JP6759191B2 - Surgical staples and screwdriver placement for staple cartridges - Google Patents

Description

The present invention relates to staple instruments and, in various embodiments, to surgical staple fasteners for producing one or more rows of staples.

Staple fasteners can include a pair of cooperating elongated jaw members, each jaw member being inserted into the patient and adapted to be positioned with respect to the tissue to be stapled and incised. In various embodiments, one of the jaw members supports a staple cartridge that houses at least two rows of laterally spaced staples therein, and the other jaw member is a staple in the staple cartridge. Anvils with stapled pockets aligned with rows can be supported. In general, staple fasteners further include a push bar and knife blade that are slidable with respect to the jaw member and are stapled through the cam surface on the push bar and / or the cam surface on the wedge thread that is pushed by the push bar. Staples can be continuously ejected from the cartridge. In at least one embodiment, the cam surface actuates a plurality of staple drivers associated with the staples of the cartridge to push the staples against the anvil and laterally into the tissue gripped between the jaw members. It can be configured to form a row of deformed staples spaced apart from each other. In at least one embodiment, the knife blade can follow the cam surface and make an incision in the tissue along the line between the staple rows. An example of such a stapler is "SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING 7 US , Incorporated herein by reference.

The above discussion is intended only to explain various aspects of the art in the field of the invention at the time and should not be regarded as denying the claims.

Various features of the embodiments described herein are shown in detail within the scope of the claims. However, various embodiments relating to both the mechanism and the method of operation, along with their advantages, can be understood by the following description in conjunction with the accompanying drawings below.
FIG. 5 is a perspective view of a surgical fastening instrument according to at least one embodiment. It is an exploded view of the end effector of the surgical fastening instrument of FIG. It is a top view of the fastener cartridge of the end effector of FIG. It is a bottom view of the anvil of the end effector of FIG. It is a partial bottom view of the anvil according to at least one embodiment. It is a partial bottom view of the anvil according to at least one embodiment. FIG. 3 is an exploded perspective view of an end effector comprising a staple cartridge comprising an angle oriented staple, a group of first multi-staple drivers, and a group of second multi-staple drivers according to various embodiments of the present disclosure. It is one perspective view of the 1st multi-staple driver of FIG. It is a top view of the first multi-staple driver of FIG. It is a perspective view of the first multi-staple driver of FIG. 8, and further shows the staple of FIG. 7 supported by the multi-staple driver. It is a perspective view of one of the 2nd multi-staple drivers of FIG. It is a top view of the 2nd multi-staple driver of FIG. 8C. It is a perspective view of the 2nd multi-staple driver of FIG. 8C, further showing the staple of FIG. 7 supported by the multi-staple driver. It is a top view of the staple cartridge according to various embodiments of this disclosure. FIG. 5 is a plan view of the arrangement of a multi-staple driver and a drive wedge according to various embodiments of the present disclosure. FIG. 5 is a plan view of the arrangement of a multi-staple driver and a drive wedge according to various embodiments of the present disclosure. FIG. 5 is a plan view of the arrangement of a multi-staple driver and a drive wedge according to various embodiments of the present disclosure. FIG. 5 is a plan view of the arrangement of a single staple driver and drive wedge according to various embodiments of the present disclosure. It is an elevation view of the drive wedge of FIG. FIG. 5 is a plan view of the arrangement of staples and drive wedges according to various embodiments of the present disclosure. FIG. 3 is a perspective view of staples according to at least one embodiment that is unmolded, i.e., exemplified in the unlaunched configuration. It is an elevation view of the staple of FIG. It is an elevation view of the staple of FIG. 17 of the structure after molding, that is, after firing. An elevational view of a staple containing an expandable coating, according to at least one embodiment illustrated in an unmolded, i.e., unfired configuration. FIG. 20 is a partial bottom view of the staples of FIG. 20 deployed within the patient's tissue. FIG. 2 is a partial bottom view of the staples of FIG. 20 deployed within the patient's tissue, exemplifying the coating in the expanded state. Shown is a structure stapled by staples according to at least one embodiment. Shown is a structure stapled by staples according to at least one embodiment. Shown is a structure stapled by staples according to at least one embodiment. Elevations of drive wedges and staples according to various embodiments of the present disclosure. It is a perspective view of the drive wedge and the staple of FIG. It is a top view of the drive wedge and staple of FIG. 26. It is a perspective view of the circular staple device. It is a perspective view of a part of the staple fastening head of a circular staple fastening device, and a fastener cartridge assembly. FIG. 5 is a perspective view of a portion of the staple fastening head of a circular staple fastening device and another fastener cartridge assembly. FIG. 5 is a perspective view of a portion of the staple fastening head of a circular staple fastening device and another fastener cartridge assembly. Shows a structure stapled by staples according to at least one embodiment, at least a portion of the staples within the staples overlap. It is a partial plan view of the staple cartridge configured to unfold the staple line of FIG. 32. FIG. 3 is a partial plan view of an anvil configured to deform the staples emitted from the staple cartridge of FIG. 33. FIG. 5 is a partial plan view of a staple cartridge configured to develop staple lines according to at least one embodiment. FIG. 3 is a partial plan view of an anvil configured to deform the staples emitted from the staple cartridge of FIG. 35. FIG. 6 is an exploded perspective view of an end effector including a driverless staple cartridge with threads according to various embodiments of the present disclosure. It is a perspective view of the thread of FIG. 37. It is a partial plan view of the thread and the staple of FIG. 37 which shows the development progress of the staple. FIG. 37 is an elevational view of the threads and staples of FIG. 37 showing the unfolding progress of the staples. FIG. 37 is a perspective view of a screwless staple cartridge thread shown in FIG. 37 according to various embodiments of the present disclosure. FIG. 3 is a partial plan view of a driverless staple cartridge with angled staples and threads of FIG. 39 according to various embodiments of the present disclosure. FIG. 3 is a partial perspective view of the thread of FIG. 39 and the staple of FIG. 20 according to various embodiments of the present disclosure. FIG. 3 is a partial perspective view of threads and staples according to various embodiments of the present disclosure. FIG. 3 is a plan view of an array of staples according to various embodiments of the present disclosure. FIG. 5 is a plan view of an array of staples and drive wedges according to various embodiments of the present disclosure. FIG. 3 is a partial perspective view of a staple cartridge having an internally arranged staple cavity cavity according to various embodiments of the present disclosure. It is a partial plan view of the staple cartridge of FIG. 43. It is a perspective cross-sectional partial view of the staple cartridge of FIG. 43 which shows the staple and the driver positioned in the staple cartridge. FIG. 3 is a partial perspective view of a staple cartridge having an internally arranged staple cavity cavity according to various embodiments of the present disclosure. It is a partial plan view of the staple cartridge of FIG. It is a partial perspective cross-sectional view of the staple cartridge of FIG. FIG. 3 is a partial perspective view of a staple cartridge having an internally arranged staple cavity cavity according to various embodiments of the present disclosure. It is a partial plan view of the staple cartridge of FIG. It is a partial perspective cross-sectional view of the staple cartridge of FIG. 49 which shows the staple and the multi-staple driver positioned in the staple cartridge. Shows the previous staple pattern embedded within the tissue. The staple pattern developed by the staple cartridge of FIG. 3 is shown. The staple pattern of FIG. 52A in the stretched state is shown. FIG. 6 is a partial plan view of a staple cartridge with an implantable auxiliary material positioned on the cartridge body and the cartridge body according to at least one embodiment. FIG. 3 is a partial plan view of an implantable auxiliary material according to at least one embodiment. FIG. 6 is a partial plan view of a staple cartridge with an implantable auxiliary material positioned on the cartridge body and the cartridge body according to at least one embodiment. FIG. 3 is a partial plan view of an implantable auxiliary material according to at least one embodiment. FIG. 3 is a partial plan view of an implantable auxiliary material according to at least one embodiment. It is an exploded perspective view of a part of an end effector and a surgical staple fastening instrument. FIG. 5 is a perspective view of a surgical staple cartridge supported on the deck of the staple cartridge at a position where the buttress member can remove the buttress from the cartridge. FIG. 5 is a top view of the surgical staple cartridge and buttress member of FIG. 59. It is a perspective view of a part of a surgical staple cartridge and a buttress member of FIGS. 59 and 60. FIG. 5 is a perspective view of another part of the surgical staple cartridge and the buttress member of FIGS. 59-61. It is a perspective view of the proximal end of the surgical staple cartridge and the buttress member of FIGS. 59-62. Another perspective view of the proximal end of the surgical staple cartridge and buttress member of FIGS. 59-63, wherein the retaining tab is folded for insertion into a longitudinal slot in the cartridge. Another perspective view of the proximal end of the surgical staple cartridge and buttress member of FIGS. 59-64, wherein the retaining tab is inserted into the longitudinal slot and held internally by the staple thread. It is an exploded view of another surgical staple cartridge and another buttress member. It is a bottom view of the buttress member of FIG. It is an enlarged view of a part of the buttress member of FIG. 67, in which the position of the lower staple cavity in the staple cartridge is shown by a broken line. It is an enlarged view of a part of another buttress member in which the position of the lower staple cavity in a staple cartridge is shown by a broken line. It is a top view of a part of another buttress member, the position of the lower staple cavity in the staple cartridge is shown by the dashed line. It is a top view of a part of another buttress member. It is a cross-sectional view of the buttress member of FIG. 71 cut out along the line 72-72 of FIG. 71. It is a perspective view of another surgical staple cartridge. FIG. 7 is a top view of the surgical staple cartridge of FIG. 73. It is an enlarged perspective view of a part of the surgical staple cartridge of FIGS. 73 and 74. It is a top view of another surgical staple cartridge. FIG. 6 is a side elevation view of a portion of a surgical staple fastening device in which tissue "T" is clamped between the surgical staple cartridge of FIG. 76 and the device anvil. FIG. 6 is an enlarged view of a portion of the surgical staple cartridges of FIGS. 76 and 77, part of which is shown in cross section. FIG. 3 is a partial cross-sectional elevation view of staple cartridges and anvils according to various embodiments of the present disclosure. FIG. 3 is a partial cross-sectional elevation view of staple cartridges and anvils according to various embodiments of the present disclosure.

Corresponding reference signs indicate corresponding members through multiple figures. The illustrations described herein illustrate various embodiments of the invention in one form, and such illustrations should be construed as limiting the scope of the invention in any way. Absent.

The applicant of the present application owns the following patent applications filed on the same date as the present application, each of which is incorporated herein by reference in its entirety:
U.S. Patent Application No. ___________, Title "CIRCULAR FASTENEER CARTRIDGES FOR APPLYING RADIALLY EXPANDABLE FASTENEER LINES", Agent Reference Number END7503USNP / 140283,
U.S. Patent Application No. ___________, Title "SURGICAL STAPLE AND DRIVER ARRANGEMENTS FOR STAPLE CARTRIDGES", Agent Reference Number END7505USNP / 140285,
U.S. Patent Application No. ___________, Title "SURGICAL STAPLING BUTTRESSES AND ADJUNCT MATERIALS" (agent reference number END7506USNP / 140286),
U.S. Patent Application No. ___________, Title "FASTENEER CARTRIDGE FOR CREATING A FLEXIBLE STAPLE LINE", Agent Reference Number END7507USNP / 140287,
U.S. Patent Application No. ___________, title "METHOD FOR CREATEING A FLEXIBLE STAPLE LINE", agent reference number END7508USNP / 140288.

The applicant of the present application owns the following patent applications filed on June 30, 2014, each of which is incorporated herein by reference in its entirety:
U.S. Patent Application No. 14 / 318,996, entitled "FASTENEER CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENT CONFIGURATIONS",
U.S. Patent Application No. 14 / 319,006, entitled "FASTENER CARTRIGGE COMPRISING FASTENEER CAVITIES INCLUDING FASTENEER CONTROL FEATURES",
U.S. Patent Application No. 14 / 319,014, entitled "END EFFECTOR COMPRISING AN ANVIL INCLUDING PROJECTIONS EXTENDING THEREFROM",
U.S. Patent Application No. 14 / 318,991, Title "SURGICAL FASTENEER CARTRIDGES WITH DRIVER STABILIZING ARRANGEMENTS",
US Patent Application No. 14 / 319,004, entitled "SURGICAL END EFFECTORS WITH FIRING ELEMENT MONITORING ARRANGEMENTS",
U.S. Patent Application No. 14 / 319,008, entitled "FASTENEER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS",
U.S. Patent Application No. 14 / 318,997, entitled "FASTENEER CARTRIDGE COMPRISING DEPLOYABLE TISSUE ENGAGING MEMBERS",
U.S. Patent Application No. 14 / 319,002, entitled "FASTENEER CARTRIDGE COMPRISING TISSUE CONTROL FEATURES",
U.S. Patent Application No. 14 / 319,013, entitled "FASTENEER CARTRIDGE ASSEMBLES AND STAPLE RETANER COVER ARRANGEMENTS",
U.S. Patent Application No. 14 / 319,016, entitled "FASTENEER CARTRIDGE INCLUDING A LAYER ATTACEED THERETO".

Many specific details are provided to provide a complete understanding of the overall structure, function, manufacture and use of embodiments described herein and shown in the accompanying drawings. However, it will be appreciated by those skilled in the art that embodiments can be implemented without such specific details. In other examples, well-known behaviors, components, and elements are not described in detail to avoid obscuring the embodiments described herein. It will be understood by those skilled in the art that the embodiments described and illustrated herein are non-limiting examples, and therefore the details of the particular structures and functions disclosed herein may be typical and exemplary. Will be understood. Modifications and changes to this can be made without departing from the scope of the claims.

The terms "comprise" (and any form of comprise, such as "comprises" and "comprising"), "have" (and any form of have, such as "has" and "having"), " "Include" (and any form of include such as "includes" and "including"), "contain" (and any form of content such as "contains" and "contining") are open. A type of concatenated verb. As a result, a surgical system, device, or device that "equipped", "has", "contains", or "contains" one or more elements is one or more of them. It has the elements of, but is not limited to having only one or more of them. Similarly, one or more of the elements of a system, device, or device that "equipped", "has", "contains", or "contains" one or more features. However, it is not limited to having only one or more of these characteristics.

The terms "proximal" and "distal" are used herein with reference to the clinician operating the handle portion of the surgical instrument. The term "proximal" refers to the part closest to the clinician, and the term "distal" refers to the part located far from the clinician. For convenience and clarity, it will be further understood that spatial terms such as "vertical", "horizontal", "top", and "bottom" can be used with respect to the drawings herein. Let's go. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limited and / or absolute.

The surgical fastening instrument 100 is shown in FIG. The surgical fastening instrument 100 is configured to deploy an expandable staple wire. Although various expandable staple wires are disclosed herein, the surgical fastening instrument 100 is capable of deploying any one of these expandable staple wires. Further, surgical instruments other than the surgical fastening instrument 100 are capable of deploying any one of the expandable staple wires disclosed herein.

The surgical fastening instrument 100 includes a handle 110, a shaft 120, and an end effector 200. The handle 110 articulates the pistol grip 140, the closure trigger 150 configured to activate the closure system, the launch trigger 160 configured to activate the launch system, and the end effector 200 with respect to the shaft 120. It comprises a joint motion actuator 170 configured to actuate the joint motion system of. The disclosure of US Pat. No. 7,845,537, entitled "SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES", issued December 7, 2010, is incorporated by reference in its entirety. Other embodiments are envisioned that include a single trigger configured to activate a closure system and a launch system. Various embodiments are envisioned in which the end effectors of surgical instruments are not articulatory. The disclosure of U.S. Patent Application No. 13 / 974,166, entitled "FIRING MEMBER RETRACTION DEVICES FOR POWERED SURGICAL INSTRUMENTS," filed August 23, 2013, is incorporated by reference in its entirety.

The closure trigger 150 is rotatable towards the pistol grip 140 to activate the closure system. Primarily with reference to FIG. 2, the closure system comprises a closure tube 122 that is moved distally as the closure trigger 150 is moved towards the pistol grip 140. The closure tube 122 is engaged with the first jaw portion of the end effector 200, including the anvil 220. In at least one embodiment, the anvil 220 is one or more protrusions positioned in one or more elongated slots 212 defined within a second jaw extending from the anvil 220. 228 is provided. The protrusion 228 and the elongated slot 212 are constructed to allow the anvil 220 to rotate between the open position and the closed position with respect to the second jaw rest or fixed cartridge channel 210. Be placed. In various alternative embodiments, the cartridge channel can be rotatable relative to a stationary or fixed anvil 220. Regardless of whether the cartridge channel or end effector anvil is fixed or not, the end effector can be articulated or non-articulated with respect to the shaft.

With reference to FIG. 2 again, the anvil 220 includes a tab 226 that engages with a slot 124 defined within the closure tube 122. When the closure tube 122 is moved distally by the closure trigger 150, the side wall of slot 124 can engage the tab 226 to rotate the anvil 220 towards the cartridge channel 210. When the closure tube 122 is moved proximally, another side wall of slot 124 can engage the tab 226 to rotate the anvil 220 away from the cartridge channel 210. In some embodiments, the urging spring is positioned between the anvil 220 and the cartridge channel 210 and can be configured to urge the anvil 220 away from the cartridge channel 210.

Referring again to FIG. 2, the firing trigger 160 is rotatable towards the pistol grip 140 to activate the firing system. The launch system comprises a launch member extending within the shaft 120. The launch system further comprises a thread 250 that is operably engaged with the launch member. When the firing trigger 160 is rotated towards the pistol grip 140, the firing trigger 160 drives the firing member and thread 250 distally within the end effector 200. The end effector 200 further comprises a staple cartridge 230 positioned within the cartridge channel 210. Other embodiments are envisioned where the staple cartridge 230 is replaceable and therefore removable from the cartridge channel 210, but the staple cartridge 230 is not easily replaceable and / or not removable from the cartridge channel 210. ..

The staple cartridge 230 includes a plurality of staple cavities 270. Each staple cavity 270 is configured to detachably store the staples inside, but some staple cavities 270 may not accommodate the staples stored therein. The staple cartridge 230 further comprises a plurality of staple drivers 240 movably positioned internally. Each driver 240 is configured to support the three staples and / or lift the three staples together or simultaneously out of the respective staple cavity 270. Each driver 240 of the embodiments shown in FIGS. 1 to 4 deploys three staples at the same time, but other embodiments are envisioned in which the driver can deploy less than three staples or more than three staples at the same time. The thread 250 comprises one or more inclined surfaces 252, the inclined surfaces 252 being configured to slide under the driver 240 to lift the driver 240 upwards towards the deck surface 233 of the staple cartridge 230. Will be done. The thread 250 is movable from the proximal end 231 to the distal end 232 of the staple cartridge 230 and sequentially lifts the driver 240. When the driver 240 is lifted towards the deck by the threads 250, the driver 240 lifts the staples towards the anvil 220. As the thread 250 travels distally, the staples are driven against the anvil 220 and ejected from the staple cavity 270 by the driver 240. The staple cartridge 230 may further comprise a support pan 260 mounted therein, the support pan 260 extending around the bottom of the staple cartridge 230, with the driver 240, staples and / or threads 250 in the cartridge 230. Hold.

The pusher member that advances the thread 250 and / or the thread 250 distally engages the first jaw including the anvil 220 and / or the second jaw including the staple cartridge 230 to engage the anvil 220 and the staple cartridge. The 230s can be configured to be positioned relative to each other. In at least one embodiment, the thread 250 comprises at least one first protrusion 256 extending from it, the first protrusion 256 configured to engage the anvil 220 and the cartridge channel 210. It is configured to engage at least one second protrusion 258. The protrusions 256 and 258 can position the anvil 220 and the staple cartridge 230 relative to each other. When the thread 250 is advanced distally, the protrusions 256 and 258 can position the anvil 220 and set a tissue gap between the anvil 220 and the deck 233.

The end effector 200 may further include a cutting member configured to incise the tissue trapped between the staple cartridge 230 and the anvil 220. With reference to FIG. 2 again, thread 250 includes a knife 254, but any suitable cutting member can be utilized. When the thread 250 is advanced distally to deploy the staples from the staple cavity 270, the knife 254 is moved distally to traverse the tissue. In certain alternative embodiments, the launching member that pushes the thread 250 distally can include a cutting member. The cartridge 230 includes a longitudinal slot 234 configured to receive the knife 254 at least partially. Anvil 220 also includes a longitudinal slot configured to receive the knife 254 at least partially, but includes a slot configured such that only one of the cartridge 230 and the anvil 220 receives the cutting member. The form is assumed.

Further with respect to the above, with reference primarily to FIG. 1, the handle 110 of the surgical instrument 100 comprises a joint motion actuator 170 capable of articulating the end effector 200 around the joint motion joint 180 when actuated. When the actuator 170 is pushed in the first direction, the end effector 200 can rotate in the first direction, and when the actuator 170 is pushed in the second direction, the end effector 200 is in the second, i.e. , Can rotate in the opposite direction. With reference to FIG. 2, the end effector 200 includes a joint motion stop 182 mounted at the proximal end. In an exemplary embodiment, a clasp 182 is mounted on the cartridge channel 210 via a pin 184, and the pin 184 extends through the cartridge channel 210 and an opening 214 defined within the clasp 182. The shaft 120 is located between the first engaged position where the lock is engaged with the clasp 182 and the second, i.e., disengaged position where the lock is disengaged from the clasp. Can further include locks that can be moved with. When the lock is in the engaged position, the lock can hold the end effector 200 in place. When the lock is in the disengaged position, the end effector 200 can rotate around the articulating joint 180. The disclosure of US Patent Application No. 14 / 314,788, entitled "ROBOTICALLY-CONTROLLLED SHAFT BASED ROTARY DRIVE SYSTEMS FOR SURGICAL INSTRUMENTS", filed June 25, 2014, is incorporated by reference in its entirety. The disclosure of US Patent Application Publication No. 2013/0168435, entitled "SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR", filed on February 26, 2013, is incorporated by reference in its entirety.

With reference to FIGS. 3 and 4, the staple cavity 270 of the staple cartridge 200 can be positioned and positioned such that the staples stored in the staple cavity are deployed as part of the expandable staple wire. .. The staple cavity 270 is arranged in the staple cavity array. The staple cavity array comprises a first row of staple cavities 270a that detachably house the first row of staples. The staple cavities 270a in the first row extend along the first longitudinal axis 272a adjacent to the longitudinal slot 234. The staple cavity array comprises a second row of staple cavities 270b that detachably house the staples of the second row. The staple cavities 270b in the second row extend along the second longitudinal axis 272b adjacent to the staple cavities 270a in the first row. The staple cavity array comprises a third row of staple cavities 270c that detachably house the staples of the third row. The staple cavities 270c in the third row extend along the staple cavities 270b in the second row.

With reference to FIGS. 3 and 4 again, the first longitudinal axis 272a is parallel to, or at least substantially parallel to, the second longitudinal axis 272b, while the first longitudinal axis 272a is the second longitudinal. Other arrangements that are not parallel to the directional axis 272b are possible. Another arrangement in which the second longitudinal axis 272b is parallel to, or at least substantially parallel to, the third longitudinal axis 272c, but the second longitudinal axis 272b is not parallel to the third longitudinal axis 272c. Is possible. Another arrangement in which the first longitudinal axis 272a is parallel to, or at least substantially parallel to, the third longitudinal axis 272c, but the first longitudinal axis 272a is not parallel to the third longitudinal axis 272c. Is possible.

Referring again to FIGS. 3 and 4, the staple cartridge 230 is a first of a staple cavity array containing a first row 270a, a second row 270b, and a third row 270c on a first surface of a longitudinal slot 234. A portion 1 and a second portion of the cavity array comprising a first row 270a, a second row 270b, and a third row 270c are provided on the second side of the longitudinal slot 234. The first cavity array portion is a mirror image of the second cavity array portion with respect to the longitudinal slot, but other configurations can be utilized.

The staple cartridge 230 is configured to deploy the staple array shown in FIG. 52A. The staple cartridge 230 is attached to the first row of staples 280a along the first longitudinal axis 282a, the second row of staples 280b along the second longitudinal axis 282b, and the third longitudinal axis 282c. It is configured to unfold a third row of staples 280c along. In various embodiments, the staple cartridge 230 has a first row of staples 280a, a second row of staples 280b, and a third row of staples 280c on the first side of the longitudinal incision 284, as well as the longitudinal direction. First row staples 280a, second row staples 280b, and third row staples 280c are configured to be deployed on the second side of the incision 284. The staples 280a in the first row can be positioned adjacent to the longitudinal incision 284 and the staples 280c in the third row can be positioned farthest from the longitudinal incision 284. The staples 280b in each second row can be positioned between the staples 280a in the first row and the staples 280c in the third row.

Further, with respect to the above, the first staple 280a is detachably stored in the first staple cavity 270a, the second staple 280b is detachably stored in the second staple cavity 270b, and the third staple The 280c is removably housed in a third staple cavity 270c. The staple cavities 270a to 270c are configured and arranged so as to unfold the staples 280a to 280c in the arrangement shown in FIG. 52A. The first staple 280a is oriented at a first angle 274a with respect to the longitudinal axis 282a. The second staple 280b is oriented at a second angle 274b with respect to the longitudinal axis 282b. The third staple 280c is oriented at a third angle 274c with respect to the longitudinal axis 282c. The first angle 274a is different from the second angle 274b, but in other embodiments, the first angle 274a and the second angle 274b may be the same. The third angle 274c is different from the second angle 274b, but in other embodiments, the third angle 274c and the second angle 274b may be the same. The first angle 274a may be the same as the third angle 274c, but in other embodiments, the first angle 274a and the third angle 274c may be different.

Further, with respect to the above, the first angle 274a can be measured with respect to the first longitudinal axis 282a and the second angle 274b can be measured with respect to the second longitudinal axis 282b. The third angle 274c can be measured with respect to the third longitudinal axis 282c. When the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c are parallel to each other, the first angle 274a, the second angle 274b and / or the third. The angle 274c can be measured with respect to any one of the first longitudinal axis 282a, the second longitudinal axis 282b, and the third longitudinal axis 282c. When the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c are parallel to the longitudinal slot 234, the first angle 274a, the second angle 274b, And / or a third angle 274c can be measured with respect to slot 234 in the longitudinal direction. Correspondingly, when the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c are parallel to the tissue transverse section 284, the first angle 274a, first. The angle 274b of 2 and / or the third angle 274c can be measured relative to the tissue cross section 284.

The first staple 280a, the second staple 280b, and the third staple 280c can be positioned and positioned to provide laterally overlapping staple lines. More specifically, with reference to FIG. 52A again, the longitudinal row of the second staple 280b is positioned laterally with respect to the longitudinal row of the first staple 280a, with the second staple 280b Aligned with the gap between the first staples 280a, similarly, the longitudinal rows of the third staples 280c are positioned laterally with respect to the longitudinal rows of the second staples 280b. The third staple 280c is aligned with the gap between the second staples 280b. Such an arrangement can limit the flow of blood from the tissue T to the transverse section 284.

In an exemplary embodiment, each first staple 280a is relative to the distal leg 283a, which is distal to the distal leg 283b of the adjacent second staple 280b, and further to the distal leg 283b. It is provided with a proximal leg 285a which is proximal. Similarly, each third staple 280c is distal to the distal leg 283b of the adjacent second staple 280b, further proximal to the distal leg 283b. The proximal leg 285c is provided. The first staple 280a and the second staple 280b adjacent to the third staple 280c described above are relative to the proximal leg 285a of the first staple 280a and the proximal leg 285c of the third staple 280c. It comprises a proximal leg 285b that is proximal. This is just one exemplary embodiment and any suitable arrangement can be utilized.

Further, with respect to the above, the first staple 280a straddles the first longitudinal axis 282a. The distal leg 283a of the first staple 280a is positioned on one side of the first longitudinal axis 282a and the proximal leg 285a is positioned on the opposite side of the first longitudinal axis 282a. In other words, the legs of the first staple 280a are biased with respect to the first longitudinal axis 282a. An alternative embodiment is envisioned in which the first staple 280a is aligned with the first longitudinal axis 282a, i.e. on the same straight line.

The second staple 280b straddles the second longitudinal axis 282b. The distal leg 283b of the second staple 280b is positioned on one side of the second longitudinal axis 282b and the proximal leg 285b is positioned on the opposite side of the second longitudinal axis 282b. In other words, the legs of the second staple 280b are biased with respect to the second longitudinal axis 282b. An alternative embodiment is envisioned in which the second staple 280b is aligned with the second longitudinal axis 282b, i.e., on the same straight line.

The third staple 280c straddles the third longitudinal axis 282c. The distal leg 283c of the third staple 280c is positioned on one side of the third longitudinal axis 282c and the proximal leg 285c is positioned on the opposite side of the third longitudinal axis 282c. In other words, the legs of the third staple 280c are offset with respect to the third longitudinal axis 282c. An alternative embodiment is envisioned in which the third staple 280c is aligned with the third longitudinal axis 282c, i.e., on the same straight line.

In certain embodiments, the first staple 280a can include a proximal leg 285a aligned with the distal leg 283b of an adjacent second staple 280b. Similarly, the third staple 280c can include a proximal leg 285c aligned with the distal leg 283b of the adjacent second staple 280b. In various embodiments, the first staple 280a can include a proximal leg 285a that is positioned distal to the distal leg 283b of the adjacent second staple 280b. Similarly, the third staple 280c can include a proximal leg 285c that is positioned distal to the distal leg 283b of the adjacent second staple 280b.

The row of second staples 280b is surrounded by a row of first staples 280a and a row of third staples 280c. The second staple 280b is surrounded by the first staple 280a on one side and by the third staple 280c on the other side. More specifically, the first staple 280a is positioned laterally inward with respect to the proximal leg 285b of the second staple 280b, and similarly the third staple 280c is of the second staple 280b. Positioned laterally outward with respect to the distal leg 283b. As a result, the first staple 280a can provide a border on one side of the second staple 280b and the third staple 280b can provide a border on the opposite side of the second staple 280b. ..

A conventional staple array is illustrated in FIG. The staple array includes a first row of staples 380a positioned along a first longitudinal axis 382a, a second row of staples 380b positioned along a second longitudinal axis 382b, and a tissue T. It comprises a third row of staples 380c positioned along a third longitudinal axis 382c positioned on the first side of the incision 384. The staples 380a are aligned or at least substantially aligned with the first longitudinal axis 382a, the staples 380b are aligned or at least substantially aligned with the second longitudinal axis 382b, and the staples 380c are aligned with the third longitudinal axis. Aligned with, or at least substantially aligned with, the directional axis 382c. In other words, the first staple 380a is not oriented at an angle with respect to the first longitudinal axis 382a, and the second staple 380b is oriented at an angle with respect to the second longitudinal axis 382b. However, the third staple 380c is not oriented at an angle with respect to the third longitudinal axis 382c. The staple array also includes a first row of staples 380a positioned along a first longitudinal axis 382a, a second row of staples 380b positioned along a second longitudinal axis 382b, and an incision. A third row of staples 380c positioned along a third longitudinal axis 382c positioned on the second side, or opposite side, of portion 384.

When a longitudinal tensile force is applied to the tissue T stapled by the staple array illustrated in FIG. 52, the tissue will stretch in the longitudinal direction. Moreover, in various embodiments, the staples 380a, 380b, and 380c can be longitudinally translated when the tissue is stretched longitudinally. Such arrangements may be suitable in many situations, but staples 380a, 380b, and 380c may limit tissue elongation and / or migration. In some embodiments, the tissue stapled with staples 380a, 380b, and 380c may be significantly less flexible than the non-stapled adjacent tissue. In other words, staple arrays with staples 380a, 380b, and 380c can cause abrupt changes in the material properties of the structure. In at least one example, a large strain gradient can occur in the tissue as a result of the staple array, and a large strain gradient can then generate a large stress gradient in the tissue.

When the staples 380a-380c are released from the staple cartridge, the legs of the staples can puncture the tissue T. As a result, the staple legs create holes in the tissue. The various types of tissue are elastic and can stretch around the staple legs as they pass through the tissue. In various embodiments, the elasticity of the tissue allows the tissue to stretch and elastically return towards the staple legs, reducing or eliminating the gap that exists between the tissue and the staple legs. Can be done. Such elasticity can also allow the tissue to stretch when an extension force is applied to the tissue, but such elasticity can be hampered by certain staple patterns. In at least one example, the staple pattern shown in FIG. 52 can prevent longitudinal elongation of the tissue. When longitudinal stretching forces are applied to the stapled tissue by the staple pattern of FIG. 52, the tissue may be pulled away from the staple legs and begin to create gaps between them. In some cases, especially in obesity resection applications, such gaps can result in increased bleeding from gastric tissue. Air leaks can occur in lung tissue in certain cases, especially in lung resection applications.

The staple array shown in FIG. 52A is more flexible than the staple array shown in FIG. 52. Referring here to FIG. 52B, when longitudinal tensile force is applied to the tissue T, one of the staples 280a, 280b, and 280c translates longitudinally when the tissue is stretched longitudinally, and / Or two, it can rotate when the tissue is stretched longitudinally. The flexible staple array shown in FIG. 52 can create significant extensibility along the staple lines, for example in the longitudinal direction defined by the staple lines. Such longitudinal extensibility can reduce stress and / or strain gradients within the stapled tissue T and / or the tissue T surrounding the stapled tissue T. In addition, the flexible staple array shown in FIG. 52A reduces or eliminates the gap between the staple legs and the tissue T when longitudinal stretching forces are applied to the tissue, resulting in the staple legs and tissue. Bleeding and / or air leakage between and can be reduced.

With respect to the longitudinal translation of the staples 280a, 280b, and 280c, the first staple 280a can move along the first longitudinal axis 282a and the second staple 280b is the second longitudinal axis. It can move along the 282b and the third staple 280c can move along the third longitudinal axis 282c. When the first staple 280a moves along the first longitudinal axis 282a, the first staple 280a can extend over the entire first longitudinal axis 282a. In other words, the distance between the first staples 280a, or gap distance, is such that the longitudinal force is applied to the tissue along the first longitudinal axis 282a and / or parallel to the first longitudinal axis 282a. Can increase when Similarly, the second staple 280b can extend over the entire second longitudinal axis 282b as the second staple 280b moves along the second longitudinal axis 282b. The distance between the second staples 280b, or gap distance, is when a longitudinal force is applied to the tissue along the second longitudinal axis 282b and / or parallel to the second longitudinal axis 282b. Can increase. Similarly, the third staple 280c can extend over the entire third longitudinal axis 282c as the third staple 280c moves along the third longitudinal axis 282c. The distance between the third staples 280c, or gap distance, is when a longitudinal force is applied to the tissue along the third longitudinal axis 282c and / or parallel to the third longitudinal axis 282c. Can increase.

