RU2488359C2 - Supporting material with activated binding substance - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine and can be applied for surgical suturing of tissues. In different versions of realisation product from supporting material can include means of fixation, which can be put into interaction with parts of working organ for carrying out fixation of product from supporting material with possibility of defixation, at least, to part of working organ. Working organ can include means intended for adhesion with parts of product from supporting material for fixation of product from supporting material with possibility of defixation to working organ. At least, in one version of realisation fixation to working organ can be carried out with possibility of defixiation of more than one product from supporting material.

EFFECT: product from supporting material and working organ of surgical instrument include means, which can assist surgeon in fast and proper fixation of product from supporting material to working organ.

10 cl, 63 dwg

Description

Technical field

The present invention generally relates to a supporting material for a surgical instrument, as well as to a supporting material, the properties of which allow it to be attached to the node of the working body of the surgical instrument with the possibility of release.

State of the art

A surgical instrument, such as, for example, a surgical stapler, may be designed to insert staples into tissue during surgery. In various versions of its implementation in practice, the surgical stapler may include a working body for installation at the far end of the surgical stapler. The working body can be made with the possibility of its placement (and at least partial advancement) inside the catheter or trocar installed in the wall of the patient’s body, so that the surgeon can use the working body to perform work in the surgical area. In various versions of its implementation in practice, the working body may comprise a first gripping element including a cassette with brackets and, in addition, a second gripping element including an anvil. The first and second gripping elements can be made with the possibility of moving in a direction closer to each other, to clamp between them the layers of fabric and apply compressive force to them. In at least one embodiment, in practice, the cassette with brackets may be designed to hold the brackets with the possibility of their removal, and the anvil may be designed to deform the brackets when they are installed from the cassette with brackets.

In some situations, the fabric layers may be relatively thin, have a high fluid content and / or have an uneven thickness, which can lead to improper placement of staples inside the fabric. To solve this problem, you can use the product from the supporting material to support the fabric while it is clamped and stapled. In at least one embodiment, in practice, an article of support material may be releasably attached to at least one of the following: first and second gripping elements before being introduced into the surgical area. In various embodiments, in practice, an article of support material can be used to distribute the compressive force applied by the anvil over the surface of this support material to create a more uniform distribution of the compressive load within the fabric. In at least one embodiment, a uniform distribution of the compressive load may increase the likelihood that the staples will be properly inserted into the fabric.

In various embodiments, in practice, the surgeon may have difficulty attaching the product from the supporting material to the gripping elements of the working body. In at least one embodiment, in practice, an article of support material can be attached to one of the gripping elements using a binder designed to release the article of reference material. In such an embodiment, in practice, the surgeon must carefully align the position of the support material with respect to the gripping element due to the ability of the binder to instantly attach the supporting material to the gripping element. Under such conditions, it may be necessary to remove the product from the support material from the gripping element and replace it with a new product from the support material. As a result, the surgeon can spend valuable time on positioning and aligning the product from the supporting material on the gripping element of the working body. Thus, there is a need for improvement over the prior art, which is described above.

SUMMARY OF THE INVENTION

According to at least one aspect of the present invention, an article of support material and / or a working body of a surgical instrument may include means that could assist a surgeon or other clinician in properly aligning and attaching an article of support material to a working body. In at least one embodiment of the present invention, the article of support material may include at least one element extending from it, and this element may be configured to engage with one of the cavities for the brackets formed in cassette with brackets, and / or with a recess formed in the anvil. In at least one such embodiment of the present invention, this element can be installed in the bracket cavity and / or recess in the anvil with landing due to friction and / or compression, in order to fix the article of the supporting material with the possibility of release, for example , in one of the following: a cassette with brackets or an anvil. In various embodiments of the present invention, in one of the following: a cassette with brackets and / or anvil can be formed a groove or groove, and the groove can be made in such a way as to take part of the product from the supporting material and to fix this product from the supporting material with the possibility of release . In at least one embodiment of the invention, the article of support material may have a protrusion extending from it, and the protrusion may be configured so that it can be released into contact with the channel of the cutting element formed in at least one from the following: cassette with brackets and anvil. In such an embodiment of the present invention, the protrusion can be installed in the channel, for example, with a fit due to compression, due to friction and / or otherwise be mated with the channel.

According to at least one aspect of the present invention, the article of support material and the working body may include means that work together, for example, collars, which make it possible to attach the product of the supporting material to the working body with a snap fit. In various embodiments, the working body may include elastic elements extending from it, and these elastic elements can be designed to contact with parts of the support material and to fix the supporting material in the working body with the possibility of release. In at least one embodiment of the present invention, one of the following: a cassette with brackets and an anvil may include a plurality of fixing elements, and parts of the support material can be mounted on the fixing elements with friction fit to fix the support material on a cassette with brackets and / or anvil with the possibility of release.

According to at least one aspect of the present invention, the article of support material can be releasably attached to the casing, and the casing can be made to slide at least one of the following: cassette with brackets and anvil of the working body . In at least one embodiment of the present invention, an article of support material may include a side portion adapted to be attached to the casing and, in addition, a main body adapted to engage with brackets when the brackets are mounted from the cassette with brackets . In such an embodiment of the present invention, the side portion can be used to release the main body to the casing. In at least one embodiment of the present invention, a recess or perforated hole can be created in the product from the support material between the side part and the main body, for example, so that the main body can be separated from the side part. In at least one embodiment of the present invention, as a result, a perforated hole and / or recess may make it possible to remove the casing from the supporting material after the brackets are installed in the main body.

According to at least one aspect of the present invention, it is possible to use packaging for an article of support material in order to quickly align and position the article of support material within a tool body. In various embodiments of the present invention, the package may include a first part, a second part, and an article of support material that can be releasably attached to the first part. In at least one embodiment of the present invention, the second part may be movable between a first position in which it is adjacent to an article of support material and a second position. In various embodiments of the present invention, the article of support material can be opened when the second part is in the second position, as a result of which the package can be positioned between the gripping elements of the open working body to engage the open part of the supporting material in engagement with one of the gripping elements of the working body. In various embodiments of the present invention, the support material may comprise a binder on the surface to fix the material to one of the gripping elements. After adhesion of the product from the supporting material to one of the gripping elements, the second part can be pulled away from the working body to release the first part from the product from the supporting material.

According to at least one aspect of the present invention, an article of support material can be attached to at least one of the following: an anvil and a cassette with staples of a working member. In various embodiments of the present invention, one or more holes or slots may be made in the anvil and / or cassette with brackets, which can be designed to receive one or more fasteners to fix the product of the supporting material on the anvil or cassette with brackets. In various embodiments of the present invention, the fasteners can be released from the holes in the anvil and / or cassette with brackets to make it possible to separate the product from the supporting material from the working body. The fasteners, in addition, can be made with the possibility of removal from the product of the supporting material and can consist of bioabsorbable material, as a result of which they can be absorbed by the patient’s body. In at least one embodiment of the present invention, the article of support material can be attached to the working body using one or more removable clamps.

According to at least one aspect of the present invention, an article of support material intended to be releasably attached to a working body may comprise an inactive binder. In various embodiments of the present invention, the surgeon can position and align the product from the supporting material on the working body many times without binding the inactive binder to the working body. Once the surgeon is satisfied with the orientation of the support material on the working body, he can then apply the reactant to the inactive binder. In various embodiments of the present invention, the reactant can activate an astringent and cause the release of the article of support material to bind to a part of the working body. In at least one embodiment of the invention, a recess may be provided in the article of support material to accommodate the applicator, whereby the deposition of the reactant on an inactive binder can be facilitated.

According to at least one aspect of the present invention, the working body may include a retractable locking element designed to fix the product of the supporting material on the working body. In various embodiments of the present invention, the locking element may be configured to move between a first or distant position and a second or proximal position. In at least one embodiment of the present invention, the flexible member may be engaged in engagement with the hand grip area during operation so that the surgeon can use this hand grip area to retract the flexible element relative to the working member. In various embodiments of the present invention, the flexible member may hold the article of support material in position while the brackets are mounted through this support material. In at least one embodiment of the present invention, the locking element can be retracted relative to the working body so that the supporting material can be disengaged from the working body and the working body can be removed from the surgical area.

Brief Description of the Drawings

The above and other distinguishing features and advantages of this invention, as well as the method for their achievement, will become more apparent and the invention itself will become more clear when considering the following description of the options for its implementation together with the accompanying drawings, of which:

Figure 1 is a General view of the node of the working body, designed to enter into the clutch, cutting, stapling and applying products from the supporting material to the fabric, according to one embodiment of the present invention, not limiting its scope;

Figure 2 is a General view of the node of the working body shown in Figure 1, after the working body is used for engaging, cutting, stapling and applying articles of supporting material to the fabric, according to one embodiment of the present invention, limiting its volume;

Figure 3 is a General view of the node of the working body attached to the distal end of the surgical instrument, according to one embodiment of the present invention, not limiting its scope;

Figure 4 is a General view of the node of the working body, including at least one product of the supporting material, where this node of the working body is in the open state, according to one embodiment of the present invention, not limiting its scope;

Figure 5 is a General view of the cartridge with brackets, which is part of the node of the working body shown in Figure 4, moreover, on this cartridge with the possibility of release fixed supporting material;

Fig.6 is a General view with a spatial separation of the parts of the cassette with brackets and supporting material shown in Fig.5;

Fig.7 is a General view of the connecting element intended for use with the node of the working body shown in Fig.4;

Fig.8 is a General view of the anvil, which is part of the node of the working body shown in Fig.4, and on the anvil with the possibility of release recorded at least one product from the supporting material;

Fig.9 is a side view of the connecting element shown in Fig.7;

Figure 10 is a General view with a spatial separation of the parts of the anvil and the supporting material shown in Fig;

11 is a General view of the cassette with brackets and anvils that are part of the node of the working body, with attached products from the supporting material, according to one embodiment of the present invention, not limiting its scope;

Fig is a General view with a spatial separation of the parts of the node of the working body, including a cassette with brackets and anvil, according to one embodiment of the present invention, not limiting its scope;

Fig.13 is a General view with a spatial separation of the parts of the node of the working body shown in Fig.12, from which some components are removed;

Fig - front view of the node of the working body shown in Fig;

Fig - General view of the node of the working body, according to another embodiment of the present invention, not limiting its scope;

