510 to a distal end of the body portion 520. Generally, the head portion 510 has a substantially rectangular shape that is used as a flange to facilitate placement of the support 500 in position on the assembly of anvil 300 and / or cartridge assembly 200.

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After placement of the support 500 on the anvil assembly 300 and / or cartridge assembly 200, the head portion 510 and the neck portion 530 can be torn or otherwise cut from the body portion 520.

The rear support portion 532 500 includes a notch 528 at a proximal edge thereof. Notch 528 is substantially centered with respect to the longitudinal axis. The notch 528 that has a triangular shape or a V-shaped configuration can be used to provide a conduit for the scalpel during a support cut 500. The notch 528 has a length "L3a", as shown in Figure 3.

As can be seen in Figure 3, the support 500 has a total length "La". The body portion 520 of the support 500 has a length "L1a", and the rear portion 532 has a length "L2a". The body portion 520 has a width "W1a" and the rear portion 532 has a width "W2a" that is smaller than the width "W1a" of the body portion 520, where a shoulder 534 is defined between a side edge of the body portion 520 and a side edge of the rear portion 532. It is contemplated that a shoulder 534 is provided or defined along each opposite side edge of the support 500.

Still in reference to Figure 3, the neck portion 530 of the support 500 has a length "L4a", and the head portion 510 has a length "L5a". The neck portion 530 of the support 500 has a width "W3a" which is smaller than the width "W1a" of the body portion 520 and smaller than the width "W2a" of the rear portion 532. In addition, the head portion 510 it has a width "W4a" that is substantially equal to the width "W1a" of the body portion 520.

The uniform support profile 500 that simultaneously satisfies the requirements of one or more different assemblies offers advantages of simplifying the assembly process, minimizing the total number of unique components, and reducing the assembly costs associated with them.

Also, the support 500 can be used on or in connection with the cartridge assembly 200 and / or anvil assembly 300. In this way, a single profile support 500 is produced and used for the cartridge assembly 200 and / or the anvil assembly 300. Thus, manufacturing and storage costs of supports 500 can be reduced.

As mentioned above, the DLU 100 includes an anvil surgical support 500 and a surgical cartridge support 500 previously loaded in the anvil assembly 300 and cartridge assembly 200.

An example method for loading the anvil assembly 300 and / or the cartridge assembly 200 with a support 500 will be described below.

During the manufacturing and / or assembly process of the DLU 100, the loading of the anvil assembly 300 and / or cartridge assembly 200 with support 500 includes the step of placing a support 500 on an anvil assembly tissue contact surface 300 and / or cartridge assembly 200 so that the support notch 528 is disposed near a proximal end of anvil assembly 300 and / or cartridge assembly 200 and that the support head portion 510 extends from one end distal of anvil assembly 300 and / or cartridge assembly 200. With the support 500 positioned in such a way against the anvil assembly 300 and / or the cartridge assembly 200, the proximal sutures "S2" and / or "S4 are removed ". Tension is then applied to the support 500, distally, when the head portion 510 is pulled. Then the distal sutures "S1" and / or "S3" are removed. At this point, all sutures "S1-S4" are compressed at their respective attachment points 316, 318, 236, 238 of anvil assembly 300 and / or cartridge assembly 200. After suture compression "S1-S4 ", the support head portion 510 may be released 500. Next, the DLU 100 may be removed from a socket and the head portion 510 and the neck support portion 530 500 may be removed or cut from the portion of body 520.

Although the above embodiments show and describe surgical staplers that incorporate the use of movable scalpel blades to cut and release surgical supports of the tissue contact surfaces of the anvil assembly and cartridge assembly in relation to endoscopic surgical staplers, it is intended and Within the scope of the present description that any of the embodiments described herein may be incorporated into any type of surgical stapler, which includes and is not limited to open surgical staplers, such as, for example, linear surgical staplers, staplers circular, and transverse surgical staplers.

Also, although only proximal and distal sutures have been shown and described as fixing the support 500 to the anvil assembly 300 and / or cartridge assembly 300, it is contemplated that, in any of the embodiments described herein, it can provide any amount of transverse sutures along a length of the anvil assembly and / or cartridge assembly to assist with the fixing of the support 500 along a length thereof.