As discussed earlier, the staples 280a, 280b, and / or 280c can move with the tissue T when it is stretched. When the tissue T is pulled longitudinally, further with respect to the above, the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c remain parallel to each other. Can be done. In some examples, the orientation of the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c is, for example, a lateral force, i.e. a longitudinal force. It can be non-parallel, such as when a lateral force is applied to the tissue T. In certain embodiments, the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c can be closer to each other when the tissue T is pulled longitudinally. .. Such movement may be the result of lateral contraction that occurs within the tissue T when a longitudinal stretching force is applied to the tissue T. In some embodiments, the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c are, for example, when a lateral force is applied to the tissue T. You can be separated from each other.

With respect to the rotational movement of the staples 280a, 280b, and 280c, the first staple 280a can rotate with respect to the first longitudinal axis 282a when a longitudinal tensile force is applied to the tissue T. Each first staple 280a can rotate between an initial first angle 274a and another first angle 274a when a longitudinal tensile force is applied to the tissue T. In at least one embodiment, each first staple 280a has an initial orientation in which the first staple 280a extends laterally with respect to the first longitudinal axis 282a and a first longitudinal axis 282a. Can rotate with another orientation that is closer to the alignment of. In some embodiments, longitudinal tensile force is applied to the tissue T to rotate the first staple 280a in an orientation that is in line with the first longitudinal axis 282a. In various embodiments, each first staple 280a can rotate around an axis extending through the first longitudinal axis 282a.

As discussed earlier, the first staple 280a rotates between an initial first angle 274a and another first angle 274a when a longitudinal tensile force is applied to the tissue T. Can be done. In various embodiments, the initial, i.e., unstretched, first angle 274a can be, for example, from about 5 ° to about 85 °. In certain embodiments, the initial, i.e., unstretched, first angle 274a can be, for example, from about 30 ° to about 60 °. In at least one embodiment, the initial, i.e., unstretched first angle 274a can be, for example, about 45 °. In at least one embodiment, the initial, i.e. unstretched, first angle 274a is, for example, about 10 °, about 20 °, about 30 °, about 40 °, about 50 °, about 60 °, about 70. ° and / or can be about 80 °.

In various examples, the first angle of 274a after stretching can be, for example, from about 5 ° to about 85 °. In a particular example, the first angle of 274a after stretching can be, for example, from about 30 ° to about 60 °. In at least one example, the stretched first angle 274a can be, for example, about 45 °. In at least one example, the first angle of 274a after stretching is, for example, about 10 °, about 20 °, about 30 °, about 40 °, about 50 °, about 60 °, about 70 °, and / or. It can be about 80 °.

In various examples, the difference between the unstretched first angle 274a and the stretched first angle 274a can be, for example, about 1 ° to about 45 °. In a particular example, the difference between the unstretched first angle 274a and the stretched first angle 274a is, for example, about 1 °, about 2 °, about 3 °, about 4 °, and / or about. It can be 5 °. In a particular example, the difference between the unstretched first angle 274a and the stretched first angle 274a is, for example, about 5 °, about 10 °, about 15 °, about 20 °, and / or about. It can be 25 °.

Further, with respect to the above, the second staple 280b can rotate with respect to the second longitudinal axis 282b when a longitudinal tensile force is applied to the tissue T. Each second staple 280b can rotate between an initial second angle 274b and another second angle 274b when a longitudinal tensile force is applied to the tissue T. In at least one embodiment, each second staple 280b has an initial orientation in which the second staple 280b extends laterally with respect to the second longitudinal axis 282b and a second longitudinal axis. It can rotate with another orientation that is closer to the alignment with 282b. In some embodiments, the longitudinal tensile force is applied to the tissue T to rotate the second staple 280b in an orientation that is in line with the second longitudinal axis 282b. In various embodiments, each of the second staples 280b can be aligned with the second longitudinal axis 282b and / or rotate around an axis extending through the second longitudinal axis 282b.

As discussed earlier, the second staple 280b rotates between an initial second angle 274b and another second angle 274b when a longitudinal tensile force is applied to the tissue T. Can be done. In various embodiments, the initial, i.e., unstretched second angle 274b can be, for example, from about 5 ° to about 85 °. In certain embodiments, the initial, i.e., unstretched, second angle 274b can be, for example, about 30 ° to about 60 °. In at least one embodiment, the initial, i.e., unstretched second angle 274b can be, for example, about 45 °. In at least one embodiment, the initial, i.e., unstretched second angle 274b is, for example, about 10 °, about 20 °, about 30 °, about 40 °, about 50 °, about 60 °, about 70. ° And / or 80 °.

In various examples, the second angle of 274b after stretching can be, for example, from about 5 ° to about 85 °. In a particular example, the stretched second angle 274b can be, for example, about 30 ° to about 60 °. In at least one example, the stretched second angle 274b can be, for example, about 45 °. In at least one example, the second angle 274b after stretching is, for example, about 10 °, about 20 °, about 30 °, about 40 °, about 50 °, about 60 °, about 70 °, and / or. It can be about 80 °.

In various examples, the difference between the unstretched second angle 274b and the stretched second angle 274b can be, for example, about 1 ° to about 45 °. In a particular example, the difference between the unstretched second angle 274b and the stretched second angle 274b is, for example, about 1 °, about 2 °, about 3 °, about 4 °, and / or about. It can be 5 °. In a particular example, the difference between the unstretched second angle 274b and the stretched second angle 274b is, for example, about 5 °, about 10 °, about 15 °, about 20 °, and / or about. It can be 25 °.

Further, with respect to the above, the third staple 280c can rotate with respect to the third longitudinal axis 282c when a longitudinal tensile force is applied to the tissue T. Each third staple 280c can rotate between an initial third angle 274c and another third angle 274c when a longitudinal tensile force is applied to the tissue T. In at least one embodiment, each third staple 280c has an initial orientation in which the third staple 280c extends laterally with respect to the third longitudinal axis 282c and a third longitudinal axis 282c. It is possible to rotate with another orientation that is closer to the alignment with. In some embodiments, the longitudinal tensile force is applied to the tissue T to rotate the third staple 280c in an orientation that is in line with the third longitudinal axis 282c. In various embodiments, each third staple 280c can be aligned with the third longitudinal axis 282c and / or rotate around an axis extending through the third longitudinal axis 282c.

As discussed earlier, the third staple 280c rotates between an initial third angle 274c and another third angle 274c when a longitudinal tensile force is applied to the tissue T. Can be done. In various embodiments, the initial, i.e., unstretched, third angle 274c can be, for example, from about 5 ° to about 85 °. In certain embodiments, the initial, i.e., unstretched, third angle 274c can be, for example, from about 30 ° to about 60 °. In at least one embodiment, the initial, i.e., unextended third angle 274c can be, for example, about 45 °. In at least one embodiment, the initial, i.e., unstretched third angle 274c is, for example, about 10 °, about 20 °, about 30 °, about, 40 °, about 50 °, about 60 °, about. It can be 70 ° and / or about 80 °.

In various examples, the stretched third angle 274c can be, for example, from about 5 ° to about 85 °. In a particular example, the stretched third angle 274c can be, for example, about 30 ° to about 60 °. In at least one example, the stretched third angle 274c can be, for example, about 45 °. In at least one example, the stretched third angle 274c is, for example, about 10 °, about 20 °, about 30 °, about 40 °, about 50 °, about 60 °, about 70 °, and / or. It can be about 80 °.

In various examples, the difference between the unstretched third angle 274c and the stretched third angle 274c can be, for example, about 1 ° to about 45 °. In a particular example, the difference between the unstretched third angle 274c and the stretched third angle 274c is, for example, about 1 °, about 2 °, about 3 °, about 4 °, and / or about. It can be 5 °. In a particular example, the difference between the unstretched third angle 274c and the stretched third angle 274c is, for example, about 5 °, about 10 °, about 15 °, about 20 °, and / or about. It can be 25 °.

In various examples, the first staple 280a in the staples of the first row can be rotated by the first amount and the second staple 280b in the staples of the second row is the first quantity. Can be rotated in a second amount different from. The first amount may be less than or greater than the second amount. In various examples, the first staple 280a in the staples of the first row can rotate with the first amount, and the third staple 280c in the staples of the third row is the first quantity. Can be rotated in a third amount different from. The first amount may be less than or greater than the third amount. In various examples, the third staple 280c in the staples of the third row can rotate with a third amount, and the second staple 280b in the staples of the second row is a third quantity. Can be rotated in a second amount different from. The third amount may be less than or greater than the second amount.

In at least one application, it would be desirable for the innermost row of staples, i.e. the staples in the row closest to the incision, to be more inflexible or non-extensible than the staples in the other rows. It would also be desirable for the outermost row of staples, i.e. the staples in the row farthest from the incision, to be more flexible or extensible than the staples in the other rows. When the angle between the first staple axis and the first longitudinal axis is less than the angle between the second staple axis and the second longitudinal axis, the first staple is the second staple. May not have as much room to rotate towards the first longitudinal axis as it has to rotate towards the second longitudinal axis, and thus may cure the tissue more than the second staple. Similarly, when the angle between the second staple axis and the second longitudinal axis is less than the angle between the third staple axis and the third longitudinal axis, the second staple is the second staple. The staples of 3 may not have as much room to rotate towards the second longitudinal axis as they have to rotate towards the third longitudinal axis, thus hardening the tissue more than the third staple. obtain.

Further, with respect to the above, the staple pattern disclosed in FIG. 52A includes six rows of staples in the longitudinal direction. For example, other embodiments are envisioned that include less than 6 rows of staples, such as 4 rows of staples, or more than 6 rows of staples, such as 8 rows of staples.

The first staple 280a, the second staple 280b, and the third staple 280c can include any suitable configuration, such as, for example, a V-shaped configuration or a U-shaped configuration. Staples with a V-shaped configuration can include a base, a first leg extending from the first end of the base, and a second leg extending from the second end of the base. , The first leg and the second leg extend in a direction that is non-parallel to each other. Staples having a U-shaped configuration can include a base, a first leg extending from the first end of the base, and a second leg extending from the second end of the base. , The first leg and the second leg extend in a direction parallel to each other.

With respect to the staple pattern disclosed in FIG. 52A, for example, each first staple 280a comprises a proximal staple leg 285a and a distal staple leg 283a. Staple cartridges configured to unfold the staple pattern disclosed in FIG. 52A can include proximal and distal ends. The proximal staple leg 285a may be closer to the proximal end of the staple cartridge than the distal staple leg 283a, and similarly, the distal staple leg 283a may be closer to the staple cartridge than the proximal staple leg 285a. It may be close to the distal end. The base of each first staple 280a can define the first base axis. The proximal staple leg 285a and the distal staple leg 283a can extend from the first base axis. The first staple 280a can be positioned and positioned such that the first base axis extends towards the longitudinal notch 284 and towards the distal end of the staple cartridge.

With respect to the staple pattern disclosed in FIG. 52A, for example, each second staple 280b comprises a proximal staple leg 285b and a distal staple leg 283b. As discussed earlier, staple cartridges configured to develop the staple pattern disclosed in FIG. 52A can include proximal and distal ends. The proximal staple leg 285b may be closer to the proximal end of the staple cartridge than the distal staple leg 283b, and similarly, the distal staple leg 283b may be closer to the staple cartridge than the proximal staple leg 285b. It may be close to the distal end. The base of each second staple 280b can define a second base axis. The proximal staple leg 285b and the distal staple leg 283b can extend from the second base axis. The second staple 280b can be positioned and positioned such that the second base axis extends towards the longitudinal notch 284 and towards the proximal end of the staple cartridge.

With respect to the staple pattern disclosed in FIG. 52A, for example, each third staple 280c comprises a proximal staple leg 285c and a distal staple leg 283c. As discussed earlier, staple cartridges configured to develop the staple pattern disclosed in FIG. 52A can include proximal and distal ends. The proximal staple leg 285c may be closer to the proximal end of the staple cartridge than the distal staple leg 283c, and similarly, the distal staple leg 283c may be closer to the staple cartridge than the proximal staple leg 285c. It may be close to the distal end. The base of each third staple 280c can define a third base axis. The proximal staple leg 285c and the distal staple leg 283c can extend from the third base axis. The third staple 280c can be positioned and positioned such that the third base axis extends towards the longitudinal notch 284 and towards the distal end of the staple cartridge.

With respect to the staple pattern disclosed in FIG. 52A, for example, the first staple 280a can be aligned with the third staple 280c. The proximal staple leg 285a of the first staple 280a can be aligned with the proximal staple leg 285c of the third staple 280c. When the proximal staple leg 285a is aligned with the proximal staple leg 285c, the proximal staple leg 285a and the proximal leg 285c can be positioned along an axis perpendicular to the incision line 284. The distal staple leg 283a of the first staple 280a can be aligned with the distal staple leg 283c of the third staple 280c. When the distal staple leg 283a is aligned with the distal staple leg 283c, the distal staple leg 283a and the distal staple leg 283c can be positioned along an axis perpendicular to the incision line 284. .. In such a situation, the third staple 280c can seal the tissue when the first staple 280a is deformed. Similarly, the first staple 280a can hold the tissue together when the third staple 280c is deformed. In other embodiments, the first staple 280a does not have to be aligned with the third staple 280c.

Further, with respect to the above, the first staple 280a can be aligned with the third staple 280c when the staple pattern is in the unstretched state. When the staple pattern is extended in the longitudinal direction, the first staple 280a and / or the third staple 280c can be translated and / or rotated. In various situations, the first staple 280a can remain aligned with the third staple 280c when the tissue is stretched longitudinally. In other situations, the first staple 280a may not remain aligned with the third staple 280c.

With respect to the staple pattern disclosed again in FIG. 52A, the distal staple leg 283b of the second staple 280b is the proximal staple leg 285a of the first staple 280a and / or the proximal leg of the third staple 280c. It can be aligned with 285c. The distal staple leg 283b of the second staple 280b, the proximal staple leg 285a of the first staple 280a, and / or the proximal staple leg 285c of the third staple 280c are perpendicular to the notch line 284. It can be positioned along the axis. The proximal staple leg 285b of the second staple 280b can be aligned with the distal staple leg 283a of the first staple 280a and / or the distal staple leg 283c of the third staple 280c. The proximal staple leg 285b of the second staple 280b, the distal staple leg 283a of the first staple 280a, and / or the distal staple leg 283c of the third staple 280c are perpendicular to the notch line 284. It can be positioned along the axis.

Further, with respect to the above, the staple legs of the second staple 280b can be aligned with the staple legs of the first staple 280a and / or the third staple 280c when the staple pattern is in the unstretched state. When the staple pattern is extended longitudinally, the first staple 280a, the second staple 280b, and / or the third staple 280c can be translated and / or rotated. In various situations, the legs of the second staple 280b may not remain aligned with the legs of the first staple 280a and / or the third staple 280c when the tissue is stretched longitudinally. is there. In other situations, the legs of the second staple 280b may remain aligned with the legs of the first staple 280a and / or the third staple 280c when the tissue is stretched longitudinally. it can.

In various embodiments, the staple pattern can be arranged such that the staples in one longitudinal staple row overlap with the staples in another longitudinal staple row. For example, the distal staple leg 283b of the second staple 280b is positioned distal to the proximal staple leg 285a and / or the third staple 280c proximal leg 285c of the first staple 280a. be able to. For example, the proximal staple leg 285b of the second staple 280b may be positioned proximally to the distal staple leg 283a of the first staple 280a and / or the distal staple leg 283c of the third staple 280c. Can be done. The proximal staple leg 285b of the second staple 280b, the distal staple leg 283a of the first staple 280a, and / or the distal staple leg 283c of the third staple 280c are perpendicular to the notch line 284. It can be positioned along the axis.

As discussed earlier, the second staple 280b can overlap the first staple 280a and / or the third staple 280c when the staple pattern is in the unstretched state. When the staple pattern is extended longitudinally, the first staple 280a, the second staple 280b, and / or the third staple 280c can be translated and / or rotated. In various situations, the second staple 280b can remain overlapped with the first staple 280a and / or the third staple 280c when the tissue is stretched longitudinally. In some situations, the second staple 280b may no longer overlap the first staple 280a and / or the third staple 280c when the tissue is stretched longitudinally.

The staple pattern shown in FIG. 52A is shown in an unstretched state. When the stapled tissue is elongated longitudinally by the staple pattern shown in FIG. 52A, the staples may move longitudinally with the tissue and / or rotate within the tissue, as illustrated in FIG. 52B. it can. Also, such movement is illustrated in FIG.

The surgical instrument 100 is configured to be used during a laparoscopic surgical procedure. The end effector 200 and shaft 120 are sized and sized for insertion into the patient via a trocar or cannula. The trocar can include an internal passage with an inner diameter. In some examples, the inner diameter can be, for example, about 5 mm or about 12 mm. The end effector 200 is a linear end effector that applies staples along a straight line. Staples are at least partially curved, for example, as disclosed in U.S. Pat. No. 8,827,133, entitled "SURGICAL STAPLING DEVICE HAVING SUPPORTS FOR A FLEXIBLE DRIVE MECHANISM," issued September 9, 2014. Other surgical instruments to be applied along the stapled line are envisioned. The entire disclosure of US Pat. No. 8,827,133, entitled "SURGICAL STAPLING DEVICE HAVING SUPPORTS FOR A FLEXIBLE DRIVE MECHANISM," issued September 9, 2014, is incorporated herein by reference in its entirety. Such surgical instruments could be adapted to apply curved expandable staples using the principles disclosed herein. The surgical instrument 100 is adapted for use during a laparoscopic surgical procedure, while the surgical instrument 100 is during an incision surgical procedure in which the surgical instrument 100 is inserted into the patient through a large incision. Can be used for. Further, the expandable stapler lines disclosed herein, such as those disclosed in U.S. Patent Application Publication No. 2014/0042205 filed on October 21, 2013, entitled "SURGICAL STAPLING INSTRUMENT" , Can be applied by stapler for open surgery. The disclosure of US Patent Application Publication No. 2014/0042205, entitled "SURGICAL STAPLING INSTRUMENT", filed October 21, 2013, is incorporated herein by reference in its entirety.

Referring now to FIG. 4, the anvil 220 includes an array of internally defined molded pockets 290a, 290b, and 290c configured to deform the staples 280a, 280b, and 280c, respectively. The first molding pocket 290a is positioned along the first longitudinal axis 292a, the second longitudinal pocket 290b is positioned along the second longitudinal axis 292b, and the third molding pocket 290c. Is positioned along the third longitudinal axis 292c. The longitudinal axes 292a, 292b, and 292c are parallel and extend between the proximal end 221 and the distal end 222 of the anvil 220. The anvil 220 further comprises an internally defined longitudinal slot 224 configured to receive at least a portion of the launching member. In at least one embodiment, the launching member comprises a cut portion extending between the anvil 220 and the staple cartridge 230. The anvil 220 is located on one side of the longitudinal slot 224 with a row of first molding pockets 290a, a row of second molding pockets 290b, and a row of third molding pockets 290c, on the opposite side of the longitudinal slot 224. It comprises another row of first molding pockets 290a, a row of second molding pockets 290b, and a row of third molding pockets 290c. As the reader will recognize, the molded pockets 290a, 290b, and 290c are aligned with the staple cavities 270a, 270b, and 270c defined in the staple cartridge 230, respectively, and correspond to those staple cavities.

The molding pockets 290a, 290b, and 290c are configured to, for example, transform the staples 280a, 280b, and 280c into a B-shaped configuration. In various embodiments, the molded pockets 290a, 290b, and 290c are configured to, for example, transform U-shaped staples and / or V-shaped staples into such a B-shaped configuration. Each molded pocket 290a, 290b, and 290c comprises a proximal end configured to receive the proximal leg of the staple and a distal end configured to receive the distal leg of the staple. .. Therefore, any suitable anvil can be utilized to form the staples emitted from the staple cartridge into any suitable shape. The respective molding pockets 290a, 290b, and 290c can be provided with a groove extending between the proximal and distal ends. The groove can include a side wall that is configured to deform the staple in a plane and prevent or at least limit the movement of the staple leg out of the plane when the staple leg is deformed.

With reference to FIG. 5, the anvil 320 comprises an array of internally defined molded pockets 390a, 390b, and 390c. Similar to the above, the plurality of first molding pockets 390a are arranged along the first longitudinal axis, and the plurality of second molding pockets 390b are arranged along the second longitudinal axis. The third molding pocket 390c of the above is arranged along the third longitudinal axis. The molding pockets 390a, 390b, and 390c, respectively, include a molding pocket proximal end and a molding pocket distal end. For example, each first molded pocket 390a is configured to receive a proximal end 393a configured to receive the proximal leg of the first staple and a distal leg of the first staple. Each second molded pocket 390b, including the distal end 395a, is configured to receive the proximal leg of the second staple, the proximal end 393b, and the distal leg of the second staple. Each molded pocket 390c includes a distal end 395b configured to receive a portion, a proximal end 393c configured to receive a proximal leg of a third staple, and a third staple. Includes a distal end 395c configured to receive the distal leg of the.

Proximal ends 393a, 393b, and 393c, as well as distal ends 395a, 395b, and 395c can be provided with any suitable configuration. Referring again to FIG. 5, the proximal ends 393a, 393b, and 393c, and the distal ends 395a, 395b, and 395c, respectively, comprise an expansion cup. The expansion cups are wider than the groove 397 defined between them. In certain embodiments, the expansion cups and the grooves extending between them can be, for example, in the shape of an hourglass. When the staple leg enters such a molded pocket, the leg can enter the expansion cup, and when the staple leg is deformed, the expansion cup guides the staple leg into the groove 397. Can be done. Each expansion cup can include curved and / or angled sidewalls that can be configured to guide the staple legs towards the groove 397. The expansion cup can adjust the orientation of the misaligned staple legs in certain examples.

The staple molding pockets 390a, 390b, and 390c are nested. For example, the distal expansion cup 395b of the second molding pocket 390b is positioned between the expansion cups 393c and 395c of the adjacent third stapler molding pocket 390c, and further the proximal expansion cup of the second molding pocket 390b. The 393b is positioned in the middle of the expansion cups 393a and 395a of the adjacent first molding pocket 390a. Further, for example, the proximal expansion cup 393a of the first molding pocket 390a is positioned in the middle of the expansion cups 393b and 395b of the adjacent second molding pocket 390b. Further, for example, the distal expansion cup 395c of the third molding pocket 390c is positioned in the middle of the expansion cups 393b, 395b of the adjacent second molding pocket 390b. The enlarged molding cup of each staple cavity can define a rectangular outer circumference that can position the entire molding pocket. As a result of the nested arrangement described above, the rectangular outer circumference of one stapler molding cavity can overlap the rectangular outer circumference of another molding cavity. For example, the rectangular peripheral portion of the second molding cavity 390b can overlap the rectangular outer peripheral portion of the first molding cavity 390a and / or the rectangular outer peripheral portion of the third molding cavity 390c.

With reference to FIG. 6, the anvil 420 comprises an array of internally defined molded pockets 490a, 490b, and 490c. Similar to the above, the plurality of first molding pockets 490a are arranged along the first longitudinal axis, and the plurality of second molding pockets 490b are arranged along the second longitudinal axis. The third molding pocket 490c of the above is arranged along the third longitudinal axis. The molding pockets 490a, 490b, and 490c, respectively, include a molding pocket proximal end and a molding pocket distal end. For example, each first molded pocket 490a is configured to receive a proximal end 493a configured to receive the proximal leg of the first staple and a distal leg of the first staple. Each second molded pocket 490b, including the distal end 495a, is configured to receive the proximal leg of the second staple, the proximal end 493b, and the distal leg of the second staple. Each molded pocket 490c includes a distal end 495b configured to receive a portion, a proximal end 493c configured to receive a proximal leg of a third staple, and a third staple. Includes a distal end 495c configured to receive the distal leg of the.

The proximal ends 493a, 493b, and 493c, and the distal ends 495a, 495b, and 495c can be provided with any suitable configuration. With reference to FIG. 6 again, the proximal ends 493a, 493b, and 493c, and the distal ends 495a, 495b, and 495c, respectively, comprise an expansion cup. The expansion cups are wider than the groove 497 defined between them. In certain embodiments, the expansion cups and the grooves extending between them can be, for example, in the shape of an hourglass. When the staple legs enter such a molded pocket, the legs can enter the expansion cup, and when the staple legs are deformed, the expansion cup guides the staple legs into the groove 497. Can be done. Each expansion cup can include curved and / or angled sidewalls that can be configured to guide the staple legs towards the groove 497. The expansion cup can adjust the orientation of the misaligned staple legs in certain examples.

The stapler molding pockets 490a, 490b, and 490c are nested. For example, the distal expansion cup 495b of the second molding pocket 490b is positioned between the expansion cups 493c and 495c of the adjacent third stapler molding pocket 490c, and further the proximal expansion cup of the second molding pocket 490b. The 493b is positioned in the middle of the expansion cups 493a and 495a of the adjacent first molding pocket 490a. Further, for example, the proximal expansion cup 493a of the first molding pocket 490a is positioned in the middle of the expansion cups 493b and 495b of the adjacent second molding pocket 490b. For example, the distal expansion cup 495c of the additional third molding pocket 490c is positioned intermediate between the expansion cups 493b and 495b of the adjacent second molding pocket 490b. The enlarged molding cup of each staple cavity can define a rectangular outer circumference that can position the entire molding pocket. As a result of the nested arrangement described above, the rectangular outer circumference of one stapler molding cavity can overlap the rectangular outer circumference of another molding cavity. For example, the rectangular peripheral portion of the second molding cavity 490b can overlap the rectangular outer peripheral portion of the first molding cavity 490a and / or the rectangular outer peripheral portion of the third molding cavity 490c.

Referring again to FIG. 52A, the staples 280a, 280b, and 280c do not overlap. Other embodiments are envisioned in which at least a portion of the staples in the staple pattern overlap. Referring here to FIG. 32, the staple pattern disclosed therein comprises a longitudinal staple 580a in the first row and a longitudinal staple 580b in the second row. As the reader will recognize, a portion of the staples 580a in the first row and the staples 580b in the second row overlap. In at least one embodiment, the base of the second staple 580b extends beneath the base of the first staple 580a. In such an example, the distal leg 585b of the second staple 580b is positioned on one side of the base of the first staple 580a and the proximal leg 583b of the second staple 580b is the first staple 580a. Positioned on the opposite side of the base. Similarly, in at least one embodiment, the base of the first staple 580a extends beneath the base of the second staple 580b. In such an example, the distal leg 585a of the first staple 580a is positioned on one side of the base of the second staple 580b and the proximal leg 583a of the first staple 580a is the second staple 580b. Positioned on the opposite side of the base. As a result of the above, the first staple 580a is mixed with the second staple 580b.

Referring again to FIG. 32, the staple patterns are the staples 580a in the first row, the staples 580b in the second row positioned on one side of the longitudinal tissue incision, and the staples 580a in the first row, It comprises a second row of staples 580b positioned opposite the longitudinal tissue incision. The first staple 580a is oriented distally and towards the longitudinal tissue incision and the second staple 580b is oriented proximally and towards the longitudinal tissue incision.

Referring again to FIG. 32, the staples 580a in the first row are positioned along the first longitudinal axis and the staples 580b in the second row are positioned along the second longitudinal axis. As a result of the overlap of the first staple 580a and the second staple 580b, in certain embodiments, the first longitudinal axis can be adjacent to the second longitudinal axis. In some embodiments, the overlap of the staples in the first row and the staples in the second row is such that the angled staples in these rows of staples are conventional, for example, the staple pattern illustrated in FIG. It can be made possible to have the same centerline spacing that can be achieved with staple patterns arranged longitudinally. In some examples, the overlap of the staples in the first row and the staples in the second row is achieved by the angled staples in these rows of staples with the traditional longitudinally arranged staple pattern. It can be possible to have staple spacing closer than it can be. In at least one embodiment, the first longitudinal axis may be in line with the second longitudinal axis.

The staple pattern shown in FIG. 32 includes a repeating pattern. The repeating pattern comprises two first staples 580a, then two second staples 580b, then two first staples 580a, then two second staples 580b and the like. This repeating pattern extends longitudinally in the proximal and distal directions. The staples 580a in the first row have cuts inside and the cuts are filled with staples 580b, similarly, the staples 580b in the second row have cuts inside and the staples Filled with 580a. The repeating pattern is on one side of the longitudinal incision and the repeating pattern is on the opposite side of the longitudinal incision. These repeating patterns are mirror images of each other. Other repeating patterns are conceived.

FIG. 33 illustrates a staple cartridge 530 configured to detachably store and deploy the staple pattern disclosed in FIG. 32. The staple cartridge 530 has a first row of staple cavities 570a for detachably storing the first staple 580a and a second row of staple cavities 570b for detachably storing the second staple 580b. Including. At least a portion of the first staple cavity 570a and the second staple cavity 570b are interconnected to detachably house the overlapping first staple 580a and second staple 580b. The first row of staple cavities 570a can be arranged along the first longitudinal axis, and the second row of staple cavities 570b can be arranged along the second longitudinal axis. The first longitudinal axis and the second longitudinal axis can be adjacent or co-aligned as appropriate to develop the staple pattern disclosed herein. The staple cavities 570a in the first row and the staple cavities 570b in the second row are positioned on the first side of slot 534 in the longitudinal direction, and the staple cavities 570a in the first row and the staple cavities 570b in the second row. Is positioned on the second side of slot 534 in the longitudinal direction. The longitudinal slot 534 is configured to receive the launching member. The launching member can include cutting elements such as knives.

FIG. 34 illustrates an anvil 520 configured to deform the staples of the staple pattern disclosed in FIG. 32. The anvil 520 has a first molded cavity 590a configured to deform the legs of the first staple 580a and a second molded cavity 590b configured to deform the legs of the second staple 580b. Includes a repeating pattern of molded cavities that include. The first forming cavity 590a and the second forming cavity 590b are arranged in an alternating pattern. The alternating pattern is an array of first forming cavities 590a and second forming cavities 590b positioned along the first longitudinal axis, positioned on one side of the longitudinal slot 524, as well as a second longitudinal. It comprises an array of first molding cavities 590a and second molding cavities 590b positioned along the axis. The alternating pattern is an array of first forming cavities 590a and second forming cavities 590b positioned along the first longitudinal axis, positioned opposite the longitudinal slot 524, as well as a second longitudinal. It further comprises an array of first forming cavities 590a and second forming cavities 590b positioned along the directional axis. The array of molding cavities 590a and 590b can define a mirror image with respect to slot 524 in the longitudinal direction. The longitudinal slot 524 is configured to receive the launching member. The launching member can include cutting elements such as knives.

The staple pattern shown in FIG. 32 includes two rows of staples on each side of the longitudinal tissue incision, but such a staple pattern comprises three or more rows of staples, for example, three rows of staples. Can include. Such third row staples can be mixed with first row staples 580a and / or second row staples 580b. Alternatively, such third row staples need not be mixed with staples 580a in the first row or staples 580b in the second row. In such an embodiment, the staples 580a in the first row and the staples 580b in the second row can be mixed, and the staples in the third row are, for example, the staples 580a and / or the first row. It can be adjacent to two rows of staples 580b.

The staple pattern shown in FIG. 35 includes a longitudinal row of first staples 680a, a longitudinal row of second staples 680b, and a longitudinal row of third staples 6870c. The first staple 680a has a first bottom width. The second staple 680b has a second bottom width. The third staple 680c has a third bottom width. The width of the staple base extends from the base to the first staple leg extending from the base, measured along the base extending between the first staple leg and the second staple leg. It can be defined as the distance to the second staple leg. In at least one embodiment, the bottom width is measured between the cross-sectional center of the first staple leg and the cross-sectional center of the second staple leg. In any case, other embodiments are envisioned in which the first bottom width is shorter than the second bottom width, but the second bottom width is shorter than the first bottom width. The third bottom width is shorter than the first bottom width and the second bottom width, but other embodiments in which the third bottom width is longer than the first bottom width and / or the second bottom width. is assumed.

In the embodiment shown in FIG. 35, the second staple 680b has the longest bottom width. As a result, if the staples in the staple pattern rotate within the tissue as the tissue is stretched longitudinally, the second staple 680b will pass an arc length greater than that of the first staple 680a. .. Similarly, the first staple 680a will pass through an arc length greater than that of the third staple 680c. In various examples, as a result, the first staple 680a will pass through the first arc length and the second staple 680b will pass through the second arc length. The staple 680c of 3 will pass through the third arc length, and the first arc length, the second arc length, and the third arc length are different. Such arc lengths may differ even if the staples 680a, 680b, and / or 680c have the same degree. In certain embodiments, the first arc length, the second arc length, and / or the third arc length may be the same.

In the embodiment shown in FIG. 35, the first staple 680a is positioned and arranged alternately in the staple cartridge 630. The most distal first staple 680a is oriented towards the distal end of the staple cartridge 630 and towards the longitudinal slot 634 defined within the staple cartridge 630. The next first staple 680a in the second longitudinal row is oriented towards the proximal end of the staple cartridge 630 and towards the longitudinal slot 634. This pattern is then repeated within the longitudinal row of the first staple 680a.

The second staple 680b is positioned and arranged alternately in the staple cartridge 630. The most distal second staple 680b is oriented towards the distal end of the staple cartridge 630 and towards the longitudinal slot 634 defined within the staple cartridge 630. The next second staple 680b in the second longitudinal row is oriented towards the proximal end of the staple cartridge 630 and towards the longitudinal slot 634. This pattern is then repeated within the longitudinal row of second staples 680b.

The third staple 680c is positioned and arranged alternately in the staple cartridge 630. The most distal third staple 680c is oriented towards the distal end of the staple cartridge 630 and towards the longitudinal slot 634 defined within the staple cartridge 630. The next third staple 680c in the third longitudinal row is oriented towards the proximal end of the staple cartridge 630 and towards the longitudinal slot 634. This pattern is then repeated within the longitudinal row of third staples 680c.

Further referring to the staple pattern shown in FIG. 35, the longitudinal rows of the first staple 380a are nested within the longitudinal rows of the second staple 380b. Similarly, the longitudinal rows of the third staple 380c are nested within the longitudinal rows of the second staple 380b.

