CN110198673A

CN110198673A - End effector including distal tissue adjoining members

Info

Publication number: CN110198673A
Application number: CN201480020293.8A
Authority: CN
Inventors: K·J·施密德; B·W·史密斯; F·E·谢尔顿四世
Original assignee: Ethicon Endo Surgery Inc
Current assignee: Ethicon Endo Surgery Inc
Priority date: 2013-02-08
Filing date: 2014-02-07
Publication date: 2019-09-03
Anticipated expiration: 2034-02-07
Also published as: MX362624B; JP6290262B2; JP2016506829A; BR112015018972A2; BR112015018972B1; MX2015010284A; RU2015138092A; CN110198673B; RU2662861C2; BR112015018972A8

Abstract

The invention discloses a kind of fastener cartridge, the fastener cartridge may include the warehouse with securing member chamber, be stored at least partly in the intracorporal fastener in the storehouse, and be located in the layer (11150) on the warehouse.The warehouse may include proximal end and distal end.Similarly, the layer may include proximal end and distal end.The distal end of the layer can extend relative to the distal end of the warehouse towards distal side.In addition, the layer may include distal part (11156), the distal part extends relative to the securing member chamber being limited in the warehouse towards distal side.The distal part can be against the tissue positioning fastened, and can flexibly support the tissue after the layer is abutted against the tissue implantation.The layer may include portions of proximal (11158), and the portions of proximal is extended proximally relative to the securing member chamber, and the securing member chamber can flexibly support the tissue after the layer is implanted.

Description

End effector including distal tissue adjoining members

Cross reference to related applications

This non-provisional is according to the regulation of 35 U.S.C. § 120, to the title for being filed on March 28th, 2012 For the U.S. of " Tissue Thickness Compensator Comprising a Plurality of Medicaments " The part continuation application of patent application serial number 13/433,129, the complete disclosure of the patent application is accordingly by reference It is incorporated herein.

Background technique

The present invention relates to surgical instruments, and in various embodiments, are related to being designed to cut and suturing tissue Surgery cuts and suture instruments and its nail bin.

Detailed description of the invention

The following explanation of the embodiment of the present invention, the features and advantages of the present invention and its acquisition methods are referred in conjunction with the accompanying drawings It will become apparent, and be better understood invention itself, in the accompanying drawings:

Fig. 1 is the front, left perspective view of surgical stapling and cutting off apparatus, and wherein handle portions include that the automatic of connecting rod triggering returns Contracting mechanism and ratchet manual retract mechanism；

Fig. 2 is the surgical stapling of Fig. 1 and the right rear perspective view of cutting off apparatus, wherein a part of elongated shaft be removed and The right half-shell of shank shell is removed to expose automatic firing end traveling cam mechanism and manually percussion cam mechanism；

Fig. 3 be the surgical stapling of Fig. 1 and the handle portions of cutting off apparatus and elongated shaft the right side after perspective dismantling view；

Fig. 4 is the surgical stapling of the part dismantling of Fig. 1 and the right side elevation view of cutting off apparatus；

Fig. 5 be Fig. 1 part dismantling surgical stapling and cutting off apparatus right rear perspective view, wherein close mechanism closure and It clamps, and gemmule pawl firing lock completes first stroke, and wherein manual retract mechanism is removed to expose link-type tooth The distal link of item, the distal link trigger the automatic retracted of firing lock；

Fig. 6 is under the original state that end effector is opened and anti-inversion organization is engaged, outside the part dismantling of Fig. 4 The left side elevation view of section suture and cutting off apparatus；

Fig. 7 is that immediately distal link has been activated and has locked anti-reversing trip lever forward to allow link-type rack gear to bounce back Later, the left side thin portion front view of the surgical stapling of the dismantling of Fig. 1 and cutting off apparatus；

Fig. 8 be the surgical stapling of Fig. 1 and the manual retract mechanism of cutting off apparatus free pulley and backgear and manually return The right dismantling perspective view of contracting lever and ratchet pawl；

Fig. 9 is the left side elevation view of the surgical stapling of Fig. 1 and the part dismantling of cutting off apparatus, and wherein anti-inversion organization engages The link-type tooth fired completely disconnected before to the manual retrieving lever in actuating Fig. 8 from combination stretching/compressing spring Item；

The left side elevation view of the part dismantling of the surgical stapling that Figure 10 is Fig. 9 and cutting off apparatus, wherein anti-turn discharges thick stick Hidden parts, backgear and the manual percussion trip lever of bar are shown in phantom；

Figure 11 is after the actuating of percussion trip lever manually has made link-type rack gear manual retrieving, and the surgery of Figure 10 stitches Close the left side elevation view disassembled with the part of cutting off apparatus；

Figure 12 is the left side elevation view of the surgical stapling of Figure 11 and the part dismantling of cutting off apparatus, wherein link-type rack gear quilt It omits, to depict the manual percussion trip lever being disengaged with anti-inversion organization；

Figure 13 is the right side elevation view of alternative anti-turn relieving mechanism, and wherein link-type rack gear is in retraction position, and And anti-reversing trip lever is proximally positioned, wherein anti-down flap is joined to trigger shaft；

Figure 14 is the right side thin portion front view of the backgear of Figure 13, automatic retracted cam and farthest side connecting rod；

Figure 15 is to slide automatic retracted cam distad in another firing schedule and lock anti-reversing trip lever, from And the right side elevation view of the automatic releasing mechanism after being disengaged with anti-inversion organization；

Figure 16 is open the front, left perspective view of nail administration assembly, leads to wherein the right half part of replaceable nail bin is included in nail In road；

Figure 17 is the decomposition of the nail administration assembly of Figure 16 with complete replaceable nail bin and non-joint connecting shaft configuration Perspective view；

Figure 18 is the perspective view that can be positioned on the intracorporal multiple staple drivers in storehouse of nail bin；

Figure 19 is the two cuttves of the nail administration assembly of Figure 16 and the perspective view of trigger shaft (E type crossbeam)；

Figure 20 is the perspective view of the wedge-shaped slides of the nail bin of nail administration assembly；

Figure 21 is the left side elevation view that the center line 21-21 of the nail administration assembly along Figure 16 is intercepted in longitudinal cross-section；

Figure 22 is no replaceable nail bin and the not no nail administration assembly of the opening of Figure 16 of the distal part of nail channel Perspective view；

Figure 23 is the anterior elevational view that the line 23-23 of the nail administration assembly along Figure 16 is intercepted in cross-section, is depicted in figure The inside staple drivers and two cuttves of nail bin and a part of trigger shaft；

Figure 24 is the longitudinal axis 24-24 interception substantially along the nail administration assembly of the closure of Figure 16 to include between two cuttves Center contact point but also lateral shift between wedge-shaped slides are to show the left side of the nail and staple drivers that are located in nail bin Side front view；

Figure 25 is the left side thin portion front view of the nail administration assembly of Figure 24, typical feelings when wherein two cuttves are than replacement nail bin Condition slightly more bounces back；

Figure 26 corresponds in Figure 24 describe the left side thin portion front view of the nail administration assembly of Figure 25 of configuration, wherein two Knife starts to fire；

Figure 27 is the left side section of the nail administration assembly of the closure of Figure 24 after two cuttves and trigger shaft distad fire Front view；

Figure 28 is after nail bin percussion and two cuttves retraction, and the left side section of the nail administration assembly of the closure of Figure 27 is faced Figure；

Figure 29 is the left side cross-sectional details front view of the nail administration assembly of Figure 28, and wherein two cuttves are allowed to fall into locking position It sets；

Figure 29 A is the local perspective view of the jaw of end effector assembly according to various embodiments of the present disclosure, wherein Various elements are all removed from jaw, are depicted at the percussion component of non-firing position in figure, and are further depicted and actuator Release stop part engagement sliding part；