Any of the surgical supports described herein may be comprised of GLYCOMER 631, a block copolymer, or any polymer described above, such as film, non-spun, mesh or other material, and may also be made as a film. , not spinning, mesh or other type of

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material, from poly-L-lactide (PLL), or polycaprolactam (Nylon-6), or polyglycolic acid (PGA) each of which are homopolymers, or from trimethylene glycolide carbonate (Gly-TMC), which it is a copolymer, PLL and Gly-TMC, both of which are biodegradable polyesters polymerized through a ring opening reaction. The non-spun material can be manufactured using a meltblown process or by direct spinning (spun bond), or other known process. Non-spun materials and polymers are described in US Patent Application No. 13 / 293,215, entitled "Hydrophilic Medical Devices", filed on November 10, 2011 (United States Patent Publication No. 2013-0123816).

In certain embodiments, non-spun, felted or other relatively flexible materials having filaments are preferred.

Now with reference to Figure 11, a surgical support having a uniform profile is generally illustrated as 600, according to another embodiment of the present description. The support 600 includes a head portion 610, a body portion 620, a neck portion 630 that interconnects the head portion 610 and the body portion 620, and a rear portion 632 extending proximally from the portion of body 620.

The support 600, similar to the support 500, is configured to be fixed so that it can be released to any anvil assembly 300 and / or sized cartridge assembly 200, as described above. The support body portion 620 defines a pair of opposing distal recesses 624, formed at opposite transverse side edges near a distal location 622 thereof.

In order to fit various types of profiles, the rear support portion 632 600 includes two pairs of opposite recesses, a first proximal pair of recesses 626a, and a second proximal pair of recesses 626b (located distally to the first proximal pair of recesses 626a). Each of the proximal pair of recesses 626a, 626b has a substantially V-shaped profile. Each of the proximal pair of recesses 626a, 626b is deeper compared to the proximal pair of recesses 526a, 526b of the rear support portion 532. 500

The neck portion 630 connects the head portion 610 to a distal end of the body portion 620. Generally, the head portion 610 has a substantially rectangular shape that is used as a flange to facilitate placement of the support 600 in position on the anvil assembly 300 and / or cartridge assembly 200. After placement of the support 600 on the anvil assembly 300 and / or cartridge assembly 200, in at least certain circumstances, the head portion 610 and the neck portion 630 they can be torn, damaged or otherwise cut from body portion 620.

The rear support portion 632 600 includes a notch 628 at a proximal edge thereof. Notch 628 is substantially centered with respect to the longitudinal axis. Notch 628 that has a U-shaped configuration, a triangular or V-shaped configuration, and can be used to provide a scalpel conduction during a support cut 600. Notch 628 has a length "L3b", such as shown in Figure 11. The length "L3b" of notch 628 of support 600 is greater than the length "L3a" of notch 528 of support 500, and the notch 628 ends just before the first recesses 626a.

As shown in Figure 11, the support 600 has a total length "Lb", which is greater than the total length "La" of the support 500. The support body portion 620 has a length "L1b", and the rear portion 632 has a length "L2b". The body portion 620 has a width "W1b" and the rear portion 632 has a width "W2b" that is smaller than the width "W1b" of body portion 620, wherein a shoulder 634 is defined between a side edge of the body portion 620 and a side edge of the rear portion 632. It is contemplated that a shoulder 634 is provided or defined along each edge of the opposite side of the support 600.

Referring to Figures 3 and 11, it is contemplated that the supporting body portion 620 has a length "L1b" that is greater than the length "L1a" of the supporting body portion 520 500. Likewise, it is contemplated that the rear portion 632 of the support 600 has a length "L2b" which is greater than the length "L2a" of the rear portion 532 of support 500.

Referring to Figure 11, the neck support portion 630 600 has a length "L4b", and the head portion 610 has a length "L5b". The neck support portion 630 600 has a width "W3b" that is smaller than the width "W1b" of the body portion 620, and that is substantially the same as the width "W2b" of the rear portion 632. In addition, the head portion 610 has a width "W4b" that is substantially equal to the width "W1b" of body portion 620.