The staple cartridge 630 further comprises, with respect to the above, a plurality of first staple cavities 670a configured to detachably house the first staple 680a inside. The staple cartridge 630 has a plurality of second staple cavities 670b configured to removably store the second staple 680b, and a plurality of first staples 680c configured to removably store the third staple 680c. The staple cavity 670c of 3 is further provided. With reference to FIG. 36, the anvil 620 can be configured to deform the staples 680a, 680b, and 680c as they are ejected from the staple cartridge 630. The anvil 620 comprises a stapler molded pocket pattern aligned with staple cavities 670a, 670b, and 670c. For example, the anvil 620 has a plurality of first molding pockets 690a aligned with a first staple cavity 670a, a plurality of second molding pockets 690b aligned with a second staple cavity 670b, and a third staple cavity. It comprises a plurality of third molded pockets 690c aligned with the 670c.

As discussed earlier, the staple pattern can have several columns. The staples in each row can have the same or different orientations. FIG. 23 illustrates an embodiment comprising a row of staples having a first group of staples 780a oriented in a first direction and a second group of staples 780b oriented in a second direction. The first staple 780a and the second staple 780b are positioned along the longitudinal axis. The first staple 780a is angled with respect to the longitudinal axis and the second staple 780b is aligned with the longitudinal axis. Other arrangements are possible. The staples 780a are arranged in an alternating pattern with the staples 780b.

With reference to FIG. 23 and again with reference to FIG. 24, the staples in the staple row can translate the tissue and rotate within the tissue as it is stretched longitudinally. In some examples, translation and / or rotation of staples within the tissue can create holes or gaps between the staples and the tissue. Such holes or gaps can cause leakage. Even though the various staple patterns disclosed herein can minimize such leaks, certain improvements to the staples themselves can be made to reduce and / or eliminate these leaks. ..

Referring here to FIGS. 17 and 18, the staples are in an unfired configuration, for example, staples 280a, 280b, 280c, 380a, 380b, 380c, 580a, 580b, 680a, 680b, 680c, 780a, and / or 780b. It is shown. Although the unfired configuration of this staple is V-shaped, the principles discussed herein can be applied to any suitable shaped staple. FIG. 19 illustrates the staples of FIGS. 17 and 18 in the post-launch configuration. Although the post-launch configuration of this staple is B-shaped, the principles discussed herein can be applied to any suitable shaped staple. FIG. 20 shows the staples of FIGS. 17-19 including the coating 881, which staples are hereinafter referred to as staples 880. FIG. 21 illustrates a staple 880 deployed in a tissue and a hole or gap 882 existing between the staple 880 and the tissue. FIG. 22 illustrates coating 881 on staples 880 in the expanded state. The extended coating 881 can fill the entire gap 882. In some situations, the expanded coating 881 can stretch the tissue. In various other situations, the coating 881 may not fill the entire gap 882.

The staple 880 can be made of any suitable material, such as metal. In certain embodiments, for example, staple 880 can be made of titanium and / or stainless steel.

The expandable staple coating 881 can be constructed of any suitable material. For example, the staple coating 881 can be composed of poly-L-lactic acid and / or poly-95L / 5D lactic acid. Other copolymer compositions of PLA are also available. In various embodiments, the staple coating 881 can begin to form a gel as soon as the staple 880 is implanted in the tissue, and the gel can swell to fill the gap 882 or at least partially. it can. In various embodiments, the coating 881 can be applied to the staple 880 by immersing the staple wire in one or more solutions that coat the wire. In at least one embodiment, the staple wire can be immersed in a first solution for applying the base coating and then, for example, a second solution for applying PLA. In some embodiments, the coating 881 can be applied to the staple 880 when the staple 880 is positioned within the staple cartridge. The entire disclosure of ELASTOMERIC BIOMATERIALS FOR TISSUE ENGINEERING, Progress In Polymer Science 38 (2013) 584-671 (Q. Chen et al.) Is incorporated herein by reference.

The staple coating 881 can be made of, for example, a hydrophilic material. For example, the hydrophilic material can include a hydrogel derivatized with a peptide containing the RGD peptide sequence microspheres. The metal wire of staple 880 can be coated with a natural biopolymer such as, for example, hyaluronan or hyaluronic acid. Other hydrogels are also available. In various embodiments, the staple coating 881 can begin to swell as soon as the staple 880 is implanted in the tissue, and the coating 881 can swell to fill the gap 882 or at least partially. .. In various embodiments, the coating 881 can be applied to the staple 880 by immersing the staple wire in one or more solutions that coat the wire. In at least one embodiment, the staple wire can be immersed in, for example, a first solution for applying the base coating and then a second solution for applying the peptide-loaded hyaluronan. In some embodiments, the coating 881 can be applied to the staple 880 when the staple 880 is positioned within the staple cartridge. ATTACHMENT OF HYALULONAN TO METALLIC SURFACES, J. Mol. Biomed. Mater. Res. 68A: The entire disclosure of 95-106 (2004) (William G. Pitt et al.) Is incorporated herein by reference.

The staple coating 881 can be composed of, for example, xerogel. The staple coating 881 can be composed of, for example, gelatin microspheres and / or nanospheres. Gelatin contains at least partially or completely denatured forms of collagen to which cells can bind and degrade via enzymatic action. In various examples, gelatin can load, for example, fibroblasts and / or platelet-derived growth factor. As the coating 881 decomposes, the coating 881 can at least partially fill and at least partially seal the gap 882. In various embodiments, the coating 881 can be applied to the staple 880 by immersing the staple wire in a water-in-oil emulsion and then lyophilizing gelatin microspheres and / or nanospheres onto the staple wire. GELATIN MICROSPHERES CROSS-LINKED WITH GENIPIN FOR LOCAL DELIVERY OF GROWTH FACTORS, J. Mol. Tissue Eng. Rain. Med. The entire disclosure of 4: 514-523 (2010) (Luis Solorio et al.) Is incorporated herein by reference.

The staple 880 is composed of wires having a circular cross section, whereas the staple 880 can be composed of wires having any suitable cross section, such as a polygonal cross section. The non-circular cross section can have an outer circumference that is larger than the circular cross section for a particular overall width. Such a non-circular cross section can support more coating material than a circular cross section, which allows the coating to expand and fill holes larger than staples with a circular cross section. Can be made possible. In certain embodiments, the non-circular cross section can be formed to create one or more grooves in the circular cross section. In at least one such embodiment, such grooves can extend longitudinally along the staple legs. In some embodiments, the longitudinal groove can extend along the axis. In certain embodiments, the longitudinal groove can wrap around the staple legs. In at least one embodiment, such longitudinal grooves can spirally extend around the leg.

The staples of the staple cartridge can be deployed with or without the use of an auxiliary material, such as a buttress material. In many cases, the auxiliary material can be placed on the top surface of the staple cartridge, i.e. the deck, so that when the staple is released from the staple cartridge, the staple abuts the auxiliary material against the tissue. Can be captured. FIG. 55 illustrates two pieces of auxiliary material 239 positioned on the deck surface 238 of the staple cartridge 230. The first piece of auxiliary material 239 is positioned on the first side of slot 234 in the longitudinal direction and the second piece of auxiliary material 239 is positioned on the second side of slot 234 in the longitudinal direction. Will be done. An alternative embodiment is envisioned in which a single piece of auxiliary material is supported by a deck surface 238, the single piece extending across both sides of the longitudinal slot 234 and the staple cartridge 230. Referring again to FIG. 55, each piece of auxiliary material 239 is substantially rectangular, with a row of first staple cavities 270a, a row of second staple cavities 270b, and a third staple cavity 270c. Extends across staple patterns, including rows of The staples 280a, 280b, and 280c stored in the staple cavities 270a, 270b, and 270c assist when the staples 280a, 280b, and 280c are formed by the anvil 220 and discharged from the staple cartridge 230, respectively. It penetrates the agent material 239 and traps a part of the auxiliary agent material 239 inside.

In addition to or instead of the auxiliary material positioned on the staple cartridge, the auxiliary material may be positioned on the anvil. Staples that penetrate the tissue can penetrate the anvil aid before contacting the anvil and then re-penetrate the anvil aid before re-entering the tissue.

After the staples 280a, 280b, and 280c have been deformed by the anvil 220, further with respect to the above, the auxiliary material 239 is captured against the tissue by the staples 280a, 280b, and 280c. In other words, the auxiliary material 239 is implanted in the tissue with staples 280a, 280b, and 280c. As discussed above, the adjunct material 239 can be stretched with the tissue when the tissue is stretched longitudinally.

Auxiliary material can provide many advantages. Auxiliary material can assist in sealing the puncture holes created by the staple legs. In various embodiments, the staple leg is capable of pushing the auxiliary material into the puncture hole as the staple leg penetrates the tissue. Auxiliary material can also help seal the gap created between the staple legs and the tissue when the tissue is stretched longitudinally. Auxiliary material can reinforce the tissue. In various embodiments, the adjunct material can strengthen the tissue and prevent the staples from tearing the tissue.

With reference to FIG. 55 again, the reader will recognize parts of the auxiliary material 239 that are not captured by the staples 280a, 280b, and 280c. For example, the portion of the auxiliary material that extends around the outer circumference may not be captured by the staples. Similarly, the portion of the auxiliary material positioned in the middle of the staple may not be captured by the staple. Such an uncaptured portion of the adjunct material 239 does not provide the sealing benefits described above and at the same time can interfere with the extensibility provided by the staple pattern discussed herein. Such uncaptured portions can also impede the rotation of staples within the tissue, as discussed above. Improvements to the embodiment of FIG. 55 are shown in FIGS. 53, 54, 56, and 57. Such embodiments include recesses, notches, cuts, slits, openings, and / or any other suitable breaks configured to increase the extensibility of the auxiliary material. In addition, such breaks can facilitate the rotation of staples within the tissue.

With reference to FIG. 53, the auxiliary material 939 comprises a scalloped edge or side surface 938. The scalloped side 938 includes an internally defined recess or notch 937. The notch 937 has a curved configuration, but a suitable configuration can be utilized. The notch 937 reduces the perimeter of the uncaptured material that extends around the periphery of the auxiliary material 939, increasing the flexibility and extensibility of the auxiliary material 939.

With reference to FIG. 53 again, the auxiliary material 939 further comprises an internally defined opening 936. The opening 936 is rectangular and includes through holes, although other embodiments are envisioned. The opening 936 is located in the middle of the adjacent second staple cavity 270b and between the first staple cavity 270a and the third staple cavity 270c, but alternative locations are envisioned. The opening 936 reduces uncaptured material in the staple wire and increases the flexibility and extensibility of the auxiliary material 939.

With reference to FIG. 53 again, the body of the auxiliary material 939 extends over the staple cavities 270a, 270b, and 270c. An alternative embodiment is envisioned in which the auxiliary material 939 does not extend over the staple cavities 270a, 270b, and / or 270c. With reference to FIG. 54, the auxiliary material 939'contains slots or openings 935a, 935b, and 935c, and slots or openings 935a, 935b, and 935c are staple cavities 270a, 270b, and 270c, respectively. Partially extends over. The openings 935a, 935b, and 935c are larger than the opening 936, but the openings 935a, 935b, and / or 935c may be the same size as the opening 936 and / or larger than the opening 936. ..

With reference to FIG. 56, the auxiliary material 1039 comprises a notched edge or side surface 1038. The notched side surface 1038 includes an internally defined recess or notch 1037. The notch 1037 has an angular configuration, but a suitable configuration can be utilized. The notch 1037 reduces the outer circumference of the uncaptured material that extends around the auxiliary material 1039 and increases the flexibility and extensibility of the auxiliary material 1039.

Referring again to FIG. 56, the auxiliary material 1039 further comprises an internally defined slit 1036. The slit 1036 is rectangular and includes through holes, although other embodiments are envisioned. Auxiliary material 1039 includes slits 1036a in the first row and slits 1036b in the second row. The slit 1036a is located between the adjacent second staple 1080b and between the first staple 1080a and the third staple 1080c, although alternative locations are envisioned. The slit 1036b is located in the middle of the adjacent third staple 1080c and in the middle of the second staple 1080b and the fourth staple 1080d, but alternative locations are envisioned. The slit 1036a is parallel to the first staple 1080a and the third staple 1080c, and similarly the slit 1036b is parallel to the second staple 1080b and the fourth staple 1080d, although the slit is of any preference. Can have different directions. The slits 1036a and 1036b reduce the uncaptured material in the staple wire and increase the flexibility and extensibility of the auxiliary material 1039. The slits 1036a and 1036b are shorter than the bases of the staples 1080a, 1080b, 1080c, and 1080d, but the slits 1036a and / or 1036b are the same length as the bases of the staples 1080a, 1080b, 1080c, and 1080d, and / or staples. Embodiments longer than the 1080a, 1080b, 1080c, and 1080d bases are envisioned.

With reference to FIG. 57, the auxiliary material 1139 comprises a notched edge or side surface 1138. The notched side 1138 includes an internally defined recess or notch 1137. The notch 1137 has a curved configuration, but a suitable configuration can be utilized. The notch 1137 reduces the perimeter of the uncaptured material that extends around the auxiliary material 1139 and increases the flexibility and extensibility of the auxiliary material 1139.

With reference to FIG. 57 again, the auxiliary material 1139 further comprises an internally defined slit 1136. The slit 1136 is rectangular and includes through holes, although other embodiments are envisioned. Auxiliary material 1139 includes slits 1136a in the first row and slits 1136b in the second row. The slit 1136a is located in the middle of the adjacent second staple 1180b and in the middle of the first staple 1180a and the third staple 1180c, but alternative locations are envisioned. The slit 1136b is located in the middle of the adjacent third staple 1180c and in the middle of the second staple 1180b and the fourth staple 1180d, but alternative locations are envisioned. The slit 1136a is parallel to the first staple 1180a and the third staple 1180c, and similarly the slit 1136b is parallel to the second staple 1180b and the fourth staple 1180d, although the slit is of any preference. Can have different directions. The slits 1136a and 1136b reduce the uncaptured material in the staple wire and increase the flexibility and extensibility of the auxiliary material 1139. The slits 1136a and 1136b are shorter than the bases of the staples 1180a, 1180b, 1180c, and 1180d, but the slits 1136a and / or 1136b are the same length as the bases of the staples 1180a, 1180b, 1180c, and 1180d and / or the staples. Embodiments longer than the 1180a, 1180b, 1180c, and 1180d bases are envisioned.

As described herein, launching members and / or wedge threads can launch and / or eject staples from a staple cavity defined within the staple cartridge across the staple cartridge. For example, the launching member and / or wedge thread can be translated along the firing path within the staple cartridge, and the launching member and / or wedge thread engages the staple driver and / or the staple itself along the firing path. The staples can then be driven from the staple cavities. Also, as described herein, staple arrangements, including angularly oriented staples, can provide a variety of advantages and advantages. For example, an array of angularly oriented staples can provide increased flexibility and / or longitudinal stretchability within the stapled tissue.

When the staples are angularly oriented with respect to the firing path, at least a portion of the staple driver and / or staple may not overlap and / or be above the firing path. For example, the base of the angularly oriented staples can traverse the launch path such that the staple legs are positioned on either side of the launch path. In addition, the angle-oriented staple driver can cross the launch path and the ends of the staple driver can be positioned on either side of the launch path. In other examples, only the end of the staple and / or staple driver may be above the launch path, yet in other embodiments the staple and / or staple driver may be completely deviated from, for example, the launch path. ..

In an example where at least a portion of the staple and / or staple driver is offset from the launch path, the moment arm between the launch path and the staple and / or part of the staple driver positioned on either side of the launch path is a staple. Torque can be generated within and / or within the staple driver. Torque can affect the tilt and / or tilt movement of the staple during deployment. As a result, the staple legs of the torqued staples cannot engage the tissue with comparable force and / or velocity, and / or the staple legs simultaneously pierce and / or capture the tissue. I don't get it. Torque application and / or rotation of staples during deployment can adversely affect tissue penetration and / or staple formation, thus preventing and / or preventing torque generation during deployment of an array of angularly oriented staples in various embodiments. It may be desirable to keep it to a minimum.

When the staple driver is angled with respect to the wedge thread's launch path, only some of the angled drivers can receive driving or lifting force from the wedge thread. For example, driving force can be applied to a driver angled along an oblique path. The wedge thread can include multiple drive wedges to stabilize the angled driver and prevent torque application and / or rotation of the driver, and thus of the staples supported on it, at least two. One drive wedge can come into contact with the driver and apply driving force at multiple locations on the driver. For example, a pair of laterally spaced drive wedges can engage and lift an angled driver so that the driving force is laterally spaced along the length of the driver. It is designed to be distributed. Further, in at least one embodiment, the laterally spaced drive wedges can be equidistant from the center of mass of the angled driver so that the driver is mass balanced with respect to the plurality of drive wedges. It has become.

Further or / or to stabilize the angled driver and prevent torque application and / or rotation of the driver, and thus torque application and / or rotation of the angled staples supported on it. Drivers can be connected and / or linked together. In some examples, angled multi-staple drivers can be integrally formed. Connected drivers and / or multi-staple drivers can support multiple staples, which can reduce the number of moving parts in the staple cartridges, each interconnected and / or integrated. It is possible to prevent the relative movement of the staple cradle formed on the staple support surface between the staple support surfaces. In addition, angled multi-staple drivers may be larger, i.e. wider and / or longer than single-staple drivers. As a result, the multi-staple driver can have an increased aspect ratio. For example, a multi-staple driver can have a 1: 1 aspect ratio. In certain examples, the aspect ratio can be 3: 2 or 2: 1. Still in other examples, the aspect ratio can be, for example, less than 1: 1 or more than 2: 1. The higher the aspect ratio of a multi-staple driver, the greater stability can be provided to the staples supported on it.

In various examples, a single drive wedge can engage an angled multi-staple driver, and in certain examples, the driving force applied to the driver by the drive wedge is relative to the driver's center of mass. The balance can be adjusted. In another embodiment, the plurality of drive wedges can be engaged with an angled multi-staple driver, which allows the drive force to be laterally distributed throughout the driver. In various embodiments, the cumulative driving force applied to the angled multi-staple driver by the laterally spaced drive wedges can be balanced with respect to the driver's center of mass.

In other situations, the staples can be fired without a screwdriver to stabilize the angled staples in the staple cartridge and prevent torque application and / or rotation thereof during deployment. For example, the wedge thread may include a staple engaging surface that directly engages the staple thread engaging surface in a stapleless cartridge without a screwdriver. The wedge thread can contact each staple at a plurality of laterally spaced positions along the base of the staple. For example, the wedge thread can include multiple drive wedges, the at least two drive wedges being able to contact the angled staples to apply driving force at multiple locations. In various examples, a pair of laterally spaced drive wedges can engage an angled staple to lift the staple so that the driving force is along the length of the base of the staple. They are evenly distributed at laterally spaced intervals. Further, in at least one embodiment, the laterally spaced drive wedges can be equidistant from the center of mass of the angled staples so that the staples are mass balanced with respect to the drive wedges. It has become.

The end effector assembly 2000 is disclosed in FIG. As shown, the end effector assembly 2000 includes a first jaw 2002, a second jaw 2004, a closed tube or frame 2006, and an end effector joint motion joint 2009. The end effector assembly 2000 is movable between the first, i.e., open position and the second, i.e., closed position. As shown, the first jaw 2002 includes a pivot pin 2008, which is movably positioned within the closure slot 2010 of the second jaw 2004. For example, the pivot pin 2008 of the second jaw 2004 when the first jaw 2002 pivots with respect to the second jaw 2004 and with respect to the frame 2006 of the end effector assembly 2000 illustrated. It is configured to pivot and translate within the closed slot 2010.

In another embodiment, the first jaw 2002 can be secured to the frame 2006 and the second jaw 2004 is pivoted with respect to the first jaw 2002 to end effector assembly 2000. The jaws 2002 and 2004 can be opened and closed. Still in other embodiments, both jaws 2002, 2004 can be pivotally and / or otherwise moved to open and / or close the jaws 2002, 2004 of the end effector assembly 2000. For example, at least one of the jaws 2002, 2004 rotates, spins, slides, and / or translates with respect to the other jaws 2002, 2004 and / or the frame 2006 of the end effector assembly 2000. Open and / or close jaws 2002, 2004.

Still referring to FIG. 7, the end effector assembly 2000 is sized and constructed to receive the staple cartridge 2020, and the staple cartridge 2020 is configured for removable positioning within the end effector assembly 2000. For example, the staple cartridge 2020 shown can be a single-use and / or disposable cartridge, which can be replaced with another staple cartridge after firing the staple 2012 from it. The staple cartridge 2020 disclosed in FIG. 7 includes a deck 2026, a cartridge body 2024, and a casing 2022 that partially surrounds or encapsulates the cartridge body 2024. The staple cartridge 2020 shown also includes a staple 2012 that can be releasably positioned within the cartridge body 2024. The staples 2012 disclosed in FIG. 7 are generally "V-shaped" staples with non-parallel extending legs.

In various embodiments, the staple cartridge, such as the staple cartridge 2020, may be formed integrally with the end effector assembly 2000, for example, and / or permanently fixed within one of the jaws 2002, 2004, for example. it can. In such an example, the end effector assembly 2000 may be a single-use and / or disposable end effector. In another embodiment, the staple cartridge secured to the end effector assembly 2000 can, for example, be reloaded with additional staples for subsequent firing.

With reference to the staple cartridge 2020 disclosed in FIG. 7 again, longitudinal slots 2032 are defined at least partially through the cartridge body 2024. The illustrated longitudinal slot 2032 extends along the longitudinal axis L, which extends between the proximal and distal ends 2023 of the cartridge body 2024. The longitudinal slot 2032 shown in FIG. 7 extends from the proximal end 2023 to the distal end 2025 and traverses a portion of the length of the cartridge body 2024.

In some embodiments, the longitudinal slot 2032 traverses the entire length of the cartridge body 2024. In another embodiment, the longitudinal slot 2032 can extend, for example, from the distal end 2023 to the proximal end 2025. Still in other embodiments, the cartridge body 2024 may not include predefined and / or preformed longitudinal slots. For example, the firing member and / or cutting element can traverse and / or cut the cartridge body 2024 during the firing stroke to form a slot internally.

The staple cartridge 2020 disclosed in FIG. 7 is configured to launch an array 2011 of staples 2012 into the tissue. The staple array 2011 shown in FIG. 7 includes an angled staple 2012, the angled staple 2012 being angled with respect to the longitudinal axis L and with respect to the launch path of the drive wedges 2064a, 2064b. This is described further herein. The staple cartridge 2020 disclosed in FIG. 7 also includes multi-staple drivers 2040a, 2040b described herein that drive and support the angled staples 2012 within the array 2011.

The angled staples 2012 are removably positioned within the angled staples 2028 defined within the cartridge body 2024 disclosed in FIG. For example, the illustrated staple cavity 2028 is angularly oriented with respect to the longitudinal axis L. The illustrated arrangement of staple cavities 2028 corresponds to the illustrated staple array 2011 positioned within the staple cartridge 2020. Each staple cavity 2028 shown in FIG. 7 includes an opening 2030 within the deck 2026, each opening 2030 extending between the proximal end, the distal end, and between the proximal and distal ends. Includes the staple axis. The staple axis of the opening 2030 is inclined and / or angled with respect to the longitudinal axis L of the cartridge body 2024. For example, in the staple cartridge 2020 of FIG. 7, all the staple cavities 2028 defined in the cartridge body 2024 are angularly oriented with respect to the longitudinal axis L, and the various staple cavities 2028 are relative to the other staple cavities 2028. Is angularly oriented.

The staple cavities 2028 disclosed in FIG. 7 are arranged in a plurality of rows on each side of the longitudinal slot 2032. For example, a portion of the staple cavity 2028 is located in the first inner row 2033, the first outer row 2035, and the first intermediate row 2037 on the first side 2027 of the longitudinal slot 2032 and staples. Another portion of the cavity 2028 is located in the second inner row 2034, the second outer row 2038, and the second intermediate row 2036 in the second side 2029 of the longitudinal slot 2032. In the staple cartridge 2020 shown in FIG. 7, the staple cavity 2028 and its rows 2033, 2034, 2035, 2036, 2037, 2038 are symmetrical with respect to the longitudinal slot 2032.

The staple cavities 2028 shown do not intersect or otherwise contact each other, but the longitudinal rows 2033, 2034, 2035, 2036, 2037, 2038 of the staple cavities 2028 overlap. For example, the various staple cavities 2028 shown in FIG. 7 extend laterally outward and / or laterally inward beyond the staple cavities 2028 in adjacent rows of staple cavities 2028. In addition, various illustrated staple cavities 2028 extend proximally and / or distally beyond the staple cavities 2028 in adjacent rows of staple cavities 2028. Since the staples 2012 are arranged in an overlapping array 2011, bleeding and / or fluid flow within the stapled tissue can be controlled. The overlapping array of staples can be incorporated into, for example, other staple cartridges and / or end effector assemblies disclosed herein, similar to the staple array 2011.

In another embodiment, more or less staple cavities 2028 than three rows can be positioned on both sides 2027, 2029 of longitudinal slot 2032. In some embodiments, one of the side 2027, 2029 of the staple cartridge 2020 may include a different number of rows of staple cavities 2028 than the opposite side 2027, 2029. In some embodiments, the staple cavities 2028 may not overlap longitudinally and / or laterally with the staple cavities 2028 in adjacent rows. Further or / or, in certain embodiments, the staple cavities 2028 and / or rows thereof may be asymmetric with respect to the longitudinal slot 2032 and / or the longitudinal axis L.

Still referring to FIG. 7, the illustrated staple cavities 2028 in each longitudinal row are parallel or substantially parallel. For example, as disclosed in FIG. 7, the staple cavities 2028 in the first inner row 2033 are parallel to each other, and the staple cavities 2028 in the first outer row 2035 are parallel to each other, first. The staple cavities 2028 in the middle row 2037 are parallel to each other, the staple cavities 2028 in the second inner row 2034 are parallel to each other, and the staple cavities 2028 in the second outer row 2036 are parallel to each other. Yes, the staple cavities 2028 in the second intermediate row 2038 are parallel to each other.

Also, as disclosed in FIG. 7, the staple cavities 2028 in each longitudinal row are angularly oriented with respect to the staple cavities 2028 in adjacent longitudinal rows. For example, the staple cavities 2028 in the first intermediate row 2037 relative to the staple cavities 2028 in the first inner row 2033 and in the first outer row 2035 on the first side 2027 of the cartridge body 2024 shown. Angle oriented. Further, the staple cavity 2028 in the second intermediate row 2038 is angled to the second side 2029 of the illustrated cartridge body 2024 with respect to the staple cavity 2028 in the second inner row 2034 and the second outer row 2036. Oriented.

In another embodiment, only some of the staple cavities 2028 in the respective longitudinal rows 2033, 2034, 2035, 2036, 2037, 2038 can be parallel to each other and / or the longitudinal rows 2033, 2034. , 2035, 2036, 2037, 2038 can all include staple cavities 2028 that are parallel to each other. Further or, in certain embodiments, at least a portion of the staple cavity 2028 can be randomly oriented. In some examples, at least one of the staple cavities 2028 in longitudinal rows 2033, 2034, 2035, 2036, 2037, 2038 is adjacent longitudinal rows 2033, 2034, 2035, 2036, 2037, It may be parallel to at least one of the staple cavities 2028 in 2038. In a particular embodiment, the staple cartridge 2020 may include at least one staple cavity 2028 and / or at least one row of staple cavities parallel to the longitudinal axis L of the cartridge body 2024. See, for example, FIG.

The staple cartridge 2020 disclosed in FIG. 7 includes drivers 2040a and 2040b, and the drivers 2040a and 2040b are configured and sized so as to be movable within the cartridge body 2024 (FIG. 7). Referring to FIGS. 7-9, the drivers 2040a, 2040b include a first driver 2040a (FIGS. 8-8B) and a second driver 2040b (FIGS. 8C-9). The first and second drivers 2040a and 2040b are each configured to support a plurality of staples 2012. As shown in FIGS. 7 to 9, the multi-staple first driver 2040a has a first outer shape, and the multi-staple second driver 2040b has a second outer shape. The outer shapes of the multi-staple drivers 2040a and 2040b correspond to the arrangement of the staple 2012 array 2011 and the staple cavities 2028 shown in FIG.

As described herein, the arrangement of staples 2012 and staple cavities 2028 on the first side 2027 of the longitudinal slot 2032 is such that the staples 2012 and staple cavities 2028 on the second side 2029 of the longitudinal slots 2032 It is a mirror image of the arrangement. Further, the outer shape of the first driver 2040a is a mirror image of the outer shape of the second driver 2040b. As shown in FIG. 7, the first driver 2040a is positioned on the first side 2027 of slot 2032 in the longitudinal direction and the second driver 2040b is positioned on the second side 2029 of slot 2032 in the longitudinal direction. To.

In some embodiments, the driver on one side of the cartridge body does not have to be a mirror image of the driver on the other side of the cartridge body. Further, the first multi-staple driver 2040a and / or the second multi-staple driver 2040b can be positioned on different and / or both sides 2027, 2029 of the longitudinal slot 2032. For example, multi-staple drivers with different contours can be positioned on the same side of slot 2032 in the longitudinal direction. Still in other embodiments, the staple cartridge 2020 can include three or four or more different outer shape multi-staple drivers. For example, specialized and / or different staple drivers can correspond to a particular staple and / or a group of staples. Alternatively, in some embodiments, all multi-staple drivers in the staple cartridge 2020 can have the same outer shape.

The first and second multi-staple drivers 2040a, 2040b disclosed in FIGS. 7-9 include a plurality of troughs, i.e., cradle 2042 supporting the staples. Further, each of the illustrated drivers 2040a and 2040b is configured to drive a plurality of staples 2012. For example, the first driver 2040a (FIGS. 8-8B) includes a first pedestal 2042a, a second pedestal 2042b, and a third pedestal 2042c, including a first pedestal 2042a and a second pedestal 2042a. The pedestal 2042b and the third cradle 2042c are each sized and configured to support one staple 2012. For example, the base 2014 (FIG. 8B) of the staple 2012 is positioned within the cradle 2042a, 2042b, 2042c of the first driver 2040a, respectively. Further, with reference primarily to FIGS. 8C-9, the second driver 2040b also includes a first pedestal 2042a, a second pedestal 2042b, and a third pedestal 2042c, the first pedestal 2042a, The second pedestal 2042b and the third pedestal 2042c are each sized and configured to support one staple 2012. For example, the base 2014 (FIG. 9) of the staple 2012 is positioned within the cradle 2042a, 2042b, 2042c of the second driver 2040a, respectively.

As disclosed in FIG. 7, the first driver 2040a is the right driver, and the right driver is positioned on the right side of the staple cartridge 2020, i.e. within the first side 2027. The first cradle 2042a (FIGS. 8-8B) of each first driver 2040a is configured to align with the staples 2012 in the first outer row 2035 of the staple cavity 2028, each first. The second cradle 2042b (FIGS. 8-8B) of the drivers 2040a is configured to align with the staples 2012 in the first intermediate row 2037 of the staple cavities 2028, the third of each first driver 2040a. The cradle 2042c (FIGS. 8-8B) is configured to align with the staples 2012 in the first inner row 2033 of the staple cavities 2028.

Further, as disclosed in FIG. 7, the second driver 2040b is the left driver, and the left driver is positioned on the left side of the staple cartridge 2020, i.e. within the second side 2029. For example, the first cradle 2042a (FIGS. 8C-9) of each second driver 2040b is configured to be aligned with the staples 2012 in the second outer row 2036 of the staple cavity 2028 and each second. The second cradle 2042b (FIGS. 8C-9) of the second driver 2040b is configured to be aligned with the staple 2012 in the second intermediate row 2038 of the staple cavity 2028 and of each second driver 2040b. The third cradle 2042c (FIGS. 8C-9) is configured to align with the staple 2012 in the second inner row 2034 of the staple cavity 2028.

The respective cradle 2042a, 2042b, 2042c disclosed in FIGS. 8-9 are defined within the stage or platform 2045 of the first driver 2040a or the second driver 2040b. For example, the first driver 2040a shown and the second driver 2040b shown show include the platform 2045, and the cradle 2042a, 2042b, 2042c are defined within the platform 2045, respectively. The platforms 2045 disclosed in FIGS. 8-9 of the drivers 2040a, 2040b are at the same height, or altitude, and each staple 2012 in the array 2011 is at the same height, i.e., relative to the other staples 2012 in the array 2011. It is configured to hold at altitude. Still referring to FIGS. 8-9, connecting flanges 2048 are also disclosed, which extend between the stages 2045 of the respective drivers 2048a, 2040b. The connecting flange 2048 can limit and / or suppress relative movement between steps 2048.

In other embodiments, the steps or platforms 2045 can have different heights and / or altitudes. For example, the height of each step 2045 can be varied to control the post-molded height of the staples 2012 and thus the compression of the tissue trapped within the molded staples 2012. Further or / or, the depths of the respective pedestals 2042a, 2042b, 2042c can be varied to control the height of the molded staples 2012 and thus the compression of the tissue trapped within the molded staples 2012. it can.

The first and second drivers 2040a, 2040b and their cradle 2042a, 2042b, 2042c are oriented in an arrangement that complements the arrangement of the staple cavities 2028 and staple array 2011 within the staple cartridge 2020. As disclosed in FIGS. 8A and 8D, the respective pedestals 2042a, 2042b, 2042c include a first end 2044 and a second end 2046, the first of the respective pedestals 2042a, 2042b, 2042c. The end 2044 is distal to the second end 2046 of the same cradle 2042a, 2042b, 2042c. Further, an axis is defined between the first end 2044 and the second end 2046 of the respective cradle 2042a, 2042b, 2042c. For example, the first axis Aa is defined by a first cradle 2042a, a second axis _{A b} is defined by the second cradle 2042B, the third axis _{A c} of the third cradle Defined by 2042c.

In the arrangement shown, the orientation of the first axis A _a is configured to conform or correspond to the orientation of the staple 2012 marked with a supported angle by the first cradle 2042a, the second axis A _b orientation is configured to conform or correspond to the orientation of the staple 2012 marked with a supported angle by the second cradle 2042B, the orientation of the third axis a _c is supported by the third receiving tray 2042c It is configured to match or correspond to the orientation of the angled staples 2012.

As disclosed in FIGS. 8A and 8D, the first axis A _a is parallel or generally parallel to the third axis A _c. Further, the second axis A _b shown in FIGS. 8A and 8D crosses both the first axis A _a and the third axis A _c . For example, as disclosed in FIGS. 8A and 8D, the axis A _b 2 are perpendicular or generally perpendicular to the first axis A _a and the third axis A _c.