Fig is a part of a General view of the node of the working body shown in Fig, from which some components are removed, and this node includes a retractable element designed to fix at least one product from the supporting material, with the possibility of release;

Fig.17 is a view in section of the node of the working body shown in Fig.15, with a section of the plane 17-17 shown in Fig.16;

Fig is a General view with a spatial separation of the parts for part of the node of the working body shown in Fig;

Fig.19 - Fig.21 are side views of various cutting elements intended for use with the node of the working body, according to various embodiments of the present invention, not limiting its scope;

Fig. 22 is a perspective view of a cassette with brackets on which an article of support material is fixed with a possibility of release, according to one embodiment of the present invention, not limiting its volume;

Fig is a General view with a spatial separation of the parts of the cassette with brackets and products from the supporting material shown in Fig, and the product from the supporting material includes many coming from him elements;

Fig.24 is a section along the plane 24-24 shown in Fig.22, illustrating the elements shown in Fig.23, mated with cavities for brackets, according to one of the embodiments of the present invention, not limiting its scope;

Fig. 25 is a sectional view of an article of supporting material including elements that are interfaced with cavities for staples of a cassette with brackets, according to one embodiment of the present invention, not limiting its scope;

Fig is a view with a spatial separation of the parts corresponding to Fig, which shows the above-mentioned elements separated from the cavities for the brackets of the cassette with brackets, according to one of the embodiments of the present invention, not limiting its scope;

Fig. 27 is a sectional view with a spatial separation of parts of a node of a working body, including fixing elements coming from the anvil, and a cassette with brackets of this working body, which are designed to fix the product from the supporting material with the possibility of release, according to one embodiment of the present invention not limiting its scope;

Fig. 28 is a sectional view with a spatial separation of parts of a node of a working body, including fixing elements coming from the anvil, and a cassette with brackets of this working body, which are designed to fix the product from the supporting material with the possibility of release, according to one embodiment of the present invention not limiting its scope;

Fig is a view in section of the working body, which shows the product of the supporting material placed inside the working body, and this product of the supporting material has a recess, according to one embodiment of the present invention, not limiting its volume;

Fig. 30 is a cross-sectional view of a working body showing a product from a support material placed inside a working body, this product from a supporting material having perforated holes and recesses, according to one embodiment of the present invention, not limiting its volume;

Fig - a General view of the parts of the product from the reference material shown in Fig, during their removal from the intermediate region;

Fig. 32 is a cross-sectional view of an anvil in which an article of support material is mated to a groove for a cutting element according to one embodiment of the present invention that does not limit its volume;

Fig - cross section of the cartridge with brackets, including fixed on it with the possibility of release of the product from the supporting material, according to one embodiment of the present invention, not limiting its volume;

Fig. 34 is a cross-sectional view of an article of support material placed on the anvil with the possibility of release, according to one embodiment of the present invention, not limiting its scope;

Fig. 35 is a partial view of an article of support material fixed on the anvil with the possibility of release, according to one embodiment of the present invention, not limiting its scope;

Fig. 36 is a partial view of an article of support material fixed on the anvil with the possibility of release, according to one embodiment of the present invention, not limiting its scope;

Fig. 37 is a partial view of an article of support material fixed on the anvil with the possibility of release, according to one embodiment of the present invention, not limiting its scope;

Fig. 38 is a perspective view of a packaging assembly, including an article of support material, wherein the packaging assembly is located within the disclosed working body of a surgical instrument, according to one embodiment of the present invention, not limiting its scope;

Fig. 39 is a perspective view of the package assembly shown in Fig. 38, in which the working body is shown in the closed state on the package and the article of supporting material;

Fig. 40 is a perspective view of the package assembly shown in Fig. 39, which shows an article of support material that has engaged with an anvil of the working body, and the package while it is removed from the article of the article of support, according to one embodiment of the present invention. not limiting its scope;

Fig. 41 is a perspective view of a packaging assembly for an article of support material in a sterile outer packaging, according to one embodiment of the present invention, not limiting its scope;

Fig. 42 is a perspective view of the inner package included in the package assembly shown in Fig. 41 in an unopened state;

Fig. 43 is a perspective view of the package shown in Fig. 42 in a partially open state;

Fig. 44 is a perspective view of the package shown in Fig. 42 in an open state;

Fig. 45 is a perspective view of the package shown in Fig. 42 placed inside the disclosed working body;

Fig is a General view of the packaging shown in Fig, where the package is partially removed from the working body;

Fig. 47 is a perspective view of an applicator assembly for an article of support material, wherein the applicator assembly is located inside a working body of a surgical instrument, according to one embodiment of the present invention, not limiting its scope;

Fig. 48 is a plan view of the applicator assembly shown in Fig. 47;

Fig. 49 is a plan view of an applicator assembly according to one of the alternative embodiments of the present invention, not limiting its scope;

Fig. 50 is a perspective view of an applicator assembly for support material, according to one embodiment of the present invention, not limiting its scope;

Fig. 51 is another general view of the applicator assembly for the support material shown in Fig. 50;

Fig. 52 is a perspective view of the applicator assembly for the support material shown in Fig. 50, which is placed inside the working body of a surgical instrument;

Fig. 53 is a perspective view of the applicator assembly for the support material shown in Fig. 50, which is partially removed from the working member;

Fig. 54 is a perspective view of an applicator for supporting material for mounting at least one article of supporting material in a working body of a surgical instrument, according to one embodiment of the present invention, not limiting its scope;

Fig.55 is a General view with a spatial separation of the parts of the applicator for the supporting material shown in Fig.54;

Fig. 56 is a vertical sectional view of the applicator for the support material shown in Fig. 54, from which some components have been removed;

Fig. 57 is a perspective view of the applicator for the support material shown in Fig. 54, from which some components have been removed;

Fig. 58 is a perspective view of an alternative applicator for supporting material for mounting at least one article of supporting material in a working body of a surgical instrument, according to another embodiment of the present invention, not limiting its scope;

Fig.59 is a General view with a spatial separation of the parts of the applicator for the supporting material shown in Fig.58;

Fig. 60 is a vertical sectional view of the applicator for the support material shown in Fig. 58, from which some components have been removed;

Fig. 61 is a perspective view of the applicator for the support material shown in Fig. 58, from which some components have been removed;

Fig. 62 is a perspective view of an article of support material, according to one embodiment of the present invention, not limiting its scope; and

Fig. 63 is a cross-sectional view of the article of support material shown in Fig. 62 with a plane 63-63 shown in Fig. 62.

Detailed Description of Preferred Embodiments

Some exemplary embodiments of the present invention will now be described in order to provide a thorough understanding of the principles of construction, operation, manufacture and use of the devices and methods discussed herein. One or more examples of these options are shown in the accompanying drawings. Specialists in the art will understand that the devices and methods described in detail here and depicted in the accompanying drawings are exemplary embodiments of the present invention, not limiting its scope, which is defined solely by the paragraphs of the attached claims. The distinctive features depicted or described in relation to one of the exemplary embodiments of the present invention, can be combined with the distinctive features of other variants of its implementation. It is assumed that such modifications and changes are not beyond the scope of the present invention.

In various embodiments of the present invention, as shown in FIGS. 1 to 2, the working member of a surgical instrument may include at least one article “B” of support material that is releasably attached to this working member. In at least one of the embodiments of the present invention, the working body can be configured to come into contact with the fabric "T" and clamp it, install the braces in this fabric, as well as cut the fabric and the product from the supporting material. In such an embodiment of the present invention, the working member can then be removed from the fabric, leaving the staples and the article of support material attached to the fabric on both sides of the “I” cut. In various embodiments of the present invention, the surgical instrument may include a handle assembly, a working body assembly, an instrument barrel, and at least one article of support material that is releasably attached to the working body assembly. In at least one embodiment of the present invention, as shown in FIG. 3, the handle assembly 12 can be attached to the first or proximal end 13 of the tool barrel 16 and, in addition, the working organ assembly 14 can be made with the possibility of attachment to the second, or distant, end 15 of the barrel 16 of the tool. In various embodiments of the present invention, the node 14 of the working body and at least part of the shaft 16 of the instrument can be arranged to accommodate (and at least partially advance) inside the catheter or trocar installed in the patient’s body during minimally invasive surgical intervention. More detailed various surgical instruments are described in US patent application No. 11 / 329,020, entitled "Surgical Instrument Having an Articulating End Effector" (which is registered on January 10, 2006; U.S. Patent Application No. 11 / 343,321, entitled "Surgical Cutting and Fastening Instrument with Closure Trigger Locking Mechanism", filed January 31, 2006; and U.S. Patent Application No. 11 / 529,935, entitled “Surgical Staples Having Attached Drivers and Stapling Instruments for Deploying the Same” (registered September 29, 2006, the text of which is hereby incorporated by reference in its entirety) description.

In various embodiments of the present invention, the node of the working body of a surgical instrument may include a first gripping element and a second gripping element, wherein at least one of the first and second gripping elements may be movable relative to another gripping element, as a result of which between them you can clamp the fabric. In various embodiments of the present invention, as shown in FIGS. 4 to 11, the first gripping element 20 may include a cassette 22 with brackets and, in addition, the second gripping element 24 may include anvil 26. In at least one of the embodiments of the present invention, the cassette 22 with brackets may include a panel 28 with many formed in it cavities 30 for brackets. Anvil 26 may include an anvil lid 27 and anvil face 32, and a plurality of recesses 34 may be formed on the anvil face 32. In various embodiments of the present invention, each staple cavity 30 may be designed to be retractable inside, and each anvil recess 34 may be designed to deform at least a portion of the bracket during installation. In various embodiments of the present invention, at least one of the following: a cassette with brackets and an anvil may contain one or more gripping means, or corrugation elements 35, which can be designed to hold tissue inside the working body.