Referring to Figures 3 and 11, it is contemplated that the neck portion 630 of support 600 has a width "W3b" that is greater than the width "W3a" of the neck portion 530 of support 500. Likewise, it is contemplated that the support head portion 610 600 has a length "L5b" that is greater than the length "L5a" of the support head portion 510.

Now with reference to Figures 12-14, a surgical support having a uniform profile is generally illustrated as 700, according to even another embodiment of the present description. The 700 support includes a portion of

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head 710, a body portion 720, a tip portion 736 extending distally from the body portion 720, a neck portion 730 that interconnects the tip portion 736 and the body portion 720, and a posterior portion 732 extending proximally from body portion 720.

As shown in Figures 12-14, the support 700 has a total length "Lc", which is greater than the total length "La" of the support 500. The body portion 720 of the support 700 has a length "L1c ", the rear portion 732 has a length" L2c ", and the tip portion 734 has a length" L6c ". The body portion 720 has a width "W1c", a rear portion 732 has a width "W2c" that is smaller than the width "W1c" of the body portion 720, where a shoulder is defined between a side edge of the body portion 720 and a side edge of the rear portion 732, and a tip portion 734 has a width "W5c" that is smaller than the width "W1c" of the body portion 720, where a shoulder is defined between a side edge of a body portion 720 and a side edge of a tip portion 734. It is contemplated that projections are provided or defined along each opposite side edge of the support 700.

Referring to Figures 3, 12 and 13, it is contemplated that the body portion 720 of the support 700 has a length "L1c" that is greater than the length "L1a" of the body portion 520 of support 500. Likewise, contemplates that the rear portion 732 of the support 700 has a length "L2c" which is greater than the length "L2a" of the rear portion 532 of support 500.

Referring to Figures 12 and 14, the tip portion 736 of the support 700 has a length "L6c."

The neck support portion 730 700 has a length "L4c", and the head portion 710 support 700 has a length "L5c". The neck support portion 730 700 has a width "W3c" that is smaller than the width "W5c" of the tip portion 736. The neck support portion 710 700 has a width "W4c" that is substantially the same as the width "W5c" of the tip portion 736.

Referring to Figures 12 and 13, it is contemplated that the neck portion 730 of support 700 has a width "W3c" which is greater than the width "W3a" of the neck portion 530 of support 500. Likewise, it is contemplated that the support head portion 710 700 has a length "L5c" which is substantially the same as the length "L5a" of the support head portion 510.

The support 700, similar to the support 600, is configured to be fixed so that it can be released to any anvil assembly 300 and / or sized cartridge assembly 200, as described above. The support 700 defines a pair of opposite distal recesses 724, formed at opposite transverse side edges of tip portion 736. Each distal recess 724 has a substantially V-shaped profile. Specifically, each distal recess 724 includes a distal portion that is oriented orthogonally to a longitudinal support axis 700, and a proximal portion that is oriented transversely to the longitudinal support axis 700. In one embodiment, the proximal portion of each distal recess 724 may be oriented approximately at an angle of 63 ° relative to the longitudinal axis of support 700.

In order to fit various types of profiles, the rear support portion 732 700 includes two pairs of opposite recesses, a first proximal pair of recesses 726a, and a second proximal pair of recesses 726b (located distally to the first proximal pair of recesses 726a). Each of the proximal pair of recesses 726a, 726b has a substantially V-shaped profile.

Specifically, each recess of the first proximal pair of recesses 726a and each recess of the second proximal pair of recesses 726b includes a distal portion that is orthogonally oriented to a longitudinal support axis 700 and a proximal portion that is oriented transversely to the axis. longitudinal support 700. In one embodiment, the proximal portion of each of the first and second proximal pair of recesses 726a, 726b may be oriented approximately at an angle of 60 ° relative to the longitudinal support axis 700.

As best illustrated in Figure 13, the segment or portion of side edges of the rear portion 732, located between the first proximal pair of recesses 726a and the second proximal pair of recesses 726b, is corner or conical towards the axis. longitudinal support 700, from a proximal end to a distal end thereof.