In an example in which drivers 2040a, 2040b are used in staple cartridges with different arrangements of staples 2012 and staple cavities 2028, the relative orientations of the cradle 2042a, 2042b, 2042c may be different. In some arrangements, for example, axis _{A a,} A b, all Ac, can be parallel. Still in another arrangement, for example, all the axes _Aa, A b, _{A c,} may cross. In certain instances, one axis _{A a, A b, A c} is may be perpendicular to at least one other axis _{A a, A b, A c} . Additionally or alternatively, in some instances, one axis _{A a, A b, A c} is can be parallel to at least one other axis _{A a, A b, A c} .

With reference mainly to FIGS. 8 to 8C, the first and second drivers 2040a and 2040b are integrally formed pieces. For example, the respective drivers 2040a and 2040b are integrally molded parts. In other embodiments, at least one step 2045 and / or connection flange 2048 can be formed independently. In such an example, for example, a plurality of pieces can be glued together, welded, and / or otherwise attached together to form a single piece.

The multi-staple drivers 2040a, 2040b disclosed in FIGS. 7-9 are configured to drive the staples 2012 from the staple cavities 2028 over a plurality of longitudinal rows 2033, 2034, 2035, 2036, 2037, 2039. In the staple cartridge 2020 shown in FIG. 7, the staples 2012 are arranged in three longitudinal rows on each side of the slot 2032, and the drivers 2040a, 2040b have the staples 2012 in each of the three longitudinal rows. It is configured to support and drive. For example, each illustrated first driver 2040a has a staple 2012 positioned in the first inner row 2033, a staple 2012 positioned in the first intermediate row 2037, and a first outer side of the staple cavity 2028. It is configured to drive staples 2012 positioned in row 2035. Further, each illustrated second driver 2040b has a staple 2012 positioned in the second inner row 2034, a staple 2012 positioned in the second intermediate row 2038, and a second outer side of the staple cavity 2028. It is configured to drive staples 2012 positioned in row 2036.

In another embodiment, staples 2012 can be placed in more than three longitudinal rows, or less than three longitudinal rows, on each side of slot 2032, with drivers 2040a, 2040b in slots 2032. Each side of the can be configured to engage the staples 2012 within each of the longitudinal rows. For example, the staple cartridge 2020 can have two rows of staple cavities 2028 on both sides of the longitudinal axis L, and the internally positioned multi-staple driver can include two cradle and two cradle. Can be configured to support staples within each of the two rows. In some embodiments, the multi-staple driver can fire multiple staples 2012 from the same row of staple cavities 2028. For example, a multi-staple driver can fire adjacent staples 2012 in the same row, for example, more proximal staples 2012 and more distal staples 2012. In certain embodiments, the multi-staple driver does not have to engage the staples 2012 in all rows on the side of slot 2032 in the longitudinal direction. For example, a separate and well-distinguished driver may engage staples within one of the columns, for example the outermost and / or innermost columns. Further or, in certain embodiments, the staple cartridge 2020 may include at least one multi-staple driver and at least one single staple driver. See, for example, FIG.

The end effector assembly 2000 disclosed in FIG. 7 further includes a launching member 2060, which is configured to move relative to the cartridge body 2024. During the firing stroke, the firing member 2060 is configured to traverse the cartridge body 2024 and drive engage with the thread 2058 to move the thread 2058 through the cartridge body 2024. For example, a portion of the illustrated launch member 2060 is sized and positioned to fit within the longitudinal slot 2032. As disclosed in FIG. 7, a portion of the launching member 2060 configured to fit within the longitudinal slot 2032 includes a cutting edge 2061, which is the first jaw portion of the end effector assembly 2000. It is configured to make an incision in the tissue clamped between 2002 and the second jaw 2004.

The wedge thread 2058 disclosed in FIG. 7 is configured to engage the drivers 2040a, 2040b to lift the drivers 2040a, 2040b and thus launch the staples 2012 supported therein into the tissue. In the illustrated end effector assembly 2000, the intermediate wedge 2062 of the thread 2058 can slide and / or translate within the longitudinal slot 2032 and is a laterally positioned drive wedge defined on the thread 2058. That is, the drive rails 2064a and 2064b can be engaged with the staple drivers 2040a and 2040b. For example, thread 2058 shown in FIG. 7 includes drive wedges, that is, rails 2064a, 2064b, which move along launch paths F ₁ (FIG. 8A) and F ₂ (FIG. 8D) during the launch stroke. to, multi-staple first and second driver 2040a which is aligned to the firing path _F 1, _{F 2} and longitudinally configured to contact 2040b.

As disclosed in FIG. 7, the thread 2058 includes drive wedges 2064a, 2064b on both sides of the central portion 2062. Driving wedge 2064a of the first side 2027 of the staple cartridge 2020, first firing path _{F 1} are configured to move along a (FIG. 8A), the driving wedge 2064b of the second side 2029 of the staple cartridge 2020 , It is configured to move along a _second launch path F ₂ (FIG. 8D).

Each drive wedge 2064a, 2064b disclosed in FIG. 7 engages with one of the multi-staple drivers 2040a, 2040b, lifts the drivers 2040a, 2040b in the staple cavity 2028, and discharges the staple 2012 from the cartridge body 2024. It is configured as follows. In the arrangement shown, the three stages 2045 of each first driver 2040a remain fixed to each other and the three stages 2045 of each second driver 2040b remain fixed to each other. .. In other words, the stages 2045 of a single driver 2040a, 2040b do not move and / or rotate with respect to each other. Since the steps 2045 of the single drivers 2040a, 2040b do not move and / or rotate with respect to each other, the relative movement of the staples 2012 supported by the respective drivers 2040a, 2040b is also suppressed. Further, each driver 2040a, 2040b has a larger base, i.e., a footprint within the cartridge body 2042, which can further reduce the rotation and / or torque application of the drivers 2040a, 2040b. As a result, the movement and / or tilt of the staple 2012 during deployment can be prevented, minimized, and / or controlled by the multi-staple drivers 2040a, 2040b. The multi-staple driver, like the drivers 2040a, 2040b, can be incorporated, for example, into other staple cartridge and / or end effector assemblies disclosed herein.

In various embodiments, the drive wedges 2064a, 2064b of the thread 2058 can be sized, configured, and positioned to engage the drive surfaces of the drivers 2040a, 2040b, respectively. For example, drivers 2040a, 2040b can include tilted surfaces and / or trajectories, which drive wedges as the launching member 2060 and thread 2058 move through the staple cartridge 2020, respectively. It is configured to guide and / or accept a portion of 2064a, 2064b.

Driver 2040a, 2040b, and the driver 2040a, for staples 2012 supported by 2040b, respectively, the driving wedge 2064A, 2064B, and the corresponding relative positioning of the firing path _F 1, _{F 2} of the in firing drivers 2040a, 2040b And / or the staples 2012 may be selected to prevent, reduce, and / or control torque application. For example, the driver 2040a, the outer shape and / or material 2040b, respectively, chosen to install the respective driver 2040a to alignment with the corresponding firing path _F 1, _{F 2,} the mass of 2040b center (COM) can do. Further or / or the drive wedges 2064a, 2064b, and thus launch paths F ₁ and F ₂ , are positioned within the cartridge 2020 to extend through the center of mass (COM) of each of the drivers 2040a, 2040b, respectively. Can be done.

In another embodiment, as further described herein, the thread 2058 may include more than one drive wedges 2064a, 2064b on each side of the intermediate 2062. For example, the plurality of drive wedges 2064a and 2064b can move through both sides 2027 and 2029 of the cartridge body 2024. Further or / or, the drive wedges 2064a, 2064b of the wedge thread 2058 can be configured to directly engage the staple 2012 to drive the staple 2012, as further described herein.

Mainly referring to FIGS. 8A and FIG. 8D, the first and second driver 2040a, 2040b, respectively, the driving wedge 2064A, the 2064B, respectively, are on the firing path _F 1, _{F 2.} For example, the first driver 2040a is in a first firing on path _{F 1,} the second driver 2040b is above the second firing path _{F 2.} Moreover, each driver 2040a, various parts of 2040b, each driving wedge 2064A, on both sides of the 2064B, therefore, are positioned on opposite sides of the firing path _F 1, _{F 2.} Referring still to FIGS. 8A and FIG. 8D, illustrated driver 2040a, 2040b, each driver 2040a, the mass of 2040b center (COM), respectively, for example, driving a wedge 2064A, firing path _{F 1} a corresponding 2064b , F ₂ is sized and constructed to overlap. In other words, each of the illustrated driver 2040a, 2040b is balancing by mass with respect to the corresponding firing path _F 1, _{F 2.}

For example, as disclosed in FIG. 8A, the first portion 2047 of the first driver 2040a is positioned on a first side of the firing path _{F 1,} the second portion 2049 of the first driver 2040a is fired It is positioned on a second side of the path F _1. The first portion 2047 of the first driver 2040a has a first mass m ₁ , the second portion 2049 of the first driver 2040a has a mass m ₂ , and m ₂ is the first. Equal to or substantially equal to mass m ₁ . Further, as disclosed in FIG. 8D, a first portion 2047 of the second driver 2040b is positioned on a first side of the firing path _{F 2,} a second portion 2049 of the second driver 2040b is fired It is positioned on a second side of the path F _2. The first portion 2047 of the second driver 2040b has a _first mass m ₁ and the second portion 2049 of the second driver 2040b has a mass m ₂ and is equal to or equal to the first mass. Or, substantially equal, the mass m ₂ is equal to or substantially equal to the first mass m ₁ . Since drivers 2040a, 2040b is balancing by mass with respect to each of the firing path _F 1, _{F 2,} driver 2040a in firing, torquing of the staple 2012 is supported 2040b and thereon minimizes , And / or can be controlled in other ways. Further, the group of staples 2012 deployed by the respective drivers 2040a, 2040b can be lifted synchronously with respect to the cartridge body 2024 and driven simultaneously or fired into the tissue. The mass-balanced driver can be incorporated, for example, into other embodiments disclosed herein, similar to drivers 2040a, 2040b.

Further, as disclosed in FIGS. 8-9, at least one cutout 2050 is defined in the first and second multi-staple drivers 2040a, 2040b. For example, various cutouts 2050 are defined within the connecting flanges 2048 of drivers 2040a, 2040b. Cutout 2050 driver 2040a, to adjust the mass of 2040b, each driver 2040a, sized and positioned so as to adjust the balance relative to firing path _F 1, _{F 2} corresponding to the center of mass of 2040b (COM) Will be done. Further, the cutout portion 2050 is sized and positioned so as to adapt to the outer shape of the staple cavity 2028, and the drivers 2040a and 2040b are movably positioned in the staple cavity 2028.

In a particular embodiment, multiple staple cavities can be defined within the staple cartridge, at least one staple cavity may be parallel to the longitudinal axis of the staple cartridge, and at least one staple cavity of the staple cartridge. It can be angularly oriented with respect to the longitudinal axis. Referring to the staple cartridge 2120 shown in FIG. 10, for example, a plurality of staple cavities 2128 are defined in the staple cartridge 2120, and the plurality of staple cavities 2128 are parallel to the longitudinal axis L of the staple cartridge 2120.

In the illustrated staple cartridge 2120, longitudinal slots 2032 are defined partially through the cartridge body 2124. Further, what is defined in the cartridge body 2124 is a row of staple cavities 2128 on both sides of the slot 2032 in the longitudinal direction, and the row of staple cavities 2128 contains staple cavities 2128 oriented parallel to the longitudinal axis L. Including. In the staple cartridge 2120 shown, the staple cavities 2128 in the first row 2137 and the staple cavities 2128 in the second row 2138 are adjacent to the longitudinal slot 2032 and are in the first row 2137 and in the second row 2138. The staple cavity 2128 of the above is oriented parallel to the longitudinal axis L. For example, as disclosed in FIG. 10, the staple cavities 2128 in first row 2137 is aligned with the axis _{A b,} the axis _{A b,} which is parallel to the longitudinal axis L.

The staple cartridge 2120 disclosed in FIG. 10 includes an additional row of staple cavities 2128. For example, the staple cartridge 2120 shown includes a staple cavity 2128 in the third row 2135 and a staple cavity 2128 in the fourth row 2136, in which the staple cavity 2128 is an angularly oriented staple with respect to the longitudinal axis L. Cavity 2128 is included. In such an example, the staple cavities 2128 in the third row 2135 and the fourth row 2136 are also angularly oriented with respect to the staple cavities 2128 in the first row 2137 and the second row 2138. Angle-oriented with respect to each other. For example, the staple cavities 2128 in the third column 2135 is aligned with the axis _{A a,} the axis _{A a} traverse the longitudinal axis L, transverse to an axis _{A b} of the staple cavity 2128 of the first row 2137. As further disclosed in FIG. 10, the staple cavities 2128 in the fourth column 2136 extends along an axis transverse to the third axis _{A a} staple cavities 2128 in the column 2135 of. The staple cavities 2128 of the first row 2137 and the third row 2135 are positioned on the first side 2127 of the illustrated cartridge body 2124, and the second row 2136 and the fourth row 2138 are the illustrated cartridge body 2124. It is positioned on the second side of 2129.

In various embodiments, the staple cartridge 2120 disclosed in FIG. 10 can be used with the end effector assembly 2000 shown in FIG. For example, the staple cartridge 2120 can be mounted within the elongated channel of the second jaw 2004 of the end effector assembly 2000. The staple cartridge 2120 can be fired with a single staple driver, a multi-staple driver, and / or a combination thereof. For example, a multi-staple driver may be configured to fire staples from stapling cavities 2128 in first and third rows 2137, 2135 on the first side 2127 of the cartridge body 2124, and another multi-staple driver may be configured. The staples can be configured to fire from the staple cavities 2128 in the second and fourth rows 2136, 2138 on the second side 2129 of the cartridge body 2124. In various embodiments, the driver can be positioned within the cartridge body 2124 such that the driver's cradle is aligned with the staples positioned within the staple cavity 2128. In such an example, the driver and / or the staples supported on it can be mass balanced with respect to the thread launch path, for example thread 2058 (FIG. 7), where thread 2058 is the cartridge body. It can be configured to cross the 2124 and engage an internal driver.

In other embodiments, the staple cartridge 2120 may not include a driver. For example, the launching member and / or thread, such as the launching member 2060 and / or thread 2058 (FIG. 7), directly contacts, engages, and / / Or it can be configured to drive it. In such an example, the staples can be mass balanced with respect to the launch path of the thread 2058. Still in other embodiments, the staples can be held in place within the cartridge body 2124 and can be crushed and / or otherwise deformed within the cartridge body 2124, for example.

In various embodiments, the multi-staple driver can simultaneously engage the driver during deployment and balance against multiple drive wedges that co-lift the driver. For example, a multi-staple driver 2240 and a pair of drive wedges 2264a, 2264b are shown in FIG. The multi-staple driver 2240 is configured for use with, for example, a staple cartridge 2020. Further or / or, the driver 2240 can be used with various other staple cartridges having a staple array that is compatible with the array 2011 (FIG. 7) and corresponds to the arrangement of the driver 2240 shown in FIG.

In various embodiments, the staples fired from the staple cartridge 2120 can be formed to a variable post-mold height. For example, the staples can have a greater height between one of the staple legs and the base than between the other staple leg and the base. In such an example, the staples can apply greater compressive force to the tissue at the shorter ends of the staples. As described in more detail herein, the staple height is when the staple driver has a step, i.e. a height difference (see, eg, FIG. 79), and / or a stapler in the anvil. The molding pocket can be changed when it has steps, i.e. height differences (see, eg, FIG. 80).

When the angled staples are deformed to a variable height, the compressive force applied to the tissue by the angled staples can vary longitudinally and laterally. In certain embodiments, for example, it may be desirable to compress tissue that is closer to the cut line, i.e., laterally inward, than, for example, tissue that is farther from the cut line, i.e. laterally outward. In such an example, the lateral texture variability provided by the angled staples deformed to different compression heights exerts greater compressive force on the lateral medial portion of the tissue on the lateral outer side of the tissue. The compression force can be applied to the part.

With reference to FIG. 10 again, in certain embodiments, the staples emitted from the third row 2135 of the staple cavity 2128 and from the fourth row 2136 of the staple cavity 2128 can be transformed into variable heights. .. For example, the staples can have a reduced height as they are closer to the longitudinal axis L and a higher height as they are farther from the longitudinal axis L. Further or / or, staples emitted from the staple cavities 2128 in the first row 2137 and from the staple cavities 2138 in the second row are emitted from the staple cavities 2128 in the third row 2135 and the fourth row 2136. The staples can be transformed into a reduced, or uniform height, which can be less than a smaller height. In such an example, the compressive force applied to the tissue may be maximal closer to the cut line and may taper off towards the lateral side of the staple line and further outward.

Each driver 2240 disclosed in FIG. 11 includes a plurality of troughs, namely cradle 2242a, 2242b, 2242c supporting staples. For example, each driver 2240 includes a first pedestal 2242a, a second pedestal 2242b, and a third pedestal 2242c, each of which is one of staples 2012 (FIG. 7), and the like. It is sized and constructed to support one staple. For example, the staple base can be positioned within the respective cradle 2242a, 2242b, 2242c. Referring again to the staple cartridge 2020 shown in FIG. 7, the first pedestal 2242a can be aligned with the staples 2012 in the staple cavities 2028 of the first outer row 2035, and the second pedestal 2242b is the second. The third cradle 2242c can be aligned with the staples 2012 in the staple cavities 2028 of the first inner row 2037 and the third cradle 2242c can be aligned with the staples 2012 in the staple cavities 2028 of the first inner row 2033. In such an example, the first pedestal 2242a corresponds to the outer pedestal, the second pedestal 2242b corresponds to the intermediate pedestal, and the third pedestal 2242c corresponds to the inner pedestal. .. In various embodiments, another driver arrangement can be positioned on the opposite side of the staple cartridge, the other driver arrangement may be a specular reflection of the driver arrangement shown in FIG.

The pedestals 2242a, 2242b, 2242c shown in FIG. 11 are defined in the support member 2248. The support member 2248 can support the staples across a plurality of rows of staple cavities. Further, the support member 2248 supports the staples 2012 oriented at different angles with respect to the longitudinal axis L of the staple cartridge and / or, for example, the longitudinal firing paths of the drive wedges 2264a, 2264b. be able to. With reference to the illustrated support member 2248, the support member 2248 is angularly oriented with respect to the launch path of the drive wedges 2264a, 2264b. Further, the support member 2248 is angularly oriented with respect to at least one of the internally defined cradle 2242a, 2242b, 2242c. For example, the intermediate cradle 2242b disclosed in FIG. 11 is angularly oriented with respect to the support member 2248. Further, as disclosed in FIG. 11, the outer pedestal 2242c and the inner pedestal 2242a are aligned with the support member 2248.

In certain embodiments, the height of the support member 2248 may be uniform or substantially uniform so that the respective staples supported by the support member 2248 are positioned at the same height, i.e., altitude. In other embodiments, the support member 2248 may include steps with different heights and / or altitudes. For example, the height of the steps can be varied to control the height of the molded staples and thus the compression of the tissue trapped within the molded staples. Further or / or, the depths of the respective cradle 2242a, 2242b, 2242b can be varied to control the height of the molded staples and thus the compression of the tissue trapped within the molded staples.

The respective cradle 2242a, 2242b, 2242c disclosed in FIG. 11 includes a first end 2244 and a second end 2246. The first end 2244 of each pedestal 2242a, 2242b, 2242c is distal to the second end 2246 of the same pedestal 2242a, 2242b, 2242c. Further, an axis is defined between the first end 2244 and the second end 2246 of the respective cradle 2242a, 2242b, 2242c. For example, the first axis _{A a} is defined by a first cradle 2242a and the third cradle 2242C, a second axis _{A b} is defined by the second cradle 2242b. As shown in FIG. 11, the second axis A _b crosses the first axis A _a . In certain instances, the second axis A _b may be perpendicular or substantially perpendicular to the first axis A _a.

Still referring to FIG. 11, the multi-staple driver 2240 includes rails 2245a, 2045b, which rails are connected to support member 2248. The rails 2245a, 2245b are positioned to engage the wedge thread drive wedges 2264a, 2264b. For example, rails 2245a illustrated, 2245 b, the drive wedge 2264A, is aligned with the firing path _F 1, _{F 2} of the 2264B. In such an example, the rails 2245a, 2245b are elongated for receiving driving force from the drive wedges and stabilizing the multi-staple driver 2240 when the drive wedges 2264a, 2264b are drive-engaged with the rails 2245a, 2245b. Can provide surface area.

The driver 2240 can include a plurality of independently formed parts, which can be welded together and / or otherwise attached together. For example, the support member 2248 can be joined together with the rails 2245a, 2245b to form the driver 2240. In another embodiment, each driver 2240 may be an integrally molded part that includes a support member 2248 and rails 2245a, 2245b.

Disclosed in Figure 11 the driver 2240 is driven wedge 2264A, on the firing path _F 1, _{F 2} of the 2264B. Further, various parts of each illustrated driver 2240 are positioned on both sides of wedges 2264a, 2264b. As shown in FIG. 11, the driver 2240 is such that the center of mass (COM) of each driver 2240 is equidistant from the drive shaft, for example, equidistant from the launch paths F ₁ and F _{2 of} the drive wedges 2264a and 2264b. To be sized and constructed. For example, the launch paths F ₁ and F ₂ shown in FIG. 11 are separated by a width w, and the center of mass of each driver 2240 is positioned between the launch paths F ₁ and the launch path F ₂ . As shown in FIG. 11, the center of mass of the respective drivers 2240 may be offset from the first firing path F ₁ by a width w / 2 in the longitudinal direction, the width w / 2 by a second longitudinally from the launch path F ₂ It is biased in the direction. As a result, each of the illustrated drivers 2240 is mass balanced with respect to launch paths F ₁ and F ₂ . Since the driver 2240 is balancing by mass relative to firing path F _1, F _2, torquing of being deployed driver 2240 and the staple is prevented, minimized, and / or control in other ways Can be done. The mass-balanced driver could be incorporated into other staple cartridge and end effector assemblies disclosed herein, for example, like the driver 2240.

In another embodiment, the launching member can include a single drive wedge aligned with the driver 2240, which can be mass balanced with respect to the drive wedge. For example, the drive wedge can define a launch path that extends through the center of mass (COM) of each driver 2240. In such an example, the drive wedge may have a larger width to increase the stability of the driver 2240. In another embodiment, the launching member may include three or more drive wedges, and the cumulative driving force applied by the drive wedges can be balanced with respect to the outer shape of the driver 2240.

Each rail 2245a disclosed in FIG. 11, 2245 b is aligned with one of the firing path _F 1, _{F 2.} Specifically, the first rail 2245a is aligned with the _first launch path F1 and the second rail 2245b is aligned with the _second launch path F2. The drive wedges 2264a, 2264b are configured to contact the rails 2245a, 2245b to lift the driver 2240 and the staples supported on it. Still referring to FIG. 11, the illustrated drive wedges 2264a, 2264b are staggered in the longitudinal direction by a distance x. For example, the first wedge 2264a follows the second wedge 2264b by the distance x shown in FIG. Further, the first rail 2245a is staggered in the longitudinal direction with respect to the second rail 2245b. For example, the second rail 2245b is deviated distally from the first rail 2245a by the distance y shown in FIG. In the arrangement disclosed in FIG. 11, the distance x is equal to or substantially equal to the distance y so that the drive wedges 2264a and 2264b simultaneously contact and drive the rails 2245a and 2245b during the firing stroke, respectively. ing.

The drive wedges 2264a and 2264b disclosed in FIG. 11 simultaneously engage the rails 2245a and 2245b on both sides of the center of mass (COM) of the driver 2240 and equidistant from the center of mass (COM) to drive the rails, respectively. As it is lifted while lifting, the cumulative driving force is balanced throughout the deployment of the driver 2240. As a result, torque application and / or rotation of the driver 2240, and thus the staples supported on it, can be prevented, minimized, and / or controlled. For example, similar to drive wedges 2264a, 2264b, longitudinally biased drive wedges can be incorporated into other embodiments disclosed herein.

The arrangement of the multi-staple driver 2340a and the single staple driver 2340b is disclosed in FIG. 12. Since the arrangement of the drivers 2340a and 2340b corresponds to the array 2011 of the staples 2012 shown in FIG. 7, the drivers 2340a and 2340b are staple cartridges. It can be used with 2020 (Fig. 7). Further or / or, the drivers 2340a, 2340b can be used with various other staple cartridges having a staple array corresponding to the arrangement of the drivers 2340a, 2340b shown in FIG.

The drivers 2340a, 2340b include a plurality of troughs, i.e. pedestals 2342a, 2342b, 2342c that support staples. For example, the multi-staple driver 2340a includes a first pedestal 2342a and a second pedestal 2342b, and the first pedestal 2342a and the second pedestal 2342b are two staples 2012 shown in FIG. 7, respectively. , Sized and constructed to support staples. Further, the single staple driver 2340b includes a third pedestal 2342c and the third pedestal 2342c is sized and constructed to support another staple, such as another of the staples 2012 shown in FIG. Will be done. For example, the base of the staple 2012 may be in the cradle 2342a, 2342b, 2342c, respectively.

With reference to the staple cartridge 2020 shown in FIG. 7, the first pedestal 2342a can be aligned with the staples 2012 in the staple cavities 2028 of the first outer row 2035, and the second pedestal 2342b is intermediate. It can be aligned with the staples 2012 in the staple cavities 2028 in row 2037, and the third cradle 2342c can be aligned with the staples 2012 in the staple cavities 2028 in the inner row 2033. In such an example, the first pedestal 2342a corresponds to the outer pedestal, the second pedestal 2342b corresponds to the intermediate pedestal, and the third pedestal 2342c corresponds to the inner pedestal. .. Further, another driver arrangement can be positioned on the opposite side of the staple cartridge 2020, and the driver arrangement may be a mirror image of the driver arrangement disclosed in FIG.

Still referring to FIG. 12, the respective cradle 2342a, 2342b, 2342c are defined within a step and / or support portion 2345. Further, each of the drivers 2340a and 2340b includes bases 2348 and 2349, respectively. The base 2348 of each multi-staple driver 2340a extends between the steps 2345 of the driver 2340a. Further, the base 2349 of each single staple driver 2340b extends from its stage 2345.

As disclosed in FIG. 12, the respective drivers 2340a, 2340b are aligned with the firing paths F ₁ and F ₂ in the staple cartridge. Specifically, each first driver 2340a is aligned with the _first launch path F1 and each second rail 2340b is aligned with the _second launch path F2. Shown driving wedge 2364a, 2364b are configured to move along a firing path _F 1, _{F 2} in the firing stroke. Further, the drive wedges 2364a and 2364b contact the drivers 2340a and 2340b, respectively, and lift the drivers 2240a and 2340b and the staples supported on the drivers 2240a and 2340b, respectively.

The bases 2348, 2349 can serve as a counterweight to adjust and / or control the center of mass of the drivers 2340a, 2340b. For example, the outer shape and material of the respective bases 2348, 2349 maintain the center of mass of the respective drivers 2340a, 2340b and / or move the center to alignment with the corresponding launch paths F ₁ , F ₂ . Can be selected as. As shown in FIG. 12, the first base 2348 includes at least one cutout 2350. The dimensions of the cutout 2350, placement, and the outer shape is selected for the first firing path F ₁ to the first driver 2340a to balancing by mass. For example, each of the first base portion 2348, can constitute a center of mass of the multi-staple driver 2340a to maintain or the center is shifted to the first alignment of the firing path F _1, respectively The second base 2349 can be configured to move the center of mass of the single staple driver 2340b to alignment with the second launch path F ₂ .

In addition, the bases 2348, 2349 provide an elongated surface area for stabilizing the driver 2340 as the drive wedges 2364a, 2364b drive engage the drivers 2340a, 2340b. For example, a larger footprint of drivers 2340a, 2340b may promote stability and prevent torque application and / or rotation of drivers 2340a, 2340b during deployment. In addition, the driving forces can be distributed to facilitate balanced driver and staple deployment, as the bases 2348, 2349 provide a larger surface area. Drivers with elongated surface areas, such as bases 2348, 2349, can be incorporated, for example, into other embodiments disclosed herein.

Still referring to FIG. 12, the illustrated drive wedges 2364a, 2364b are staggered in the longitudinal direction by a distance x. For example, the first wedge 2364a follows the second wedge 2364b by a distance x. As further shown in FIG. 12, the illustrated drivers 2340a and 2340b are staggered in the longitudinal direction by a distance y. In the illustrated arrangement, the distance x is different from the distance y so that the drive wedges 2364a and 2364b do not come into contact with the drivers 2340a and 2340 at the same time. For example, in the arrangement shown, the first wedge 2364a contacts the first driver 2340a before the second wedge 2364b contacts the second driver 2340b. In such an example, the deployment of the first driver 2340a, and thus the movement of the first cradle 2342a and the second pedestal 2342c, is the deployment of the second staple 2340b, and thus the third pedestal 2342c. Started before the move. As a result, the staples aligned with the first driver 2340a are fired in front of the staples aligned with the second driver 2340b.

In certain embodiments, it is desirable to fire a staple or group of staples before firing another staple or group of staples. For example, to control bleeding and / or fluid flow in stapled tissue, the staples are further inwardly positioned, such as staples adjacent to longitudinal slots and thus adjacent cut lines. , Can be fired in front of the staples further outside.

In another embodiment, the staple aligned with the second driver 2340b can be fired in front of the staple aligned with the first driver 2340a. Alternatively, the first driver 2340a and the second driver 2340b may fire simultaneously such that three staples supported by adjacent multi-staple and single-staple drivers 2340a, 2340b simultaneously pierce and capture tissue. Can be done.

The arrangement of the double staple driver 2440 is shown in FIG. As arranged in FIG. 13, the double staple driver 2440 is configured to fire staples from staple cartridges having four adjacent rows of staple cavities. For example, the driver arrangement shown in FIG. 13 can be configured to fire staples from four rows of staple cavities on one side of a longitudinal slot in the cartridge body, and the corresponding mirror image driver arrangement is longitudinal. Staples can be configured to fire from four rows of staple cavities on the opposite side of the slot.

In another embodiment, a single row of double staple driver 2440 can be positioned on the first side of the staple cartridge, and a single row of double staple driver 2440 is the second of the staple cartridges, i.e. It can be positioned on the opposite side. In such an example, the double staple driver 2440 can be arranged to fire staples from two adjacent rows of staple cavities on either side of the cut line. In another example, a row of double staple drivers 2440 can be added to the arrangement shown in FIG. For example, a double staple driver can be arranged to fire staples from six or more rows of adjacent staple cavities.

The double staple driver 2440 shown in FIG. 13 includes a pair of troughs, i.e. pedestals 2442a, 2442b that support the staples. For example, each double staple driver 2440 includes a first pedestal 2442a and a second pedestal 2442b that are sized and constructed to support the staples, such as one of the staples 2012 (FIG. 7). For example, the staple base can be positioned within the cradle 2242a, 2242b, respectively.

One first pedestal 2442a of the double staple driver 2440 can be aligned with the staples in one row of staple cavities, and the second pedestal 2442b of the same double staple driver 2440 is in another row. It can be aligned with the staples in the staple cavity. Further, the first pedestal 2442a of another double staple driver 2440 can be aligned with the staples in the staple cavity in another row, and the second pedestal 2442b of the double staple driver 2440 further It can be aligned with staples in another row of staple cavities.

Still referring to FIG. 13, each double staple driver 2440 includes a step and / or support portion 2445, and the respective pedestals 2442a, 2442b are defined within one of the steps 2445. Further, each of the drivers 2440 includes a base extending between steps 2445 of the double staple driver 2440, i.e. a connecting flange 2448. Since the steps 2445 are connected by connecting flanges 2448, the pedestals 2442a, 2442b are linked so that adjustment and / or synchronous staple deployment can be initiated by the dual staple driver 2440.

The steps 2445 of the driver 2440 may have the same height. Alternatively, in some embodiments, the driver 2440 may include steps of different heights. Still in other embodiments, different drivers 2440 can have, for example, steps of different heights.

As disclosed in FIG. 13, each double staple driver 2440 is on a pair of launch paths. Specifically, one of the drivers 2440, located on the first and second firing path _F 1, _{F 2,} driver 2440 Nomou one, third and fourth firing path _F 3, F _It is on top of ₄ . A plurality of drive wedges 2464a, 2464b, 2464b, 2464d are also shown in FIG. As shown in FIG. 13, drive wedges 2464a, 2464b, 2464c, 2464d are configured to contact the double staple driver 2440 and lift the double staple driver 2240 and the staples positioned on it.

Still referring to FIG. 13, each stage 2445 includes a center of mass (COM). In addition, each of the launch paths F ₁ , F ₂ , F ₃ , and F ₄ is aligned with the center of mass of stage 2045. As a result, each stage 2445 is mass balanced with respect to the corresponding launch paths F ₁ , F ₂ , F ₃ , and F ₄ .

In various embodiments, the base 2448 extending between the stages 2445 also follows the respective launch paths F ₁ , F ₂ , F ₃ , F ₄ so that the base 2448 maintains the mass balance of the dual staple driver 2440. On the other hand, the balance can be adjusted by mass.

In some embodiments, the base 2448 can contribute to insignificant and / or negligible movement and / or variation with respect to the mass balance of the dual staple driver 2440. In such an example, the mass balance of the driver 2240 can be approximated by, for example, the mass balance of step 2445.

Still referring to FIG. 13, the illustrated drive wedges 2464a, 2464b are staggered in the longitudinal direction by a distance x. For example, the first wedge 2464a follows the second wedge 2464b by a distance x. Further, the centers of mass (COM) of the stages 2445 of each double staple driver 2440 are staggered in the longitudinal direction by a distance x. In such an example, the drive wedges 2464a, 2464b can simultaneously move into engagement with the driver 2440. Since the wedges 2464a, 2464c contact the respective drivers 2444 at the same time, the deployment of the pair of staples supported by the respective drivers 2440 can be synchronized and the staples can be simultaneously driven or fired into the tissue. it can. For example, similar to wedges 2464a, 2464b, wedges staggered in the longitudinal direction can be incorporated into other embodiments disclosed herein.

In various embodiments, the shape of the drive wedge can be selected to balance the forces applied to the staples and drivers during deployment in combination with the placement of the staples and drivers within the staple cartridge. Further, in certain embodiments, the outer shape of the drive wedge can be selected to adjust the staple deployment.