Figure 29 B is the local perspective view of the jaw of Figure 29 A, wherein various elements are all removed from jaw, depicts place in figure In the percussion component of part firing position, and further depict the sliding part being disengaged from the release stop part of actuator；

Figure 30 be include axis and reseasable tip actuator surgery suturing appliance perspective view；

Figure 31 is the axis of the surgery suturing appliance of Figure 30 and the local perspective view of end effector；

Figure 32 is the local perspective view for being just assembled into the end effector of the axis of surgery suturing appliance of Figure 30；

Figure 33 is another local perspective view for being just assembled into the end effector of the axis of surgery suturing appliance of Figure 30；

Figure 34 is the part section front view for showing the end effector of axis for the surgery suturing appliance for being not coupled to Figure 30；

Figure 35 is the part section front view for showing the end effector of axis for the surgery suturing appliance for being connected to Figure 30, and And it also shows in the sliding lining ring for opening unlocked position；

Figure 36 is the part section front view for showing the end effector of axis for the surgery suturing appliance for being connected to Figure 30, and And also show the sliding lining ring in closed locked position；

Figure 37 is the exploded view of the end effector of Figure 30, which is shown with the state that component is removed；

Figure 38 is the exploded view of the axis of Figure 30；

Figure 39 is the longitudinal sectional drawing of nail bin and anvil block in the close position, and nail bin includes rigid support portion and can press The tissue thickness compensation part of contracting, showing nail, never firing position moves to firing position during First ray；

Figure 40 is the anvil block of Figure 39 and another sectional view of nail bin, is shown after percussion sequence is completed in open position The anvil block set；

Figure 41 is the local detail drawing of the nail bin of Figure 39, shows the nail in non-firing position；

Figure 42 is the cross-section front view of nail bin, which includes rigid support portion and the compensation of compressible tissue thickness Part shows the nail in non-firing position；

Figure 43 is the detail drawing of the nail bin of Figure 42；

Figure 44 is the front view of nail bin and anvil block in an open position, which includes rigid support portion and compressible Tissue thickness compensation part, show the nail in non-firing position；

Figure 45 is the front view of nail bin and anvil block in the close position, which includes rigid support portion and compressible Tissue thickness compensation part, show in non-firing position nail and be trapped between anvil block and tissue thickness compensation part Tissue；

Figure 46 is the anvil block of Figure 45 and the detail drawing of nail bin；

Figure 47 is the anvil block of Figure 45 and the front view of nail bin, and showing to be located between anvil block and nail bin has different thickness The tissue of degree；

Figure 48 is the anvil block of Figure 45 as shown in figure 47 and the detail drawing of nail bin；

Figure 49 is to show the tissue thickness compensation part compensated to the different tissues thickness being trapped in different nails Schematic diagram；

Figure 50 is the tissue thickness compensation part shown to compressing force is applied by one or more crosscutting blood vessel of staple line Schematic diagram；

Figure 51 is the schematic diagram for showing the tissue being trapped in nail；

Figure 52 is the schematic diagram for showing the thick tissue and tissue thickness compensation part that are trapped in nail；

Figure 53 is the schematic diagram for showing the thin tissue and tissue thickness compensation part that are trapped in nail；

Figure 54 is the schematic diagram for showing the tissue thickness compensation part and the tissue with interior thickness that are trapped in nail；

Figure 55 is the partial cutaway view of the end effector of surgery suturing appliance according at least one embodiment；

Figure 56 is the partial cutaway view according to the end effector of at least one alternative embodiment；

Figure 57 is the partial cutaway view according to the end effector of another alternative embodiment；

Figure 58 is the partial cutaway view for being shown as the end effector in deflected；

Figure 59 is the partial cutaway view of the end effector of Figure 58 in release conditions；

Figure 60 is the sectional perspective view of nail bin, which includes being configured to remaining to tissue thickness compensation part into branch Support part point laterally retains component；

Figure 61 is the sectional view for being just used to the nail bin of Figure 60 of suture tissue；

Figure 62 is the perspective view of nail bin, which includes warehouse and be attached on warehouse by multiple attachment members that fire Tissue thickness compensation part；

Figure 63 is the exploded view of the nail bin of Figure 62；

Figure 64 is the front view of the nail bin of Figure 62；

Figure 65 is the sectional view of the nail bin of Figure 62 of the taken along line in Figure 64, is shown in non-firing position Attachment members can be fired；

Figure 66 is the sectional view of the nail bin of Figure 62 of the taken along line in Figure 64, is shown in the percussion position disconnected That sets fires attachment members；

Figure 67 is the perspective view of tissue thickness compensation part；

Figure 68 is the perspective view for being just assembled into the tissue thickness compensation part of Figure 167 of nail bin；

Figure 69 is the tissue thickness compensation part of Figure 68 and the exploded view of nail bin；

Figure 70 is the detail drawing of the proximal end of tissue thickness compensation part；

Figure 71 is the partial elevation view for being assembled into the tissue thickness compensation part of Figure 70 of nail bin；

Figure 72 is the tissue thickness compensation part of Figure 71 and the plan view of nail bin；

Figure 73 is the front view for tissue thickness compensation part to be remained to the installation part of nail bin；

Figure 74 is the side view of the installation part of Figure 73；

Figure 75 is the rearview of the installation part of Figure 73；

Figure 76 is the bottom view of the installation part of Figure 73；

Figure 77 is the partial cutaway view of nail bin, which includes being configured to tissue thickness compensation part releasedly Remain to the retaining pin of nail bin warehouse；

Figure 77 A is the partial perspective cutaway view of the nail bin of Figure 77, and wherein a part of the nail bin is moved because illustrating purpose It removes；

Figure 78 is the partial cutaway view of the nail bin of Figure 77, shows the retaining pin in revocation status；

Figure 79 is the partial perspective cutaway view of the nail bin of Figure 77, and the retaining pin in revocation status is also shown；

Figure 80 is the partial cutaway view of nail bin, which includes being configured to tissue thickness compensation part releasedly The clamp for remaining to warehouse shows the clamp in closed state；

Figure 81 is the partial cutaway view of the nail bin of Figure 80, shows clamp in the open state；

Figure 81 A is the perspective view for being disposed with the nail bin of layer such as tissue thickness compensation part and/or buttress material thereon, In the nail bin opposed end actuator cutting blade arrangement, and the rest part of its end effector is due to illustrating purpose It is removed；

Figure 82 is the profile view of the nail bin of Figure 81 A, is shown for cutting off the layer being arranged in nail bin distal chamber The cutting blade of distal end, wherein cutting blade is not disposed, and for clarity omits nail therein；

Figure 83 is the profile view of the nail bin of Figure 81 A, wherein the cutting blade of the distal end for cutting off layer is by portion Administration, and for clarity omit nail therein；

Figure 84 is the perspective view of the jaw of end effector assembly according to various embodiments of the present disclosure, depicts and passes through Proximal connector and distal connector are fixed to the tissue thickness compensation part of warehouse, and further depict in non-firing position Fire component；

Figure 85 A is the partial plan layout of the jaw of Figure 84, is depicted at the actuator of pre-actuated position；

Figure 85 B is the partial plan layout of the jaw of Figure 84, is depicted at the actuator of actuated position；

Figure 85 C is the detail drawing of the jaw of Figure 85 B；

Figure 85 D is the front view of the jaw of Figure 84, is depicted at the actuator of actuated position, and further depicts disconnection Proximal connector and distal connector；

Figure 86 is the partial elevation view of the jaw of Figure 84, wherein various elements all from jaw remove, depict in warehouse with The sliding part of the tab engagement of the actuator of Figure 85 A；

Figure 87 is the partial elevation view of the jaw of Figure 84, wherein various elements all from jaw remove, depict in warehouse from The sliding part that the tab of actuator is disengaged；