Referring to Figures 12 and 13, the neck portion 730 connects the head portion 710 with a distal end of the tip portion 734. Generally, the head portion 710 has a substantially rectangular shape that is used as a flange to facilitate placing the support 700 in position on the anvil assembly 300 and / or cartridge assembly 200. After placing support 700 on the anvil assembly 700 and / or cartridge assembly 200, in at least certain circumstances, the portion head 710 and neck portion 730 can be torn, damaged or otherwise cut from the tip portion 734.

The rear support portion 732 700 includes a notch 728 at a proximal edge thereof. Notch 728 is substantially centered with respect to longitudinal support axis 700. Notch 728 can have a U-shaped configuration, a triangular or V-shaped configuration, and can be used to provide a scalpel conduction during a cutting of support 700. Notch 728 has a length "L3c", as shown

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in Figures 12 and 13. The length "L3c" of notch 728 of support 700 is greater than the length "L3a" of notch 528 of support 500, and the notch 728 ends just before the first recesses 726a.

Referring to Figure 15, a surgical support 800a is shown which has a uniform profile according to another embodiment of the present description. The support 800a, similar to the support 600, is configured to be fixed so that it can be released to any anvil assembly 300 and / or sized cartridge assembly 200, as described above.

The support 800a includes a body portion 820a that has at least one mark 824 disposed on and / or on it. The 824 mark / s includes indications, eg patterns, shapes, alphanumeric labels, etc. to indicate the length of the staple line. As shown in Figure 15, the 824 mark / s may be made of biocompatible or bioabsorbable ink, and / or ink or radiopaque material, which is printed longitudinally along the body portion 820a as lines 824a and / or numbers 828a. The line mark (s) 824a may be oriented orthogonally to the longitudinal axis of the support 800a and may extend through a full width of the body portion 820a. Furthermore, it is contemplated that a plurality of line marks 824a may be equidistant from each other, defining a distance "M2a" between adjacent line marks 824a. It is contemplated that the marks can be formed using inks and / or radiopaque materials.

Referring to FIG. 16, a surgical support 800b showing a uniform profile according to another embodiment of the present description is illustrated. The support 800b, similar to the support 800a, is configured to be fixed so that it can be released to any anvil assembly 300 and / or sized cartridge assembly 200, as described above.

The support 800b includes a body portion 820b which has at least one mark 824 'arranged therein. The 824 'mark / s includes indications and / or recesses, scratch lines, reliefs, etc., to indicate a length of the staple line. As shown in Figure 16, the brand / s 824 'can be made with biocompatible or bioabsorbable ink, and / or radiopaque ink, as numbers 828b and as a series of recesses or notches 824b that they extend longitudinally along body portion 820b. The recesses 824b may be V-shaped and each, arranged on opposite sides of the body portion 820b. Furthermore, it is contemplated that a plurality of recesses 824b may be equidistant from each other, defining a distance "M3a" between adjacent recesses 824b.

It is contemplated that, in any of the embodiments described herein, brands such as those described herein may be previously incorporated into a surgical support to identify tissue or sample structures after surgical resection with a surgical instrument or stapler. surgical Marks can be applied during the manufacturing process using methods that include thermal or laser processes, printing, sewing, stamping, cutting, dyeing, etc. Alternatively, the marks can be placed forming notches or holes. Any dye or stitched structures should be biocompatible materials and it would be desirable that they be bioabsorbable. It is contemplated that the marks can be used to identify the margins of dead tissue. For example, the support material will be present in the remaining tissue and in the sample removed. A pathologist can tell a surgeon the location of any tissue that has abnormalities by referring to the marks.

Referring to Figure 17, a surgical support 800c is shown which has a uniform profile according to another embodiment of the present description. The support 800c, similar to the support 800a, is configured to be fixed so that it can be released to any anvil assembly 300 and / or sized cartridge assembly 200, as described above. The support 800c may be provided separately and attached to a surgical instrument by the user, or it may be previously loaded into an instrument, as mentioned above.