For example, the driver can include staggered and / or longitudinally skewed drive wedges, and staggered and / or longitudinally skewed drive wedges are angularly oriented staples within the staple cartridge. And / or can be configured to simultaneously engage an angle oriented driver. For example, staggered drive wedges can simultaneously move into engagement with the driver's first or proximal end and the same driver's second or distal end. The angled driver ends are simultaneously engaged by staggered wedges so that the staggered drive wedges lift the driver at the same time. As a result, torque application and / or rotation of the deploying driver, and thus the staples supported on it, can be prevented, minimized, and / or controlled.

In other driverless embodiments further described herein, the staggered drive wedges are at the same time the first, or proximal end, of the angled staple, and of the same angled staple. It can move to the second, i.e., the engagement with the distal end. The staggered drive wedges lift the staples simultaneously, as both ends of the angled staples are simultaneously engaged by staggered wedges. As a result, torque application and / or rotation of the staple during deployment can be prevented, restricted, and / or controlled.

Further or / or the driver's contour shape can define at least one firing path aligned with the non-angle oriented staples and / or the driver in the staple cartridge. For example, the launch path may be in line with the axes of various drivers and staples oriented parallel to the longitudinal axis of the staple cartridge. Since the launch path is in line with the staple and / or driver axis, the staple and / or driver can be balanced with respect to the drive wedge, and the driver and / or driver torque application and / or rotation , Can be prevented, restricted, and / or controlled.

Arrangements of drivers 2540, staples 2512a, 2512b, and drive wedges 2564a, 2564b, 2564c of wedge threads 2558 are shown in FIGS. 14 and 15. Driving wedge 2564a disclosed in FIGS. 14 and 15, 2564b, 2564c are respectively configured to move along a firing path _F 1, _{F 2,} and _{F 3} (FIG. 14), the firing path _F 1, _{F 2} , and F ₃ extends through the staple cartridge. In various embodiments, the driver 2540 arrangement can be utilized in staple cartridges having staples 2512a, 2512b and staple cavity arrangements corresponding to the illustrated driver arrangements.

As disclosed in FIG. 14, the drivers 2540 and staples 2512a, 2512b are arranged in a plurality of rows 2534, 2536. Further, the various drivers 2540 and staples 2512a in each row are oriented parallel to the longitudinal axis L, and the various drivers 2540 and staples 2512b in each row are at an angle to the longitudinal axis L. Is oriented. For example, the illustrated arrangement includes a pair of longitudinal rows 2534, 2536, with the drivers 2540 and staples 2512a, 2512b in the respective rows 2534, 2536 oriented and angled parallel to the longitudinal axis L. The orientation is repeated alternately. For example, the driver 2540 shown in the first row 2534 includes a first driver 2540a angularly oriented with respect to the longitudinal axis L, a second driver 2540b oriented parallel to the longitudinal axis L, and a longitudinal axis L. Includes a third driver 2540c angle-oriented with respect to and a fourth driver 2540d oriented parallel to the longitudinal axis L.

As disclosed in FIG. 14, the second driver 2540b and the fourth driver 2540d in the first row 2534 are aligned with the _first launch path F1. More specifically, both the proximal and distal ends 2544 and 2544 of the second and fourth drivers 2540b, 2540d are aligned with the _first launch path F1. In such instances, the first firing path _{F 1} extends through the center of mass of the second driver 2540b and the fourth driver 2540d and (COM). First firing path _{F 1} and the second and fourth driver 2540B, since it is aligned with the 2540D, second and fourth drivers 2540b, 2540d, the balance adjustment by mass relative to first firing path _{F 1} The torque application and / or rotation of the second and fourth drivers 2540b, 2540d, and thus the staples supported on the second and fourth drivers shown in FIG. 14, can be prevented, restricted, and / or controlled.

As disclosed in FIG. 14, the first driver 2540a is aligned with the axis A, the axis A is transverse to the longitudinal axis L and firing path _F 1, _{F 2,} and _{F 3.} Further, the third driver 2540c is oriented parallel to the axis A. As shown in FIG. 14, the first and third drivers 2540a, 2540c are oriented at an angle with respect to the longitudinal axis L and are on a plurality of launch paths. For example, the first and third driver 2540a illustrated, 2540C are on the first and second firing path _F 1, _{F 2.} As shown in FIG. 14, the first launch path F ₁ extends through the proximal ends 2546 of the first and third drivers 2540a, 2540c, and the second launch path F ₂ is the first and third launch paths F2. It extends through the distal ends 2544 of the third drivers 2540a, 2540c.

First and second driver 2540A, the center of mass of 2540c (COM) is first firing path _{F 1} and intermediate the second firing path _{F 2.} For example, first and second driver 2540A, the center of mass of 2540C is located from the first firing path _{F 1} and a second firing path _{F 2} equidistant, therefore, the driver 2540a, 2540c, the first and The balance is adjusted by mass with respect to the second launch paths F ₁ and F ₂ . As a result, the torque application and / or rotation of the second and fourth drivers 2540b, 2540d, and thus the staples supported therein, shown in FIG. 14 can be prevented, restricted, and / or controlled.

Further, the drive wedges 2564a, 2564c, and 2564c shown in FIGS. 14 and 15 are staggered in the longitudinal direction. For example, the first drive wedge 2564a follows the second drive wedge 2564b distally by a distance x, and the second drive wedge 2564b follows the third drive wedge 2564c distally by a distance x. As shown in FIG. 14, the proximal end 2546 and the distal end 2544 of the angle-oriented third driver 2540c are offset by a longitudinal distance y. In the arrangement shown in FIGS. 14 and 15, the longitudinal distance y between the proximal end 2546 and the distal end 2544 of the third driver 2540c is aligned with the proximal end 2546 of the third driver 2540c. It is equal to the longitudinal distance x between the drive wedge 2564a of 1 and the second drive wedge 2564b aligned with the distal end 2544 of the third driver 2540c.

In the arrangement disclosed in FIGS. 14 and 15, the first drive wedge 2564a and the second drive wedge 2564b simultaneously move into engagement with the third driver 2540c. For example, the first drive wedge 2564a contacts the proximal end 2546 of the third staple driver 2540c when the second drive wedge 2564b contacts the distal end 2544 of the third staple driver 2540c. The drive wedges 2564a, 2564b, 2564c shown in FIG. 14 are configured to engage the ends of the angled driver so that the lifting force is a staple supported on the angled third driver 2540c. It is added just below the legs of the. As a result, the staple legs can be further stabilized and tilting and / or tilting movement of the staple legs during deployment can be prevented, minimized, and / or controlled.

The first and second drive wedges 2564a, 2564b shown in FIGS. 14 and 15 are configured to similarly engage additional drivers 2540 in the first row 2534, with staples 2512a supported therein. 2512b can be deployed sequentially. For example, the first drive wedge 2564a contacts the proximal end 2546 of the first driver 2540a when the second drive wedge 2564b contacts the distal end 2544 of the first driver 2440a. Further, the first drive wedge 2564a is configured to sequentially engage and fire the parallel drivers 2540b, 2540d and staples 2512a in the first row 2534.

In various embodiments, the proximal and distal ends 2546 and 2544 of the third driver 2540c may be equidistant from the center of mass of the third driver 2540c. The drive wedges 2464a and 2464b disclosed in FIGS. 14 and 15 simultaneously contact both ends of the angularly oriented third staple driver 2540c, and the drive and / or lift force of the staple driver 2540c equidistant from the center of mass. The staple driver 2540c is balanced throughout deployment as it is configured to hang on both ends. As a result, the rotation and / or torque application of the third staple driver 2540c can be prevented, restricted and / or controlled.

In another embodiment, the drive wedges 2564a, 2564b may not be able to contact the ends 2546, 2544 of the angled staple driver 2540. However, in such an example, the drive wedges 2564a, 2564b may be configured to engage the angled staple driver 2540 at equidistant points from the center of mass of the driver 2540. Further, the drive wedges 2564a, 2564b can simultaneously contact the driver 2540c and be sufficiently biased to lift the separated locations of the driver 2540c.

Further, the second and third drive wedges 2564b, 2564c shown in FIGS. 14 and 15 similarly engage the driver 2540 in the second row 2536 and sequentially engage the staples 2512a, 2512b supported therein. It is configured to expand to. Still referring to the arrangement shown in FIG. 14, for example, the drivers 2540 in the second row 2536 have a longitudinal distance y that is also the distance between the proximal and distal ends 2546 of each driver. Oriented at such an angle that they are only separated, the longitudinal distance y is equal to the longitudinal distance x between the second drive wedge 2564b and the third drive wedge 2564c.

In another example, the longitudinal distance between the second drive wedge 2564b and the third drive wedge 2564c is greater than the longitudinal distance between the first drive wedge 2564a and the second drive wedge 2564b. May be large and / or small. Further or / or, the angled staples 2512b in the second row 2536 can be oriented at a different angle than the angled staples 2512b in the first row 2534. Further, in various embodiments, additional rows of drivers 2540 and staples 2512a, 2512b can be added to the arrangement shown in FIG. 14, and additional drive wedges engage additional drivers 2540 and additional staples 2512a. , 2512b can be configured to fire. Still in other embodiments, the arrangement can further include, for example, a single row of drivers 2540 and staples 2512a, 2512b.

The arrangement of staples 2512a, 2512b shown in FIG. 14 can also be fired from a driverless staple cartridge. For example, referring to FIG. 16, the staples 2512a, 2512b can be placed in a driverless cartridge, for example, the staple cartridge 2620 (FIG. 37), which is further described herein. Staples 2512a, 2512b in a driverless staple cartridge can be directly engaged and / or driven by threads and / or launch members. For example, the staples 2512a, 2512b can include a thread engaging surface, which is one or more of the driving wedges 2564a, 2564b, and / or 2564c of the wedge thread 2558. Is configured to be directly engaged by.

As described herein, each staple 2512A, 2512b may be balancing by mass relative to the staple 2512A, firing path _F 1 which is aligned with the _{2512b, F 2,} F _3. For example, referring to FIG. 16, the staple 2512a arranged parallel to the longitudinal axis L is aligned with _one of the launch paths F ₁ , F ₂ , and F ₃ . In the arrangement shown, one of the drive wedges 2564a, 2564b, 2564c is drive-engaged with the staple 2512a parallel along the length of the base of the staple 2512a. Furthermore, the center of mass of the respective parallel staples 2512a are aligned with one of the firing path _{F 1, F 2, F 3} . In other words, one of the launch paths F ₁ , F ₂ , and F ₃ extends through the center of mass of the respective parallel staples 2512a, thus the staples 2512a extend their respective launch paths during deployment. The balance is adjusted by mass with respect to F ₁ , F ₂ , and F ₃ . In such an arrangement, torque application and / or rotation of the staple 2512a during firing can be prevented, minimized, and / or controlled.

Further, when the staple arrangement shown in FIG. 14 is used in a driverless cartridge, a pair of skewed drive wedges 2564a, 2564b, 2564c move simultaneously to engage with their respective angle oriented staples 2512b. It is composed of. For example, the first and second drive wedges 2564a, 2564b are configured to simultaneously contact the angled staples 2512b in the first row 2534, and the second and third drive wedges 2564b, 2564c are It is configured to simultaneously contact the angled staples 2512b in the second row 2536. The wedge thread 2558 is then configured to continue to translate with respect to the staples 2512a, 2512b, sequentially contact the staples 2512a, 2512b and drive directly from the driverless staple cartridge.

As described herein, driverless staple cartridges can be used to hold and fire staple arrays containing angularly oriented staples. FIG. 37 discloses an end effector assembly 2600 including a first jaw 2002, a second jaw 2004, a frame 2006, a joint motion joint 2009, and a screwdriverless staple cartridge 2620. The staple cartridge 2620 may be a single-use and / or disposable cartridge that can be replaced with another staple cartridge after firing. FIG. 37 discloses a staple cartridge 2620 that includes a deck 2626, a cartridge body 2624, and a casing 2622 that partially surrounds or encapsulates the cartridge body 2624. Further, for example, an array of staples such as staples 2612 (FIGS. 39A and 39B) can be removably positioned within the cartridge body 2624.

In certain embodiments, the staple cartridge 2620 can be formed integrally with, for example, the end effector assembly 2600 and / or can be permanently secured within one of the jaws 2002, 2004. In such an example, the end effector assembly 2600 may be a single-use and / or disposable end effector. In another embodiment, the staple cartridge 2620 can be secured to the end effector assembly 2600, for example, additional staples can be reloaded for subsequent firing.

With reference to the staple cartridge 2620 shown in FIG. 37, the longitudinal slot 2632 is defined at least partially through the cartridge body 2624. The longitudinal slot 2632 extends along the longitudinal axis L, which extends between the proximal and distal ends 2623 of the cartridge body 2624. The longitudinal slot 2632 shown in FIG. 37 extends from the proximal end 2623 to the distal end 2625 and traverses a portion of the length of the cartridge body 2624.

In some embodiments, the longitudinal slot 2632 can traverse the entire length of the cartridge body 2624. In another embodiment, the longitudinal slot 2632 can extend, for example, from the distal end 2623 to the proximal end 2625. Still in other embodiments, the cartridge body 2624 may not include pre-defined and / or pre-molded longitudinal slots. For example, the firing member and / or cutting element can traverse and / or cut the cartridge body 2624, for example, during the firing stroke.

The staple cartridge 2620 disclosed in FIG. 37 is configured to launch an array of angled staples 2612 (FIGS. 38A and 38B), for example the array being oriented as in the staple array 2011 shown in FIG. be able to. The angled staples 2612 can be removably positioned within the angled staple cavities 2628 shown in FIG. 37, and the angled staple cavities 2628 are defined within the cartridge body 2624. For example, the staple cavity 2628 shown is angularly oriented with respect to the longitudinal axis L. Further, the illustrated arrangement of the staple cavities 2628 corresponds to the arrangement of the staples 2612 positioned within the cartridge 2620. Each staple cavity 2628 shown in FIG. 37 includes an opening 2630 within the deck 2626, and each opening 2630 includes a proximal end and a distal end. The staple axis can extend between the proximal and distal ends, and the staple axis of the opening 2630 shown in FIG. 37 is inclined with respect to the longitudinal axis L of the cartridge body 2624 and / or. It has an angle. In the staple cartridge 2620 of FIG. 37, all staple cavities 2628 are angularly oriented with respect to the longitudinal axis L, and various staple cavities 2628 are angularly oriented with respect to other staple cavities 2628.

The staple cavities 2628 shown in FIG. 37 are arranged in a plurality of rows on each side of the longitudinal slots 2632. For example, the staple cavity 2628 is located in the first inner row 2633, the first outer row 2635, and the first intermediate row 2637 on the first side 2627 of the longitudinal slot 2632, the staple cavity 2628. It is located within the second middle row 2636 at the second inner row 2634, the second outer row 2638, and the second side 2629 of the longitudinal slot 2632. The staple cavities 2628 do not intersect or otherwise touch each other, but the longitudinal rows 2633, 2634, 2635, 2636, 2637, 2638 of the staple cavities 2628 overlap. For example, the staple cavity 2628 extends laterally outward and / or inward beyond the staple cavity 2628 in the adjacent row of the staple cavity 2628, and the staple cavity 2628 extends the staple in the adjacent row of the staple cavity 2628. It extends proximally and / or distally beyond the cavity 2628. The stapling cavity 2628 and the staples positioned therein are arranged in an overlapping array to control bleeding and / or fluid flow within the stapled tissue. In the staple cartridge 2620 shown in FIG. 37, the staple cavities 2628 and their rows are symmetrical with respect to the longitudinal slot 2632.

In other examples, more or less staple cavities 2628 than three rows can be positioned on each side of the longitudinal slot 2632, and in some examples one side 2627, 2629 of the staple cartridge 2620. Can include a different number of rows of staple cavities 2628 than the other side 2627, 2629 of the staple cartridge 2620. In some embodiments, the staple cavities 2628 may not overlap longitudinally and / or laterally with the staple cavities 2628 in adjacent rows. Further or / or, in certain embodiments, the staple cavities 2628 and / or rows thereof may be asymmetric with respect to the longitudinal slot 2632 and / or the longitudinal axis L.

Still referring to FIG. 37, the illustrated staple cavities 2628 in each longitudinal row are parallel or substantially parallel. In other words, the staple cavities 2628 in the first inner row 2633 are parallel to each other, the staple cavities 2628 in the first outer row 2635 are parallel to each other, and the staple cavities 2628 in the first intermediate row 2637. Are parallel to each other, the staple cavities 2628 in the second inner row 2634 are parallel to each other, and the staple cavities 2628 in the second outer row 2636 are parallel to each other and in the second intermediate row 2638. The staple cavities 2628 of are parallel to each other.

Also, as shown in FIG. 37, the staple cavities 2628 in each longitudinal row are angularly oriented with respect to the staple cavities 2628 in the longitudinal rows adjacent to the same side of the longitudinal slots 2632. For example, the staple cavity 2628 in the first intermediate row 2637 is angularly oriented to the first side 2627 of the cartridge body 2624 with respect to the staple cavity 2628 in the first inner row 2633 and in the first outer row 2635. Will be done. Further, the staple cavities 2628 in the second intermediate row 2638 are angularly oriented to the second side 2629 of the cartridge body 2624 with respect to the staple cavities 2628 in the second inner row 2634 and the second outer row 2636. To.

In another embodiment, only some of the staple cavities 2628 in the respective longitudinal rows 2633, 2634, 2635, 2636, 2637, 2638 can be parallel to each other and / or the longitudinal rows 2633, 2634. , 2635, 2636, 2637, 2638 can all include staple cavities 2628 that are parallel to each other. Further or, in certain embodiments, at least a portion of the staple cavity 2628 can be randomly oriented. In some examples, at least one of the staple cavities 2628 in longitudinal rows 2633, 2634, 2635, 2636, 2637, 2638 are in adjacent longitudinal rows 2633, 2634, 2635, 2636, 2637, 2638. It may be parallel to at least one of the staple cavities 2628. In a particular embodiment, the staple cartridge 2620 may include at least one staple cavity 2628 that is parallel to the longitudinal axis L of the cartridge body 2624. See, for example, FIG.

Still referring to FIG. 37, the illustrated end effector assembly 2600 includes a launch bar 2660 that is movably positioned relative to the cartridge body 2624. The firing bar 2660 is configured to traverse the cartridge body 2624 for firing staples 2612 (FIGS. 38A and 38B) from staple cavities 2628. The illustrated launch bar 2660 further comprises a cutting edge 2661, such that the cutting edge 2661 incises tissue as the launch bar 2660 translates between the first jaw 2002 and the second jaw 2004. It is composed.

The illustrated launch member 2660 fits within the longitudinal slot 2632 and is movably positioned within the threads 2658 (FIGS. 37-38B), threads 2758 (FIGS. 39-39B), or the driverless cartridge 2620. It is sized and positioned to drive engage the thread, such as thread 2858 (FIG. 40). As the launch bar 2660 translates through the longitudinal slot 2632, the launch bar 2660 passes through the cartridge body 2624 through threads 2658 (FIGS. 37-38B), 2758 (FIGS. 39-39B), or 2858 (FIG. 40). To move.

Thread 2658 is disclosed in FIGS. 37-38B. Thread 2658 is sized and positioned to engage directly with staples 2612 positioned within the driverless cartridge 2620 (FIG. 37). The illustrated thread 2658 includes a central portion 2659 and a drive wedge, i.e., a drive rail 2664. The drive wedge 2664 includes an inclined staple engagement or staple contact surface 2666 and / or an inclined surface extending from the distal end to the proximal end of the thread 2658. As shown in FIGS. 37-38B, the inclined surfaces 2666 of the wedge 2664 have equal or substantially equal degrees of inclination, i.e., angles.

Each staple contact surface 2666 shown in FIGS. 37-38B is positioned so as to be in direct contact with the staple 2612 (FIGS. 38A and 38B) positioned within the staple cartridge 2620. More specifically, the staple contact surface 2666 of the drive wedge 2664 contacts the base 2614 of each staple 2612 (FIG. 38B) and moves the staple 2612 upward to eject the staple 2612 from the staple cavity 2628. It is configured to lift. For example, in order to lift the staple 2612 from the post-descent and / or unlaunched position to the post-lift and / or post-launch position, the distal end 2667 of each inclined surface 2666 engages the base 2614 of the staple 2612. The ramp 2666 then moves distally over the entire base 2614 of the staple 2612.

In the arrangement shown, the launch bar 2660 and its cutting edge 2661 are configured to slide and / or translate within the longitudinal slot 2632. Further, the drive wedge 2664 shown in FIGS. 37-38B is shown laterally outward of the launch bar 2660 and the cutting edge 2661 and is positioned in the staple cavity 2628 (FIG. 37) with the staple 2612 (FIGS. 38A and 38B). It is configured to come into contact with. A plurality of drive wedges 2664 are positioned on either side of the central portion 2659 of wedge threads 2658. For example, in the illustrated thread 2658, four drive wedges 2664a, 2664b, 2664c, 2664d are positioned on each side of the central portion 2659.

Further, in the arrangement disclosed in FIGS. 37-38B, a plurality of drive wedges 2664a, 2664b, 2664c, 2664d are configured to engage a single angled staple 2612. For example, the first and second wedges 2664a, 2664b are configured to engage the staples 6212 positioned in the first outer row 2633 of the staple cavity 2628, with the second and third wedges 2664b, 2664c. Is configured to engage staples 2612 positioned in the first intermediate row 2637, and third and fourth wedges 2664c, 2664d are on staples 2612 positioned in the first outer row 2635. Configured to engage.

In various situations, it is desirable to support the staple 2612 in the staple cartridge 2620 disclosed in FIG. 37 and drive it from multiple positions along the base 2614 (FIG. 38B) of the staple 2612. For example, a staple 2612 that is longitudinally aligned with the launch path of the drive wedge 2664 is supported along the entire length of the base 2614 of the staple 2612. For example, when the staple 2612 is angled with respect to the launch path of the thread 2658, the staple 2612 may be located at multiple locations along the base by utilizing multiple drive wedges 2664, as shown in FIGS. 37-38B. Can be supported by. Since the angled staples 2612 are driven and supported at multiple locations along the base 2614, the staples 2612 are prevented from rotating and / or torqued during deployment, and / or It can be balanced and / or stabilized to be controlled. For example, similar to staples 2612, direct drive staples that are mass balanced with respect to a plurality of thread engaging surfaces can be incorporated into other embodiments disclosed herein.

The inclined surfaces 2666 disclosed in FIGS. 37 to 38B are staggered. For example, the illustrated inclined surfaces 2666 are arranged in a longitudinal direction so that at least one inclined surface 2666 guides at least one other inclined surface 2666 in the longitudinal direction. The inclined surfaces 2666 of the second and fourth drive wedges 2664b and 2664d guide the inclined surfaces 2666 of the first and third drive wedges 2664a and 2664c in the longitudinal direction. The inclined surfaces 2666 of the second and fourth drive wedges 2664b, 2664d are higher than the inclined surfaces 2666 of the first and third drive edges 2664a, 2664c at the aligned distal ends 2667. For example, as shown in FIGS. 38 and 38B, the first and third drive wedges 2664a, 2664c have a distal height y, and the second and fourth drive wedges 2664b, 2664d have a height y. Has a lower distal height x.

The longitudinally staggered ramps 2666 are configured to move simultaneously in engagement with the angled staples 2612. For example, the staple engagement surfaces 2666 of the first and second wedges 2664a, 2664b are configured to simultaneously engage the angled staples 2612 in the first outer row 2633 (FIG. 37) of the staple cavity 2628. Will be done. Further, the staple engagement surfaces 2666 of the second and third wedges 2664b, 2664c are configured to simultaneously engage the angled staples 2612 in the first intermediate row 2637 (FIG. 37). Further, the staple engaging surfaces 2666 of the third and fourth wedges 2664c, 2664d are configured to simultaneously engage the staples 2612 positioned in the first outer row 2635 (FIG. 37).

Deployment or firing of staples 2612 is shown in FIGS. 38A and 38B, where the third and fourth wedges 2664c, 2664d of driver 2658 are drive-engaged with staples 2612. The third wedge 2664c can first contact the staple 2612 at point A and the fourth wedge 2664d can first contact the staple 2612 at point B. The third and fourth wedges 2664c, 2664d are configured to engage the staples 2612 at the same time so that the staples 2612 contact points A and B at the same time or approximately simultaneously. Due to the height difference between the staple engaging surfaces 2666 of the third and fourth wedges 2664c, 2664d, points A and B are longitudinally such that points A and B are at the same or essentially the same altitude. It can be biased.

Still referring to FIGS. 38A and 38B, as the driver 2658 continues to move distally within the staple cartridge 2620, the staple 2612 provides the staple engaging surfaces 2666 of the third and fourth wedges 2664c, 2664d, respectively. It can be slid up to points A'and B'on the third and fourth wedges 2664c, 2664d. As shown in FIG. 38B, the staple 2612 maintains a vertically upright orientation during deployment. The staples 2612 then slide the staple engagement surfaces 2666 of the third and fourth wedges 2664c and 2664d up to points A ″ and B'' on the third and fourth wedges 2664c and 2664d, respectively. You can keep it moving. As shown in FIG. 38B, the staple 2612 continues to maintain a vertically upright orientation. In other words, the pair of staple engagement surfaces 2666 stabilizes and / or stabilizes the staple 2612 during deployment so that rotation or torque application of the staple 2612 can be prevented, minimized, and / or controlled. Or adjust the balance.

In other embodiments, all wedge thread drive wedges or rails can be tilted down to a height of zero or essentially zero. For example, with reference to FIGS. 39-39B here, the wedge thread 2758 is illustrated. The wedge thread 2758 can be used in the staple cartridge 2620 and the end effector 2600 (FIG. 37) to fire the staples 2612 from the staple cartridge 2620 (FIG. 39A).

Like the thread 2658, the wedge threads 2758 disclosed in FIGS. 39-39B include four drive wedges 2764 on either side of the central portion 2759. Each drive wedge 2764 includes an inclined staple engagement surface 2766, the inclined staple engagement surface 2766 being configured to engage directly with the staple 2612 and drive the staple 2612 from the staple cavity 2628. .. Further, similarly to the thread 2658, the staple engaging surfaces 2766 of the drive wedges 2764 shown in FIGS. 39 to 39B have the first and third drive wedges 2764a and 2764c longitudinally extending the second and fourth drive wedges 2764b and 2764d. It is staggered in the longitudinal direction so as to follow the direction.

The longitudinally staggered inclined surfaces 2766 of the drive wedges 2764a, 2764b, 2764c, 2764d disclosed in FIGS. 39-39B are configured to move simultaneously in engagement with the angled staples 2612. For example, the staple engagement surfaces 2766 of the first and second wedges 2764a, 2764b are configured to simultaneously engage the angled staples 2612 positioned in the first outer row 2635 (FIG. 37). To. Further, the staple engagement surfaces 2766 of the second and third wedges 2764b, 2764c are configured to simultaneously engage the angled staples 2612 positioned in the first intermediate row 2637 (FIG. 37). To. Further, the staple engagement surfaces 2766 of the third and fourth wedges 2764c, 2764d are configured to simultaneously engage the angled staples 2612 positioned in the first inner row 2633 (FIG. 37). To.

Further, the longitudinally staggered inclined surfaces 2666 of the drive wedges 2764a, 2764b, 2764c, 2764d disclosed in FIGS. 39-39B are configured to simultaneously drive the angled staples 2612. For example, the staple engaging surfaces 2766 of the first and second wedges 2764a, 2764b are configured to simultaneously drive the angled staples 2612 in the first outer row 2635 of the staple cavity 2628 (FIG. 37). To. Further, the staple engaging surfaces 2766 of the second and third wedges 2764b, 2764c are configured to simultaneously drive the angled staples 2612 positioned in the first intermediate row 2637 (FIG. 37). .. Further, the staple engagement surfaces 2766 of the third and fourth wedges 2764c, 2764d are configured to simultaneously engage the angled staples 2612 positioned in the first inner row 2633 (FIG. 37). To.

Primarily with reference to FIG. 39A, the second wedge 2764b and the third wedge 2764c on the first side 2627 of the cartridge body 2624 are configured to move into engagement with the second staple 2612b, the second Staples 2612b are the most recent staples and are aligned with the launch paths of the second wedge 2764b and the third wedge 2764c. Further, the second wedge 2764b and the third wedge 2764c may be equidistant from the center of mass (COM) of the second staple 2612b. As the thread 2758 continues to translate distally, the second wedge 2764b and the third wedge 2764c are configured to drive engage with the second staple 2612b to lift and fire the staple 2612b.

In the arrangement disclosed in FIG. 39A, when the second wedge 2764b and the third wedge 2764c lift the second staple 2612b, the first wedge 2764a and the second wedge 2764b on the first side 2627 of the cartridge body 2624 Is configured to move into engagement with the first staple 2612a, and the third wedge 2764c and the fourth wedge 2764d on the first side 2627 move into engagement with the third staple 2612c. It is configured as follows. Further, as shown in FIG. 39A, the first wedge 2764a and the second wedge 2764b are equidistant from the center of mass (COM) of the first staple 2612a, the third wedge 2764c and the fourth wedge. 2764d is equidistant from the center of mass (COM) of the third staple 2612c. As the thread 2758 continues to translate distally, the first wedge 2764a and the second wedge 2764b drive engage the first staple 2612a to lift and fire the staple 2612b and the third wedge 2764c. The fourth wedge 2764d is drive-engaged with the third staple 2612c to lift and fire the staple 2612c.

The paired drive wedge arrangement shown above in FIG. 39A is configured to simultaneously engage and lift the staple 2612 in the staple cartridge 2620 as the thread 2758 continues to translate distally. Threads 2758 support each staple 2612 in multiple locations along the base so that the staples 2612 are stabilized and / or balanced during deployment. Further, since the staple engaging surfaces 2766 of the threads 2758 are equidistant from the center of mass (COM) of each contacted staple 2612, rotation and / or torque application of the staple 2612 is further prevented or minimized. It can be limited or controlled. Further, since the drive wedges 2764a, 2764b, 2764c, 2764 are staggered in the longitudinal direction, the engagement of the plurality of drive wedges 2764a, 2764b, 2764c, 2764 with each staple 2612 is applied to each staple 2612 throughout deployment. Time adjustment and / or synchronization is performed to balance the applied driving force.

The propulsion thread 2858 is shown in FIG. The wedge thread 2758 can be used in the staple cartridge 2620 and the end effector 2600 (FIG. 37) to fire the staples 2612 from the staple cavity 2620 (FIG. 39A). Like the threads 2658 and 2758, the drive thread 2858 includes a plurality of drive wedges 2864 on either side of the central portion 2859. Each drive wedge 2864 includes an inclined staple engagement surface 2866, the inclined staple engagement surface 2766 being configured to engage directly with the staple 2612 and drive the staple 2612 from the staple cavity 2628. .. Further, the sloping staple engagement surface 2866 is angled, i.e. laterally sloping. Since the staple engagement surface 2866 is tilted laterally and longitudinally, each surface 2866 includes a longitudinally biased support portion that is angular throughout deployment and firing. Drive-engages with the attached staple 2612.

For example, the inclined staple engagement surface 2866 disclosed in FIG. 40 is configured to drive engage with the staple 2612 along a portion of the base of each staple 2612. In the arrangement shown in FIG. 40, the driving force applied to the staple 2612 is distributed over a larger surface area. For example, the staple engagement surface 2866 can contact at least 50% of the length of the base of the staple 2612. In another embodiment, the staple engagement surface can contact at least 75% of the length of the base of the staple 2612. Still in other embodiments, the staple engagement surface can contact less than 50% or more than 75% of the length of the base of the staple 2612. Further, the driving force from the thread 2858 is balanced with respect to the center of mass of each staple 2612 in order to further stabilize and balance the staples 2612 during deployment. As a result, the rotation and / or torque application of the staple 2612 can be prevented, minimized, or controlled.

As described herein, staple arrays containing staples angled with respect to the longitudinal axis of the staple cartridge and / or the firing path of the firing member offer various advantages. For example, such staple arrays can provide increased flexibility and / or stretchability within stapled tissue. As a result, the incidence of tissue tearing can be reduced. In certain embodiments, the staple array can also include staples with different length bases. Variable length bases within the staple array can promote increased flexibility and / or stretchability in the stapled tissue. Moreover, in certain arrangements, staples with shorter bases can be nested within the staple array. For example, staples with shorter bases can be positioned in a smaller space between staples with longer bases. Such an arrangement can increase the density of stapled wires, which can improve control of bleeding and / or fluid flow within stapled tissue.

The staple array 3011 is shown in FIG. Array 3011 includes long staples 3012 and short staples 3013. As shown in FIG. 41, the long staple 3012 has a baseline length of l ₁ and the short staple 3013 has a baseline length of l ₂ less than l ₁ . In an array 3011 shown, the first long staple 3012a is aligned with the axis _{A a} first short staple 3013 is aligned with the axis _{A b} is parallel to the axis _{A a.} Staple 3012e, 3013b, 3013c, and 3013d, etc., further long staple and a short staple 3012,3013, for example, is parallel to the axis _{A a} and _{A b.} As further disclosed in array 3011 shown in FIG. 41, the second long staple 3012 is aligned with the axes A _a and _c across the axes A and _b . For example, staples 3012c, 3012d, and the like 3012F, long staple 3012 further is parallel to the axis _{A c.}

In another arrangement, a further short staple 3012 may also be parallel to the axis A _c. In some embodiments, the various staples can be placed along the axes that are non-parallel to the axes A _a , _Ab and _Ac . For example, the staple array 3011 can include staples oriented parallel to the longitudinal axis of the staple cartridge and / or the firing path of the drive thread. Moreover, in various embodiments, the staple array 3011 can include staples having a different baseline length than l ₂ and l ₁ . In some embodiments, the staple array 3011 may include additional and / or fewer longitudinal rows of staples 3012, 3013. For example, a row of long staples 3012 aligned with a first long staple 3012a can be removed and / or a row of long staples 3012 aligned with a second long staple 3012b can be removed. The row of short staples that can and / or are aligned with the first short staple 3013a can be removed and / or the row of long staples 3012 that is aligned with the third long staple 3012c can be removed. And / or a row of short staples 3013 aligned with a second short staple 3013b can be removed and / or of a long staple 3013 aligned with a fourth long staple 3012d. Columns can be removed.