Figure 87 A is the partial plan layout of the jaw of end effector assembly according to various embodiments of the present disclosure, is described Trigger shaft of the percussion component against the release stop part of actuator；

Figure 87 B is the partial plan layout of the jaw of Figure 87 A, depicts and extends through the release of actuator in percussion component and stop The trigger shaft of block piece；

Figure 88 is the perspective view of the jaw of end effector assembly according to various embodiments of the present disclosure, depicts fixation To the tissue thickness compensation part of warehouse, and further depict the percussion component in non-firing position；

Figure 89 is the partial elevation view of the jaw of Figure 88, wherein various elements are shown in a transparent manner, depicts extension Across the actuator of jaw, and further depict the percussion component in non-firing position；

Figure 90 is the partial cutaway view of nail bin, which includes being configured to tissue thickness compensation part releasedly The retaining pin for remaining to warehouse shows the retaining pin being active；

Figure 91 is the partial cutaway view of the nail bin of Figure 90, shows the retaining pin in dead status；

Figure 92 is the perspective view of the actuator of the nail bin of Figure 90, which is configured to keep retaining pin invalid；

Figure 93 A is the perspective view of the fastener cartridge assembly of end effector assembly according to various embodiments of the present disclosure, Depict the tissue thickness compensation part discharged from the warehouse of fastener cartridge assembly；

Figure 93 B is the perspective view of the fastener cartridge assembly of Figure 93 A, and the tissue for depicting the warehouse fixed to nail bin groupware is thick Spend compensating part；

Figure 93 C is the front view of the fastener cartridge assembly of Figure 93 A, wherein various elements are all from fastener cartridge assembly removal, It is depicted at the percussion component of pre- firing position；

Figure 93 D is the front view of the fastener cartridge assembly of Figure 93 A, wherein various elements are all from fastener cartridge assembly removal, It is depicted at the percussion component of part firing position；

Figure 94 is the partial perspective of the fastener cartridge assembly of end effector assembly according to various embodiments of the present disclosure Figure depicts the tissue thickness compensation part discharged from the warehouse of fastener cartridge assembly；

Figure 95 is the partial perspective of the fastener cartridge assembly of end effector assembly according to various embodiments of the present disclosure Figure depicts the tissue thickness compensation part discharged from the warehouse of fastener cartridge assembly；

Figure 96 is the partial cutaway view of the fastener cartridge assembly of Figure 95, depicts the tissue being maintained in the bridgeware of warehouse The installation part of thickness compensation part；

Figure 97 is the perspective view of the fastener cartridge assembly of end effector assembly according to various embodiments of the present disclosure, is retouched The tissue thickness compensation part discharged from the warehouse of fastener cartridge assembly is drawn；

Figure 98 is the perspective view of the fastener cartridge assembly of Figure 97, depicts the tissue of the warehouse fixed to fastener cartridge assembly Thickness compensation part；

Figure 99 is the cross-section front view of the end effector assembly of Figure 97, depicts the warehouse fixed to fastener cartridge assembly Tissue thickness compensation part, and further depict the end effector in unclamped position；

Figure 100 is the cross-section front view of the end effector assembly of Figure 97, depicts and is not attached to fastener cartridge assembly The tissue thickness compensation part of warehouse, and further depict the end effector assembly in clamped position；

Figure 101 is the perspective view of nail bin application device component, which includes that top tissue thickness is mended Part and nail bin are repaid, which includes multiple holding feature structures extending therefrom, which includes lower part Tissue thickness compensation part；

Figure 102 is located at the nail bin application device component of Figure 101 in staple cartridge channel and just in the nail bin application device The front view for the anvil block being closed on component；

Figure 103 is the nail bin of anvil block and the Figure 101 just removed from end effector in the Figure 102 for being again turned on position The front view of application device；

Figure 104 is located at the group of the Top tissue thickness compensation part of Figure 101 and the centre of Lower tissue thickness compensation part The sectional view knitted；

Figure 105 is to show to be sewn onto tissue and organized by the Top tissue thickness compensation part of cutting element cutting and lower part thick Spend the sectional view of compensating part；

Figure 106 is the perspective view of nail bin application device component according at least one embodiment, the nail bin application device group Part includes the Top tissue thickness compensation part for being configured to be attached on anvil block；

Figure 106 A is located at the nail bin application device component of Figure 106 in staple cartridge channel and just towards top tissue thickness The front view of the anvil block of compensating part movement；

Figure 106 B is shown after Top tissue thickness compensation part is engaged with anvil block, the figure just removed from end effector 106 nail bin application device；

Figure 107 is the section end view of the anvil block just moved towards the Top tissue thickness compensation part of Figure 106；

Figure 108 is the section end view of the anvil block engaged with Top tissue thickness compensation part；

Figure 109 is the perspective view of the nail bin of a non-limiting embodiment according to the present invention, and a piece of buttress material can Remain on the nail bin to release；

Figure 110 is the nail bin of Figure 109 and the decomposition perspective view of buttress material piece, and wherein buttress material piece includes from it The multiple components extended；

Figure 111 is the sectional view of the line 111-111 interception in Figure 109, is shown and a non-limit according to the present invention The component of Figure 110 of the nail cavity engagement of property embodiment processed；

Figure 112 is the sectional view of a piece of buttress material, the piece buttress material include with one according to the present invention it is non- The component of the nail cavity engagement of the nail bin of restricted embodiment；

Figure 113 is the exploded view of Figure 112, shows the nail with the nail bin of a non-limiting embodiment according to the present invention The separated component of chamber；

Figure 114 is the local perspective view of the support section of nail bin, which includes that detachable and/or interchangeable nail leg is led To part；

Figure 115 is the partial cutaway view of the nail bin of Figure 114, shows the nail just from cartridge deployment；

Figure 116 is the detail drawing of the sectional view of Figure 114 after nail bin is fired；

Figure 117 is the local perspective view of warehouse according to various embodiments of the present disclosure, shell and tissue thickness compensation part, Depict the protruding portion extended from warehouse；

Figure 118 is the local perspective view of warehouse according to various embodiments of the present disclosure, shell and tissue thickness compensation part, Depict the protruding portion extended from shell；

Figure 119 is the partial cutaway view of end effector assembly according to various embodiments of the present disclosure, depicts positioning Nail in the nail cavity of the warehouse of end effector assembly, and further depict the nail in unshaped configuration；

Figure 120 is the partial cutaway view of the end effector assembly of Figure 119, depicts the nail projected from nail cavity, and also It is depicted at the nail of shaped configuration；

Figure 121 is the perspective view of nail and lock according to various embodiments of the present disclosure, is depicted at the lock of locked configuration；

Figure 122 is the nail of Figure 121 and the perspective view of lock, is depicted at the lock of locked configuration；

Figure 123 is the nail of Figure 121 and the perspective view of lock, depicts the lock that pre- firing position is in nail cavity, and also It is depicted at the lock of locked configuration；

Figure 124 is the nail of Figure 121 and the perspective view of lock, depicts the lock that firing position is in nail cavity, and also retouch The lock in unlocked configurations is drawn；

Figure 125 is the perspective view of the fastener cartridge assembly of end effector assembly according to various embodiments of the present disclosure, Depict the lock that the lock chamber from the warehouse of fastener cartridge assembly extends；

Figure 126 is the sectional view of the lock of Figure 125, is depicted at the lock of unlocked configurations and is not attached to the connection of the lock Device；

Figure 126 A is the partial cutaway view of the fastener cartridge assembly of Figure 125, depicts warehouse, connector, tissue thickness's benefit Repay part and the lock in part assembled position；