In addition to the foregoing, as shown in FIGS. 4 to 11, the working body assembly 14 may include at least one article 36 and / or 36 'of support material, which may be arranged to fit between the first and the second gripping elements and securing with the possibility of release, for example, on one of the following: the panel 28 and / or the front surface 32. In at least one of the embodiments of the present invention, the surface of the product of the supporting material may be designed to come into contact with the fabricthe tissue is clamped between the first and second gripping elements. In such an embodiment of the present invention, the surface of the support material can be used to distribute the compressive force generated by the clamp over the fabric, remove excess fluid from the fabric, and / or improve retraction of the braces. In various embodiments of the present invention, one or more articles of support material can be placed in the assembly of the working body. In at least one embodiment of the present invention, as shown in FIG. 11, one article 36a of support material can be attached to the cassette 22 with brackets and one article 36a of support material can be attached to the anvil 24. At least in one of the other embodiments of the present invention, for example, two products 36 of the supporting material can be placed on the panel 28, and one product 36 'of the supporting material can be placed on the front surface 32. In various other embodiments of the present invention Ia within the working member assembly can be any suitable amount of products from a reference material. In any case, in various embodiments of the present invention, this product (s) may consist of a material such as, for example, bioabsorbable material, biodegradable material and / or soluble material so that the supporting material can absorb, disintegrate and / or dissolve during the process healing. In at least one embodiment of the present invention, the article (s) of the support material may consist, at least in part, of a drug, the purpose of which is to isolate it over time, to facilitate tissue healing. In further embodiments of the present invention, the article (s) of the support material may comprise, for example, non-absorbable and / or insoluble material.

In various embodiments of the present invention, as shown in FIGS. 6, 7, 9 and 10, the working body assembly may include at least one connecting element or fastener that can be used to securely release the support material, for example, at least one of the following: anvil and cassette with brackets. In at least one embodiment of the present invention, each connecting element, for example, such as connecting element 38, may include a body 40, which may, for example, have a cylindrical shape. In at least one such embodiment of the present invention, the connecting member 38 may also include a conical expanding head 42, designed to prevent, or at least hinder, sliding of the connecting element in the hole or slot 44 made in the product of the supporting material. In various other embodiments of the present invention, the connecting element may have any other suitable shape to fix the product of the supporting material in the working body. In at least one embodiment of the present invention, one or more of the connecting elements may comprise a lock, which may be designed to secure the support material on a cassette with brackets and / or anvil with the possibility of removal.

In various embodiments of the present invention, as shown in FIGS. 7 and 9, a recess 43 may be provided in the head portion 42, which recess 43 may be adapted to receive a screwdriver, a clamp, or any other suitable device. In at least one embodiment of the present invention, a screwdriver or clamp may engage with a recess 43 and be used to insert the connecting elements 38 through the article of support material and before engaging, for example, with one of the following: cassette panel 28 with brackets and anvil face 32. In at least one such embodiment of the present invention, openings 46 may be provided in the panel 28 and / or front surface 32, which may be designed to receive at least a portion of each of the connecting elements, such as, for example, the body 40 In various embodiments of the present invention, the outer boundary surface of the body 40 and the inner boundary surface of the hole 46 can work together to fix the connecting elements 38 in one of the following: anvil and cassette with sk Obami with landing due to friction or landing due to compression. In addition to the above, as shown in FIGS. 6 to 10, for example, holes 44 can be pre-formed in the product from the support material, which can be made in such a way as to allow the connecting elements 38 to pass through them through the holes 46. In at least one embodiment of the present invention, the article 36 of the supporting material can be placed nearby, or adjacent to one of the following: the panel 28 and the front surface 32 so that it is possible to align the axis of the holes 44 with syami holes 46. As a result, under such conditions, the connecting elements 38 can be installed through holes 44 of the support material in the holes 46, to fix the product of support material releasably on one of the following: the panel 28 and the front surface 32.

In addition to the above, the connecting element may have a thread that can create a threaded connection with a hole, for example, in a cassette with brackets and / or anvil. In various embodiments of the present invention, such a thread may be self-tapping and / or may be adapted to mate with a thread present in the holes. In those cases where self-tapping connecting elements are used, these elements can be used in conjunction with an article of supporting material, a cassette with brackets and / or anvil, which do not have pre-formed or pre-drilled holes. In any case, the tightening between the connecting elements and the holes of the anvil or cassette with brackets may be sufficient to hold the supporting material in place, however, making it possible to remove it from the cassette with brackets and / or panels in appropriate conditions. In at least one embodiment of the present invention, the conical expanding head 42 may be formed so that it is recessed into a conical chamfer surrounding hole 46 to provide a smooth, or substantially smooth, tissue contact surface on a product made of support material and reducing the likelihood that the fabric may get pinched by the connecting element or catch on it.

In various embodiments of the present invention, the connecting elements can be made with the possibility of release from the working body and install together with the product of the supporting material. In at least one embodiment of the present invention, the head parts of the connecting elements can be configured to separate them from the body of these elements, as a result of which the head parts can be mounted with an article of supporting material, while the bodies of these elements remain attached to the working body. In various other embodiments of the present invention, the connecting elements can remain fully engaged with the working body when an article of support material is detached from the working body. In any case, in at least one embodiment of the present invention, the connecting elements may at least partially consist of at least one of the following: bioabsorbable material, biodegradable material and soluble material, as a result of which the connecting elements can absorb disintegrate and / or dissolve inside the patient’s body. In various embodiments of the present invention, the connecting elements may, for example, consist of a drug, the purpose of which may be its allocation over time, to facilitate healing of the tissue. In further embodiments of the present invention, the connecting elements may comprise non-absorbable and / or insoluble material, for example, such as plastic.

In various embodiments of the present invention, the connecting elements can be placed in any suitable pattern or in any suitable configuration. In at least one embodiment of the present invention, the connecting elements may be located, for example, around the perimeter of the article 36 of support material. In at least one embodiment of the present invention, the connecting elements can be placed, for example, close to one or more sides and / or ends of the article of support material to prevent or at least help prevent the backing material from lagging from the cassette panel with brackets and / or the front surface of the anvil, when the working body is introduced through a trocar or brought into contact with tissue. In various embodiments of the present invention, the connecting elements can be used in conjunction with any suitable binder, for example, such as cyanoacrylate, to fix the article of the supporting material or at least part of it in the working body with the possibility of release. In at least one embodiment of the present invention, a binder may be applied to the connecting elements before these connecting elements are mated to holes in the article of support material, a cassette with brackets and / or anvil.

In various embodiments of the present invention, as shown in FIGS. 12 to 14, at least one resilient member can be used to lock the article from the supporting material onto the cassette with brackets and / or anvil of the working member. In at least one embodiment of the present invention, at least one resilient member, for example, such as resilient members 150 or 150 ', may have a first end portion, for example, first end portions 152 or 152' configured to be attached at least one of the first and second gripping elements 120 and 124, or made as a whole with them. In at least one embodiment of the present invention, each resilient member 150 may have a second end portion, such as, for example, second end portions 154 or 154 ', designed to provide contact and fixation with the possibility of releasing the product from a support material, such as product 136 or 136 'with at least one of the first and second gripping elements. In various embodiments of the present invention, the second end portion 154, for example, may have an end face 158 that may be designed to hold at least a portion of the article 136 of support material. In various embodiments of the present invention, the end face 158 may have such a shape and / or may be designed so that its surface is, for example, uneven or ribbed so as to engage with the article of the supporting material due to friction.

In various embodiments of the present invention, referring again to FIGS. 12 to 14, a plurality of resilient elements can be provided on at least two lateral sides of the gripping element in order to fix the side parts of the support material relative to the gripping element. In at least one embodiment of the present invention, the first end portions 152 of each individual resilient member 150 may be attached to each other using a connecting member, such as, for example, a connecting element or strip 156 or 156 ′. In various embodiments of the present invention, the connecting element 156 can be attached to the second gripping element 124 so that the connecting element 156 can serve as a support for the elastic elements 150. In various other embodiments of the present invention, a plurality of elastic elements 150 can be attached at least , to one of the first and second gripping elements without using a connecting element. In such an embodiment of the present invention, for example, the first end parts of the elastic elements can be attached directly to one of the first and second gripping elements.

In addition to the above, in various embodiments of the present invention, at least one resilient member can be biased towards the article of support material so that the resilient members can apply a locking force to the article and release the article with one of the first and second gripping elements. In at least one embodiment of the present invention, the article of support material may have a part 159 or 159 'in contact with the fabric and two side parts 160 or 160' extending essentially perpendicular and / or in the transverse direction relative to part 159 or 159 'in contact with the tissue. In at least one such embodiment of the present invention, the tissue contacting portion 159 may be configured to be adjacent to or in contact with the panel 128 and, in addition, the side portions 160 may be configured to so that they are adjacent to the side walls 121 of the first gripping element 120. Similarly, the tissue contacting portion 159 ′ can be placed adjacent to or in contact with the surface 132 and, in addition, the lateral portions 160 ′ can be configured in such a way so that rimykat to the side walls 125 of the second gripping member 124. In various embodiments, second end portion 154 of each elastic member 150 may be formed so as to come into engagement with the side portions 160 of the article 136 of the support material and applying thereto a fixing force. In at least one embodiment of the present invention, the elastic members 150, for example, may be configured to release the article 136 from the support material after mounting the brackets through the support material and / or when the support material is out of engagement with the working member. In at least one embodiment of the present invention, the elastic elements may consist of an elastic material, such as, for example, metal or plastic.

In various embodiments of the present invention, as shown in FIGS. 15 to 18, the locking element may be movably movable in the working body between the first position and the second position in order to release the article of supporting material in the working body. In at least one embodiment of the present invention, the working assembly 214 may include a first grip including a cassette 222 with brackets and a second grip including an anvil 226, the locking element 262 can be moved relative to the cassette 222 with brackets and anvil 226. In various embodiments of the present invention, the locking element 262 can be moved between the first or extended position near the far end 264 and the second or retracted position near the near end 263. In extended In this position, the locking element 262 can hold the supporting material 236 in the desired position, while the working body 214 is introduced into the surgical area. After that, the working body 214, for example, can be closed on the fabric, and through the supporting material in the fabric staples can be installed. In various embodiments of the present invention, the locking element 262 can be moved to a retracted position, as a result of which this locking element 262 can be disengaged from the support material 236 during operation. In at least one embodiment of the present invention, the locking element 262 can be retracted before the installation process of brackets. In any case, as a result of the above, the working body 214 can be opened and removed from the surgical intervention zone, leaving the supporting material and tissue in a stapled condition.