With reference to FIG. 41 again, the short staples 3013 are embedded in the staple array 3011 in between the two long staples 3012. Two long staples 3012 in the array 3011, such as the third long staple 3012c and the sixth long staple 3012f shown in FIG. 41, are parallel and laterally aligned. In such an arrangement, the space is defined between the third long staple 3012c and the sixth long staple 3012f, and the space is configured to adapt to the third short staple 3013c. Therefore, the third short staple 3013c in the illustrated array 3011 is sandwiched between the third long staple 3012c and the sixth long staple 3012f. In such an arrangement, the third short staples 3013c in the array 3011 and similarly arranged short staples 3013 can increase the density of staple lines by filling the space between the long staples 3012. In an example, staple wires are densified in array 3011 to improve bleeding and / or fluid flow control.

For example, similar to the staple array 3011, the densified staple wire can be incorporated into other embodiments disclosed herein.

In other embodiments, the long staples 3012 that define the space between them to accommodate the short staples may be non-parallel to each other. For example, the third and sixth long staples 3012c, 3012f can be inclined and / or otherwise non-parallel to each other. Further or / or, the long staples 3012, which define the space between them to accommodate the short staples 3013, can only partially overlap laterally. For example, in a particular embodiment, the third long staple 3012c may be laterally lateral or laterally inward with respect to the sixth long staple 3012f, one of the third and sixth staples 3012c, 3012f. Only the parts are arranged in the horizontal direction.

An array of staples, such as the array 3011, can be positioned within the staple cartridge without a driver, for example, the staple cartridge 2620 without a driver (FIG. 37), and engages directly with the staple cartridge by a drive thread. Can be driven from a staple cartridge. In such an example, the staples 3012, 3013 in the array 3011 can be mass balanced with respect to the drive wedges of the threads that are driven in contact with the staples 3012, 3013. For example, the drive wedge can apply a firing force at the end of the staple base equidistant from the center of mass of the staples 3012 and 3013, respectively. In another embodiment, the firing force can be applied at various distances along the base of the staples 3012, 3013, and the cumulative firing force can be balanced against the staples 3012, 3013. it can. Staple drivers can be used in instances where the staples are not on the launch path and / or are not balanced with respect to the launch path. For example, a multi-staple driver can lift multiple staples from a staple cartridge at the same time, as further described herein.

The staple array 3111 is shown in FIG. Array 3111 includes long staples 3112 and short staples 3113. As shown in FIG. 42, the long staple 3112 has a baseline length of l ₁ and the short staple 3113 has a baseline length of l ₂ less than l ₁ . In an array 3111 shown, first short staple 3113a is aligned with the axis _{A a} first long staple 3112a is aligned with the axis _{A b} transverse to the axis _{A a.} Additional short staple 3113 is oriented parallel to the axis _{A a,} further long staple 3112 is parallel to the axis _{A b.}

In another arrangement, at least one short staple 3113 may be oriented parallel to the axis A _b, and / or at least one long staple 3112 may be oriented parallel to the axis A _a. In some instances, it can be positioned along various staples 3112 and 3113 to the axis is non-parallel to the axis _{A a} and _{A b.} For example, the staple array 3111 may include staples oriented parallel to the longitudinal axis of the staple cartridge and / or the launch path of the drive wedge 3064, the staples of which are also shown in FIG. Further, in various embodiments, the staple array 3111 may include staples having a different baseline length than l ₂ and l ₁ , and / or the staple array 3111 may further and / or twist the staples 3112 and 3113. Can include a small number of longitudinal rows.

Still referring to FIG. 42, the short staples 3113 can be embedded in the staple array 3111 in between at least two laterally overlapping long staples 3112. In such an arrangement, the nested short staples 3113 in the array 3111 can increase the density of staple lines by filling the space between adjacent long staples 3112. Staple wires can be densified in the array 3111 to improve bleeding and / or fluid flow control. For example, similar to the staple array 3111, the densified staple wire can be incorporated into other embodiments disclosed herein.

In other embodiments, the long staples 3112 that define the space between them to accommodate the short staples may be non-parallel to each other. Further or / or, the long staples 3112 defining the space between them to adapt to the short staples 3113 may only partially overlap.

For example, an array of staples, such as the array 3111, can be positioned within a stapleless cartridge, such as a driverless staple cartridge 2620 (FIG. 37), and stapled by a drive thread, such as thread 2058 (FIG. 37). It can be driven directly from the staple cartridge by engaging directly with the cartridge. In such an example, the staples 3112 and 3113 in the array 3111 can be mass balanced with respect to the drive wedge 3064 of the thread that is driven in contact with the staples 3112 and 3113. For example, the drive wedge 3064 can apply a firing force at the end of the staple base equidistant from the center of mass of the staples 3112 and 3113.

In another embodiment, the firing force can be applied at various distances along the base of the staples 3112, 3113, and the cumulative firing force can be balanced against the staples 3112, 3113. it can. Staple drivers can be used in embodiments where the staples 3112 and 3113 are not on and / or are not balanced with respect to the launch path. For example, a multi-staple driver can lift multiple staples from a staple cartridge at the same time, as described further herein.

In various embodiments, when the thread is configured to drive the staple directly, the staple can include a thread engaging surface and the thread can include a staple engaging surface. The staple may be a generally "V-shaped" staple with a base and legs extending non-parallel. For example, referring again to the staple 2612 shown in FIGS. 39B and 40, for example, the staple 2612 is a base 2614, a first leg 2616 extending from the first end of the base 2614, and a second of the base 2614. Includes a second leg 2618 extending from the end. The staple 2612 can be formed of wire, such as a wire having a circular cross section, and thus the outer periphery of the staple 2612 can consist of a rounded surface. As a result, the thread engaging surfaces of the staple 2612 can include round and / or contour surfaces.

In another embodiment, the staple 2612 can be made of wire with a polygonal cross section, so that the outer circumference of the staple 2612 can include edges and a flat surface, i.e. a flat surface. In such an embodiment, the thread engaging surface of the staple 2612 may include, for example, at least one flat surface and / or flat surface. Still in other embodiments, the outer peripheral portion of the staple 2612 may include both a contour surface and a flat surface. For example, the staple 2612 can be formed of a wire having a circular cross section, which flattening and / or otherwise deforming to form a flat thread engaging surface. Can be done.

In certain embodiments, staples can be formed from pieces of material. For example, staples can be stamped, cut, and / or molded from a sheet of material. Various stamped staples are described in US Patent Application No. 14 / 138,481, filed December 23, 2013, entitled "SURGICAL STAPLES AND METHODS FOR MAKING THE SAME", which is by reference. The whole is incorporated herein. In various examples, staples can be formed, for example, by stamping or otherwise in a single piece of material, eg, as a single piece and / or single piece of material. can do. In various embodiments, the threaded engaging surface of the staple, the stamped staple, etc. can include a flat surface, i.e., a flat surface of a piece that has been stamped or otherwise molded. Further, in certain embodiments, the thread engaging surface can include grooves and / or cutouts, which can be configured to receive the drive wedge of the wedge thread. When the staple is angularly oriented with respect to the launch path of the drive wedge, the groove can cross the base of the staple at an angle.

Stamped staples 2912 are shown in FIGS. 26-28. The staples 2912 include a base 2914, a first leg 2916, and a second leg 2918. As shown in FIGS. 26 to 28, the outer peripheral portion of the staple 2912 includes a flat surface and a contour surface. Further, the staples 2912 include grooves, ie tracks 2915 (FIGS. 27 and 28), which are cut into the base 2914. The groove 2915 is configured to receive the drive wedge 2964 of the drive thread 2958.

In various embodiments, the width of the groove 2915 may be slightly larger than the width of the drive wedge 2964 received internally. For example, the width of the groove 2915 can be sized to accept the drive wedge 2964 and prevent lateral movement of the staples 2915 with respect to the wedge 2964.

The staples 2912 shown in FIGS. 26-28 are angularly oriented with respect to the launch path F of the drive wedge 2964 (FIG. 28). For example, the staple 2912 extends along axis A (FIG. 27), which crosses the launch path F. As a result, the illustrated groove 2915 is angularly oriented over the entire base 2914 of the staple 2912. For example, the axis A can be oriented at an angle θ with respect to the launch path F. The angle θ shown in FIG. 28 is 45 °.

The base 2914 has an extended length l. For example, the length l of the base 2914 is larger than the length of the staple legs 2916, 2918. Since the base 2914 is elongated, the groove 2915 includes an elongated guide surface for the drive wedge 2964, the track, which facilitates the stability of the staple 2912 during deployment. For example, similar to staples 2912, elongated guides for receiving drive wedges, i.e. staples with trajectories, can be incorporated into other embodiments disclosed herein.

Primarily with reference to FIG. 28, the staple 2912 has a center of mass (COM) that coincides with the launch path F. For example, the launch path F extends through the center of mass (COM) of the staple 2912 so that the staple 2912 is balanced with respect to the drive wedge 2964. As a result, the driving force applied to the staples 2912 can simultaneously lift the staple legs 2916, 2918 and torque application or rotation of the staples 2912 is prevented, minimized and / or controlled. obtain.

In various embodiments, grooves or trajectories similar to groove 2915 can be defined within unprinted staples. For example, wire staples can be cut, stamped, and / or ground to create trajectories that slidably receive drive wedges. In such an example, the staple base can have the same length as the staple legs, or in other examples, the staple base can be flattened to increase or stretch the length. .. Moreover, in certain embodiments, the plurality of drive wedges can be drive-engaged to the staples, as further described herein. In such an example, the staple may include a plurality of grooves or trajectories, each of which may be configured to receive a drive wedge. Further, in a particular embodiment, for example, a staple having a guide trajectory similar to the groove 2915 can be oriented parallel to the longitudinal axis of the staple cartridge. For example, parallel staples can be aligned longitudinally with the launch path of the drive wedge. In such an example, the guide trajectory defined within the base of the staple can extend along the base of the staple parallel to it.

As described herein, angle-oriented staples can provide high flexibility and / or stretchability to stapled tissue. For example, an angled staple in an array of fired staples with a notch and / or the longitudinal axis of the staple line to facilitate elongation and / or longitudinal deformation of the stapled tissue. Can be pivoted and / or rotated towards the alignment of. Angled staples can pivot and / or rotate within an array of stapled tissue, thus reducing and / or preventing tissue tearing and / or stretching. In addition, stress within the tissue and / or trauma to the stapled tissue can be minimized.

In addition to the longitudinal flexibility provided by the longitudinally extensible array of fired staples, it may be desirable to provide lateral customization to the tissue treated by the array of staples. For example, the compressive force exerted on the tissue can be optimized and / or adjusted based on the lateral position of the tissue relative to the staple line. In certain embodiments, it may be desirable to customize the compressive force applied to the tissue before and / or during stapling. In other examples, it may be desirable to customize the compressive force applied to the stapled tissue. Further, in other embodiments, it may be desirable to customize the compressive force exerted on the tissue, for example, before, during, and after stapling.

A synergistic tissue effect can be obtained by combining transverse tissue compression customization and longitudinal tissue flexibility. The compressed tissue is elastic, for example, when the compressive forces applied to the tissue during and / or after the stapling reduce the stress generated in the compressed tissue and / or reduce the affected tissue trauma. Can adapt to increased deformation. In other words, when the optimally compressed tissue is stretched and / or stretched, the optimally compressed tissue may better adapt to the rotation and / or pivot of the staples within the tissue. Moreover, when the stapled tissue easily adapts to stapling and / or movement, stress within the stapled tissue can be reduced and trauma to the stapled tissue can be minimized. Therefore, when the staples pivot and / or move to adapt to tissue stretch or longitudinal stretch, stress and / or trauma to optimally compressed tissue can be further minimized.

Staple cartridges 3420 are shown in FIGS. 43-45. The staple cartridge 3420 shown includes a cartridge body 3424 and a deck 3422. A plurality of staple cavities 3428 are defined within the body 3424 of the staple cartridge 3420 shown, and each staple cavity 3428 forms an opening 3430 within the deck 3422. Further, the staple cavity 3428 shown in FIGS. 43 to 45 is angularly oriented with respect to the longitudinal axis L of the staple cartridge 3420 (FIG. 44). In the illustrated staple cartridge 3420, longitudinal slots 3432 are defined partially through the cartridge body 3424, and three rows of staple cavities 3428 are positioned on either side of longitudinal slots 3432. The arrangement of staple cavities 3428 shown in FIGS. 43-45 is configured to accept an array of angled staples. A plurality of staples, such as staples 3412 (FIG. 45), are removably positioned within the staple cavity 3428.

In the illustrated staple cartridge 3420, the staple cavities 3428 in the outer row on the first side of the longitudinal slot 3432 are oriented at a first angle with respect to the longitudinal axis L (FIG. 44) and are longitudinal. The staple cavity 3428 in the middle row on the first side of slot 3432 is oriented at a second angle with respect to the longitudinal axis L and the staple cavity in the inner row on the first side of slot 3432 in the longitudinal direction. The 3428 is oriented at a third angle with respect to the longitudinal axis L. In the illustrated staple cartridge 3420, the third angle is the same as or about the same as the first angle, the second angle is 90 ° or about 90 °, from the first angle and the third angle. It is biased.

As further shown in FIGS. 43-45, the staple cavities 3428 in the outer row on the second side of the longitudinal slot 3432 are oriented at a fourth angle with respect to the longitudinal axis L (FIG. 44). The staple cavities 3428 in the middle row on the second side of the longitudinal slot 3432 are oriented at a fifth angle with respect to the longitudinal axis L and in the inner row on the second side of the longitudinal slot 3432. The staple cavity 3428 of the above is oriented at a sixth angle with respect to the longitudinal axis L. In the illustrated staple cartridge 3420, the sixth angle is the same as or about the same as the fourth angle, the fifth angle is 90 ° or about 90 °, from the fourth and sixth angles. It is biased. Further, in the arrangement shown in FIGS. 43-45, the second angle is the same as or substantially the same as the fourth angle and the sixth angle, and the first angle is the same as the third angle and the fifth angle. Same or roughly the same.

In another embodiment, the staple cartridge 3420 may include additional and / or fewer rows of staple cavities. Further or / or, the angular orientation of the staples 3412 within each row can be adjusted and / or modified to accommodate different arrays. For example, in a particular embodiment, at least one staple cavity may be parallel to the longitudinal axis L.

In various embodiments, the staple cartridge 3420 shown in FIGS. 43-45 can be used with the end effector 2000 shown in FIG. For example, the staple cartridge 3420 can be mounted within the elongated channel of the second jaw 2004. Further, in certain embodiments, the staple cartridge 3420 can be fired with a single staple driver, a multi-staple driver, and / or a combination thereof. For example, a single staple driver 3440 (FIG. 45) can be positioned within each staple cavity 3428 and can be driven and engaged with a staple 3412 supported therein. The driver 3440 shown in FIG. 45 can be positioned within the cartridge body 3424 such that the cradle of each driver 3440 is aligned with one of the staples 3412 positioned within one of the staple cavities 3428. ..

In certain embodiments, the staple cartridge 3420 can include a multi-staple driver. For example, a multi-staple driver can be configured to fire the staples 3412 (FIG. 45) from the first group of staple cavities 3428, while another multi-staple driver can configure the staples 3412 to fire from the second group of staple cavities 3428. It can be configured to fire from 3428. In another example, the staple cartridge 3420 may not include a driver. For example, the launching member and / or thread, such as the launching member 2660 and thread 2658 (FIG. 37), may be configured to directly contact and engage with and / or drive the staple 3412. it can. In various embodiments, the driver 3440 and / or staple 3412 may be mass balanced with respect to the thread's firing path, eg, thread 2058 (FIG. 7) and / or thread 2658 (FIG. 37), during deployment. it can.

The decks 3422 shown in FIGS. 43-45 include a plurality of longitudinally extending portions. For example, the deck 3422 may include a first longitudinal portion 3422a, a second longitudinal portion 3422b, and a third longitudinal portion 3422c, and a longitudinal slot 3432 on one side of the longitudinal slot 3432. Opposite sides include a fourth longitudinal portion 3422d, a fifth longitudinal portion 3422e, and a sixth longitudinal portion 3422f. As shown in FIGS. 43-45, the longitudinal rows of staple cavities 3428 are aligned with the respective longitudinally extending portions 3422a, 3422b, 3422c, 3422d, 3422e, 3422f. For example, the outer row staple cavities 3428 on the first side of the longitudinal slot 3432 are aligned with the first longitudinal portion 3422a and the middle row staple cavities 3428 on the first side of the longitudinal slot 3432. Is aligned with the second longitudinal portion 3422b, and the staple cavities 3428 in the inner row on the first side of the longitudinal slot 3432 are aligned with the third longitudinal portion 3422c. Further, the outer row staple cavities 3428 on the second side of the longitudinal slot 3432 are aligned with the fourth longitudinal portion 3422d and the intermediate row staple cavities 3428 on the second side of the longitudinal slot 3432. Is aligned with the fifth longitudinal portion 3422e, and the inner row staple cavity 3428 on the second side of the longitudinal slot 3432 is aligned with the sixth longitudinal portion 3422f.

In another embodiment, the staple cartridge 3420 may include additional and / or less longitudinally extending portions. For example, the longitudinal portion can be adjusted and / or modified to accommodate different arrangements of staple cavities and staples. In certain embodiments, more than two longitudinal rows of staple cavities can coincide with at least one longitudinal portion. Further or / or at least one longitudinal portion may not include, for example, staple cavities and / or rows of staples.

In the illustrated staple cartridge 3420, adjacent longitudinal portions 3422a, 3422b, 3422c, 3422d, 3422e, and 3422f are vertically offset from each other by the raised portion 3423. For example, the raised portion 3423 extends between the first portion 3422a and the second portion 3422b, and another raised portion 3423 extends between the second portion 3422b and the third portion 3422c. To do. Further, in the illustrated arrangement, the raised portion 3423 extends between the fourth portion 3422d and the fifth portion 3422e, and another raised portion 3423 includes the fifth portion 3422e and the sixth portion 3422f. It extends between. As shown in FIGS. 43-45, longitudinal slots 3432 extend between the third portion 3422c and the fourth portion 3422d.

The raised portion 3423 disclosed in FIGS. 43-45 defines an altitude change portion within the deck 3422. For example, the raised portion 3423 between the raised portion 3423 between the first portion 3422a and the second portion 3422b defines the step upwards, so that the second portion 3422b is the first portion 3422. Has a higher altitude than. In various embodiments, the raised portion 3423 adjusts the height of the deck 3422 laterally. For example, the raised portion 3423 increases the height of the deck 3422 inward and decreases the height of the deck 3422 outward so that the maximum height is adjacent to the longitudinal slot 3432 and laterally. The side portion has the shortest height.

The gap between the deck 3422 and the stapled surface of the anvil is tissue when the jaws of the end effector are clamped, such as the first jaw 2002 and the second jaw 2004 of the end effector 2000 (FIG. 7). Control the degree of compression. Therefore, the height of deck 3422 can affect the degree of tissue compression between the clamped jaws. For example, in areas where deck 3422 is higher, the degree of compression of adjacent tissue can be relatively increased between the clamped jaws, and in areas where deck 3422 is shorter, the degree of compression of adjacent tissue can be increased between jaws. It can be relatively reduced. Therefore, the raised portion 3423 disclosed in FIGS. 43-45 can affect the lateral variation of tissue compression. As further described herein, the degree of tissue compaction can be selected and / or optimized to reduce stress and / or trauma to the compressed tissue. In addition, the staple cartridge 3420 is configured to fire a flexible array in the longitudinal direction of the staples 3412, further preserving the integrity of the stapled tissue.

The ridges 3423 disclosed in FIGS. 43-45 affect steep and / or steep steps between adjacent longitudinal portions 3422a, 3422b, 3422c, 3422d, 3422e, and 3422f. FIGS. 43-45 further disclose that the raised portion 3423 surrounds the staple cavity 3428 in the adjacent row of staple cavity 3428. For example, the ridge 3423 generally extends along a path that corresponds to and / or is compatible with the angular orientation of the staple cavity or its adjacent cavity 3428. As a result, the raised portion 3423 includes a plurality of contoured portions and / or bent portions. Further, the ridge 3423 includes a plurality of straight or generally straight portions in the middle of the contour.

In another example, the raised portion 3423 may define a less inclined altitude change portion. For example, at least one ridge 3423 and / or a portion thereof gently inclines to different altitudes and / or gradually increments. Moreover, in certain embodiments, the heights of the longitudinal portions 3422a, 3422b, 3422c, 3422d, 3422e, 3422f can vary. For example, the height of the respective longitudinal portions 3422a, 3422b, 3422c, 3422d, 3422e, 3422f can vary laterally and / or longitudinally. In such an example, the deck may define, for example, an intermediate sloping and / or angled surface of the ridge 3423.

In other staple cartridges, the ridges can extend along different paths between the staple rows and the staple cavities. For example, the staple cartridge 3520 shown in FIGS. 46-48 is similar to the staple cartridge 3420 (FIGS. 43-45), and similar reference characters refer to similar elements. For example, the staple cartridge 3520 includes a cartridge body 3524 and a deck 3522. A plurality of staple cavities 3528 are defined in the main body 3524 of the staple cartridge 3520 shown, and each staple cavity 3528 forms an opening 3530 in the deck 3422. Further, the staple cavities 3528 shown in FIGS. 46-48 fit into the array of staple cavities 3428 shown in FIGS. 43-45. For example, in the illustrated staple cartridge 3520, longitudinal slots 3532 are defined partially through the cartridge body 3524, and three rows of staple cavities 3528 are positioned on either side of longitudinal slots 3532. The arrangement of staple cavities 3528 shown in FIGS. 46-48 is configured to accept an array of angled staples. A plurality of staples, such as staples 3412 (FIG. 45), can be removably positioned within the staple cavity 3528.

The decks 3522 disclosed in FIGS. 46-48 include a plurality of longitudinally extending portions. For example, the illustrated deck 3522 has a first longitudinal portion 3522a, a second longitudinal portion 3522b, a third longitudinal portion 3522c, and a longitudinal slot on one side of the longitudinal slot 3532. Opposite sides of 3432 include a fourth longitudinal portion 3522d, a fifth longitudinal portion 3522e, and a sixth longitudinal portion 3522f. As shown in FIGS. 46-48, the longitudinal rows of staple cavities 3528 are aligned with the respective longitudinally extending portions 3522a, 3522b, 3522c, 3522d, 3522e, 3522f. Further, in the illustrated staple cartridge 3520, the adjacent longitudinal portions 3522a, 3522b, 3522c, 3522d, 3522e, and 3522f are vertically offset from each other by the raised portion 3523.

The ridges 3523 disclosed in FIGS. 46-48 extend along a different path than the ridges 3423 of decks 3422 (FIGS. 43-45). For example, the ridge 3423 includes a plurality of cut-ins, such as, for example, cut-ins 3523a, 3523b, 3523c, and 3523d (FIG. 47), and the ridge 3523 extends along and / or adjacent to the staple cavity 3528. Does not exist. The contour shapes of the cut-ins 3523a, 3523b, 3523c, and 3523d can be selected to adjust the tissue compression. For example, the cut-in can expand the area of pressure reduction and reduce the area adjacent to the pressure increase. In various embodiments, it may be desirable to provide cut-ins 3523a, 3523b, 3523c, and 3523d towards the knife slot 3532, for example, to provide a region of reduced tissue compression.

As further described herein, the ridges 3523 disclosed in FIGS. 46-48 can affect the lateral variation of tissue compression. For example, tissue compaction can be selected and / or optimized to reduce stress and / or trauma to the compressed tissue. In addition, the staple cartridge 3520 is configured to fire a flexible array in the longitudinal direction of the staple 3512, further preserving the integrity of the stapled tissue.

In other embodiments, the ridges on the cartridge deck may be straight or generally straight. For example, the staple cartridge 3620 shown in FIGS. 49-51 is similar to the staple cartridge 3420 (FIGS. 43-45), and similar reference characters refer to similar elements. For example, the staple cartridge 3620 includes a cartridge body 3624 and a deck 3622. A plurality of staple cavities 3628 are defined in the main body 3624 of the staple cartridge 3620 shown, and each staple cavity 3628 forms an opening 3630 in the deck 3622. Further, the staple cavities 3628 shown in FIGS. 49-51 conform to the arrangement of the staple cavities 3528 shown in FIGS. 46-48. For example, in the illustrated staple cartridge 3620, the longitudinal slots 3632 are defined partially through the cartridge body 3624, and the three rows of staple cavities 3628 are positioned on either side of the longitudinal slots 3632. The arrangement of staple cavities 3628 shown in FIGS. 46-48 is configured to accept an array of angled staples. A plurality of staples, such as staples 3612 (FIG. 51), are removably positioned within the staple cavity 3628.

The deck 3622 disclosed in FIGS. 49-51 includes a plurality of longitudinally extending portions. For example, the illustrated deck 3622 has a first longitudinal portion 3622a, a second longitudinal portion 3622b, and a third longitudinal portion 3622c, and a longitudinal slot on one side of the longitudinal slot 3632. On the opposite side of the 3632 is a fourth longitudinal portion 3622d, a fifth longitudinal portion 3622e, and a sixth longitudinal portion 3622f. As shown in FIGS. 49-51, the longitudinal rows of staple cavities 3628 are aligned with the respective longitudinally extending portions 3622a, 3622b, 3622c, 3622d, 3622e, 3622f. Further, in the illustrated staple cartridge 3620, the adjacent longitudinal portions 3622a, 3622b, 3622c, 3622d, 3622e, and 3622f are vertically offset from each other by the raised portion 3623.

The ridges 3623 disclosed in FIGS. 49-51 extend along a different path than the ridges 3423 of decks 3422 (FIGS. 43-45) and the ridges 3523 of decks 3522 (FIGS. 46-48). For example, the ridge 3623 extends along a straight path that extends parallel to the longitudinal slot 3632. Further, a portion of the longitudinal ridge 3523 extends through the staple cavity 3628 in the staple cartridge 3620. As a result, one end, or one side, of the staple cavity 3628 is positioned within one of the longitudinal deck portions 3622a, 3622b, 3622c, 3622d, 3622e, or 3622f and the other end, or opposite side, of the same staple cavity 3628. Is positioned within another of the longitudinal deck portions 3622a, 3622b, 3622c, 3622d, 3622e, or 3622f.

As further described herein, the ridges 3623 disclosed in FIGS. 49-51 can affect the lateral variation of tissue compression. For example, tissue compaction can be selected and / or optimized to reduce stress and / or trauma to the compressed tissue. In addition, the staple cartridge 3620 is configured to fire a flexible array in the longitudinal direction of the staples 3612, further preserving the integrity of the stapled tissue.

In a particular embodiment, the staple cartridge 3620 includes a multi-staple driver, such as the multi-staple driver 3640 disclosed in FIG. Each multi-staple driver 3640 is configured to fire staples 3612 from a group of staple cavities 3628. For example, similar to the multi-staple drivers 2040a, 2040b (FIGS. 7-9), the multi-staple driver 3640 includes three stages 3645, and a trough, i.e., the cradle 3642, is defined within each stage 3645. Further, the steps 3645 of the multi-staple driver 3640 are connected by a connecting flange 3648. Each multi-staple driver 3640 shown in FIG. 51 is configured to support the staples 3612 across multiple rows of staple cavities 3628 and fire the staples 3612 from the staple cavities 3628 in the plurality of rows. In FIG. 51, the height of each step 3645 and the depth of each pedestal 3642 defined inside are the same, and the staples 3612 formed between the steps 3645 and the staple forming surface on the anvil are the same. It is designed to have the height after molding.

As further described herein, it may be desirable to customize and / or optimize the staple height after molding in order to affect the various tissue compressions within the molded staples. Therefore, at least one of the multi-staple drivers 3640 can be modified to form staples 3612 with different post-mold heights. For example, the steps 3645 and / or cradle 3642 of the staple multi-staple driver 3640 have different dimensions such that at least two of the staples 3612 formed by the modified multi-staple driver 3640 have different post-molded heights. Can be modified to have. In another embodiment, the steps 3645 and / or cradle 3642 of different staple drivers 3640 are configured such that the first driver 3640 forms a staple 3612 with a first molded height and a second driver. The 3640 can be modified to form a second, i.e., a staple with a different post-molded height of 3612.

Still in other embodiments, the staple cartridge 3620 may include a single staple driver. Alternatively, the staple cartridge 3620 may not include a driver. For example, the launching member and / or thread, such as the launching member 2660 and the thread 2658 (FIG. 37), may be configured to directly contact, engage, and / or drive the staple 3612, for example. it can. In various embodiments, the driver 3640 and / or staple 3612 can be mass balanced with respect to the thread's launch path, such as thread 2058 (FIG. 7) and / or thread 2658 (FIG. 37).

As described herein, staples in a staple array can be formed to different post-mold heights to customize and / or optimize tissue compression within the molded staples. For example, in various examples, it is desirable to compress the structure and therefore laterally change the staple size after molding. In such a situation, for example, a tissue closer to the cut line can be compressed than a structure farther from the cut line. Various staple arrays with different unmolded heights and / or different post-adult heights have been published in US Pat. No. 7,866,528, January 1, 2011, entitled "STAPLE DRIVE ASSEMBLY", 2010. US Pat. No. 7,726,537 issued on June 1, 2010, title "SURGICAL STAPLER WITH UNIVERSAL ARTICULATION AND TISSUE PRE-CLAMP", US Pat. No. 7,641, issued on January 5, 2010. No. 091, title "STAPLE DRIVE ASSEMBLY", US Pat. No. 7,635,074 issued December 22, 2009, title "STAPLE DRIVE ASSEMBLY", and US patent issued August 16, 2011. No. 7,997,469, entitled "STAPLE DRIVE ASSEMBLY", each of which is incorporated herein by reference in its entirety.

With reference to FIGS. 49-51 again, in various embodiments, the staple cartridge 3620 can be used with end effectors configured to deform the staples 3612 to different post-mold heights. The angled staple cavities 3628 in the staple cartridge 3620 are arranged in a plurality of rows. For example, the angled staple cavities 3628 are located on the first side of the staple cartridge 3620 in a first outer row, a first middle row, and a first inner row, and the angled staple cavities 3628 Are arranged on the second side of the staple cartridge 3620 in a second outer row, a second middle row, and a second inner row. In various embodiments, the staples 3612 fired from the staple cavities 3628 in the first outer row have a higher post-molded height than the staples 2612 fired from the staple cavities 3628 in the first intermediate row. And / or the staples 3612 fired from the staple cavities 3628 in the first intermediate row have a higher post-molded height than the staples 2612 fired from the staple cavities 3628 in the first inner row. Can be taken. Further or / or, the staple 3612 launched from the staple cavity 3628 in the second outer row may have a higher post-molded height than the staple 2612 launched from the staple cavity 3628 in the second intermediate row. Can and / or the staple 3612 fired from the staple cavity 3628 in the second middle row takes a higher post-molded height than the staple 2612 fired from the staple cavity 3628 in the second inner row. be able to.

In certain embodiments, the staples 3612 fired from the staple cartridge 3620 can have different unmolded heights. For example, the staple 3612 launched from the staple cavity 3628 in the first outer row can have a larger unmolded height than the staple 2612 launched from the staple cavity 3628 in the first intermediate row. / Alternatively, the staples 3612 launched from the staple cavities 3628 in the first intermediate row can have a larger unmolded height than the staples 2612 launched from the staple cavities 3628 in the first inner row. Further or / or, the staple 3612 launched from the staple cavity 3628 in the second outer row can have a larger unmolded height than the staple 2612 launched from the staple cavity 3628 in the second intermediate row. And / or the staple 3612 launched from the staple cavity 3628 in the second middle row may have a larger unmolded height than the staple 2612 launched from the staple cavity 3628 in the second inner row. it can.

In various embodiments, staple arrays with different unmolded heights and / or different post-molded heights can be incorporated into the various staple cartridges described herein. For example, staple cartridges 3420 (FIGS. 43-45) and / or staple cartridges 3520 (46-48) can include staples with different unmolded heights and / or staples to different post-molded heights. It can be configured to fire. In such an example, the stepped cartridge decks 3422 (FIGS. 43-45), 3522 (FIGS. 46-48), and 3622 (FIGS. 49-51) affect, for example, variable pre-launch tissue compression. For example, different post-mold staple heights can affect variable post-launch tissue compression.

As described herein, the angled staple array provides increased flexibility to the stapled tissue. A staple that is angled with respect to the notch line and / or the longitudinal axis of the staple cartridge can have one staple leg that is closer to the notch than another staple leg. In such an arrangement, the staples can be formed at different post-mold heights to laterally customize and / or optimize tissue compression. For example, one end of the staple can be formed at a first height and the other end of the staple can be formed at a second different height. In such an example, tissues treated by the same row of staples can receive different compressive forces.

The staple cartridge 3720 and the anvil 3703 are shown in FIG. 79. The staple cartridge 3720 is similar to the staple cartridge 3620 (FIGS. 49-51), and similar reference characters refer to similar elements. For example, the staple cartridge 3720 includes a cartridge body 3724 and a deck 3722. The deck 3722 includes a plurality of longitudinally extending portions 3722a, 3722b, 3722c, and adjacent longitudinally oriented portions 3722a, 3722b, 3722c are separated by a raised portion 3723. The ridge 3723 extends longitudinally along at least a portion of the length of the cartridge body 3722. An angled staple cavity 3728 is defined within the cartridge body 3724, and a raised portion 3723 extends through the staple cavity 3728. As a result, the first end of the staple cavity 3728 shown is positioned within the first longitudinal portion 3722a and the second end of the staple cartridge 3728 shown is the second longitudinal portion. Positioned within 3722b. Further, the longitudinal slot 3732 is defined partially through the illustrated cartridge body 3724.

In various embodiments, the staple cartridge 3720 can include a plurality of staple cavities 3728, the plurality of staple cavities 3728 being configured to receive an array of angled staples 3712. For example, the staple cartridge 3720 can include an arrangement of staple cavities 3728 that corresponds to the arrangement of staple cavities 3628 shown in FIGS. 49-51. In certain embodiments, for example, three rows of staple cavities 3728 can be positioned on either side of longitudinal slot 3732.

Unmolded staples 3712 and deformed staples 3712'are shown in FIG. 79. The staple 3712 includes a base 3714, a first leg 3716 extending from the base 3714, and a second leg 3718 extending from the base 3714. The driver 3740 is also shown in FIG. 79. The driver 3740 includes a trough, i.e., a cradle 3742, which is configured to support the base 3714 of staples 3712. The driver 3740 and the cradle 3742 defined therein have a variable height between the first end 3741 and the second end 3743 of the driver 3740. For example, the first end 3741 of the driver 3740 defines the first height, the second end 3743 of the driver 3740 defines the second height, and the second height is the second. It is less than 1 height.