Figure 127 is the partial cutaway view of the fastener cartridge assembly of Figure 125, is depicted at the lock of locked configuration, depicts Anvil block in clamped position, and it is depicted at the driver key of non-firing position；

Figure 128 is the partial cutaway view of the fastener cartridge assembly of Figure 125, is depicted at the lock of locked configuration, depicts Anvil block in clamped position, and further depict the driver key in part firing position；

Figure 129 is the partial cutaway view of the fastener cartridge assembly of Figure 125, is depicted at the lock of unlocked configurations, is described Anvil block in clamped position, further depicts the driver key in firing position；

Figure 130 is the sectional view of end effector, shows the firing member in part firing position；

Figure 131 is the sectional view of the end effector of Figure 130, shows the tissue thickness compensation part just far from part implantation The support section of movement；

Figure 132 be according at least one embodiment include the broken section with the nail bin of staple drivers of different height Figure；

Figure 133 is the staple drivers for showing Figure 132 and the signal with the Bu Tong nail of non-firing height being supported on Figure；

Figure 134 is the section of the nail bin according at least one embodiment including tissue thickness compensation part and support section Figure；

Figure 135 is the partial cutaway view of tissue thickness compensation part, nail guide layer and the nail in non-firing position；

Figure 136 is according to the tissue thickness compensation part of at least one alternative embodiment, nail guide layer and in not firing The partial cutaway view of the nail of position；

Figure 137 is according to the tissue thickness compensation part of at least one alternative embodiment, nail guide layer and in not firing The partial cutaway view of the nail of position；

Figure 138 is according to the tissue thickness compensation part of at least one alternative embodiment, nail guide layer and in not firing The partial cutaway view of the nail of position；

Figure 139 is according to the tissue thickness compensation part of at least one alternative embodiment, nail guide layer and in not firing The partial cutaway view of the nail of position；

Figure 140 is according to the tissue thickness compensation part of at least one alternative embodiment, nail guide layer and in not firing The partial cutaway view of the nail of position；

Figure 141 is according to the tissue thickness compensation part of at least one alternative embodiment, nail guide layer and in not firing The partial cutaway view of the nail of position；

Figure 142 is the detail drawing in the region on the top of the nail around Figure 141；

Figure 143 is according to the tissue thickness compensation part of at least one alternative embodiment, nail guide layer and in not firing The partial cutaway view of the nail of position；

Figure 144 is the detail drawing in the region on the top of the nail around Figure 143；

Figure 145 is according to the tissue thickness compensation part of at least one alternative embodiment, nail guide layer and in not firing The partial cutaway view of the nail of position；

Figure 146 is the saturating of the nail guide layer according at least one alternative embodiment and multiple nails in non-firing position View；

Figure 147 is the exploded view of tissue thickness compensation part and staple cartridge body；

Figure 148 is the front view of disposable loading unit, which includes being configured to support nail The pivotable jaw of nail bin in storehouse；

Figure 149 is located at the perspective of the tissue thickness compensation part application device in the actuator of disposable loading unit Figure；

Figure 150 is the top perspective of the tissue thickness compensation part application device of Figure 149；

Figure 151 is the bottom perspective view of the tissue thickness compensation part application device of Figure 149；

Figure 152 is the sectional view of the end effector of surgery suturing appliance according at least one embodiment, surgery seam Clutch tool includes the staple drivers with different height and wavy platform surface；

Figure 153 is the sectional view of the end effector of surgery suturing appliance according at least one embodiment, surgery seam Clutch tool includes the staple drivers with different height and staged platform surface；

Figure 154 is to show the tissue thickness compensation part including variable thickness, the staple drivers with different height and have The schematic diagram of the nail of different unshaped height；

Figure 155 is the nail for showing the Figure 154 for being implanted to tissue and the schematic diagram of tissue thickness compensation part；

Figure 156 is attached to the partial cutaway view of the tissue thickness compensation part on staple cartridge body；

Figure 157 is the tissue thickness compensation part of Figure 156 and the partial cutaway view of staple cartridge body；

Figure 158 is the partial exploded view of the tissue thickness compensation part of Figure 156；

Figure 159 is the partial exploded view of tissue thickness compensation part, staple cartridge body and firing member；

Figure 160 is the partial elevation view of the embodiment of Figure 159；

Figure 161 is the bottom view of nail bin；

Figure 162 is the thin portion bottom view of the nail bin of Figure 161；

Figure 163 is the exploded view of nail bin, shows staple drivers arrangement；

Figure 164 is attached on nail bin and has layer (such as tissue thickness compensation part) in retainer and nail bin intermediate arrangement Retainer one embodiment perspective view, wherein retainer, layer and nail bin are arranged with respect to surgical stapling device, and wherein Staple cartridge channel is removed because illustrating purpose；

Figure 165 is the perspective view of the retainer of Figure 164；

Figure 166 is the plan view of the retainer of Figure 164, layer and nail bin；

Figure 167 is the sectional view of the retainer of Figure 164, layer and nail bin, wherein the top followed closely extends from the nail cavity in nail bin And it extends in layer；

Figure 168 is to maintain the perspective view of one embodiment of device, and wherein the retainer includes movable cam portion and lock Determine tab；

Figure 169 is attached to the perspective view of the retainer of Figure 168 of nail bin, and wherein it is outer to be positioned to insertion for nail bin and retainer In the staple cartridge channel of the end effector of section's stitching unstrument；

Figure 170 is the Figure 168 for being positioned to be inserted into but be not fully inserted in the warehouse channel of the end effector of surgical stapling device Retainer plan view；

Figure 171 is the section end of the retainer of Figure 168 in the staple cartridge channel for being positioned to be inserted into but be not fully inserted Figure 170 View；

Figure 172 is the plan view of the retainer for the Figure 168 being fully inserted into the staple cartridge channel of Figure 170；

Figure 173 is the section end view of the retainer for the Figure 168 being fully inserted into the staple cartridge channel of Figure 170, wherein the guarantor Holder is in the unlocked state and just removes from nail bin；

Figure 174 is the plan view of end effector insert according at least one embodiment；

Figure 175 is the front view of the end effector insert of Figure 174；

Figure 176 is the perspective view of the end effector insert of Figure 174；

Figure 177 is the local perspective view of the end effector insert of Figure 174, depicts the end for engaging surgical instruments The end effector insert of the anvil block of portion's actuator；

Figure 178 is the local perspective view of the end effector insert of Figure 174, depicts the end for engaging surgical instruments The end effector insert of the nail bin of portion's actuator；

Figure 179 is the front view of the end effector insert of Figure 174, depicts and is engaging the end of surgical instruments and hold The end effector insert of row device；

Figure 180 is located at the front view of the end effector insert of Figure 174 in the end effector of surgical instruments；

Figure 181 is the local perspective view of one embodiment of nail bin groupware, which includes nail bin layer and opposite nail The attachable layer of the anvil block of storehouse positioning；

Figure 182 is the local perspective view of the nail bin groupware of Figure 181, and wherein the attachable layer of anvil block is secured to nail bin；

Figure 183 is the local perspective view of one embodiment of nail bin groupware, which includes nail bin layer and opposite nail The attachable layer of the anvil block of storehouse positioning, wherein the proximal part of the attachable layer of anvil block is by adhesive or by being attached to In the attachment features structure of nail bin, and wherein a part of the attachable layer of anvil block be illustrated as because illustrating purpose it is transparent；

Figure 184 is the local perspective view of the nail bin groupware of Figure 183, wherein the turning of the proximal part of the attachable layer of anvil block It is illustrated as separating with nail bin and from nail bin lift-off；

Figure 185 is the local perspective view of one embodiment of nail bin groupware, which includes nail bin layer and opposite nail The attachable layer of the anvil block of storehouse positioning, wherein the attachable layer of anvil block is attached on nail bin layer；