In various embodiments of the present invention, the locking element may have proximal end portions that are capable of engaging with a lever or other actuator in the handle that is part of the surgical stapling tool during operation so that the surgeon can remotely control the retraction of the locking element as outlined above. In at least one embodiment of the present invention, the locking element 262 may have distal end parts that can be engaged with the locking plate 264, or otherwise fix these end parts with the possibility of release, so that it was required to apply force to the locking elements 262, to move them from the locking plate 264. After that, the locking elements 262 can be taken closer, by a distance L, to move these elements to their second position. In at least one embodiment of the present invention, the locking elements 262 can be retracted, for example, through channels or holes 266 in the support material 236, until they are sufficiently removed from the support material. In at least one such embodiment of the present invention, the locking elements 262 may be located in the holes 266 that guide these elements during their retraction. In various embodiments of the present invention, the locking elements may consist of a flexible wire. In at least one embodiment of the present invention, the working body may contain two or more articles of supporting material that are fixed in this working body using retractable locking elements. In at least one such embodiment of the present invention, as shown in FIGS. 17 and 18, the operating member 214 may include locking elements 262 ′ designed to hold the support material 236 ′ in position.

In various embodiments of the present invention, the working body assembly may include a cutting element for cutting one or more articles of support material. In at least one embodiment of the present invention, the movement of the cutting element relative to the working element can cause the initiating drive of the surgical instrument, and this cutting element can be guided by a groove for the cutting element present in the anvil and / or cassette with the brackets of the working element. In at least one embodiment of the present invention, as shown in FIG. 19, the upper portion 267 of the cutting element 268 may be configured to slide within the groove provided in the anvil and, in addition, the lower portion 269 of the cutting element can be made in such a way as to slide inside the groove in the cassette with brackets. In various embodiments of the present invention, the cutting member 268 may have a positive inclined blade 270, i.e. a blade with a lower end of the cutting edge located farther than the upper end. In at least one alternative embodiment of the present invention, such a shape can cut the support material substantially without moving it away and disturb the alignment of the support material in the working body. In at least one embodiment of the present invention, as shown in FIG. 20, the blade 270 ′ of the cutting member 268 ′ may have a negative angle of inclination, i.e. the lower end of the cutting edge of this blade is closer than the upper end. In other alternative embodiments of the present invention, as shown in FIG. 21, the blade 270 ″ of the cutting member 268 ″ may comprise a first part 270a ”having a positive angle of inclination and a second part 270b” having a negative angle of inclination.

As outlined above, the working body assembly may include a cassette with brackets, an anvil and at least one article of support material located in the gap between the cassette with brackets and an anvil. In at least one embodiment of the present invention, as shown in FIGS. 22 to 24, an article of support material, such as support material 336, may be configured to snap into at least one of the following: a cassette 322 with brackets and / or an anvil (not shown) for fixing articles made of supporting material with the possibility of release in the working body. As shown in FIGS. 23 and 24, the cassette 322 with brackets may have a first side wall 302 and a second side wall 304, wherein at least one of the first and second side walls may have a shoulder 306 extending outward from this wall . In various embodiments of the present invention, the support material 336 may have a first edge or side portion, 308, a second edge, or side portion, 310 and at least one shoulder 312 extending at least partially along the length of the edges 308 and 310. In at least one embodiment of the present invention, as shown in FIG. 24, the flanges 312 can be designed to engage with the collars 306 with a snap fit to secure the support material 336 to the cassette 322 with release brackets driving.

In addition to the above, as shown in FIG. 24, the support material 336 may have a surface 316 that is capable of being placed adjacent to or adjacent to the panel 328 of the cassette 322 with brackets. In at least one embodiment of the present invention, the side edges 308 and 310 may include side walls that can extend perpendicularly or transversely with respect to surface 316. In such embodiments of the present invention, the flanges 312 can extend from said side walls so that these flanges 312 could be interlocked behind the flanges 306 of the cassette 322 with brackets. In various embodiments of the present invention, the flanges 312 of the support material 336 can be disengaged from the flanges 306 of the cassette 322 with brackets when brackets are mounted from the cassette 322. More specifically, when the brackets are installed, these brackets can contact the supporting material 336, apply a lifting force to the supporting material 336, and remove the supporting material 336 from the cassette 322 with brackets. An advantage is that, as a result, the support material 336 can be automatically disengaged from the cassette 322 with brackets when brackets are installed from the cassette and / or when the working member is opened, as described above.

In various embodiments of the present invention, as shown in FIGS. 23 and 24, the article of support material may include at least one element extending from it, which may be designed to hold the support material with the possibility of release to one of the following: cassette with brackets and / or anvil. In at least one embodiment of the present invention, element 318 may extend from support material 336 in a direction perpendicular or transverse to surface 316. In various embodiments of the present invention, element 318 may mate with one of the brace cavities 320, and / or a recess in the anvil, ensuring landing due to friction or landing due to compression, to fix the product from the supporting material with the possibility of release on one of the following: cassette with brackets and anvil . By analogy with the foregoing, in various embodiments of the present invention, the brackets installed from the cavities 320 for brackets can apply a lifting force to the supporting material 336 and remove the elements 318 from the interface with the cavities 320 for brackets. In various embodiments of the present invention, the staples may pierce protrusions 318 and / or support material 336 to attach the support material to the fabric, as outlined above.

As shown in Fig. 23, an article of support material may have more than one element extending from it, or a protrusion, for fixing an article of support material on one of the following: a cassette with brackets and an anvil. In various embodiments of the present invention, as shown in FIGS. 25 to FIG. 26, for example, more than one member 318 ′ may extend from a support material 336 ′. In at least one embodiment of the present invention, the elements 318 'can enter cavities 320' made in the cassette 322 'with brackets and / or recesses made in the anvil (not shown) with a fit due to crimping, resulting whereby these elements can fix the product from the supporting material by friction on one of the following: a cassette with brackets and / or anvil, as outlined above. As described in more detail below, the cassette with brackets and / or anvil may have grooves or holes made therein, in addition to the cavities in the cassette with brackets and recesses in the anvil for receiving protrusions, or fixing elements coming from the product of the supporting material.

In various embodiments of the present invention, as shown in FIG. 33, at least one of the following: the anvil and the cassette with brackets that are part of the working body assembly may have one or more grooves and / or grooves for fixing the product from supporting material with the possibility of release in the node of the working body. In at least one embodiment of the present invention, the cassette 722 with brackets may have at least one opening 704 made therein, which may be designed to receive a protrusion 706 coming from the supporting material 736. In at least one such an embodiment of the present invention, the protrusion 706 may be received by the hole 704 with a fit due to compression and / or fit due to friction, for fixing the supporting material 736 with the possibility of release in this hole. In at least one embodiment of the present invention, as shown in FIG. 33, the supporting material 736 may have a body 708 with a surface 710, and the surface 710 may be arranged to be placed adjacent to the panel 728 and / or adjacent to this panels 728. In various embodiments of the present invention, the protrusion 706 may extend from the body 708, for example, in a direction perpendicular or transverse to the plane defined by the surface 710.

In various embodiments of the present invention, the protrusion 706, for example, may include a first part, or a foot, 712 and a second part, or a foot, 714, the first part 712 can be made so as to pass through the hole 704, and the second part 714 can in size and shape to be slightly larger than the hole 704. In at least one such embodiment of the present invention, the protrusion 706 can be inserted into the hole 704 and advanced through it until the second part 714, at least partially not will come out through her. In various embodiments of the present invention, the protrusion 706 may deviate inwardly as it is inserted into the hole 704, and then snap in, moving outwardly as soon as it has passed through. In any case, the second part 714 may come into contact with the surface on the back of the panel 728 near the hole 704 in order to fix the supporting material 736 with the possibility of release on the cassette 702 with brackets with snap fit. In at least one embodiment of the present invention, the protrusion 706 can be locked in the hole 704 with the possibility of release until it is exerted by the force from the brackets installed from the cassette with brackets and / or until you open the working body as described above.

In various embodiments of the present invention, as shown in FIG. 27, the cassette 322 "with brackets and / or anvil 326", for example, may have grooves 334 ", which can be designed to receive support material 336". In at least one embodiment of the present invention, the grooves 334 "may be designed to fix the supporting material 336" on the cartridge 322 "with brackets with the possibility of release. In at least one such embodiment of the present invention, the support material 336 ”can be positioned to fit due to compression between the locking elements 302” and 304 ”so that to overcome friction between the supporting material 336” and the locking elements 302 ”and 304” it took an effort. In various embodiments of the present invention, the locking elements 302 ″ and 304 ″ may have collars or overhangs that can prevent, or at least hinder, the support material 336 ″ from rising upward. In various embodiments of the present invention, as shown in FIG. 28, the working body assembly may include a cassette 422 with brackets and an anvil 426, wherein at least one of the following: a cassette with brackets and an anvil may include a first locking member extending from them 402 and / or second locking element 404. In at least one embodiment of the present invention, the first and second locking elements 402 and 404 may extend substantially perpendicularly and / or in the transverse direction relative to one of the following go: panels 428 and / or front surface 432 to fix the product 436 of the supporting material to the working body. In various embodiments of the present invention, the first and second locking elements 402 and 404 may be designed to fix articles 436 of support material between them with a fit due to friction. In at least one embodiment of the present invention, the coefficient of friction between the side walls and the locking elements may be sufficient so that it is not possible to displace the support material during insertion of the working body into the surgical area and work with it in this area. After the brackets are inserted into the soft tissue, the working member can be re-opened and, in various embodiments of the present invention, the frictional force between the supporting material 436 and the locking elements 402 and 404 can be overcome.

In various embodiments of the present invention, as shown in FIG. 32, the operative member of the surgical stapling instrument may include an anvil and a cassette with brackets (not shown), and as outlined above, the anvil can be brought into contact with the cassette during operation staples so that the working body could clamp tissue between them. In at least one embodiment of the present invention, the anvil 626 may have a front surface 632 and, in addition, a groove 602, which may be designed to be able to slide into it a cutting element, such as, for example, a cutting element 668. B various embodiments of the present invention, although not shown, the cassette with brackets may also have a groove designed to fit the sliding element 668 therein. In any case, the cutting element 668 may have blades e, for example, such as a blade 670, where the blade 670 may be designed to cut soft tissue and / or supporting material 636 located inside the working body.

In at least one embodiment of the present invention, referring again to FIG. 32, the support material 636 may have a main body with a surface, such as, for example, surface 604, which surface can be designed to accommodate, for example , near the anvil face 632. In various embodiments of the present invention, the support material 636 may further comprise a protrusion 606 extending from the main body in a perpendicular and / or transverse direction relative to the surface 604. In at least one embodiment of the present invention, the protrusion 606 can be inserted into the groove 602 for the cutting element and engagement in this groove for fixing the supporting material 636 on the anvil 626 with the possibility of release. Although not shown, an article of support material may have similar means that allow it to be fixed on a cassette with brackets.