When the driver 3740 is fired and lifted in the staple cavity 3728, the staple 3712 rides upwards on the lifting driver 3740 and is deformed by the stapler molding pocket 3705 of the anvil 3703. Molded staples 3712'are also shown in FIG. 79. The height after molding of the staple 3712'is a function of the distance between the driver 3740 after lifting and the stapler molding pocket 3705 of the anvil 3703, that is, the gap. The molded staple 3712'has a variable height because the distance between the staple support surface 3742 of the driver 3740 after lifting and the staple molding pocket 3705 varies in the staple cartridge 3720 disclosed in FIG. 79. For example, the height of the molded staples 3712'is greater between the first leg 3716'and the base 3714' than between the second leg 3718' and the base 3714'. In various embodiments, the angular orientation of the staples 3712'allows the first leg 3716' to be located farther from the longitudinal slot 3732 than the second leg 3718'. In such an example, the first leg 3716'may be the outer leg of the staple 3712' and the second leg 3718'may be the inner leg of the staple 3712'. In such an arrangement, tissue compression may be greater between the inner leg 3718'and the base 3714' than between the outer leg 3716'and the base 3714'.

For example, similar to staple cartridges 3720 and anvil 3705, staple cartridge and anvil arrangements configured to deform angled staples to different post-molded heights are described in other embodiments disclosed herein. Can be incorporated. For example, like the driver 2740, for example, a driver with a cradle that supports variable height staples can be incorporated into other staple cartridges and / or end effector assemblies disclosed herein.

The unmolded staple 3712 shown in FIG. 79 also has a variable height. For example, the staple 3712 defines a first height at the first leg 3716 and a second height at the second leg 3718, where the second height is less than the first height. Is. Further, the base 3714 of the staple 3712 defines a bend, i.e., a step 3715, which lifts the second leg 3718 relative to the first leg 3716.

In another embodiment, the unmolded staple 3712 may have a uniform height. Further or / or, the base 3714 of the unmolded staples 3712 may be straight or approximately straight between the first leg 3716 and the second leg 3718. In such an example, the staples 3712 may still have a variable post-mold height when the distance between the staple support surface 3742 of the lifted driver 3740 and the staple molding pockets 3705 is variable. For example, one of the staple legs 3716, 3718 may be in a more deformed and / or compressed state than the other staple legs 3716, 3718 to accommodate additional leg lengths. In addition, the distance between the staple support surface 3742 and the staple molding pocket 3705 varies so that the base 3714 can be bent during firing and / or otherwise deformed to adapt to height differences. it can.

The staple cartridge 3820 and the anvil 3803 are shown in FIG. The staple cartridge 3820 is similar to the staple cartridge 3620 (FIGS. 49-51), and similar reference characters refer to similar elements. For example, the staple cartridge 3820 includes a cartridge body 3824 and a deck 3822. Unlike decks 3622 (FIGS. 49-51), decks 3822 have a flat or generally flat stepless surface. An angled staple cavity 3828 is defined within the cartridge body 3824. Further, the longitudinal slot 3832 is defined partially through the illustrated cartridge body 3824.

In various embodiments, the staple cartridge 3820 can include a plurality of staple cavities 3828, the plurality of staple cavities 3828 being configured to accept an array of angled staples. For example, the staple cartridge 3820 can include a staple cavity arrangement that corresponds to the staple cavity 3628 arrangement shown in FIGS. 49-51. In certain embodiments, three rows of staple cavities 3828 can be positioned on either side of, for example, longitudinal slots 3832.

Unmolded staples 3812 are shown in FIG. The staples 3812 include a base 3814, a first leg 3816 extending from the base 3814, and a second leg 3818 extending from the base 3814. The driver 3840 is also shown in FIG. The driver 3840 includes a trough, i.e., a cradle 3842, which is configured to support a base 3814 of staples 3812.

The anvil 3803 includes a laterally stepped cartridge facing surface 3801. The first staple molding pocket 3805a and the second staple molding pocket 3805b are defined in the stepped surface 3801. As shown in FIG. 80, the first staple molding pocket 3805a is in the first step 3801a of the stepped surface 3801, and the second staple molding pocket 3805b is in the second step 3801b of the stepped surface 3801. It is in.

When the driver 3840 is fired and lifted in the staple cavity 3828, the staple 3812 rides upward on the driver 3840 being lifted and is deformed by the staple forming pockets 3805a, 3805b of the anvil 3803. Molded staples 3812'are also shown in FIG. The height of the staples 3812'after molding is a function of the distance between the lifted driver 3840 and the staple molding pockets 3805a and 3805b of the anvil 3803, that is, the gap. Since the distance between the staple support surface 3842 of the driver 3840 after lifting and the staple molding pockets 3805a and 3805b, respectively, is different in the staple cartridge 3720 disclosed in FIG. 79, the molded staple 3812'has a variable height. take. For example, the height of the molded staples 3812'is greater between the first leg 3816'and the base 3814' than between the second leg 3818' and the base 3814'. In various embodiments, the angular orientation of the staples 3812'allows the first leg 3816' to be located farther from the longitudinal slot 3832 than the second leg 3818'. In such an example, the first leg 3816'may be the outer leg of the staple 3812' and the second leg 3818'may be the inner leg of the staple 3812'. In such an arrangement, tissue compression may be greater between the inner leg 3818'and the base 3814' than between the outer leg 3816'and the base 3814'.

In another embodiment, the staple 3812'can be deformed to a smaller height at the outer leg 3816'. As a result, tissue compression may be greater between the outer leg 3816'and the base 3814' than between the inner leg 3818'and the base 3814'.

For example, similar to staple cartridges 3820 and anvils 3805a, 3805b, staple cartridge and anvil arrangements configured to deform angled staples to different post-molded heights are other embodiments disclosed herein. Can be incorporated into the form. For example, similar to pockets 3805a, 3805b, for example, variable depth pockets can be incorporated into other embodiments disclosed herein.

The unmolded staple 3812 shown in FIG. 80 also has a variable height. For example, the staples 3812 define a first height at the first leg 3816 and a second height at the second leg 3818, where the second height is less than the first height. Is.

In another example, the unmolded staple 3812 may have a uniform height. In such an example, the staples 3812 may previously take a variable post-mold height when the distance between the staple support surface 3842 of the lifted driver 3840 and the staple molding pockets 3805 is variable. For example, one of the staple legs 3816, 3818 may be in a more deformed and / or compressed state than the other staple legs 3816, 3818 to accommodate additional leg lengths.

In certain types of surgical procedures, the use of surgical staples or surgical fasteners has become a suitable method for joining tissues, and specially configured surgical staplers or circular surgical fasteners are available for these applications. Has been developed in. For example, intracavitary or circular staplers have been developed for use in surgical procedures used to form "anastomosis". Circular staplers that are useful for performing anastomosis are described, for example, in US Pat. No. 5,104,025, title "INTRALUMINAL ANASTOMOTIC SURGICAL STAPLER WITH DETACEED ANVIL", US Pat. No. 5,309,927, title "CIRCULAR STAPLER". SPRING METHOD ”, US Pat. No. 7,665,647, Title“ SURGICAL CUTTING AND STAPLING DEVICE WITH CLOSE OPERATUS FOR LIMITING MAXIMUM TISSUE COMPRESSION №. FOR DEPLOYING SURGICAL STAPLES WITH TISSUE COMPRESSION FEATURES ”is disclosed, the entire disclosure of which is incorporated herein by reference.

A form of "anastomosis" involves a surgical procedure in which the intestinal part is joined together after the connecting part (usually the lesioned part) has been resected. This procedure requires joining the ends of the two tubular compartments together to form a continuous tubular pathway. Previously, this surgical procedure was a laborious and time-consuming operation. The surgeon had to accurately cut and align the ends of the intestine and maintain the alignment while joining the ends with multiple sutures. With the development of the circular fastening device, this anastomotic procedure has been greatly simplified and the time required to perform the anastomotic procedure has also been shortened.

In general, conventional circular staplers or fastening devices consist of an elongated shaft that includes a proximal actuating mechanism and a distal staple fastening mechanism mounted on the shaft. The distal stapling mechanism typically consists of a fixed stapling cartridge accommodating a plurality of staples arranged in a concentric array. Round blades are also concentrically mounted in the cartridge so that the blade is inside the staples. The blade is axially movable in the distal direction. Axial extending from the center of the cartridge is the trocar shaft. The trocar shaft is also axially movable within the elongated shaft. The trocar shaft is configured to be removablely attached to the anvil member. The anvil member includes a staple molded lower surface that is arranged to face the staple cartridge that forms the end of the staple when the staple is advanced and comes into contact with the anvil member. The distance between the distal surface of the staple cartridge and the staple molded lower surface of the anvil is controlled by an adjustment mechanism mounted at the proximal end of the stapler shaft. The tissue contained between the staple cartridge and the staple anvil is stapled and cut at the same time the actuating mechanism is actuated by the surgeon.

When performing anastomosis using a circular stapler, the intestine is typically stapled initially using a conventional surgical stapler, with double-row staples at the target site of the intestine (ie, lesion). It is placed on both sides of the part or sample). The target site is usually cut at the same time the site is stapled. After removing the specimen, the surgeon typically inserts an anvil proximal to the staple line into the proximal end of the lumen (ie, intestine). This is done by the surgeon inserting the anvil head into the entrance cut into the proximal lumen (intestine). Occasionally, the anvil may be placed transanally by placing the anvil head at the distal end of the stapler and inserting the instrument through the rectum. The proximal end of the intestine is then sutured to the anvil shaft using sutures or other conventional binding tools. The surgeon then cuts off the excess tissue adjacent to the knot and the surgeon attaches the anvil to the stapler's trocar shaft. The surgeon then closes the gap between the anvil and the cartridge by pulling the anvil towards the staple cartridge. As the anvil moves towards the cartridge, the proximal and distal ends of the intestine are clamped between them. The stapler is then activated, which causes a row of staples to be driven through both ends of the intestine to form contact with the anvil. At the same time, when the staples are driven and molded, the circular blades are driven through the ends of the intestinal tissue, cutting the ends adjacent to the inner row of staples. The surgeon then retrieves the stapler from the intestine and the anastomosis is complete.

Effective healing of the colon-rectal anastomosis can be challenged by several factors and conditions. For example, healing can be achieved by the presence of bacterial contamination in the anastomotic region. In general medical care, the success rate of anastomosis tends to improve with the patient's return to mobility. It is desirable for the patient to return to content passage as soon as possible. One of the restraints on the passage of contents is the risk of "stenosis". If the colon contents cannot pass through the staple wire, or if the colon contents dramatically stress the staple wire, crevices, tears, or leaks can occur. Linear expandable lines of staples have been developed for highly expandable organs such as the lungs. However, such staple configurations are not suitable for use associated with circular staplers.

FIG. 29 illustrates one form of circular stapler, or staple fastening device, generally designated as 5000. Various circular staple fastening devices for installing surgical staples or fasteners are well known and used. Therefore, various details regarding the structure and operation of the circular staple fastening device are disclosed herein and go beyond what may be necessary to understand the innovations and arrangements illustrated in the accompanying drawings. Not discussed in detail. Further details regarding circular fasteners and staple fasteners can be found in U.S. Pat. No. 7,665,647, entitled "SURGICAL CUTTING AND STAPLING DEVICE WITH CLOSURE APPARATUS FOR LIMITING MAXIMUM TISSUE COMPRESION". , As with other US patents incorporated herein by reference, are incorporated herein in its entirety. Generally, the circular stapler 5000 shown in FIG. 29 includes a head 5002, an anvil 5004, an adjustment knob assembly 5006, and a handle 5010 that supports the trigger 5008 up. The handle assembly 5010 is coupled to the head 5002 by a bow shaft assembly 5012. In the illustrated arrangement, the trigger 5008 is pivotally supported by the handle assembly 5010 and is used to operate the stapler 5000 when the safety mechanism (not shown) is released. When the trigger 5008 is activated, the firing mechanism is movably advanced within the shaft assembly 5012 and the staples or fasteners are ejected or unfolded from the head 5002 to bring the anvil 5004 into contact with the anvil molded underside 5005. It is supposed to be formed. At the same time, a round blade operably supported within the head 5002 (not visible in FIG. 29) was advanced distally towards the anvil 5004 and clamped between the head 5002 and the anvil 5004 in a known manner. It serves to cut the tissue. The stapled device 5000 is then removed from the surgical site, leaving the stapled tissue in place.

As can also be seen in FIG. 29, the anvil 5004 includes a circular body portion 5014 having an anvil shaft 5016 projecting from it. The anvil shaft 5016 is configured to be detachably attached to a trocar shaft 5050 operably supported within the shaft assembly 5012. See FIG. 29A. As can be seen, the trocar shaft 5050 is operably interlocked with the adjustment knob assembly 5006, which is movably supported by the shaft assembly 5012 and rotatably supported on the handle assembly 5010. The anvil shaft 5016 can be detachably attached to the trocar shaft 5050 by retaining clips 5052, or other releasable fastening arrangements are also used to detachably secure the anvil shaft 5016 to the trocar shaft 5050. obtain. Once the anvil shaft 5016 is attached to the trocar shaft 5050, the clinician can move the anvil 5004 towards and away from the head 5002 by rotating the adjustment knob 5006 in the appropriate direction of rotation.

FIG. 29A illustrates a head 5002 with a unique and novel fastener cartridge assembly 5020 operably mounted internally. As can be seen in the figure, the fastener cartridge assembly 5020 includes a cartridge body 5022 that includes a circular deck 5030. The circular deck 5030 may form a plane 5032, which is arranged such that the anvil shaft 5016 faces the stapled bottom surface 5005 of the anvil 5004 when attached to the trocar shaft 5050. Multiple fastener cavities 5040 are provided within the circular deck 5030 and are configured to internally receive at least one surgical staple or surgical fastener (not shown) and at least one surgical staple or surgical. The staples are operably supported on the driver assembly 5060, which is movably supported within the body 5022 of the fastener cartridge assembly 5020. The driver assembly 5060 is operably coupled to the corresponding movable portion of the shaft assembly 5012 that is operably interlocked with the trigger 5008. The activation of trigger 5008 results in, for example, an axial movement of the driver assembly 5060 in the distal "DD" direction. The movement of the driver assembly 5060 in the distal "DD" direction results in the movement or extrusion of the surgical staples or fasteners supported within the respective fastener cavities 5040, resulting in staple molding underside 5005 on the anvil 5004. Contact with will be formed.

Still referring to FIG. 29A, for example, each fastener cavity 5040 includes two cavity ends 5042, 5044. In the illustrated arrangement, each cavity end 5042, which may also be referred to herein as the "first cavity end", is positioned on a first circular axis "FCA" having a first radius "FR". Will be done. The first radius "FR" can be measured from the instrument shaft axis "SA". Also, in an exemplary arrangement, each cavity end 5044, which may also be referred to herein as a "second cavity end," has a second radius "SR" that is different from the first radius "FR". Positioned on the circular axis "SCA" of 2. In the illustrated embodiment, the second radius "SR" also measured from the shaft axis "SA" is larger than the first radius "FR". Also, in an exemplary embodiment, each fastener cavity 5040 includes a cavity axis "CA". In an exemplary embodiment, each fastener cavity 5040 is located within a circular deck 5030 with respect to a first circular axis "FCA" and a second circular axis "SCA", respectively, with respect to the cavity axis "CA". Is formed at an acute angle with the first circular axis "FCA" and the second circular axis "SCA". In other words, the cavity ends 5042 of the adjacent fastener cavities 5040 are adjacent to each other, and the ends 5044 of the same fastener cavity 5040 are separated from each other. Such an arrangement is sometimes referred to herein as a "zigza" orientation. However, in other arrangements, the cavity axis "CA" can be perpendicular to the first and second circular axes "FCA" and "SCA".

In the arrangement illustrated in FIG. 29A, the respective cavity ends 5042, 5044 may be V-shaped so as to terminate entirely at a point. For example, each cavity end 5042 may terminate at point 5043 overall, and each end 5044 may terminate at point 5045 overall. Point 5043 may be positioned on the first circular axis "FCA" or intersect the first circular axis "FCA", and point 5045 may be located on the second circular axis "SCA". It can be positioned or intersect the second circular axis "SCA". Such cavity placement results in the application of surgical staples or fasteners in a tissue-like pattern. In the illustrated arrangement, each fastener cavity 5040 internally supports one surgical staple or surgical fastener. However, in other arrangements, more than one staple or fastener may be supported within each cavity. The fastener cartridge assembly 5020 uses staples of similar size in each fastener cavity 5040. In other arrangements, different sized surgical staples or fasteners may be used within the fastener cartridge assembly. Surgical staples that can be used include, for example, two staple legs extending from the central body portion or crown. The legs can be received within the V-shaped ends 5042, 5044 of the fastener cavity 5040, and whenever the legs are ejected from the cavity 5040, the legs are first or second circular. It extends through the axis. These staple orientations can address some of the concerns associated with staple stenosis discussed above. In particular, the staple configuration formed when using the fastener cartridge assembly 5020 may allow the staple wire to expand and bend like a natural large intestine rather than a general staple wire. For example, staples or fasteners can be twisted when the staples or fasteners are pulled radially, and staples or fasteners minimize stress on the healing zone for maximum flexibility and strength. Can be.

Another area of interest related to the colon-rectal anastomosis procedure concerns radial leakage through the attachment area. The fastener cartridge assembly 5020 described above may also address this area of interest. Another fastener cartridge assembly 5120 is shown in FIG. 30 and can address the various problems and concerns mentioned above. As can be seen in the figure, the fastener cavities are arranged in an "asymmetric pattern" and the staples applied through the inner ring of the cavity, the inner circular array, are the outer ring of the cavity, the outer. It performs a different function than staples or fasteners applied through a circular array.

More specifically and with reference to FIG. 30, the fastener cartridge assembly 5120 includes a cartridge body 5122 including a circular deck 5130. The circular deck 5130 may form a plane 5132, which is arranged so that the anvil shaft 5016 faces the stapled bottom surface 5005 of the anvil 5004 when attached to the trocar shaft 5050. A first ring 5036 of the first cavity 5040 is provided in the circular deck 5130, and a second ring 5160 of the second cavity 5170 is provided via the cartridge deck 5130 as shown. Each of the first and second cavities 5040 and 5170 is configured to internally receive at least one surgical staple or surgical fastener (not shown) and at least one surgical staple or surgical fastener. The tool is operably supported on a driver assembly 5060 that is movably supported within the body 5122 of the fastener cartridge assembly 5120.

Each fastener cavity 5040 includes two cavity ends 5042, 5044. Each cavity end 5042 is positioned on a first circular axis "FCA" with a first radius "FR". The first radius "FR" can be measured from the instrument shaft axis "SA". Each cavity end 5044 is positioned on a second circular axis "SCA" having a second radius "SR" different from the first radius "FR". In the illustrated embodiment, the second radius "SR" also measured from the shaft axis "SA" is larger than the first radius "FR". Each fastener cavity 5040 includes a cavity axis "CA". In an exemplary embodiment, each fastener cavity 5040 is located within a circular deck 5130 with respect to a first circular axis "FCA" and a second circular axis "SCA", respectively, with respect to the cavity axis "CA". Is formed at an acute angle with the first circular axis "FCA" and the second circular axis "SCA". In other words, the cavity ends 5042 of the adjacent fastener cavities 5040 are adjacent to each other, and the ends 5044 of the same fastener cavity 5040 are separated from each other. Such an arrangement is sometimes referred to herein as a "zigza" orientation. However, in other arrangements, the cavity axis "CA" can be perpendicular to the first and second circular axes "FCA", "SCA".

Also, in the arrangement illustrated in FIG. 30, the cavity ends 5042, 5044 may be V-shaped so as to be totally terminated at a point. For example, each cavity end 5042 may terminate at point 5043 overall, and each end 5044 may terminate at point 5045 overall. Point 5043 may be positioned on the first circular axis "FCA" or intersect the first circular axis "FCA", and point 5045 may be located on the second circular axis "SCA". It can be positioned or intersect the second circular axis "SCA". Such cavity placement results in the application of surgical staples or fasteners in a tissue-like pattern. Also, in an exemplary arrangement, the second ring 5160 includes a plurality of second fastener cavities 5170 aligned on a third circular axis "TCA", which is a third circular axis "TCA". , Arranged at a third radius "TR" from the shaft axis "SA". In the illustrated arrangement, the third radius "TR" is less than the first and second radii. However, in other arrangements, the third radius "TR" is larger than the first radius. However, in a further arrangement, the third radius "TR" is larger than the first and second radii.

The unique and novel fastener cartridge assembly 5120 serves to orient the staples or fasteners within the tissue so that the staples or fasteners are "adjustable" to the amount of expansion applied to the staple wire. .. Surgical staples that can be used include, for example, two staple legs extending from the central body portion or crown. When the leg is ejected from the cavity, the leg is in any case the first circular axis "FCA", the second circular axis "SCA", or the third circular axis "SCA". It may be received within the V-shaped end of the fastener cavity so that it extends through the "TCA". These staple orientations can result in amelioration of the problems associated with staple stenosis discussed above. For example, one ring of staples or fasteners (eg, second ring 5160) provides a standard sealing mechanism, the first ring 5036 is a radial and flexible aspect of the staple wire. Can be aligned towards. Therefore, such an arrangement may also provide the same or similar advantages discussed above with respect to the fastener cartridge assembly 5020.

FIG. 31 shows another unique and novel fastener cartridge assembly 5220 that can address the various issues and concerns mentioned above. As can be seen in the figure, the fastener cavities are arranged in an "asymmetric pattern" and the staples applied through the inner ring of the cavity are staples or fasteners applied through the outer ring of the cavity. It functions differently from the staples.

More specifically and with reference to FIG. 31, the fastener cartridge assembly 5220 includes a cartridge body 5222 that includes a circular deck 5230. The circular deck 5230 may form a plane 5232, which is arranged such that the anvil shaft 5016 faces the stapled bottom surface 5005 of the anvil 5004 when attached to the trocar shaft 5050. A first ring 5236 of the first cavity 5240 is provided in the circular deck 5230, and a second ring 5260 of the second cavity 5270 is provided via the cartridge deck 5230 as shown. Each of the first and second cavities 5240, 5270 is configured to internally receive at least one surgical staple or surgical fastener (not shown) and at least one surgical staple or surgical fastener. The tool is operably supported on a driver assembly 5060 that is movably supported within the body 5222 of the fastener cartridge assembly 5220.

Each fastener cavity 5240 includes two cavity ends 5242, 5244. Each cavity end 5242 is positioned on a first circular axis "FCA" with a first radius "FR". The first radius "FR" can be measured from the instrument shaft axis "SA". Each cavity end 5244 is positioned on a second circular axis "SCA" having a second radius "SR" different from the first radius "FR". In the illustrated embodiment, the second radius "SR" also measured from the shaft axis "SA" is larger than the first radius "FR". Each fastener cavity 5240 includes a cavity axis "CA". In an exemplary embodiment, each fastener cavity 5240 is located within a circular deck 5230 with respect to a first circular axis "FCA" and a second circular axis "SCA", respectively, with respect to the cavity axis "CA". Is formed at an acute angle with the first circular axis "FCA" and the second circular axis "SCA".

Further, in the arrangement illustrated in FIG. 31, the cavity ends 5242 and 5244 may be V-shaped so as to be totally terminated at a point. For example, each cavity end 5242 may terminate at point 5243 overall, and each end 5244 may terminate at point 5245 overall. Point 5243 may be positioned on the first circular axis "FCA" or intersect the first circular axis "FCA", and point 5245 may be located on the second circular axis "SCA". It can be positioned or intersect the second circular axis "SCA". Such cavity placement results in the application of surgical staples or fasteners in a tissue-like pattern. Also, in an exemplary arrangement, the second ring 5260 includes a plurality of second fastener cavities 5270 aligned on a third circular axis "TCA", which is a third circular axis "TCA". , Arranged at a third radius "TR" from the shaft axis "SA". In the illustrated arrangement, the third radius "TR" is less than the first and second radii. However, in other arrangements, the third radius "TR" is larger than the first radius. However, in a further arrangement, the third radius "TR" is larger than the first and second radii. These staple orientations can result in amelioration of the problems associated with staple stenosis discussed above. In particular, the staple configuration formed when using the fastener cartridge assembly 5220 may allow the staple wire to expand and bend like a natural large intestine rather than a general staple wire. For example, staples or fasteners can be twisted when the staples or fasteners are pulled radially, and staples or fasteners minimize stress on the healing zone for maximum flexibility and strength. Can be.

Auxiliary thin film / buttress materials have been shown to improve hemostasis and pulmonary blood flow arrest (pneumostasis) by sealing around the staple tip. Buttress materials are used in many applications to harden and / or reinforce soft tissues. Various buttress material arrangements have been developed and configured for the arrangement of surgical staple cartridges or surgical staple fastening devices on anvils. It can be difficult to attach the buttress member to the cartridge or anvil and then release the buttress material from it. FIG. 58 illustrates each part of the surgical end effector 5300 and the surgical cutting and fastening instrument 5400. The end effector 5300 uses a unique and novel arrangement in which the buttress member 5500 is attached to and released from the surgical staple cartridge 5320. Examples of the types of surgical cutting and fastening instruments shown in FIG. 58 are disclosed in U.S. Patent Application No. 14 / 318,991, filed June 30, 2014, entitled "SURGICAL FASTENEER CARTRIDGES WITH DRIVER STABILIZING ARRANGEMENTS". And this entire disclosure is incorporated herein by reference. Further details beyond what is needed to understand the configuration and use of the End Effector 5300 can be obtained by reference to that document and a number of other documents incorporated into that document by reference. Can be done.

As can be seen in FIG. 58, the end effector 5300 shown therein includes an elongated staple channel 5302 configured to operably support the staple cartridge 5320 internally. The elongated staple channel 5302 is coupled to the spinal section 5404 operably supported within the elongated shaft assembly 5402 of the surgical staple fastener 5400. The staple cartridge 5320 includes a cartridge body 5322 that can be made from a polymeric material. In an exemplary embodiment, a metal bottom tray 5324 is attached to the cartridge body 5322. The cartridge body 5322 includes a deck 5330 having a plurality of staple cavities 5332 defined therein. Each staple cavity 5332 is configured to retract the staples internally. The cartridge body 5322 further includes a longitudinal slot configured to removably receive the launch member 5410 internally. The cartridge body 5320 may further comprise a distal end 5326, a proximal end 5328, and an opposing longitudinal side surface 5329 extending between the distal end 5326 and the proximal end 5328. In various embodiments, each longitudinal side surface 5329 may include adjacent or continuous edges with no internally defined breaks.

Located within each staple cavity 5332 are staples 5342, which are supported on the corresponding staple driver 5340 and the corresponding staple driver 5340 is movably supported within the cartridge body 5322. The staple driver 5340 is lifted upward as the launch member 5410 is driven distally via the staple cartridge 5320. As discussed in more detail in U.S. Patent Application No. 14 / 318,991, the launcher 5410 advances the staple thread 5350 distally, moving the staple driver 5340 and staple 5342 upwards and the staple cavity 5332. It is configured to be lifted out of. The end effector 5300 further includes an anvil 5360 mounted on an elongated staple channel 5302. In an exemplary embodiment, the anvil 5360 comprises a pair of trunnions 5362 that are movably received within the trunnion slot 5304 of the elongated staple channel 5302. As further seen in FIG. 58, the anvil 5360 includes an anvil tab 5364 that interacts with the closed tube segment 5420. The movement of the closed tube segment 5420 in the distal "DD" direction can move the anvil 5360 towards the staple cartridge 5320. Due to the movement of the closure tube 5420 in the proximal direction "PD", the anvil separates from the staple cartridge 5320. In other embodiments, an arrangement of cartridges and anvils can be used, the anvils are stationary (eg, non-movably attached to the elongated shaft of the surgical device), elongated channels and / or staple cartridges Can move towards and away from the anvil.

As can be seen in FIGS. 58 and 59, the buttress member 5500 is configured to be accepted between the surgical staple cartridge 5320 and the anvil 5360. More precisely, the buttress member 5500 is configured to be received between the stapled lower surface 5366 of the anvil 5360 and the deck 5330 of the staple cartridge 5320. In an exemplary embodiment, the buttress member 5500 is configured to be tension-mounted on the deck 5330 of the staple cartridge 5320. Buttress materials, including the buttress member 5500, may include, for example, materials made by Gore SeaM Guard, materials made by Synovis peri-Strips, and / or polyurethane. Other suitable buttress or auxiliary materials are disclosed in U.S. Patent Application No. 14 / 318,991 filed June 30, 2014, entitled "SURGICAL FASTENEER CARTRIDGES WITH DRIVER STABILIZING ARRANGEMENTS", and the entire disclosure. Is incorporated earlier herein by reference. A variety of other suitable buttress or auxiliary materials are also disclosed in US Patent Application No. 13 / 763,095, entitled "LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES," filed February 28, 2013. The entire disclosure of is incorporated herein by reference. US Patent Application No. 13 / 531,619 filed June 25, 2012, title "TISSUE STAPLER HAVING A THICKNESS COMPENSATOR COMPRISING INCORPORATING A HEMOSTATIC AGENT", Japanese Patent Application 13/53, June 25, 2012 No. 623, title "TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORATING AN OXYGEN GENERATING AGENT" US, US patent application No. 13 / 531,627 filed on June 25, 2012, title "TISSUE STAPLER HAVING A TISPENTATER MICROBIAL AGENT ”, and US Patent Application No. 13 / 531,630 filed June 25, 2012, entitled“ TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORATING AN ANTI-INFLAMMATORY AGENT Be incorporated.

In an exemplary embodiment, the staple cartridge 5320 extends upward from the deck 5330 adjacent to each staple cavity 5332 in various ways and arrangements as described in detail in US Patent Application No. 14 / 318,991. Includes protrusion 5336. In other embodiments, the staple cartridge does not have such a protrusion. In an exemplary embodiment, the buttress member 5500 internally comprises a hole 5502 corresponding to a protrusion 5336. See, for example, FIGS. 61 and 62. However, as can be seen in those figures, the hole 5502 only adapts to the protrusion 5336 such that the buttress material spans at least each portion of the crown of the staples supported within the cavity. Those portions of the buttress material corresponding to the staple crown portions are generally identified as 5504 in FIGS. 61 and 62.

The buttress member 5500 is such that the buttress member 5500 is held under tension prior to activation of the surgical instrument and then released from the cartridge body 5322 when the surgical instrument is activated, i.e. "fired". , Includes means for releasably fixing the buttress member 5500 to the cartridge body 5322. For example, as can be seen in FIG. 58, the buttress member 5500 includes a distal end 5503 having at least one distal holding mechanism 5506 inside. In the illustrated arrangement, the two distal holes 5506 are provided at the distal end 5503 and are configured to receive the corresponding holding member 5338 projecting from the distal end 5326 of the cartridge body 5322. As shown in FIGS. 59 and 60, the holding member 5338 is distant from the distal end portion 5503 of the buttress member 5500 in order to releasably hold the distal end of the buttress member 5500 to the distal end portion 5326 of the cartridge 5320. It is configured to be received within the buttress 5506. Other forms of releasable holding members (shape, number, size, configuration) and arrangement also attach the buttress member 5500 to the staple cartridge 5320 when tension is applied to the buttress member 5500 proximally and / or distally. Can be used to hold releasably.

Referring to FIGS. 63-65, the buttress member 5500 includes a proximal end portion 5510 having a proximal holding mechanism 5511 on it. In an exemplary embodiment, the proximal holding mechanism 5511 comprises at least one holding tab 5512 projecting proximally from it. The holding tab 5512 is such that the holding tab 5512 is aligned with the elongated slot 5334 in the cartridge body 5322 when the hole 5506 is inserted above the holding member 5338 into the cartridge body 5322 and the buttress member 5500 is received by the cartridge deck 5330. Located in. See FIG. 64. The retaining tab 5512 is folded over the proximal end of the cartridge body by the staple thread 5350 and held in the elongated slot 5334 when the staple thread 5350 is in the proximal starting position within the cartridge 5320. The staple thread 5350 may be of the form and structure disclosed in US Pat. No. 14,318,991, the staple thread 5350 stabilizes the thread 5350, prevents the staple thread 5350 from swinging or rotating and / or. Includes a stabilizer 5352 extending distally to prevent. As can be seen in FIG. 65, the holding tab 5512 is held in the elongated slot 5534 by the stabilizing member 5352 and / or the other portion of the staple thread 5350. Such an arrangement serves to hold the buttress member 5500 under tension on the staple deck 5330. In other words, the buttress member 5500 can be extended between the holding member 5338 and the proximal end 5328 of the staple cartridge 5320. When the clinician activates the surgical instrument to initiate the launch process, the launch member 5410 is advanced distally in the distal "DD" direction. The launching member 5410 interlocks with the staple thread 5350 and, as discussed in US Patent Application No. 14 / 318,991, the launching member 5410 moves the staple thread 5350 distally through the staple cartridge 5320. , The staple driver 5340 was driven upward and the staple 5342 supported on it was driven to form contact with the lower 5366 of the anvil 5360 and clamped between the anvil 5360 and the staple cartridge 5320. The tissue is cut by the cutting member 5410. Once the staple thread 5350 has moved and disengaged from engagement with the retaining tab 5512, the retaining tab 5512 is released and the buttress material 5500 can be released from the staple cartridge 5320 with the stapled tissue. Such an arrangement serves to release the tension of the buttress material 5500 at the beginning of the firing process. Moreover, such a buttress arrangement does not require any additional release parts or configurations.