Surgical support 800c includes a body portion 820c that has at least one mark 824 "arranged on and / or on it. The mark / s 824" includes indications, eg patterns, shapes, alphanumeric labels, etc. to indicate a length of the staple line. As shown in Figure 17, the 824 "mark / s may be made of biocompatible or bioabsorbable ink that is printed longitudinally along the body portion 820c as lines 824c and / or numbers 828c. s line mark / s 824c may / n be oriented orthogonally to the longitudinal axis of the support 800c and may extend through a full width of the body portion 820c. Also, it is contemplated that a plurality of marks of lines 824c may not be equidistant from each other, defining, for example, a distance "M4a" between a first mark of lines 824c1 and a second mark of lines 824c2 and a distance "M4b" between a second mark of lines 824c2 and a mark of adjacent lines or third line mark 824c3.

Referring to FIG. 18, a surgical support 800e having a uniform profile according to another embodiment of the present description is illustrated. The support 800d, similar to the support 800a, is configured to be fixed so that it can be released to any anvil assembly 300 and / or sized cartridge assembly 200, as described above.

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The support 800e includes a body portion 820e which has at least one mark 824 "'arranged therein. The mark / s 824"' includes indications and / or recesses, scratch lines, reliefs, etc., for indicate a length of the staple line. As shown in Figure 18, the 824 "mark / s may be made of biocompatible or bioabsorbable ink that is printed longitudinally along the body portion 820d as lines 824d and / or numbers 828d. The mark / s 824 "'may also include a series of recesses 826e extending longitudinally along the body portion 820d. The recesses 826d can be V-shaped and each one arranged on opposite sides of the body portion 820d. Likewise, it is contemplated that a plurality of recesses 826d and line marks 824d are positioned in an alternate pattern and may be equidistant from each other, defining a distance "M5a" between the line mark 824d and the adjacent recess 826d.

Now referring to Figure 19, a surgical support 900 is illustrated which has a uniform profile according to another embodiment of the present description. The support 900, similar to the support 800a, is configured to be fixed so that it can be released to any anvil assembly 300 and / or sized cartridge assembly 200, as described above.

The support 900 includes a body portion 920 having at least one mark 924 disposed on and / or on it. The brand / s 924 includes indications, eg patterns, shapes, alphanumeric labels, etc. to indicate the length of the staple line. As shown in Figure 20, the brand / s 924 may be made of biocompatible or bioabsorbable ink that is printed longitudinally along the body portion 920 as lines 924 and / or numbers 928 The line mark (s) 928 may be oriented orthogonally to the longitudinal axis of the support 900 and may vary in length, thus extending through a percentage or full width of the body portion 920 In addition, it is contemplated that a plurality of line marks 924 may be equidistant from each other, defining a distance "M6a" between adjacent line marks 924. It is contemplated that any of the embodiments described herein may include the described marks.

In any of the embodiments described herein, the surgical support may also include at least one source of radioactive material disposed in or on the body portion of the support.

The radioactive material 940 is disposed in and / or on the body portion 920 and includes encapsulated radioactive isotopes. It is envisioned that the radioactive material 940 is manufactured as brachytherapy seeds and that the seeds may be incorporated into the body portion 920 of the surgical support 900 before loading the surgical support 900 into the anvil assembly 300 and / or cartridge assembly 200 The radioactive material 940 may take the form of individual radioactive seeds / capsules or radioactive seeds / capsules incorporated in a biocompatible or bioabsorbable strand or similar material.

As shown in Figure 20, the radioactive material 940 may be extended along the entire body portion 920 at various depths. Alternatively, the radioactive material 940 may be arranged uniformly throughout the entire body portion 920. Also, the radioactive material 940 may be deposited in or on a section of the body portion 920. In addition, the radioactive material 940 may be disposed only along each side side edge of the surgical support body portion 920 900. In this manner, the radioactive material 940 is unaffected, impacted or disturbed by any staple fired by the stapling apparatus or by the scalpel blade that advances during a shot of the stapling device. It is contemplated that any of the embodiments described herein may include the radioactive material.

It is contemplated that the process of incorporating the radioactive material 940 into the surgical support 900 includes inserting the radioactive material 940 into a hearth (not shown) capable of retaining the radioactive material 940, then coupling or overlapping the hearth with the surgical support 900 e incorporate the radioactive material 940 into the body portion 920 of the surgical support 900.

As shown in Figure 21, the radioactive material 940 may be in the form of a seed incorporated in a pore 950 or bag arranged in the surgical support 900. For example, the pore 950 can be formed while the solera is coupled with the surgical support 900 prior to incorporating the radioactive material 940 inside.