In various embodiments of the present invention, the groove 602 for the cutting element may have a first side wall 608 and a second side wall 610, and the protrusion 606 may be made so as to engage due to friction with the first and second side walls and / or be placed between them with landing due to compression with the fixation of this protrusion 606 inside the groove 602 with the possibility of release. In at least one embodiment of the present invention, the groove 602 may have a transverse portion 612, which may be designed to accommodate cams 631 extending from the cutting element 668, and the cams 631 may be designed to hold the anvil 626 in a closed position. In at least one embodiment of the present invention, the protrusion 606 may have at least one shelf 614 extending from it, which may be configured to extend at least partially into the transverse portion 612 and assist in fixing the protrusion 606 inside the groove 602. In various embodiments of the present invention, the protrusion may comprise resilient means that can exert a biasing force on the side walls of the groove 602 when they are compressed into the groove 602.

In various embodiments of the present invention, in addition to the above, the cutting element 668 may be designed to cut the protrusion 606 as it moves inside the anvil 626 and separate the first part 618 from the second part 620. In at least one embodiment of the present invention grooves 616 can reduce the thickness of the support material 636 in cross section to reduce the force required to dissect the support material. In various embodiments of the present invention, the size and shape of one or more grooves 616 can be selected so that at least a portion of the protrusion 606 is thinner than the first part 618 and / or the second part 620. As described above, at least one of grooves 616 can be made, for example, of a V-shape, as a result of which the cutting edge 670 can contact with the protrusion 606 in the base of the V-shaped profile or near it. In various embodiments of the present invention, although not shown, in the protrusion 606, for example, at least one perforated hole can be made that can reduce the force required to cut this protrusion.

In various embodiments of the present invention, either in addition to, or instead of, the devices for attaching support material described above, the article of support material can be attached to the operative member of a surgical instrument using a binder. In at least one embodiment of the present invention, as shown in FIGS. 29 and 30, the working body assembly 514 may include an anvil 526 having a front surface 532 and, in addition, a cassette 522 with brackets having a panel with a surface 528 (Note 1). In at least one embodiment of the present invention, an article of support material, for example, such as support material 536, may be placed adjacent to one of the following: face surface 532 and panel surface 528, the support material 536 may include a main body 502 and at least one area 506 capture by hand. In at least one such embodiment of the present invention, the arm grip region 506 may extend from the body 502 so that the surgeon can use this region 506 to position and align the support material 536 in the working body assembly. In at least one embodiment of the present invention, the hand grip area 506 may extend in a direction that is parallel to the plane of the surface 504 and / or extend laterally with respect to that plane.

In various embodiments of the present invention, as shown in FIGS. 29 and 30, the support article may have an inactive or inert binder on its surface, for example, such as a binder 512, which can be applied to this surface until it is flush against to one of the following: cassette panels with brackets and the anvil face. In at least one embodiment of the present invention, the binder 512 may be designed to bind releasably to the surface 504, for example to the face 532 and / or panel 528, when the binder is activated by a reactant. By analogy with the above, such an activated binder can be used to hold the surface 504 in contact with the front surface 532 and / or the panel 528 with the possibility of release. In various embodiments of the present invention, the activated binder can be made with the possibility of releasing the supporting material fixed on the panel and / or front surface, in response to the force applied to it, for example, when installing brackets from the cassette with brackets and / or when opening the working body. In various embodiments of the present invention, an inactive binder can be applied to the support material along the perimeter of the main body 502, whereby, for example, the reactant can be easily applied to an inactive binder.

In various embodiments of the present invention, an inactive binder on the support material may contain one component of a bicomponent binder, and the reactant may contain another component of a bicomponent binder, thereby activating the binder when the two components are combined. Formulated otherwise, a non-activated binder may contain a material that is inert until it is introduced into the reactant, as described below. In at least one embodiment of the present invention, the non-activated binder and reactant may contain, for example, an epoxy resin suitable for use in surgery. In various embodiments of the present invention, a non-activated binder may contain, for example, a waterproof material, whereby the binder may be substantially insoluble and / or substantially incapable of reaction when added to water. In at least one embodiment of the present invention, the binder may contain material such as, for example, a hot-melt binder, silicone, urethane, cyanoacrylate, hydrogel and / or isocyanate, or any suitable monomer and / or polymer. In various embodiments of the present invention, suitable binders and attachment devices may include those described in US Pat. No. 5,263,629, entitled "Method and Apparatus for Achieving Hemostasis along a Staple Line" (Method and apparatus for achieving hemostasis on a staple line ), which was issued on November 23, 1993; US Patent No. 6,656,193, entitled "Device for Attachment of Buttress Material to a Surgical Fastening Device", issued December 2, 2003; US Patent No. 6,592,597, entitled "Adhesive for Attaching Buttress Material to a Surgical Fastening Device", issued July 15, 2003; US patent No. 6,273,897, entitled "Surgical Buttress and Surgical Stapling Apparatus" (Surgical support material and surgical stapling device), which is issued August 14, 2001; and U.S. Patent Application No. 10 / 674.303, entitled "Apparatus and Method for Attaching a Surgical Buttress to a Stapling Apparatus", which is filed September 30, 2003, the text of which is Mentioned in its entirety in this description. In various embodiments of the present invention, the reactant may include a material comprising at least one of the following: an aerobic initiator, an anaerobic initiator, a quaternary ammonium salt or compound and / or any other suitable radical initiator, for example, such as anionic initiators, including The materials described in US Patent Application No. 11 / 479,424, entitled "Absorbable Cyanoacrylate Compositions", which is registered June 30, 2006 and the text of which is referred to fully included in this description. In various embodiments of the present invention, for example, binders and / or reactants that are commercially available by Closure Medical Corporation can be used. In at least one embodiment of the present invention, the binder can be made to be activated by ultraviolet radiation or any suitable photochemical process. Several of these binders are commercially available, for example, by Henkel Loctite Corporation.

In addition to the above, in various embodiments of the present invention, the use of an inactive or inert binder on a support material may allow the surgeon to install and reinstall the support material on the front surface of the anvil and / or cassette panel with brackets without immediately binding the binder substances. In at least one embodiment of the present invention, an inactive binder may not bind to the front surface and / or panel until a reactant is applied to the inactive binder. This distinguishing feature provides a significant advantage in that the surgeon does not need to properly position the product from the supporting material on the first attempt, instead he can install and reinstall the product from the supporting material on the panel and / or front surface to ensure a correct fit and alignment with respect to the front surface and / or panel. In various embodiments of the present invention, together with a binder / reactant, for fixing the product of the supporting material on the front surface and / or panel of the working body before applying the reactant, for example, at least one fixing or positioning element, such as a fixing element 318, can be used (Fig.23).

In various embodiments of the present invention, at least one groove or channel may be provided in the article of support material, which may be designed to house the reactant. In at least one embodiment of the present invention, as shown in FIG. 29, the support material 536 may have recesses 508 that may be between the main body 502 and the hand grip areas 506. More specifically, between the first side of the main body 502 and the first hand grip region 506, a first recess 508 can be created and, in addition, a second recess 508 can be created between the second side of the main body 502 and the second hand grip region 506. In various embodiments of the present invention, at least a portion of the non-activated binder 512 on the support material 536 may be located along the recesses 508 so that an applicator can be inserted into the recesses 508, for example, oh as an applicator 514 to apply the reactant to the binder 512 and activate that substance. As a result, in at least one embodiment of the present invention, recesses 508 can facilitate the application of the reactant. In various embodiments of the present invention, the reactant applicator 514 may have an absorbable tip 516 that may be designed to be dispensed as well as to apply a certain amount of reactant.

In various embodiments of the present invention, as shown in FIGS. 30 and 31, at least one perforated hole may be formed from the support material in the article 536 to enable, for example, removal from the main body 502 of at least one of the areas 506 capture by hand. In at least one embodiment of the present invention, the perforated holes 510 may be between the main body 502 and the hand grip areas 506 so that when sufficient force is applied to the hand grip area 506, the article of the support material can be torn along a line or path, defined by the perforated holes 510. In various embodiments of the present invention, the perforated holes 510 can be placed adjacent to and / or inside the recesses 508, resulting in a grip region 506 which can be easily separated from the main body 502 due to the reduced thickness of the support material inside and / or next to the recesses 508. In at least one embodiment of the present invention, as a result of the above, the product of the support material can be located inside the working body, the reactant can apply on an inactive binder located on the supporting material, and at least one of the areas of capture by hand can be removed from the center material of the supporting material.

In various embodiments of the present invention, an article of support material, an inactive binder, and a reactant may be included, for example, in a surgical accessory kit. In at least one embodiment of the present invention, an inactive binder may be pre-applied to the support material. In various other embodiments of the present invention, the surgeon may use the kit to apply an inactive binder to the surface of the supporting material and allow the binder to “set”, i.e. harden or dry, as a result of which it can be placed on the surface essentially without adhesion to the surface. In at least one embodiment of the present invention, the article of support material can then be placed close to one of the following: a cassette with brackets or an anvil of the working body. In at least one such embodiment, as outlined above, the support material may have at least one arm grip region extending from it, which the surgeon can hold to manipulate the support material relative to the working body. After that, the anvil of the working body can be closed on the supporting material in order to keep it in the desired position until the reactant is applied to it. At this point, as shown in FIG. 31, the hand grip area can be removed with the anvil closed. Alternatively, the surgeon can wait until the activated binder is at least partially hardened before the removal of the mentioned area. In any case, the working body can then be introduced into the surgical area, and the supporting material can be attached to the tissue with staples, as described above. In various other embodiments, the grip area (s) of the hand may be torn away from the main body of the support material after the staples engage with the fabric.