Figure 186 is the detail drawing for the layer that the nail bin layer of Figure 185 and the anvil block being attached on the nail bin layer attach；

Figure 187 is the partial plan layout of the attachable layer embodiment of anvil block；

Figure 188 is the partial plan layout of the attachable layer of the anvil block of the Figure 187 just cut by cutting blade；

Figure 189 is the plan view of the tissue compensating part of sleeve according at least one embodiment；

Figure 190 is the perspective view of the tissue compensating part of Figure 189；

Figure 191 is the front view of the tissue compensating part of Figure 189；

Figure 192 is the perspective view of tissue thickness compensation part；

Figure 193 is attached to the perspective view of the tissue thickness compensation part of Figure 192 on nail bin；

Figure 194 is thick with another tissue of a tissue thickness compensation part of Figure 192 at least partly be overlapped Figure 192 Spend the detail drawing of compensating part；

Figure 195 is the perspective view for being attached with the nail bin of tissue thickness compensation part thereon；

Figure 196 is thick with another tissue of a tissue thickness compensation part of Figure 195 at least partly be overlapped Figure 195 Spend the detail drawing of compensating part；

Figure 197 be include tissue thickness compensation part nail bin exploded view, which includes multiple layers；

Figure 198 is to show the tissue thickness compensation part for the Figure 197 being implanted on the side of patient tissue and in the group The diagrammatic cross-section of another tissue thickness compensation part for the Figure 197 being implanted on the other side knitted；

Figure 199 is the decomposition perspective view of the end effector of suture instruments according to various embodiments, the end effector Including nail bin and tissue thickness compensation part；

Figure 200 is the sectional view of Figure 199 tissue thickness compensation part according to various embodiments；

Figure 20 1 is the top view of tissue thickness compensation part according to various embodiments, which includes more A circular piece；

Figure 20 2 is the top view of tissue thickness compensation part according to various embodiments, which includes more A circular piece；

Figure 20 2A is the sectional view of tissue thickness compensation part according to various embodiments；

Figure 20 3 is the top view of tissue thickness compensation part according to various embodiments；

Figure 20 4 is the top view of tissue thickness compensation part according to various embodiments, which includes more A hexagon piece；

Figure 20 5 is the top view of the tissue thickness compensation part of fastening according to various embodiments, the tissue thickness of the fastening Compensating part includes multiple；

Figure 20 6 is the top view of tissue thickness compensation part according to various embodiments, which includes more A slit；

Figure 20 7A is the exploded view of nail bin and layer according at least one embodiment；

Figure 20 7B is the sectional view for capturing layer and tissue T between nail bin and anvil block according at least one embodiment；

Figure 20 7C is the perspective view of the layer including cylindricality anti-skid stud according at least one embodiment；

Figure 20 8 is the sectional view of the layer in Figure 20 7C；

Figure 20 9 is the perspective view of the layer according at least one embodiment including linear protrusion；

Figure 21 0 is the sectional view of the layer in Figure 20 9；

Figure 21 1 is the perspective view of the layer including cheese protrusion according at least one embodiment；

Figure 21 2 is the sectional view of the layer in Figure 21 1；

Figure 21 3 is the perspective view for according at least one embodiment including the linear layer being recessed；

Figure 21 4 is the sectional view of the layer in Figure 21 3；

Figure 21 5 is the perspective view of the layer according at least one embodiment including linear protrusion；

Figure 21 6 is the sectional view of the layer in Figure 21 5；

Figure 21 7 is the perspective view of the layer according at least one embodiment including linear protrusion；

Figure 21 8 is the perspective view of the layer including conical projections according at least one embodiment；

Figure 21 9 is the perspective view of the layer including pyramid protrusion according at least one embodiment；

Figure 22 0 is the sectional view of the layer in Figure 21 9 according at least one embodiment；

Figure 22 1 is the perspective view of layer according at least one embodiment；

Figure 22 2 is the sectional view of the layer in Figure 22 1；

Figure 22 3 is the perspective view for according at least one embodiment including the layer being recessed；

Figure 22 4 is the sectional view of the layer in Figure 22 3；

Figure 22 4A be according at least one embodiment including reduced thickness portions layer and capture include it is multiple nail at The sectional view of tissue T between the anvil block and nail bin of shape pit；

Figure 22 4B is that the layer including multiple protrusions and capture are including that the forming of multiple nails is recessed according at least one embodiment The sectional view of tissue T between the anvil block and nail bin in hole；

Figure 22 5 is layer (such as group of the anvil block fixed to surgical end effectors according at least one embodiment Knit thickness compensation part) perspective section view；

Figure 22 6 is secured to the sectional view of the layer of Figure 22 5 of anvil block；

Figure 22 7 is the sectional view of the layer of Figure 22 5；

Figure 22 8 is the perspective view for the retainer embodiment being used together with nail bin；

Figure 22 9 be include Figure 22 8 that the layer attachable with nail bin and anvil block engages retainer nail bin groupware perspective Figure；

Figure 23 0 is the plan view of the nail bin groupware of Figure 22 9；

Figure 23 1 is the section end view of the nail bin groupware of Figure 22 9, and wherein the nail bin of nail bin groupware insertion end effector is logical In road, and the anvil block of end effector is positioned with respect to nail bin groupware；

Figure 23 2 is the section end view of nail bin groupware shown in Figure 23 1 and end effector, and wherein anvil block is located against anvil block Attachable layer and retainer pressing；

Figure 23 3 is the profile view of nail bin groupware shown in Figure 23 1 and end effector, and wherein anvil block is from retainer It is lifted away from, so that the layer that the anvil block of attachment is attached is removed from retainer；

Figure 23 4 is the profile view of end effector shown in Figure 23 1, and wherein the attachable layer of anvil block is attached to anvil block Upper and retainer has removed；

Figure 23 5 is the perspective view for the layer embodiment that anvil block is attachable according at least one embodiment；

Figure 23 6 is the perspective view for the layer embodiment that anvil block is attachable according at least one embodiment；

Figure 23 7 is the perspective view for the layer embodiment that anvil block is attachable according at least one embodiment；

Figure 23 8 is the perspective view with the attachable layer embodiment of the anvil block that can dispose attachment features structure, wherein can portion Administration's attachment features structure is in non-guidewire lumen；

Figure 23 9 is the perspective view of the attachable layer of the anvil block of Figure 23 8, wherein attachment features structure can be disposed with guidewire lumen It shows；

Figure 24 0 is the profile view of the attachable layer of the anvil block of Figure 23 8 of the anvil positioning of opposed end actuator, In can dispose attachment features structure and be deployed in the slit of anvil block；

Figure 24 1 is the perspective view with the attachable layer embodiment of the anvil block that can dispose attachment features structure, wherein can portion Administration's attachment features structure is in non-guidewire lumen；

Figure 24 2 is the perspective view of the attachable layer of the anvil block of Figure 24 1, wherein attachment features structure can be disposed with guidewire lumen It shows；

Figure 24 3 is the profile view of the attachable layer of the anvil block of Figure 24 1 of the anvil positioning of opposed end actuator, In can dispose attachment features structure and be deployed in the slit of anvil block；

Figure 24 4 is the decomposition perspective view of anvil block and tissue thickness compensation part according at least one embodiment；

Figure 24 5 is the layer (such as tissue thickness compensation part) that anvil block and anvil block attach according at least one embodiment Profile view, the anvil block include multiple nail shapes pits, the attachable layer of the anvil block include be aligned with forming pit it is multiple Capsule；

Figure 24 6 is the detail drawing of the capsule of the attachable layer of the anvil block of Figure 24 5；

Figure 24 7 is the schematic diagram for showing the anvil block and the attachable layer of anvil block of Figure 24 5 of relative organization's positioning, which will It is closed from the stapling for being located in tissue nail bin on opposite sides；