Now referring to Figure 22, a surgical support 1000 is illustrated which has a uniform profile according to another embodiment of the present description. Surgical support 1000 includes a body portion 1020 that has an annular shape and has at least one 1024 mark arranged on and / or on it. The 1024 mark / s include indications, eg patterns, shapes, alphanumeric labels, etc. to indicate a length of the staple line. As shown in Figure 23, the 1024 mark / s may be made of biocompatible or bioabsorbable ink, and / or radioactive material, which is printed radially around the body portion 1020 as lines 1024 and / or numbers 1028. The line mark / s 1028 may / or be radially oriented towards a central axis of the body portion 1020 and may extend through a full radius of the body portion 1020. Furthermore, it is contemplated that a plurality of line marks 1024 may be radially arranged, equidistant from each other, defining an arc length "M7a" between adjacent line marks 1024.

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Still in reference to Figure 22, the surgical support 1000 also includes at least one radioactive material 1040 disposed in and / or on the body portion 1020. It is envisioned that the radioactive material 1040 is manufactured as brachytherapy seed / s and that the The seed / s may / n be incorporated into the body portion 1020 of the surgical support 1000 before loading the surgical support 1000 into a surgical stapling device.

Also, the radioactive material 1040 may be deposited in or on a section of the body portion 1020. It is contemplated that the process of incorporating the radioactive material 1040 into the surgical support 1000 includes inserting the radioactive material 1040 into a hearth (not shown ) capable of retaining the radioactive material 1040, then coupling the hearth with the surgical support 1000 and incorporating the radioactive material 1040 into the body portion 1020 of the surgical support 1000. The radioactive material 1040 may be incorporated in a pore or bag (no sample) arranged in the surgical support 1000. For example, the pore or bag (not shown) can be created at the same time as the hearth is coupled with the surgical support 1000 prior to incorporating the radioactive material 1040.

In any of the embodiments described in the present invention, the braces may be incorporated into, or configured for use with, devices that are part of an electrical surgical system or robotic surgical system.

It is also contemplated that, for any of the supports described in the present description, the supports may have bags or pores manufactured previously (eg, by the manufacturer) configured and arranged for the reception of the radioactive material described above. It is contemplated that brachytherapy seeds may be packaged or provided, with or without a hearth, and that the user can apply the seeds to the support or supports. For example, the user (such as a surgeon or operating room nurse) can place a seed in one or more of the bags or pores described above. It is contemplated that the bags or pores are previously manufactured in the support, whether previously loaded in a surgical instrument or not. In certain embodiments, the bags or pores are disposed on the lateral edges of the surgical support, as shown in Figures 23-25. The support can be configured with lateral wings that extend beyond the sides of the surgical stapler jaws. In any of the embodiments described herein, the support material may be porous and be configured to promote internal tissue growth.

Figure 23 shows a surgical support 1010 presenting a series of marks, which can be manufactured as described above. The 1020a marks may have a 1020 pattern that would help a surgeon, operating room nurse, and / or pathologist identify the location of certain tissue that has been excised from the body. For example, the pattern shown has shorter and longer alternate lines, however, other patterns can be used. The support 101 has a notch 1022 located centrally and proximally at the location where a scalpel of a surgical stapler will cut through the tissue, to assist in the advancement of the scalpel. Said notch 1022 may have a triangular or oblong shape.

The surgical support 101 may have wings or lateral edges 1024, along the long sides of the support, which extend beyond the sides of the staple cartridge 1030. Said wings 1024 may include or incorporate bags or pores for the reception of the radioactive material. For example, brachytherapy seeds, which can be configured as described herein, can be inserted into bags or pores 1025. This can be done by the manufacturer, or the surgeon, or the operating room nurse, since Whether the staple cartridge assembly has a previously loaded support or not. A tool 1040, which can be a specially designed clamp or device, can be used to securely insert the seed or seeds 1026 into the bags or pores 1025. An advantage of having a plurality of bags or pores along The length of the side edges of the support 1010 is that the surgeon or the operating room nurse can insert seeds 1026 into one or all of the bags, on one or more sides of the support, or can do so with a beneficial pattern.