In various embodiments of the present invention, the packaging assembly for at least one article of support material may include means for activating an inactive binder located on the support material. In at least one embodiment of the present invention, the packaging unit may contain a certain amount of the reactant stored therein, which reactant can be released in such a way that it can come into contact with an inactive binder and activate this binder. In various other embodiments of the present invention, the packaging unit may contain an initiator, which may be designed to cause a reaction between the inactive binder and another chemical inside the packaging unit. In further embodiments of the present invention, an inactive binder may be made to activate upon application of sufficient pressure thereto. Such pressure can be created by closing the anvil of the working body on the supporting material and pressing it against the cassette with brackets. Such materials may contain one or more pressure sensitive binders, such as, for example, an organosilicon binder and an acrylic binder. In various embodiments of the present invention, the package may comprise an article of support material on which a biocompatible hot-melt binder is located, which binder can be made to melt by exposure to heat generated by an exothermic chemical reaction. In at least one embodiment of the present invention, the initiator, for example, can be mixed with a chemical to cause an exothermic reaction, which will cause heat to be generated in the localized area of the binder. In various embodiments of the present invention, the initiator can be separated from the chemical by a removable sheet or other suitable separation device so that when the sheet is removed, the initiator and the chemical can become unprotected from each other. In at least one such embodiment of the present invention, the initiator may comprise an oxidizing agent, or, for example, any other suitable chemical compound that readily transfers oxygen atoms, and the chemical may contain, for example, iron or an iron compound that can be oxidized by the oxidizing agent, causing exothermic reaction.

In various embodiments of the present invention, the package may include an article of support material with a biocompatible hot melt binder on it, which binder can be made to melt due to exposure to heat created by a power source, such as, for example accumulator battery. In at least one embodiment of the present invention, the package may comprise a power source. In the following embodiments of the present invention, the energy source can be placed, for example, on the site of the working body, the product of the supporting material, the casing for the working body and / or the applicator of the supporting material. In various embodiments of the present invention, the packaging unit may contain first and second contacts and / or any other suitable conductors and resistors that may be designed to create a closed electrical circuit with a battery during operation. In at least one embodiment of the present invention, the power source can be activated, for example, by means of a switch on the package, and electricity can be supplied to the contacts.

In various embodiments of the present invention, the anvil included in the assembly of the working body may include a removable part or casing, which can be made with the possibility of sliding along the second part of the anvil and attached to the site of the working body. In at least one embodiment of the present invention, as described in more detail below, an article of support material may be attached to the casing before installing the casing in the assembly of the working body. In at least one embodiment of the present invention, as shown in FIG. 34, the casing 802 may be slidable over the anvil portion 826 such that the casing 802 is held in place using at least one of the following landing schemes: due to snapping-in and due to compression. In at least one such embodiment of the present invention, the casing 802 may be configured such that it at least partially encompasses the outer boundary surface 804 of the anvil portion 826, and this casing 802 may be configured to contact the outer boundary surface 804. In various embodiments of the present invention, the casing 802 may have recesses 806 formed on the working surface 808, these recesses 806 may be designed to deform the brackets, installed aemyh of the staple cartridge as described above. In various embodiments of the present invention, the housing 802 may be made by casting or machining from a metal billet to produce any suitable configuration and may consist of any suitable material, such as, for example, aluminum.

As indicated above and shown in FIG. 34, support material 836 may be provided on housing 802, and at least a portion of the support material 836 may be releasably attached to housing 802 using, for example, a binder. In at least one embodiment of the present invention, as shown in FIG. 35, the support material 836 'may have a main body 812' and at least one side portion 814 ', the side portions 814' may be liberably attached to the casing 802 'using a binder 810'. In various embodiments of the present invention, the side portions 814 'may be detached from the housing 802' if a force is applied to them. In at least one embodiment of the present invention, by analogy with the foregoing, such an effort can occur when the brackets are mounted from the cassette with brackets and engaged with the support material. In various embodiments of the present invention, as shown in FIG. 36, at least one perforated hole and / or recess may further be provided in the article of support material, which may make it possible to separate a portion of the support material in contact with the fabric from that part supporting material, which is attached with a binder to the working body. In at least one embodiment of the present invention, the support material 836 "may have a main body 812", which can be designed to come into contact with tissue placed inside the working body, and, in addition, the side parts 814 ", which can be attached to the casing 802 "anvil, for example, using a binder 810". In various embodiments of the present invention, one or more perforated holes 816 ”may be provided in the support material 836”, which may be between the main body 812 ”and the side portions 814”. In addition to the side portions 814 ”that are separated from the housing 802”, as outlined above, or instead of these side portions 814 ”, the main body 812” can be made so that it can be separated from the side portions 814 ”along the path defined by the perforated holes 816 ”when a force is applied to them. In at least one such embodiment of the present invention, the side portions 814 "may remain attached to the housing 802" after the main body 812 "is separated from it. In various other embodiments of the present invention, as shown in FIG. 37, the housing 802 ″ ″ may comprise an article of support material, for example, such as support material 836 ″ ″, may have one or more recesses 818 ″ ″ located between the main body 812 ″ ″ and the side parts 814 ″ ″, which can, by analogy with the above, make it possible to separate the main body 812 ″ ″ from the side parts 814 ″ ″.

In addition to the above, in various embodiments of the present invention, as soon as the main body is freed from the side parts, the working body can be removed from the fabric and the supporting material attached to the fabric with staples. In at least one embodiment of the present invention, the used casing 802, for example, can then be removed from the anvil portion 826, removed, and replaced with another casing. In at least one such embodiment of the present invention, the interchangeable housing may comprise an article of support material, for example, such as support material 836, placed thereon so that the working member can be reused. In various embodiments of the present invention, the removed casing can be sterilized as described below and another article of support material attached to the casing, whereby it can be used again.

In various embodiments of the present invention, a package comprising an article of support material may be configured to mount an article of support material on one of the following: an anvil and a cassette with brackets of a working member. In at least one embodiment of the present invention, as shown in FIGS. 38 to 40, the package 902 may include a first portion 904, with a surface 905 that may be designed to be fixed thereto with the possibility of releasing the article 936 from the supporting material . In various embodiments of the present invention, a binder 910 may be present on the surface 908 of the support material 936, the binder 910 may be designed to fasten the support material 936 to the anvil 926. In addition to the first part 904, the package 902 may include a second part 906 attached to the first part 904, and to the second part 906, a second article of support material may be attached, for example, such as support material 937. In various embodiments of the present invention By analogy with the support material 936, on the support material 937 there may be a binder deposited thereon, which can be used to attach the support material 937 with the possibility of release to the cassette 922 with brackets. In order to remove parts 904 and 906 from articles made of supporting material, the surgeon can grasp at least one of parts 904 and 906 and pull them away from articles made of supporting material, as shown in FIG. 40. In fact, the package 902 can be moved between the first, attached position and the second, unfastened position.

In various embodiments of the present invention, as shown in FIGS. 41 to FIG. 46, the packaging assembly for at least one article of support material may include an outer packaging 901 ′ that can serve as a cover for the inner packaging 902 ′ to contain the latter under sterile conditions. During use, the surgeon can open the outer packaging 901 ', take out the inner packaging 902' and perform some actions with the inner packaging 902 'to open access to the supporting material 936'. In at least one embodiment of the present invention, the inner packaging 902 'may include a sheet coating comprising a first part 904' and a second part 906 ', said first and second parts being able to serve as a shell for at least for part of the supporting material 936 'when they are in the first position, as shown in Fig. 42. In various embodiments of the present invention, the surgeon can rotate the second part 906 'relative to the first part 904' by grasping and pulling the valve 938 'located on the second end 940' of the second part 906 ', as shown in Fig. 42, and moving the second part 906 'to the second position, as shown successively in Figures 43 and 44. In at least one such embodiment of the present invention, the surgeon may rotate the second part 906' relative to the first part 904 'until the second part 906' at which, at least m re a part thereof is positioned next to the first part 904 '.

After that, in various embodiments of the present invention, the support material 936 'can then be aligned with one of the following: anvils and / or cassettes with brackets of the working body, as described above. In at least one embodiment of the present invention, as shown in Figs. 45 and 46, the inner packaging 902 'can be inserted into the working body 914' between the anvil 926 'and the cassette 922' with brackets so that the supporting material 936 'can was aligned, for example, relative to the cartridge 922 'with brackets. In various embodiments of the present invention, by analogy with the above, the anvil 926 'can be rotated in the direction of the cassette 922' with brackets and clamped on the packaging 902 'and the supporting material 936' so that the supporting material 936 'can be pressed against the cartridge 922 'with brackets, and binder 910 was able to secure the supporting material 936' on this cassette. After that, the anvil 926 'can be opened again and the layer of sheet coating 918' can be separated from the supporting material 936 'or otherwise removed.

In various alternative embodiments of the present invention, the packaging unit may include one or more pull-out cords designed to remove the sheet coating from the supporting material located inside the packaging unit. In at least one such sheet-coated embodiment of the present invention, some steps can be taken to allow access to the support material, the support material can be secured to a working body, and the pull-out cords can be pulled toward or away from you to remove the sheet coating with reference material. In various other embodiments of the present invention, as shown in Figs. 47 and 48, pull-out cords can be attached to a portion of the support material so that, for example, the grip area present in the support material can be removed from that portion of the support material that comes in contact with the tissue. In at least one such embodiment of the present invention, the support material 1002 can be sandwiched between the anvil and the cassette with the brackets of the working body, and efforts can be made to pull out the cords 1006 that are attached to the grip area 1004 of the hand contained in the support material 1002. As a result, in various embodiments of the present invention, the distal end 1003 of the support material 1002 can be pulled toward the proximal end 1005 using pull-out cords 1006, whereby the hand grip region 1004 can separate from the tissue contacting part 1036 along the perforated holes 1008. In at least one embodiment of the present invention, an opening 1010 may be provided in the support material 1002, which may be at the distal end of the tissue contacting part 1036, this the hole 1010 may form an already remote portion between the hand grip area 1004 and the tissue contact portion 1036 to reduce the force required to remove the hand grip area 1004. In at least one embodiment of the present invention, as shown in FIG. 49, at least one pull-out cord 1006 ′ may be attached to the hand grip region 1004 ′ in the support material 1002 ′ so that the proximal the end 1005 could be pulled toward the distal end 1003 to remove the hand grip area 1004.

In various embodiments of the present invention, to apply an article of support material to at least one of the following: an anvil and a cassette with brackets of a working body, an applicator can be used. In at least one embodiment of the present invention, as shown in FIGS. 50 to 53, the applicator assembly 1102 may include an applicator 1104 and at least one article 1136 of support material, the applicator 1104 may have at least at least one surface serving as a support for the supporting material 1136 on it. In at least one such embodiment of the present invention, the applicator 1104 may have an upper surface 1106 and a lower surface 1108, each of which is said to have a top and bottom surface Tei can be designed to accommodate releasably at least one product 1136 from the reference material. In various embodiments of the present invention, each article of support material 1136 can be releasably attached to the upper and lower surfaces of the applicator 1104, for example, by using a binder and / or mechanical fastener. As shown in Figs. 50 and 51, each article 1136 of the supporting material may have a front surface 1110, which at least partially can be covered with a binder to fix this front surface 1110 on the working body. In at least one such embodiment, a binder may be applied to the article 1136 from a support material in a plurality of local zones 1112.