Figure 24 8 is the signal shown towards 5 anvil block of Figure 24 and the nail fired from the nail bin part of the cartridge movement of Figure 24 7 Figure；

Figure 24 9 is the sectional view for the layer embodiment that the anvil block that opposite anvil block and patient tissue are arranged attaches, wherein nail bin Nail by fired across the anvil block attach layer and patient tissue；

Figure 25 0 is the sectional view for the layer embodiment that the anvil block that opposite anvil block and patient tissue position attaches, wherein nail bin Nail by fired across the anvil block attach layer and patient tissue；

Figure 25 1 shows the holding device assembly being just inserted into surgical instruments, and wherein the surgical instruments includes anvil block and nail bin Channel, and a part for being wherein inserted into tool is removed because illustrating purpose；

Figure 25 2 shows the holding device assembly for the Figure 25 1 being just inserted into surgical instruments, wherein insertion tool it is a part of because It illustrates purpose and is removed；

Figure 25 3 shows the insertion tool of Figure 25 1, which just moves with respect to retainer to engage in staple cartridge channel Nail bin simultaneously engages the attachable layer (such as tissue thickness compensation part) of the anvil block with anvil block, wherein a part of the insertion tool It is removed because illustrating purpose；

Figure 25 4 shows the figure just moved with respect to retainer so that the layer and nail bin that retainer is attached from anvil block are disengaged 251 insertion tool, wherein a part of the insertion tool is removed because illustrating purpose；

Figure 25 5 is the perspective view of the retainer embodiment engaged with nail bin, wherein attachment features structure can be disposed by having The attachable layer of anvil block is engaged with retainer, and wherein retainer is oriented in insertion end effector；

Figure 25 6 is the perspective view of the retainer of Figure 25 5；

Figure 25 7 is the front view of the retainer of Figure 25 5；

Figure 25 8 is the front view of the attachable layer of the retainer, nail bin and anvil block for the Figure 25 5 being inserted into end effector, Wherein the attachment features structure of disposing of the attachable layer of anvil block has been disposed, and the one of the layer that wherein anvil block and anvil block attach Part is removed because illustrating purpose；

Figure 25 9 is the front view for the retainer embodiment being inserted into end effector, wherein attachment features can be disposed by having The attachable layer of the anvil block of structure is disposed on retainer, and the one of the layer and anvil block that wherein retainer, anvil block attach Part is removed because illustrating purpose；

Figure 26 0 is the front view of the retainer of Figure 25 9, and wherein the attachable layer of anvil block is disposed attachment by retainer Feature structure deployment, and wherein a part of the attachable layer of retainer, anvil block and anvil block is removed because illustrating purpose；

Figure 26 1 is the thin portion front view of the retainer of Figure 25 9, the layer that anvil block attaches and anvil block, wherein attachment can be disposed Feature structure is not yet disposed, and wherein the part of the attachable layer of retainer, anvil block and anvil block is removed because illustrating purpose；

Figure 26 2 is the thin portion front view of the retainer of Figure 25 9, the layer that anvil block attaches and anvil block, wherein attachment can be disposed Feature structure has been deployed in the slit of anvil block, and wherein the part of the attachable layer of retainer, anvil block and anvil block because of diagram Purpose and be removed；

Figure 26 3 shows the tissue thickness compensation part including flowable attachment part according to certain non-limiting embodiments；

Figure 26 4 show according to certain non-limiting embodiments be aligned with the slit in nail bin in stress free position Contact adhesive layered product；

Figure 26 5 is shown to be glued according to the pressure-sensitive of the Figure 26 4 being releasably attached on nail bin of certain non-limiting embodiments Mixture layered product；

Figure 26 6 shows the tissue thickness compensation part including flowable attachment part according to certain non-limiting embodiments；

Figure 26 7 show according to certain non-limiting embodiments be aligned with the nail cavity in nail bin in stress free position Contact adhesive layered product；

Figure 26 8 is shown to be glued according to the pressure-sensitive of the Figure 26 7 being releasably attached on nail bin of certain non-limiting embodiments Mixture layered product；

Figure 26 9 to Figure 27 3 shows the pressure sensitive adhesive layer including adhesive tab according to certain non-limiting embodiments Laminate；

Figure 27 4 to Figure 27 9 shows the pressure sensitive adhesive layer including adhesive tab according to certain non-limiting embodiments Laminate；

It includes for being releasably attached to anvil block that Figure 28 0 to Figure 28 3, which is shown according to certain non-limiting embodiments, Tab contact adhesive layered product；

Figure 28 4 to Figure 28 8, which is shown, is releasably attached to anvil using application device according to certain non-limiting embodiments Contact adhesive layered product on seat；

Figure 28 9 to Figure 29 2 show according to certain non-limiting embodiments be releasably attached to it is pressure-sensitive viscous on anvil block Mixture layered product；

Figure 29 3 is the perspective view of the end effector of surgery suturing appliance, which includes extending from anvil block Implantable transition portion and the implantable transition portion extended from nail bin；

Figure 29 4 is the schematic diagram for describing the tissue between the anvil block and nail bin for the surgery suturing appliance for being located in Figure 29 3.

In multiple views, corresponding reference symbol indicates corresponding component.Example shown in this article shows in one form Certain embodiments of the present invention, and the range that such example should not be construed as in any way limiting the present invention are gone out.

Specific embodiment

Present applicant also possesses the U.S. Patent application of following identification, and each of these U.S. Patent applications are to draw Mode is respectively integrally incorporated herein:

The U.S. of entitled " SURGICAL INSTRUMENTS WITH RECONFIGURABLE SHAFT SEGMENTS " Patent application serial number 12/894,311 (being now U.S. Patent Publication 2012/0080496)；

Entitled " SURGICAL STAPLE CARTRIDGES SUPPORTING NON-LINEARLY ARRANGED STAPLES AND SURGICAL STAPLING INSTRUMENTS WITH COMMON STAPLE-FORMING POCKETS” U.S. Patent Application Serial Number 12/894,340 (being now U.S. Patent Publication 2012/0080482)；

The United States Patent (USP) Shen of entitled " JAW CLOSURE ARRANGEMENTS FOR SURGICAL INSTRUMENTS " It please sequence number 12/894,327 (being now U.S. Patent Publication 2012/0080499)；

Entitled " SURGICAL CUTTING AND FASTENING INSTRUMENTS WITH SEPARATE AND The U.S. Patent Application Serial Number of DISTINCT FASTENER DEPLOYMENT AND TISSUE CUTTING SYSTEMS " 12/894,351 (being now U.S. Patent Publication 2012/0080502)；

Entitled " IMPLANTABLE FASTENER CARTRIDGE HAVING A NON-UNIFORM The U.S. Patent Application Serial Number 12/894,338 (being now U.S. Patent Publication 2012/0080481) of ARRANGEMENT "；

Entitled " IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER " U.S. Patent Application Serial Number 12/894,369 (being now U.S. Patent Publication 2012/0080344)；

The beauty of entitled " IMPLANTABLE FASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS " State's patent application serial number 12/894,312 (being now U.S. Patent Publication 2012/0080479)；

The U.S. of entitled " SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE " is special Sharp patent application serial numbers 12/894,377 (being now U.S. Patent Publication 2012/0080334)；

Entitled " SURGICAL STAPLING INSTRUMENT WITH COMPACT ARTICULATION CONTROL The U.S. Patent Application Serial Number 12/894,339 (being now U.S. Patent Publication 2012/0080500) of ARRANGEMENT "；

Entitled " SURGICAL STAPLING INSTRUMENT WITH A VARIABLE STAPLE FORMING The U.S. Patent Application Serial Number 12/894,360 (being now U.S. Patent Publication 2012/0080484) of SYSTEM "；