Existing stapled techniques are not particularly suitable for use in tissues that undergo stretching during the healing process. For example, in thoracic parenchymal staples, the staples are fired into the lungs in a folded configuration. After the procedure is complete, the lungs swell, which often results in doubling the surface area of the lungs. Existing stapled techniques generally do not have the ability to stretch as much as lung tissue. This can result in a dramatic strain gradient in the immediate vicinity of the staple line, which can result in high stresses within the staple line, especially within the row of staples farthest from the cut. Therefore, there is a need for techniques that allow staple wires to stretch and / or increase in length to remove strain gradients and associated stresses to eliminate or at least reduce potential sources of air leakage. To do
Auxiliary thin film / buttress materials have been shown to improve hemostasis and pulmonary blood flow arrest (pneumostasis) by sealing around the staple tip. In many applications, buttress materials are used to cure and / or reinforce soft tissues. However, existing buttress materials may not be sufficiently elastic so as not to interfere with the adaptability of the elastic staple wire. Figures 66-68 illustrate one form of the buttress material 6100 that can address such issues. As can be seen in those figures, the buttress material 6100 includes a buttress body 6102 that is sized to be operably received by deck 6004 of the surgical staple cartridge 6000. In an exemplary embodiment, the surgical staple cartridge 6000 includes a cartridge body 6002 that defines the deck 6004. The cartridge body 6002 includes a centrally located elongated slot 6006 configured to receive a tissue cutting member (not shown) through it. A plurality of staple pockets, or staple cavities, are provided in the deck 6004 on each side of the elongated slot 6006. As shown, a first cavity 6012 in the first row 6010 is provided on each side of the elongated slot 6006. The first cavities 6012 in each first row 6010 are parallel to each other. Each of the first cavities 6012 is arranged at an angle to the elongated slot 6006 and is adjacent to it. The illustrated cartridge body 6002 further includes two rows 6020 of second staple cavities 6022 arranged at an angle to the first staple cavities 6012. Two rows 6030 of the third staple cavity 6032 are also provided within the cartridge body 6002 as shown. In at least one form, the third staple cavity 6032 is parallel to the corresponding first staple cavity 6012. However, other staple or fastener cavity arrangements can be used. Further, the staple cartridge body 6002 may have a lateral bulge 6008 projecting laterally from it. As can be seen in FIG. 66, the proximal end 6003 of the cartridge body 6002 is narrower than the rest of the cartridge body 6002.

In an exemplary embodiment, the buttress body 6102 includes four edges 6110, 6140, 6150, 6160, and a central portion 6152. At least two of the edges 6110, 6140, 6150, 6160 include various edge notch configurations. In an exemplary embodiment, the edges 6110, 6160 include an edge notch internally. More specifically, as can be seen in FIG. 67, a plurality of first edge notches 6114 are formed within the first portion 6112 of the first edge 6110. In an exemplary embodiment, the first edge notch 6114 extends inward from the first edge portion 6112 at a first acute angle 6115 (“notch angle”) and is parallel to each other. As further seen in FIGS. 66 and 67, the second edge notch 6118 extends inward from the second portion 6116 of the first edge portion 6112. In one arrangement, for example, the second edge notch 6118 extends inward vertically (“notch angle”) from the second portion 6116. As further seen in FIGS. 66 and 67, the third edge notch 6122 extends inward from the third portion 6120 of the first edge portion 6110. In one arrangement, for example, the third edge notch 6122 extends inward vertically (“notch angle”) from the third portion 6120. As further seen in FIGS. 66 and 67, the fourth edge notch 6126 extends inward from the fourth portion 6124 of the first edge portion 6110. In one arrangement, for example, the fourth edge notch 6126 extends inward at an acute angle (“notch angle”) from the fourth portion 6124. As further seen in FIGS. 66 and 67, the fifth edge notch 6130 extends inward from the fifth portion 6128 of the first edge portion 6110. In one arrangement, for example, the fifth edge notch 6130 extends inward at an acute angle (“notch angle”) from the fifth portion 6128.

Still referring to FIGS. 66 and 67, a series of primary edge notches 6164 extend inward from the primary portion 6162 of the second edge portion 6160. In the illustrated arrangement, the primary edge notch 6164 extends inward vertically (“notch angle”) from the primary edge portion 6162. As further seen in FIGS. 66 and 67, the secondary edge notch 6168 extends inward from the secondary portion 6166 of the second edge 6160. In one arrangement, for example, the secondary edge notch 6168 extends inward at an acute angle (“notch angle”) from the secondary edge portion 6166. As further seen in FIGS. 66 and 67, the tertiary edge notch 6172 extends inward from the next portion 6170 of the second edge 6160. In one arrangement, for example, the next edge notch 6172 extends inward at an acute angle (“notch angle”) from the next portion 6170. As further seen in FIGS. 66 and 67, the quartic edge notch 6176 extends inward from the quartic portion 6174 of the second edge 6160. In one arrangement, for example, the quartic edge notch 6176 extends inward vertically (“notch angle”) from the quartic portion 6174. As further seen in FIGS. 66 and 67, the quintic edge notch 6180 extends inward from the quintic portion 6178 of the second edge portion 6160. In one arrangement, for example, the quintic edge notch 6180 extends inward vertically (“notch angle”) from the quintic portion 6178.

The buttress material 6100 illustrated in FIGS. 66 and 67 also has five different widths, Wl, W2, W3, W4, W5, along the entire length of the buttress 6100. W1 corresponds to the edge portions 6112 and 6162. W2 corresponds to the edge portions 6116 and 6166. W3 corresponds to the edge portions 6120 and 6170. W4 corresponds to the edge portions 6124, 6174. W5 corresponds to the edge portions 6128, 6178. Other buttress material embodiments may have a constant width or a different number of widths to facilitate working support on staple cartridges and / or anvils of surgical staple fasteners. In addition, the number, shape, size, and placement of edge notches can vary from embodiment to embodiment.

In the embodiments shown in FIGS. 66 and 67, the buttress material 6100 includes a plurality of cutout openings therein. As can be seen in those figures, the cutouts are arranged in parallel rows. In particular, the cutouts 6204 in the rows 6200 are provided with slits that are arranged at an angle to the edges so that the cutouts 6204 in each row 6200 are parallel to each other. The cutout 6204 may or may not extend completely through the buttress material 6100. Similarly, the cutout portion 6206 of the row 6202 is provided with a lateral slit perpendicular to the edge portion of the buttress material 6100. The cutout 6206 may or may not extend completely through the buttress material 6100. In other embodiments, the number, shape, size, orientation, spacing, depth, and location of such cutouts can vary.

FIG. 68 illustrates the arrangement of one cutout, where the staple cavity positions 6012, 6022, and 6032 are shown by dashed lines. As can be seen in the figure, any portion of any cutout 6204, 6206 of the staple cavity 6012, 6022, 6032 when the buttress material 6100 is aligned and positioned on the deck 6004 of the surgical staple cartridge 6000. Not positioned above any one. FIG. 69 illustrates a similar buttress material arrangement, with staple cavities 6012, 6022, and 6032 shown by dashed lines. Part 6103 of the buttress material 6100'where the staple / fastener legs will eventually penetrate is also shown by the dashed line. Part 6103 may also be referred to herein as a "staple penetration zone." As can be seen in the figure, none of the optional cutouts 6208, 6209 is located above the staple penetration zone 6103. The cutouts 6208 and 6209 are arranged in a longitudinal row of buttress material 6100'. The cutouts 6208 in each row are substantially parallel to each other and are arranged at an acute angle to the edge of the buttress material 6100'. Similarly, the cutouts 6209 in each row are arranged so that they are substantially parallel to each other and the cutouts 6209 are perpendicular to the cutouts 6208 in the adjacent row. The cutout 6208 may or may not extend completely through the buttress material 6100'. As can also be seen in FIG. 69, an entire row of cutouts 6208 is located between the fastener cavity 6032 and the buttress material 6100'edge to facilitate further flexibility of the buttress material 6100'. To do. As with other embodiments, the number, shape, size, orientation, spacing, depth, and location of such cutouts can vary.

FIG. 70 shows another buttress member embodiment 6100 ″. In this embodiment, the buttress material comprises a plurality of edge notches 6300 including a rugged wavy curve forming a meandering edge. Such edge notches / meandering edges allow the staples to rotate while reducing material stress during elongation.

Figures 71 and 72 exemplify another buttress member 6400 made from a woven fabric material that may or may not be bioabsorbable. In addition, the buttress material may include any of the buttress materials described herein, including unique and novel attributes described below. For example, the buttress member 6400 is a correspondingly molded portion of a surgical staple cartridge or anvil (eg, a strut) to support the buttress member 6400 in the desired orientation / alignment with respect to the staples / fasteners in the staple cartridge. , Projections, etc.) and through which holes or openings 6402 may be included. In an exemplary arrangement, the buttress member 6400 is located internally for alignment with the corresponding 6012, 6022, 6032 fastener cavities in the surgical staple cartridge when the buttress member 6400 is supported on the carriage deck. Includes staple zones 6404, 6406, 6408. Staple zones can be formed by compressing and heating the material in order to allow the material to remain in a compressed state permanently. As can be seen in FIG. 72, the compressed staple region (generally represented as 6410) has a smaller cross-sectional thickness than the adjacent uncompressed portion of the buttress member 6400 (generally represented as 6412). In addition, the buttress member 6400 may have linear edges 6420, 6422, 6424 and / or meandering edges 6426. The buttress member may have a shape that matches the shape of the surgical staple cartridge and / or anvil of the surgical instrument.

All of the aforementioned buttress member embodiments can be used on the deck of surgical staple cartridges or in connection with the anvil of surgical staple fastening devices. All buttress members can have a shape that matches the shape of the surgical staple cartridge and / or anvil, with straight or linear edges or edges and / or wavy, serrated, and / or. It may have serpentine edges or a combination of such edge configurations. Buttress members can have a constant width or can have multiple widths. The cutout through the buttress material removes excess material to promote or allow deformation, twisting, etc. of the buttress as less stress is passed through the buttress material during longitudinal extension. In other words, the cutout allows the buttress to "accordion act" as if the staples themselves were in motion. The meandering or irregular edges allow the staples to rotate and at the same time reduce the stress on the material during elongation. The buttress configuration described above allows for increased extensibility, while at the same time providing a "softening structure" that still seals the relevant area. Further, the buttress member described above not only does not suppress staple twisting, but also allows the staple and auxiliary agent (buttress) to move in the same manner when stretched. Such a buttress member arrangement includes a buttress member that essentially comprises a range of various mechanical behaviors that allow optimum performance of the staple wire.

FIGS. 73-78 exemplify another staple cartridge 6500 having a structure similar to that of the staple cartridge 6000 described above, except that the staple cartridge 6500 additionally includes a plurality of protrusions. In an exemplary embodiment, the surgical staple cartridge 6500 includes a cartridge body 6502 defining a deck 6504. The cartridge body 6502 includes a centrally located elongated slot 6506 mounted within the bottom tray 6524 and configured to receive a tissue cutting member (not shown) through it. Multiple staple pockets, or staple cavities, are provided within the deck 6504 on each side of the elongated slot 6506. As shown, a first cavity 6512 in the first row 6510 is provided on each side of the elongated slot 6506. The first cavities 6512 in each first row 6510 are parallel to each other. Each of the first cavities 6512 is arranged at an angle to the elongated slot 6506 and is adjacent to it. The illustrated cartridge body 6502 further includes a second staple cavity 6522 in two rows 6520 arranged at an angle to the first staple cavity 6512. A third staple cavity 6532 in two rows 6530 is also provided within the cartridge body as shown. In at least one form, the third staple cavity 6532 is parallel to the corresponding first staple cavity 6512. The cartridge body 6502 further has two longitudinal side surfaces 6508.

The cartridge body 6502 can further include a plurality of protrusions 6550 extending from the deck surface 6504. The protrusion 6550 can be configured to engage the tissue positioned midway between the anvil 5360 and the cartridge 6500 to control the movement of the tissue with respect to the cartridge 6500. The tissue can be moved relative to the cartridge 6500 in various examples. In at least one embodiment, the tissue can flow relative to the cartridge 6500 as the anvil is moved between the open position and the closed position where the tissue is squeezed between the anvil and the cartridge 6500. .. In such an example, the tissue may flow laterally towards the longitudinal flank 6508, distally towards the distal end 6503 and / or proximally towards the proximal end 6505. In at least one other embodiment, the tissue can flow relative to the cartridge 6500 as the cutting member is advanced distally through the tissue captured between the anvil and the cartridge 6500. In such an example, the tissue can flow laterally, distally and / or proximally, but primarily due to the distal movement of the cutting edge. In various embodiments, the overhang 6550 can be configured to limit or prevent the flow of tissue to the staple cartridge. The protrusion 6550 can be positioned at the proximal and / or distal end of the staple cavities 6512, 6522, 6532. In various embodiments, each overhang 6550 may include a cuff extending around the ends of the corresponding staple cavities 6512, 6522, and 6532. In a particular embodiment, each protrusion 6550 may include a bow-shaped ridge extending around the ends of the corresponding staple cavities 6512, 6522, and 6532.

Figures 76-78 illustrate a cartridge arrangement that includes a protrusion 6550. The cartridge arrangement shown in FIGS. 73-75 is similar to the cartridges in FIGS. 76-78, but also includes a row of projecting columns 6560 formed on the deck surface 6504. In the arrangement of FIGS. 73-75, for example, projecting stanchions 6560 are provided between the respective staple cavities 6512, 6522, and 6532 within each row of staple cavities. The overhang struts 6560 serve to further control the flow of tissue during the clamping and reflection process.

Primarily with reference to FIG. 73, the cartridge body 6502 includes an inclined transition portion 6570 extending between the distal tip of the cartridge body 6502 and the deck surface 6504. The tilt transition portion 6570 facilitates movement of the cartridge 6500 with respect to tissue when positioning the cartridge 6500 and anvil within the surgical site. In such an example, the tissue can slide on an inclined surface 6570. In other arrangements, the inclined surface 6570 comprises an R surface. In the illustrated arrangement, the inclined surface 6570 comprises an angled surface. In other arrangements, the inclined surface 6570 includes a concave surface and / or a convex surface.

Staple cavities 6512, 6522, and 6532 defined within the cartridge body 6502 are arranged in a longitudinal row on each side of the longitudinal slot 6506. Each protrusion 6550 can be configured to support at least a portion of the staples 6542 that are detachably housed in the staple cavities 6512, 6522, and 6532. In various embodiments, the respective protrusions 6550 can extend the end walls 6513, 6515 of the staple cavities 6512, 6522 and 6532 above the deck 6504. In a particular embodiment, with reference to FIG. 78 as a whole, the staples 6542 positioned within the staple cavities 6512, 6522, 6532 are at the base 6543, a first leg extending from the base 6543 at a first angle. Includes 6545 and a second leg 6547 extending from the base 6543 at a second angle. The first leg 6545 can come into contact with the first end wall 6513 of the staple cavity 6532 and the second leg 6547 comes into contact with the second end wall 6515 of the staple cavities 6512, 6522, 6532. be able to. In a particular embodiment, the distance between the first leg 6545 and the second leg 6547 of the staple 6542, i.e., the spread, is when the stable 6542 is positioned within the staple cavities 6512, 6522, 6532. It may be wider than the distance between the end walls 6513, 6515 so that the legs 6545, 6547 are urged inward by the end walls 6513, 6515. When the staples 6542 are retracted into the staple cavities 6512, 6522, 6532 in an unlaunched or non-lifted position, the tips of the staple legs 6545, 6547 can be positioned within the protrusions 6550. In such an example, the protrusion 6550 can support and protect the tips of the staple legs 6545, 6547 above the deck 6504. In some embodiments, the tips of the staple legs 6545, 6547 may be positioned below the protrusion 6550 when the staple 6542 is in its unlaunched position, so the protrusion 6550 is such that the stable 6542 The tips of the staple legs 6545 and 6547 may not be supported when in the unlaunched position. When such staples 6542 are launched or lifted from the staple cavities 6512, 6522, 6532, the staple legs 6545, 6547 can then come into contact with the protrusions 6550 and be supported by the protrusions 6550. In either case, the protrusion 6550 fires sufficiently from the staple cavities 6512, 6522, 6532 so that the staple legs 6545, 6547 no longer contact the protrusion 6550 when the staple 6542 is deployed. And / or the staple legs 6545, 6547 can continue to be supported until lifted.

The layer can be made from any biocompatible material, for example a buttress material. Buttress materials can be formed from natural and / or synthetic materials. Buttress materials can be bioabsorbable and / or non-bioabsorbable. It should be understood that any combination of natural, synthetic, bioabsorbable, and non-bioabsorbable materials can be used to form buttress materials. Some non-limiting examples of materials from which batless materials can be made include, for example, poly (lactic acid), poly (glycolic acid), poly (hydroxybutyrate), poly (azine phosphate), polyester, polyethylene glycol. , Polyethylene oxide, polyacrylamide, polyhydroxyethylmethylacrylate, polyvinylpyrrolidone, polyvinyl alcohol, polyacrylic acid, polyacetate, polycaprolactone, polypropylene, aliphatic polyester, glycerol, poly (amino acid), copoly (ether ester), polyalkylene Examples include, but are limited to, oxalate, polyamide, poly (iminocarbonate), polyalkylene oxalate, polyoxaester, polyorthoester, polyphosphazene and copolymers, block copolymers, homopolymers, blends and / or combinations thereof. Not done.

Natural biopolymers can be used in forming buttress materials. Suitable natural biopolymers include, for example, collagen, gelatin, fibrin, fibrinogen, elastin, keratin, albumin, hydroxyethyl cellulose, cellulose, oxidized cellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethyl cellulose, chitan, chitosan. And / or combinations thereof, but are not limited to these. The natural biopolymer can be combined with any of the other polymeric materials described herein to produce a buttress material. Collagen of human and / or animal origin, such as type I porcine or bovine collagen, type I human collagen or type III human collagen, can be used to form the buttress material. Buttress materials can be made from denatured collagen, that is, collagen that has at least partially lost its helical structure by heating or any other method, consisting of, for example, non-hydrated chains having a molecular weight close to 100 kDa. The term "denatured collagen" means collagen that has lost its helical structure. The collagen used in the porous layer as described herein is natural collagen, or in particular, such as obtained through pepsin digestion and / or after moderate heating as defined above. It can be atelocollagen. Collagen can be pre-chemically modified by oxidation, methylation, succinylation, ethylation and / or any other known process.

If the buttress material is fibrous, the fiber can be a filament or thread suitable for knitting or weaving, or it can be a staple fiber, such as one often used to make non-woven materials. The fibers can be made from any biocompatible material. The fibers can be made from natural or synthetic materials. The material on which the fibers are formed can be bioabsorbable or non-bioabsorbable. It should be understood that any combination of natural, synthetic, bioabsorbable and non-bioabsorbable materials can be used to form fibers. Some non-limiting examples of materials from which fibers can be made include, for example, poly (lactic acid), poly (glycolic acid), poly (hydroxybutyrate), poly (azine phosphate), polyester, polyethylene glycol, etc. Polyethylene oxide, polyacrylamide, polyhydroxyethylmethylacrylate, polyvinylpyrrolidone, polyvinyl alcohol, polyacrylic acid, polyacetate, polycaprolactone, polypropylene, aliphatic polyester, glycerol, poly (amino acid), copoly (ether ester), polyalkylene oxa Examples include, but are limited to, latte, polyamide, poly (iminocarbonate), polyalkylene oxalate, polyoxaester, polyorthoester, polyphosphazene and copolymers, block copolymers, homopolymers, blends and / or combinations thereof. Not done. If the buttress material is fibrous, the buttress material can be formed using any method suitable for forming the fibrous structure, including but not limited to, for example, knitting, weaving, non-woven fabric techniques and the like. When the buttress material is foam, the porous layer is formed using any method suitable for the formation of foam or corpus cavernosum, including but not limited to, for example, lyophilization or lyophilization of the composition. Can be done.

Buttress materials can have the properties of congestion. Illustrative examples of materials that can be used to give buttless materials the ability to help stop bleeding or major bleeding include, for example, poly (lactic acid), poly (glycolic acid), poly (hydroxybutyrate), poly. (Caprolactone), poly (dioxanone), polyalkylene oxide, copoly (ether ester), collagen, gelatin, thrombin, fibrin, fibrinogen, fibronectin, elastin, albumin, hemoglobin, ovoalbumin, polysaccharides, hyaluronic acid, chondroitin sulfate, hydroxy Ethyl starch, hydroxyethyl cellulose, cellulose, oxidized cellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethyl cellulose, chitan, chitosan, agarose, maltose, maltodextrin, arginate, coagulation factor, methacrylic acid ester, polyurethane, cyanoacrylic acid, Platelet agonist, vasoconstrictor, myoban, calcium, RGD peptide, protein, protamine sulfate, epsilon aminocaproic acid, ferric sulfate, basic ferric sulfate, ferric chloride, zinc, zinc chloride, aluminum chloride, aluminum sulfate , Aluminum acetate, permanganate, tannin, osteowax, polyethylene glycol, fucan, and / or combinations thereof, but is not limited thereto. The use of natural biopolymers, and especially proteins, may be useful in forming buttress materials with congestive properties. For example, suitable natural biopolymers include, but are not limited to, collagen, gelatin, fibrin, fibrinogen, elastin, keratin, albumin, and / or combinations thereof. The natural biopolymer can be combined with any other hemostatic agent to produce a buttress porous layer. The entire disclosure of US Pat. No. 8,494,683, entitled "BUTTRESS AND SURGICAL STAPLING APPARATUS", issued July 30, 2013, is incorporated herein by reference.

All disclosures below are incorporated herein by reference.
US Pat. No. 5,403,312, issued April 4, 1995, entitled "ELECTROSURGICAL HEMOSTATIC DEVICE",
US Pat. No. 7,000,818 issued on February 21, 2006, entitled "SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS",
U.S. Pat. No. 7,422,139 issued on September 9, 2008, entitled "MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK",
U.S. Pat. No. 7,464,849, issued December 16, 2008, entitled "ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSE SYSTEM AND ANVIL ALIGNMENT COMPONENTS",
U.S. Pat. No. 7,670,334 issued on March 2, 2010, entitled "SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR",
U.S. Pat. No. 7,753,245 issued on July 13, 2010, entitled "SURGICAL STAPLING INSTRUMENTS",
US Pat. No. 8,393,514, issued March 12, 2013, entitled "SELECTIVELY ORIENTABLE IMPLANTABLE FASTENEER CARTRIDGE",
U.S. Patent Application No. 11 / 343,803, Title "SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES", now U.S. Pat. No. 7,845,537,
U.S. Patent Application No. 12/031573, filed February 14, 2008, entitled "SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES",
U.S. Patent Application No. 12 / 031,873, filed on February 15, 2008 and now U.S. Pat. No. 7,980,443, entitled "END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT",
U.S. Patent Application No. 12,235,782, currently U.S. Pat. No. 8,210,411, entitled "MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT",
U.S. Patent Application No. 12,249,117, now U.S. Pat. No. 8,608,045, entitled "POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM",
U.S. Patent Application No. 12 / 647,100 filed on December 24, 2009, entitled "MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTOROL ASSEMBLY", now U.S. Patent No. 8,220,68
U.S. Patent Application No. 12 / 893,461, filed September 29, 2012, now U.S. Pat. No. 8,733,613, entitled "STAPLE CARTRIDGE",
U.S. Patent Application No. 13 / 036,647, now filed on February 28, 2011, U.S. Pat. No. 8,561,870, entitled "SURGICAL STAPLING INSTRUMENT",
U.S. Patent Application No. 13 / 118,241, currently U.S. Patent Application Publication No. 2012/0298719, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEVLOYMENT ARRANGEMENTS",
US Patent Application No. 13 / 524,049, entitled "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE", filed June 15, 2012, now US Patent Application Publication No. 2013/0334278,
U.S. Patent Application No. 13 / 800,025 filed on March 13, 2013, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM",
US Patent Application No. 13 / 800,067, filed March 13, 2013, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM",
US Patent Application Publication No. 2007/017595, filed January 31, 2006, entitled "SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSE TRIGGER LOCKING MECHANISM",
US Patent Application Publication No. 2010/0264194, filed on April 22, 2010 and currently US Pat. No. 8,308,040, entitled "SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR".

Although various embodiments of the device have been described herein in connection with certain disclosed embodiments, many modifications and modifications can be made to those embodiments. Also, although the material is disclosed for a particular component, other materials may be used. Further, in various embodiments, a single component may be replaced by a plurality of components and a plurality of components may be replaced by a single component in order to perform a predetermined function or a plurality of functions. You may. The above description and the following claims are intended to include all such modifications and modifications.

The devices disclosed herein may be designed to be discarded after a single use, or may be designed to be used multiple times. However, in either case, the device can be readjusted for reuse after at least one use. The readjustment can include any combination of disassembling the device, followed by a cleaning or replacement step of a particular part, and subsequent reassembly steps. In particular, the device is disassembleable and any number of specific parts or parts of the device can be selectively replaced or removed in any combination. Once a particular part has been cleaned and / or replaced, the device can be reassembled for later use, either at a readjustment facility or by the surgical team shortly before the surgical procedure. Those skilled in the art will appreciate that readjustment of the equipment can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques and the resulting readjustment device are all within the scope of the present invention.

Preferably, the inventions described herein will be processed prior to surgery. First, get new or used equipment and clean it if necessary. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic bag or TYVEK bag. The container and equipment are then placed in a radiation field that can penetrate the container, such as gamma rays, X-rays, and high energy electrons. Radiation kills bacteria on instruments or in containers. The sterilized instrument can then be stored in a sterilized container. The sealed container keeps the instrument sterile until it is opened in a medical device.

Although the present invention has been described as having a representative design, the present invention may be further modified within the spirit and scope of the present disclosure. Accordingly, this application shall include any modification, use, or adaptation of the invention that uses its general principles. In addition, the present application shall include such deviations from the present disclosure as being known or customary in the field in which the invention relates.

Any patent, publication or other disclosure allegedly incorporated herein by reference, in whole or in part, has any incorporated content set forth in the existing definition, description, or disclosure. It is incorporated herein only to the extent that it is consistent with the disclosure of. As such, and to the extent necessary, the disclosures expressly set forth herein shall supersede any contradictory statements incorporated herein by reference. Any document, or portion thereof, which is incorporated herein by reference but is inconsistent with existing definitions, descriptions, or other disclosed documents described herein, is incorporated into the reference and existing disclosure. It shall be incorporated only to the extent that there is no contradiction with the content.

[Implementation]
(1) Staple cartridge,
Cartridge body and
A plurality of staples removably positioned within the cartridge body,
A driver movably positioned relative to the cartridge body, including a plurality of troughs, each of which is
The first end and
The second end and
A driver and a driver, including a trough axis extending between the first end and the second end.
A staple cartridge comprising a thread that is configured to travel along a launch path that at least partially passes through the cartridge body, the launch path that traverses at least one of the trough axes. ..
(2) The staple cartridge according to the first embodiment, wherein each of the troughs is aligned with one of the staples.
(3) The staple cartridge according to embodiment 1, wherein at least one of the trough axes is substantially parallel to the launch path.
(4) The plurality of troughs
The first trough and
The staple cartridge according to embodiment 1, wherein the trough axis of the first trough is a second trough, comprising a second trough that crosses the trough axis of the second trough.
(5) The driver is
A first step having a first height, wherein the first trough is defined in the first step, and the first step.
A second step having a second height, wherein the second height is different from the first height, and the second trough is defined within the second step. The staple cartridge according to embodiment 4, further comprising a second stage.

(6) The staple cartridge according to the fifth embodiment, wherein the driver further includes a flange connecting the first stage and the second stage.
(7) The fourth embodiment, wherein the plurality of troughs further include a third trough, and the trough axis of the third trough is substantially parallel to the trough axis of the first trough. Staple cartridge.
(8) The staple cartridge according to the fourth embodiment, wherein the trough axis of the first trough is substantially perpendicular to the trough axis of the second trough.
(9) Staple cartridge
A cartridge body that includes a deck, with longitudinal slots defined at least partially through the cartridge body, a plurality of staple cavities defined within the cartridge body, and the plurality of staple cavities.
A first staple cavity including a first opening in the deck on the first side of the longitudinal slot, and
A cartridge body comprising a second staple cavity including a second opening in the deck on the first side of the longitudinal slot.
Multiple staples
A first staple that is detachably positioned within the first staple cavity and includes a first base.
A plurality of staples, including a second staple, which is a second staple detachably positioned within the second staple cavity and includes a second base.
A driver that is movably positioned with respect to the cartridge body.
A first trough, wherein the first base is aligned with the first trough.
A second trough, wherein the second base is aligned with the second trough, and the second trough is angularly oriented with respect to the first trough. , Including, driver, and, including, staple cartridge.
(10) Each opening
The first end and
The second end and
An axis extending between the first end and the second end, wherein the axis of the second opening crosses the axis of the first opening. The staple cartridge according to embodiment 9, further comprising.

(11) The staple cartridge according to the ninth embodiment, wherein the driver includes a single molded product.
(12) The staple cartridge according to embodiment 9, wherein the second trough is substantially perpendicular to the first trough.
(13) The driver
A first step having a first height, wherein the first trough is defined in the first step, and the first step.
A second step having a second height, wherein the second trough is defined within the second step, the second height being different from the first height. The second stage and
The staple cartridge according to embodiment 9, further comprising a first step and a flange connecting the second step.
(14) The thread further comprises a drive surface configured to move along the drive axis, the driver further includes a center of mass, and the drive axis passes through the center of mass. The staple cartridge according to embodiment 9, which is postponed.
(15) The driver further comprises a center of mass, the staple cartridge further comprises a thread, and the thread.
A first drive surface configured to move along the first drive axis,
A second drive surface configured to move along a second drive axis, wherein the second drive axis is substantially parallel to the first drive axis and is substantially parallel to the first drive axis. The staple cartridge according to embodiment 9, wherein the drive axis and the second drive axis include a second drive surface equidistant from the center of mass.

(16) The staple cartridge according to the fifteenth embodiment, wherein the first drive surface and the second drive surface are staggered in the longitudinal direction.
(17) The plurality of staple cavities further include a third staple cavity including the third opening on the first side of the longitudinal slot, and the plurality of staples are said to be the third staple cavity. It further comprises a third staple that is detachably positioned within, said third staple including a third base.
The driver further comprises a third trough, the third base being aligned with the third trough, and the third trough being angularly oriented with respect to the first trough. The staple cartridge according to aspect 9.
(18) The staple cartridge according to embodiment 17, wherein the third trough is substantially parallel to the second trough.
(19) Further comprising a separate driver including a third trough, the plurality of staples further comprising a third staple including a third base, the third base being the third trough and the like. The staple cartridge according to embodiment 9, wherein the third trough is aligned and angularly oriented with respect to the first trough.
(20) The staple cartridge according to embodiment 19, wherein the separated driver further comprises a fourth trough, wherein the fourth trough is substantially parallel to the first trough.

(21) The driver further comprises a first mass center, the separated driver further comprises a second mass center, the staple cartridge further comprises a thread, and the thread comprises.
A first drive surface configured to move along a first drive axis, wherein the first drive axis extends through the first center of mass. When,
A second drive surface configured to move along a second drive axis, wherein the second drive axis is substantially parallel to the first drive axis and is substantially parallel to the first drive axis. The staple cartridge according to embodiment 19, wherein the drive axis includes a second drive surface that extends through the second center of mass.
(22) The staple cartridge according to the twenty-first embodiment, wherein the first drive surface and the second drive surface are biased in the longitudinal direction.
(23) A staple cartridge
A cartridge body that includes a deck, with longitudinal slots defined at least partially through the cartridge body, a plurality of staple cavities defined within the cartridge body, and the plurality of staple cavities being the said. A cartridge body and a cartridge body comprising a staple cavity including an opening in the deck on the first side of the longitudinal slot, the opening being angularly oriented with respect to the longitudinal slot.
A staple that is removablely positioned within the staple cavity and includes a thread engaging surface that is configured to move from an unlaunched position to a post-launched position with respect to the cartridge body.
A thread that includes a staple engaging surface that is configured to move along the longitudinal slot that at least partially passes through the cartridge body, the staple engaging surface that pulls the staple from the unlaunched position. A staple cartridge comprising a thread, which is configured to engage directly with the thread engaging surface for movement to the post-launch position.
(24) The staple engaging surface includes a first staple engaging surface, the thread engaging surface includes a first thread engaging surface, and the staple further includes a second thread engaging surface. 23. The thread further comprises a second staple engaging surface, the second staple engaging surface being configured to engage the second thread engaging surface, according to embodiment 23. The listed staple cartridge.
(25) The staple cartridge according to embodiment 24, wherein the second staple engaging surface is deviated in the longitudinal direction from the first staple engaging surface.

(26) The staple cartridge according to embodiment 25, wherein the staple further includes a center of mass, and the first thread engaging surface and the second thread engaging surface are equidistant from the center of mass.
(27) The staple cartridge according to embodiment 23, wherein the staple further comprises a base, a notch is defined within the base, and the thread engaging surface extends along the notch.
(28) The staple cavity includes a first staple cavity, and the opening includes a first opening.
The plurality of staple cavities further include a second staple cavity including a second opening in the deck on the first side of the longitudinal slot, the second opening being said first. 23. The staple cartridge according to embodiment 23, which is angularly oriented with respect to the opening of the staple.
(29) The staple includes a first staple, and the first staple is
The first leg and
Including a first base having a first length,
The staple cartridge further comprises a second staple that is detachably positioned within the second staple cavity, the second staple.
The second leg and
28. The staple cartridge according to embodiment 28, which comprises a second base having a second length, wherein the second length is different from the first length, and includes a second base. ..
(30) The staple includes a first staple, and the staple engaging surface includes a first staple engaging surface.
The plurality of staple cavities further include a second staple cavity.
The staple cartridge further comprises a second staple detachably positioned in the second staple cavity, the second staple moving from an unlaunched position to a post-launched position with respect to the cartridge body. The second staple comprises a second thread engaging surface.
The thread has a second staple engagement surface configured to engage the second thread engagement surface in order to move the second staple from the unlaunched position to the post-launch position. 23. The staple cartridge according to embodiment 23, further comprising, wherein the second staple engaging surface is laterally offset from the first staple engaging surface.

Claims (6)

It ’s a staple cartridge,
Cartridge body and
A plurality of staples removably positioned within the cartridge body,
An integral driver movably positioned relative to the cartridge body, including a plurality of troughs, each of which is a trough.
The first end and
The second end and
A driver and a driver, including a trough axis extending between the first end and the second end.
A thread configured to travel along a firing path that at least partially passes through the cartridge body, the firing path comprising a thread that traverses at least one of the trough axes.
The plurality of troughs include a first trough and a second trough.
A staple cartridge in which the trough axis of the first trough is substantially perpendicular to the trough axis of the second trough . The staple cartridge according to claim 1, wherein each of the troughs is aligned with one of the staples. The staple cartridge of claim 1, wherein at least one of the trough axes is substantially parallel to the launch path. The driver
A first step having a first height, wherein the first trough is defined in the first step, and the first step.
A second step having a second height, wherein the second height is different from the first height, and the second trough is defined within the second step. further comprising a second stage, the staple cartridge according to claim 1. The staple cartridge according to claim 4 , wherein the driver further includes a flange connecting the first stage and the second stage. The staple cartridge according to claim 1 , wherein the plurality of troughs further include a third trough, and the trough axis of the third trough is substantially parallel to the trough axis of the first trough. ..

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