In order to impose an article of supporting material on a cassette with brackets and / or anvil that are part of the working body assembly using an applicator, for example, such as applicator 1104, this applicator can be positioned at least partially between the cassette with brackets and the anvil in this way so that the anvil can be closed on the supporting material. In various embodiments of the present invention, as shown in FIGS. 52 and 53, the applicator assembly 1102 can be at least partially positioned between the anvil 1126 and the cassette 1122 with the brackets of the operating member 1114, as a result of which the anvil 1126 can be aligned with the article 1136 of reference material and close on this product. In at least one embodiment of the present invention, an groove 1116 for alignment at its first end and a tongue 1117 at its second end may be further provided in the applicator 1104, and the surgeon may use the groove 1116 for alignment to align and position the applicator assembly 1102 inside the working body 1114. In at least one such embodiment of the present invention, the alignment groove 1116 may be configured so that the working body 1114 is installed between the side walls of the groove 1116 vnivaniya in close proximity to these walls. Thanks to the binder 1112, the articles 1136 of the supporting material can be attached by adhesion to the anvil 1126 and the cassette 1122 with brackets so that when the anvil 1126 is reopened, the applicator 1104 can be removed from the working body assembly 1114, leaving the articles of the supporting material inside the working material body.

In various embodiments of the present invention, at least one protective sheet (not shown), for example, similar to sheet coating 918, can be placed on the front surface 1110, whereby the applicator 1104 can be installed and reinstalled on one of the following: anvil and cassette with the brackets of the working body 1114 without the binder 1112, for example, creating a connection with the anvil and / or cassette with brackets. In at least one such embodiment of the present invention, said sheets can be removed by the surgeon as soon as the applicator is properly positioned and aligned in the working body to allow contact of the binder with the cassette with brackets and / or anvil of the working body. In various embodiments of the present invention, in addition to or instead of the tongue 1117, the applicator may have at least one holder, such as, for example, holders 1134, the purpose of which is to facilitate the operation of the surgeon with the applicator inside the working body. In at least one embodiment of the present invention, a first holder 1134 can be created on the first side of the applicator 1104, and in addition, a second holder 1134 can be created on the second side of the applicator. In various embodiments, the holder can have corrugation elements 1138 , which can be performed with the aim of making it easier for the surgeon to hold the applicator 1104 in hands. For this, at least a part of the corrugation elements 1138 (Note p. 2) may consist of soft or elastic material and, for example, such as rubber.

In various other embodiments of the present invention, although not shown, the packaging means for at least one article of support material may include a tubular casing, which can be designed to install at least one of the following: anvils and cassettes with brackets. In at least one embodiment of the present invention, the support material may comprise a binder on the surface, which may be designed to adhere the article of support material to release at least one of the following: anvil and cassette with brackets. In at least one such embodiment of the present invention, the tubular casing may be designed to house at least one of the following: anvils and cassettes with brackets so that the position of the anvil and / or cassettes with brackets is aligned with the position of the product from supporting material inside the tubular casing. In various embodiments of the present invention, the tubular casing may include a middle wall extending between the first side and the second side of the inner boundary surface of the casing. In various embodiments of the present invention, the middle wall may have an upper surface and a lower surface, wherein each of said upper and lower surfaces may be designed to release the article of the supporting material thereto. In at least one such embodiment of the present invention, the working body can be aligned with the middle wall and closed on the middle wall to attach the supporting material to the anvil and / or cassette with brackets.

In various embodiments of the present invention, a support material feeder may be used to supply support material. In at least one embodiment of the present invention, as shown in FIGS. 54 and 55, feeder 1200 may be configured to supply support material 1236 from a housing assembly consisting of parts 1210 and 1212. As described in more detail below, feeder 1200 may include a roller, or reel, 1224 of the supporting material, and the supporting material can be supplied from the coil 1224 to the working body of the surgical instrument, as shown in Fig. 57. In various embodiments of the present invention, the support material 1236 can be attached to the carrier tape 1202 by adhesion, or otherwise supported by this tape so that as the support material 1236 is fed, this material can be separated from the carrier tape 1202. In various embodiments of the present of the invention, as shown in FIGS. 54 to FIG. 57, the carrier tape 1202 may have a surface 1204 that can be designed to receive support material 1236 on it. In various embodiments of the present invention the support material 1236 can be divided into fragments before and / or after it is placed on the surface 1204. In at least one embodiment of the present invention, each of the fragments of the support material 1236 can have a width that is equal to or less than the width of the surface 1204, and, in various embodiments of the present invention, fragments of the support material can be releasably attached to the surface 1204 of the carrier tape 1202 using, for example, a binder with low strength.

In various embodiments of the present invention, as shown in FIGS. 54 to FIG. 57, the inner wall 1214 of the first housing portion 1210 may have a plurality of connecting elements 1216 extending therefrom. At least in one embodiment of the present invention, the connecting elements 1216 may be included in conjunction with other connecting elements extending from the inner wall of the second part 1212, or in conjunction with the holes made in it to fasten together the first and second parts of the housing. In various embodiments of the present invention, as shown in FIG. 56, the feeder 1200 may further include a coil shaft 1242, which may support the coil 1224 to rotate. In at least one such embodiment of the present invention, the coil shaft 1242 may mate with an opening 1241 in the housing part 1210 and an opening (not shown) in the second part 1212. In various embodiments of the present invention, the coil shaft 1242 may be installed in the coil 1224 so that they can rotate together. As outlined above, the support material 1236 and the carrier tape 1202 can be unwound from the reel 1224 when the support material 1236 is fed. In at least one embodiment of the present invention, a force can be applied to the support material 1236 so that it can be manually pulled out the feeder 1200. In various other embodiments, which are described in more detail below, the feeder 1200 of the supporting material may further include a wheel 1234, which may have such an adhesion with the supporting material 1236, which is sufficient for the surgeon, or and another clinician could rotate the wheel 1234 and slide the supporting material 1236 from the feeder 1200. In at least one embodiment of the present invention, as shown in FIG. 55, the feeder 1200 may further include a wheel shaft 1235 that can support the wheel 1234 with the possibility of its rotation inside the case of the feeder. In at least one embodiment of the present invention, the wheel 1234 can be mounted on the shaft 1235 so that they can rotate together about the axis defined by the hole 1249 made in the first housing part 1210 and the hole (not shown) made in the second body parts 1212.

In various embodiments of the present invention, as shown in FIG. 55, the wheel 1234 can be configured to at least partially exit through an opening 1239 in the feeder body, whereby the surgeon can rotate this wheel 1234. At least in at least one embodiment of the present invention, the wheel 1234 can be made so that during operation it contacts or engages due to friction with the supporting material 1236 and / or the carrier tape 1202, as a result of which the wheel rotates Ica 1234 can cause or facilitate the movement of the supporting material 1236 further towards the pulling roller 1232. In addition to or indicated instead, the pulling roller 1232 can be designed to contact or enter into engagement due to friction with the support material 1236 and / or carrier tape 1202. In at least one embodiment of the present invention, the pulling roller 1232 may engage with the wheel 1234 during operation, for example, through a drive belt 1243, resulting in ix wheel 1234 can be transmitted to the pinch rolls 1232. Although a drive belt is shown, it is possible to use any other suitable device, e.g., such as a drive chain or drive belt. In various embodiments of the present invention, at least one of the housing parts 1210 and 1212 may include guides 1262 that can be used to align the drive belt 1243 with respect to the wheel 1234 and the pull roller 1232.

In various situations, sagging of the carrier tape 1202 may occur after it has been separated from the supporting material 1236. In at least one embodiment of the present invention, the feeder 1200 may include one or more tensioning devices to reduce such sagging of the carrier tape 1202. In various embodiments of the present of the invention, by analogy with the foregoing, the feeder 1200 may further include a shaft 1218, which can be rotatably mounted in the hole 1251 which serves as its support, made in the first Asti housing 1210, and a hole (not shown) formed in second housing portion 1212, the shaft 1218 can serve as a support pressure roller 1222 rotatably. In various embodiments of the present invention, as shown in particular in FIGS. 56 and 57, the feeder 1200 may further include a second pulling roller 1253, which may be designed to cooperate with the pinch roller 1222. In at least one embodiment of the present of the invention, the second pulling roller 1253 during operation may engage with the wheel 1236, whereby the rotation of the wheel 1234 can be transmitted to the pulling roller 1253. In various embodiments of the present invention, the feeder 1200 may additionally include a gear block containing a spur gear 1244 attached to at least one of the following: a wheel 1234 and a shaft 1235, an intermediate gear 1246, which is supported by a shaft 1247, and a driven gear 1252, which in the process operation can be in engagement with the pulling roller 1253. In at least one such embodiment of the present invention, the carrier tape 1202 can be placed between the pulling roller 1253 and the pressure roller 1222, resulting in a pulling roller 1253 in rotation with a wheel 1234, this pulling roller 1253 will be able to pull the carrier tape 1202 towards itself. In at least one embodiment of the present invention, the pinch roller 1222 and / or the pull roller 1253 may consist at least in part of compressible material, whereby the pinch roller 1222 can press the carrier tape 1202 against the pull roller 1253.

As described above with reference to FIGS. 54 to FIG. 57, the applicator 1200 may include a housing 1201 comprising a first part 1210 and a second part 1212, said first and second parts being able to be bonded to each other. In at least one embodiment of the present invention, the first and second parts of the housing 1201 may be assembled together using threaded connections, snap fit and / or otherwise. In various embodiments of the present invention, the first and second parts of the housing can be assembled together with the possibility of separation, as a result of which they can be separated to remove and replace the spent coil of the supporting material. In at least one embodiment of the present invention, the housing may include ergonomic enhancement means that make it easier for the surgeon to tackle this housing.