Entitled " SURGICAL STAPLING INSTRUMENT WITH INTERCHANGEABLE STAPLE The U.S. Patent Application Serial Number 12/894,322 of CARTRIDGE ARRANGEMENTS " (is now U.S. Patent Publication 2012/ 0080501)；

Entitled " SURGICAL STAPLE CARTRIDGES WITH DETACHABLE SUPPORT STRUCTURES AND SURGICAL STAPLING INSTRUMENTS WITH SYSTEMS FOR PREVENTING ACTUATION MOTIONS WHEN A CARTRIDGE IS NOT PRESENT " U.S. Patent Application Serial Number 12/894,350 (now for U.S. Patent Publication 2012/0080478)；

Entitled " IMPLANTABLE FASTENER CARTRIDGE COMPRISING BIOABSORBABLE The U.S. Patent Application Serial Number 12/894,383 (being now U.S. Patent Publication 2012/0080345) of LAYERS "；

The U.S. Patent Application Serial Number 12/894,389 of entitled " COMPRESSIBLE FASTENER CARTRIDGE " (being now U.S. Patent Publication 2012/0080335)；

The United States Patent (USP) of entitled " FASTENERS SUPPORTED BY A FASTENER CARTRIDGE SUPPORT " Patent application serial numbers 12/894,345 (being now U.S. Patent Publication 2012/0080483)；

The U.S. Patent Application Serial Number 12/894,306 of entitled " COLLAPSIBLE FASTENER CARTRIDGE " (being now U.S. Patent Publication 2012/0080332)；

Entitled " FASTENER SYSTEM COMPRISING A PLURALITY OF CONNECTED RETENTION The U.S. Patent Application Serial Number 12/894,318 (being now U.S. Patent Publication 2012/0080480) of MATRIX ELEMENTS "；

Entitled " FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND AN ALIGNMENT The U.S. Patent Application Serial Number 12/894,330 (being now U.S. Patent Publication 2012/0080503) of MATRIX "；

The U.S. Patent application sequence of entitled " FASTENER SYSTEM COMPRISING A RETENTION MATRIX " Row number 12/894,361 (being now U.S. Patent Publication 2012/0080333)；

Entitled " FASTENING INSTRUMENT FOR DEPLOYING A FASTENER SYSTEM The U.S. Patent Application Serial Number 12/894,367 of COMPRISING A RETENTION MATRIX " (is now U.S. Patent Publication 2012/0080485)；

The beauty of entitled " FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND A COVER " State's patent application serial number 12/894,388 (being now U.S. Patent Publication 2012/0080487)；

Entitled " FASTENER SYSTEM COMPRISING A PLURALITY OF FASTENER CARTRIDGES " U.S. Patent Application Serial Number 12/894,376 (being now U.S. Patent Publication 2012/0080486)；

Entitled " SURGICAL STAPLER ANVIL COMPRISING A PLURALITY OF FORMING The U.S. Patent Application Serial Number 13/097,865 (being now U.S. Patent Publication 2012/0080488) of POCKETS "；

The United States Patent (USP) of entitled " TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER " Patent application serial numbers 13/097,936 (being now U.S. Patent Publication 2012/0080339)；

Entitled " STAPLE CARTRIDGE COMPRISING A VARIABLE THICKNESS COMPRESSIBLE The U.S. Patent Application Serial Number 13/097,954 (being now U.S. Patent Publication 2012/0080340) of PORTION "；

Entitled " STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A The U.S. Patent Application Serial Number 13/097,856 of COMPRESSIBLE PORTION THEREOF " (is now U.S. Patent Publication 2012/0080336)；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING DETACHABLE PORTIONS's " U.S. Patent Application Serial Number 13/097,928 (being now U.S. Patent Publication 2012/0080490)；

Entitled " TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER COMPRISING The U.S. Patent Application Serial Number 13/097,891 of AN ADJUSTABLE ANVIL " (is now U.S. Patent Publication 2012/ 0080489)；

The beauty of entitled " STAPLE CARTRIDGE COMPRISING AN ADJUSTABLE DISTAL PORTION " State's patent application serial number 13/097,948 (being now U.S. Patent Publication 2012/0083836)；

The U.S. Patent Application Serial Number 13/ of entitled " COMPRESSIBLE STAPLE CARTRIDGE ASSEMBLY " 097,907 (being now U.S. Patent Publication 2012/0080338)；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING PORTIONS HAVING The U.S. Patent Application Serial Number 13/097,861 of DIFFERENT PROPERTIES " (is now U.S. Patent Publication 2012/ 0080337)；

The U.S. Patent Application Serial Number 13/097 of entitled " STAPLE CARTRIDGE LOADING ASSEMBLY ", 869 (being now U.S. Patent Publication 2012/0160721)；

Entitled " COMPRESSIBLE STAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS's " U.S. Patent Application Serial Number 13/097,917 (being now U.S. Patent Publication 2012/0083834)；

The United States Patent (USP) Shen of entitled " STAPLE CARTRIDGE COMPRISING A RELEASABLE PORTION " It please sequence number 13/097,873 (being now U.S. Patent Publication 2012/0083833)；

Entitled " STAPLE CARTRIDGE COMPRISING COMPRESSIBLE DISTORTION RESISTANT The U.S. Patent Application Serial Number 13/097,938 (being now U.S. Patent Publication 2012/0080491) of COMPONENTS "；

Entitled " STAPLE CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR's " U.S. Patent Application Serial Number 13/097,924 (being now U.S. Patent Publication 2012/0083835)；

The U.S. Patent Application Serial Number 13/ of entitled " SURGICAL STAPLER WITH FLOATING ANVIL " 242,029 (being now U.S. Patent Publication 2012/0080493)；

The U.S. Patent application sequence of entitled " CURVED END EFFECTOR FOR A STAPLING INSTRUMENT " Row number 13/242,066 (being now U.S. Patent Publication 2012/0080498)；

The U.S. Patent Application Serial of entitled " STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK " Number 13/242,086；

The U.S. of entitled " STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK ARRANGEMENT " Patent application serial number 13/241,912；

The U.S. Patent application of entitled " SURGICAL STAPLER WITH STATIONARY STAPLE DRIVERS " Sequence number 13/241,922；

Entitled " SURGICAL INSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATING The U.S. Patent Application Serial Number 13/241,637 of MULTIPLE ACTUATION MOTIONS " (is now U.S. Patent Publication 2012/0074201)；

Entitled " SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END The U.S. Patent Application Serial Number 13/241,629 (being now U.S. Patent Publication 2012/0074200) of EFFECTOR "；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF The U.S. Patent Application Serial Number 13/433,096 (being now U.S. Patent Publication 2012/0241496) of CAPSULES "；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF LAYERS " U.S. Patent Application Serial Number 13/433,103 (being now U.S. Patent Publication 2012/0241498)；

The United States Patent (USP) of entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A RESERVOIR " Patent application serial numbers 13/433,098 (being now U.S. Patent Publication 2012/0241491)；

The United States Patent (USP) of entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A RESERVOIR " Patent application serial numbers 13/433,102 (being now U.S. Patent Publication 2012/0241497)；

Entitled " RETAINER ASSEMBLY INCLUDING A TISSUE THICKNESS COMPENSATOR's " U.S. Patent Application Serial Number 13/433,114 (being now U.S. Patent Publication 2012/0241499)；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING AT LEAST ONE The U.S. Patent Application Serial Number 12/433,136 (being now U.S. Patent Publication 2012/0241492) of MEDICAMENT "；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING CONTROLLED RELEASE AND The U.S. Patent Application Serial Number 13/433,141 (being now U.S. Patent Publication 2012/0241493) of EXPANSION "；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING FIBERS TO PRODUCE A The U.S. Patent Application Serial Number 13/433,144 (being now U.S. Patent Publication 2012/0241500) of RESILIENT LOAD "；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING STRUCTURE TO PRODUCE A The U.S. Patent Application Serial Number 13/433,148 (being now U.S. Patent Publication 2012/0241501) of RESILIENT LOAD "；