Although a support and linear surgical stapling cartridge is shown, other types are contemplated. For example, a support for a circular stapler may have an external circular edge with a wing or flange that incorporates or includes pockets or pores.

It is contemplated that the radioactive material may have other shapes. For example, the wings, or eyelashes, can be provided, and a suture or strain that has a radioactive material inside or on it, can be wound around the wing or flange. It is contemplated that the radioactive material can be provided as brachytherapy seeds that are installed in bags that are attached by adhesive to the wing or flange of the surgical support. It is contemplated that the radioactive material is subject to surgical support in locations other than the lateral sides or outer circular edge.

It is contemplated that a surgical support having marks, as described herein, may or may not include the radioactive material or the means for holding the radioactive material. It is contemplated that a surgical support having the radioactive material or the means to hold the radioactive material, as described herein, may or may not include marks.

The present description also includes a surgical kit that has a surgical stapling instrument, at least one surgical support, and a separate package of encapsulated radioactive material. Stapling instrument

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Surgical can be a circular stapler. The surgical stapling instrument may be a surgical stapling loading unit. The loading unit can be a staple cartridge assembly. The at least one surgical support may be pre-loaded in the surgical stapling instrument. The at least one surgical support may include bags. The at least one surgical support may be formed with sides or lateral edges and 5 may include bags on the sides or lateral edges of at least one support. The sides or side edges may include wings that are configured to extend beyond the edges of the cartridge and / or the jaws of surgical stapling instrument. The encapsulated radioactive material may include radioactive isotopes, such as iodine or cesium isotopes, and may be brachytherapy seeds. The package may include shielding (eg, for isotopes). The package may include a hearth and isotopes may be subject to the hearth.

10 It will be understood that various modifications can be made to the embodiments described herein. For example, the surgical stapling apparatus does not need to apply staples, but rather can apply two-piece fixers, as is known in the art. In addition, the length of the linear row of staples or fasteners can be adapted to meet the requirements of a particular surgical procedure. Thus, the length of a single travel of the drive shaft and / or the length of the linear row of staples and / or fasteners within a

15 disposable loading unit may vary accordingly. Therefore, the foregoing description should not be construed as limiting but simply as examples of preferred embodiments. Those skilled in the art will envision other modifications within the scope of the claims accompanying this.

Claims (12)

5 10 fifteen twenty 25 30 1. A surgical support (900) for use in a linear surgical stapling apparatus, the surgical support comprising: an elongated rectangular body portion (920) having a longitudinal axis and defining a width and which is made of at least one of a biocompatible or bioabsorbable material; wherein the surgical support is formed with a plurality of mark / s (928) provided in or on at least one of the body portion; where the marks (928) are spaced apart and extend along the body portion and are oriented orthogonally to the longitudinal axis of the body portion, the marks extending along a percentage or a whole width of the body portion and characterized in that at least one radioactive material (940) is disposed only along at least one side edge of the body portion (920). 2. The surgical support according to claim 1, wherein at least one mark (928) is formed as a notch. 3. The surgical support according to claim 1 or claim 2, wherein at least one mark (928) includes biocompatible or bioabsorbable materials. 4. The surgical support according to claim 3, wherein at least one mark (928) includes a biocompatible ink. 5. The surgical support according to any preceding claim, wherein at least one mark (928) is sewn to the surgical support. 6. The surgical support according to any preceding claim, wherein the body portion (920) defines at least one pair of notch markers on opposite lateral sides of the surgical support. 7. The surgical support according to any preceding claim, wherein the plurality of marks is formed by physical notches and ink. 8. The surgical support according to any preceding claim, wherein the plurality of marks (928) varies in length. 9. The surgical support according to any preceding claim, wherein the plurality of marks (928) is evenly spaced along a length of the surgical support. 10. The surgical support according to any preceding claim, wherein the radioactive material (940) is at least one brachytherapy seed. 11. The surgical support according to any preceding claim, wherein the lateral edges of the surgical support include a plurality of pores configured and arranged to receive the radioactive material (940). 12. The surgical support according to claim 11, wherein the lateral edges of the support including the pores are configured to extend beyond the sides of the staple cartridge.