In various other embodiments of the present invention, as shown in FIGS. 58 to 61, the feeder or applicator 1266 may include a coil 1267 with which support material 1236 can be supplied and, in addition, a storage coil 1270, which can be designed to accumulate the carrier tape 1202 after it has been separated from the supporting material 1236. By analogy with the above, the supporting material 1236 can be supplied from the applicator 1266 due to the adhesion between this supporting material 1236, the wheel 1234 and / or the pulling roller 1232 . In at least one embodiment of the present invention, the storage coil 1270 can also engage during operation with the wheel 1234 so that the rotation of the wheel 1234 can rotate the coil 1270 and the support tape 1202 is wound around it. In various embodiments of the present invention, the applicator 1266 may include a gear block containing a spur gear 1244 attached to at least one of the following: a wheel 1234 and a shaft 1235, an intermediate gear 1246, a support for which with the possibility of its rotation is the shaft 1247, and the driven gear 1272, which can be attached to at least one of the following: the coil 1270 and the shaft 1271. As a result, in at least one such embodiment of the present invention when the wheel 1234 rotates the storage coil 1270 is driven, a force is applied directly to the carrier tape 1202, and the carrier tape 1202 is accumulated on the coil 1270.

In various embodiments of the present invention, as shown in Figs. 57 and 61, applicators 1200 and / or 1266 can be used to lay the product of the supporting material on the panel "D" of the cassette "SC" with brackets and / or the front surface "F" of the anvil "BUT". In at least one embodiment of the present invention, as shown in FIG. 61, the surgeon may first place the applicator 1266, for example, adjacent to the first end 1276 of the panel D. After that, the surgeon can pull the applicator towards the second end 1278 of the panel D, simultaneously turning the wheel 1234 to feed the supporting material 1236. As discussed above, the supporting material 1236 can be divided into separate fragments and, in at least one embodiment of the present invention, the length of these fragments can be such that these the pieces were properly stacked on the cassette panel with staples and / or the front surface of the anvil. In various other embodiments of the present invention, the article of support material may consist of one continuous strip, and the applicator may include a cutting element (not shown) that may be designed to cut the support material of any suitable length. In various embodiments of the present invention, articles of support material can have a binder on the surface (or this binder can be applied to them), which can be designed to fix the support material with the possibility of release to one of the following: panel and / or front surface .

In various embodiments of the present invention, an article of support material may be manufactured using an injection molding process. In at least one embodiment of the present invention, the injection mold (not shown) may have, for example, one or more cavities created therein that can be used to receive molten material. In various embodiments of the present invention, the molten material may include plastic and / or any other suitable support material. In various embodiments of the present invention, said mold may further include at least one gate cavity and / or a hopper that can create a fluid connection between the mold cavities and the injection molding machine. In at least one embodiment of the present invention, the mold may have first and second parts that can be separated after the molten material has sufficiently crystallized or solidified within the mold cavities.

In various embodiments of the present invention, as shown in FIGS. 62 and 63, a support article 1336 may have a first surface 1302 and a second surface 1304, and a plurality of holes or recesses 1306 may be made in said first and second surfaces. in at least one embodiment of the present invention, recesses 1306 may be created by molten material in the mold during the injection molding process. More specifically, the mold may have one or more cavities with a plurality of protrusions, which can be configured to flow around the molten metal, and after crystallization of the supporting material 1336 and removing it from the mold where the protrusions were previously located, in the supporting material Recesses 1306 may be located 1336.

In various embodiments of the present invention, the support material 1336 may further comprise a plurality of walls, such as, for example, walls 1305 formed between the first and second surfaces 1302 and 1304, the walls 1305 forming recesses 1306. In at least one embodiment of the present invention the walls 1305 can extend perpendicularly and / or in the transverse direction relative to the aforementioned first and second surfaces, as a result of which these walls 1305 can have such a structure and be placed so in such a way that they will create a structure or mesh of recesses 1306 in the support material 1336. In various embodiments of the present invention, the support material 1336 may be resilient, whereby the first surface 1302 and / or the second surface 1304 can be compressed toward each other. In at least one such embodiment of the present invention, the support material 1336 can be made in such a way that it can be squeezed or planted by squeezing between two or more locking elements of the working body, as described above. In various embodiments of the present invention, an article of support material can be compressed when a surgical instrument is installed in a working body, and then expanded when released from the working body. In at least one embodiment of the present invention, the support material 1336 may be configured to compress to move the first surface 1310 toward the surface 1312. In any case, the walls 1305 may be configured to deflect or crease. and allow portions of the supporting material 1336 to resiliently move toward each other.

The devices described herein may be designed to be destroyed after a single use, or they may be designed to be reused. However, in both cases, the device can be brought into good condition for reuse after at least one use. Bringing it into good condition can include any combination of the steps of disassembling the device, followed by cleaning or replacing specific parts and further reassembling. In particular, the device can be disassembled, and any number of specific parts or parts of the device can be selectively replaced or removed in any combination. When cleaning and / or replacing specific parts, the device can be reassembled for further use either at a facility specializing in tidying up, or by the personnel of the surgical department immediately before the surgical intervention. Those skilled in the art will understand that when a device is in good condition, many methods of disassembling, cleaning / replacing, and reassembling can be used. The use of such methods and the resulting device in good condition do not go beyond the scope of the present invention.

In a preferred case, preparatory work with the invention described herein will be performed prior to surgery. First get a new or used tool and, if necessary, clean. Then the instrument can be sterilized. According to one sterilization method, the instrument is placed in a closed and sealed container, such as a plastic bag or a TYVEK bag. The container and instrument are then placed in a zone of exposure to radiation that can penetrate into the container, such as gamma radiation, X-rays, or a stream of high-energy electrons. Radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in a sterile container. A sealed container retains the sterility of the instrument until it is opened in a medical facility.

Although the present invention is described with reference to specific examples of its structural embodiment, this invention can be further modified within the indicated essence and scope. Thus, it is intended to cover any variations, applications or modifications where its basic principles are used. In addition, it is intended that the invention covers all such deviations from the foregoing description, without departing from the well-known and generally accepted technology in the technical field to which this invention relates.

Claims (10)

1. The node of the working body for use with a surgical stapler, containing:
a cassette with brackets including a panel having a surface, a plurality of holes formed in the surface, and a longitudinal groove essentially dividing the surface;
a blade placed so as to extend posteriorly inside the longitudinal groove,
an anvil having a front surface;
a first article of support material in which a first slot is made, wherein the first article of support material is arranged to be placed between said cassette with brackets and said anvil on the first side of the longitudinal groove so that said slot is substantially aligned with the first hole, selected from said openings;
a second article of support material in which a second slot is made, wherein the second article of support material is arranged to be placed between said cassette with brackets and said anvil on the second side of the longitudinal groove opposite the first article of support material so that the second slot is essentially , combined with a second hole selected from said holes; and
the first and second connecting elements, and the first connecting element is arranged to be placed in the first slot and said first hole for fixing, with the possibility of unlocking said first article of supporting material to said cassette with brackets, and the second connecting element is arranged to be placed in the second slot and the second hole for fixing with the possibility of unlocking said second product to said cassette with brackets, while at least the first the connecting element comprises:
a head portion having a perimeter greater than the first slot of the first article of support material, the head part being adapted to mesh with the first article of support material and limit lifting the first article of support material from the surface of the panel when the first connecting element is engaged with the first hole, and
a body, with the possibility of extracting placed in the first hole, and the body has a perimeter smaller than the perimeter of the head part, and is configured so that the side wall of the first slot is made with the possibility of engagement with the perimeter of the body and limit the movement of the first product from the supporting material on the surface of the panel, moreover, the body contains a first end connected to said head part, and a second end placed in the first hole, while the head part of the first connecting element contains a section that expands r housing and said head portion is detachable from the body, when at least part of the first product of support material is separated from the staple cartridge. 2. The assembly according to claim 1, which further comprises a plurality of connecting elements, wherein a plurality of holes are formed in the front surface, and there is a third article of support material containing a plurality of slots substantially aligned with the plurality of holes, such that the plurality of connecting elements are introduced into a plurality of holes and a plurality of slots, so as to be able to detach to hold said article of the supporting material on the anvil. 3. The node according to claim 1, in which the first connecting element is made with the possibility of uncoupling from the first slot when the first product of the supporting material is disconnected from the cassette with brackets. 4. The node according to claim 1, in which the first connecting element is made of bioabsorbable material. 5. The assembly according to claim 1, in which the first connecting element is configured to be pressed into the first hole. 6. The node according to claim 1, in which the body of the first connecting element is made without threads. 7. The node of the working body for use with a surgical stapler, containing:
a cassette with brackets including a panel having a surface, a plurality of holes formed in the surface, and a longitudinal groove essentially dividing the surface;
a blade placed so as to extend posteriorly inside the longitudinal groove,
anvil;
a first article of support material in which a first slot is made, wherein the first article of support material is arranged to be placed between the cassette with the brackets and the anvil on the first side of the longitudinal groove so that said slot is substantially aligned with the first hole selected from mentioned holes;
a second article of supporting material in which a second slot is made, the second article of supporting material being arranged to be placed between the cassette with brackets and the anvil on the second side of the longitudinal groove opposite the first article of supporting material so that the second slot is essentially aligned with a second hole selected from said holes; and
many fasteners made with the possibility of fixation with the possibility of fixing the aforementioned first and second articles of supporting material to said cassette with brackets, and at least one of the fasteners contains
a body configured to engage the cassette with brackets and restrict relative movement between the first article of reference material and the cassette with brackets in a first direction parallel to the surface of the panel, and
the head part, which extends outward from the body, which serves to limit the movement of the first product from the supporting material and the cassette with brackets in the second direction perpendicular to the surface of the panel, while the body has a perimeter smaller than the perimeter of the head part and is made so that the side wall of the first slot engaged the perimeter of the body and prevented the sliding of the product from the supporting material on the surface of the panel, the body having a first end connected to the head part and a second end placed first in the first hole, wherein the fastener comprises a head portion which extends from the body and the head portion is detachable from the body, when at least part of the first product of support material is separated from the staple cartridge. 8. The node according to claim 7, in which the cassette with brackets contains many holes, and the fastening elements are made with the possibility of removable pressing into the holes for attaching the first and second products of the supporting material to the cassette with brackets. 9. The assembly according to claim 7, which further comprises a third article of support material, arranged to be placed between the cassette with brackets and the anvil, and a plurality of fasteners with the possibility of disconnecting the supporting material to the anvil. 10. The node according to claim 7, in which the fasteners are made of bioabsorbable material.

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