The beauty of entitled " TISSUE THICKNESS COMPENSATOR COMPRISING RESILIENT MEMBERS " State's patent application serial number 13/433,155 (being now U.S. Patent Publication 2012/0241502)；

Entitled " METHODS FOR FORMING TISSUE THICKNESS COMPENSATOR ARRANGEMENTS The U.S. Patent Application Serial Number 13/433,163 of FOR SURGICAL STAPLERS " (is now U.S. Patent Publication 2012/ 0248169)；

The U.S. Patent Application Serial Number 13/433,167 of entitled " TISSUE THICKNESS COMPENSATORS " (being now U.S. Patent Publication 2012/0241503)；

The U.S. Patent Application Serial Number 13/ of entitled " LAYERED TISSUE THICKNESS COMPENSATOR " 433,175 (being now U.S. Patent Publication 2012/0253298)；

Entitled " TISSUE THICKNESS COMPENSATORS FOR CIRCULAR SURGICAL STAPLERS " U.S. Patent Application Serial Number 13/433,179 (being now U.S. Patent Publication 2012/0241505)；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING CAPSULES DEFINING A The U.S. Patent Application Serial Number 13/433,115 of LOW PRESSURE ENVIRONMENT "；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISED OF A PLURALITY OF The U.S. Patent Application Serial Number 13/433,118 of MATERIALS "；

Entitled " MOVABLE MEMBER FOR USE WITH A TISSUE THICKNESS COMPENSATOR's " U.S. Patent Application Serial Number 13/433,135；

Entitled " TISSUE THICKNESS COMPENSATOR AND METHOD FOR MAKING THE SAME's " U.S. Patent Application Serial Number 13/433,140；

The United States Patent (USP) Shen of entitled " TISSUE THICKNESS COMPENSATOR COMPRISING CHANNELS " It please sequence number 13/433,147；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING TISSUE INGROWTH The U.S. Patent Application Serial Number 13/433,126 of FEATURES "；

Entitled " DEVICES AND METHODS FOR ATTACHING TISSUE THICKNESS The U.S. Patent Application Serial Number of COMPENSATING MATERIALS TO SURGICAL STAPLING INSTRUMENTS " 13/433,132；And

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF The U.S. Patent Application Serial Number 13/433,129 of MEDICAMENTS ".

Entitled " STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED The U.S. Patent Application Serial Number 11/216,562 (being now United States Patent (USP) 7,669,746) of STAPLE HEIGHTS "；

Entitled " SURGICAL STAPLING DEVICE WITH ANVIL HAVING STAPLE FORMING The U.S. Patent Application Serial Number 11/714,049 of POCKETS OF VARYING DEPTHS " (is now U.S. Patent Publication 2007/0194082)；

Entitled " SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING The U.S. Patent Application Serial Number 11/711,979 (being now United States Patent (USP) 8,317,070) of DIFFERENT LENGTHS "；

Entitled " SURGICAL STAPLING DEVICE WITH STAPLE DRIVERS OF DIFFERENT The U.S. Patent Application Serial Number 11/711,975 (being now U.S. Patent Publication 2007/0194079) of HEIGHT "；

Entitled " SURGICAL STAPLING DEVICE WITH STAPLE DRIVER THAT SUPPORTS MULTIPLE WIRE DIAMETER STAPLES " U.S. Patent Application Serial Number 11/711,977 (be now United States Patent (USP) 7, 673,781)；

Entitled " SURGICAL STAPLING DEVICE WITH MULTIPLE STACKED ACTUATOR WEDGE CAMS FOR DRIVING STAPLE DRIVERS " U.S. Patent Application Serial Number 11/712,315 (be now United States Patent (USP) 7, 500,979)；

Entitled " STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED The U.S. Patent Application Serial Number 12/038,939 (being now United States Patent (USP) 7,934,630) of STAPLE HEIGHTS "；

Entitled " SURGICAL STAPLING SYSTEMS THAT PRODUCE FORMED STAPLES HAVING The U.S. Patent Application Serial Number 13/020,263 of DIFFERENT LENGTHS " (is now U.S. Patent Publication 2011/ 0147434)；

Entitled " ROBOTICALLY-CONTROLLED SURGICAL STAPLING DEVICES THAT PRODUCE The U.S. Patent Application Serial Number 13/118,278 of FORMED STAPLES HAVING DIFFERENT LENGTHS " (is now beauty State's patent disclosure 2011/0290851)；

The beauty of entitled " ROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS " State's patent application serial number 13/369,629 (being now U.S. Patent Publication 2012/0138660)；

Entitled " SURGICAL STAPLING DEVICES FOR FORMING STAPLES WITH DIFFERENT The U.S. Patent Application Serial Number 12/695,359 (being now U.S. Patent Publication 2010/0127042) of FORMED HEIGHTS "； And

Entitled " STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED The U.S. Patent Application Serial Number 13/072,923 (being now U.S. Patent Publication 2011/0174863) of STAPLE HEIGHTS ".

Present applicant also possesses the U.S. Patent application of following identification, these U.S. Patent applications and the application are same It submits within one day, and each is respectively integrally incorporated herein by reference:

Entitled " SURGICAL STAPLING CARTRIDGE WITH LAYER RETENTION FEATURES " (generation Manage people file number END7104USCIP1/110606CIP1) U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " ADHESIVE FILM LAMINATE " (attorney number END6843USCIP19/100528CP19) U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " ACTUATOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM A The U.S. Patent Application Serial of FASTENER CARTRIDGE " (attorney number END6848USCIP2/100533CIP2) Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " RELEASABLE TISSUE THICKNESS COMPENSATOR AND FASTENER CARTRIDGE The U.S. Patent Application Serial of HAVING THE SAME " (attorney number END6848USCIP3/100533CIP3) Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " FASTENER CARTRIDGE COMPRISING A RELEASABLE TISSUE THICKNESS The U.S. Patent Application Serial of COMPENSATOR " (attorney number END6848USCIP4/100533CIP4) Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " FASTENER CARTRIDGE COMPRISING A CUTTING MEMBER FOR RELEASING A The United States Patent (USP) of TISSUE THICKNESS COMPENSATOR " (attorney number END6848USCIP5/100533CIP5) Patent application serial numbers _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " FASTENER CARTRIDGE COMPRISING A RELEASABLY ATTACHED TISSUE The U.S. Patent application sequence of THICKNESS COMPENSATOR " (attorney number END6848USCIP6/100533CIP6) Row number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " STAPLE CARTRIDGE COMPRISING A RELEASABLE COVER " (attorney number END7201USNP/120294 U.S. Patent Application Serial Number) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR " (generation Manage people file number END7102USCIP2/110604CIP2) U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " LAYER COMPRISING DEPLOYABLE ATTACHMENT MEMBERS " (attorney number END7102USCIP3/110604CIP3 U.S. Patent Application Serial Number) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES " (attorney docket Number END6232USCIP1/070348CIP1) U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " IMPLANTABLE ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES " (agency People file number END6232USCIP2/070348CIP2) U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " MULTIPLE THICKNESS IMPLANTABLE LAYERS FOR SURGICAL STAPLING The U.S. Patent Application Serial of DEVICES " (attorney number END6840USCIP2/100525CIP2) Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " RELEASABLE LAYER OF MATERIAL AND SURGICAL END EFFECTOR HAVING The U.S. Patent Application Serial of THE SAME " (attorney number END6232USCIP3/070348CIP3) Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " ACTUATOR FOR RELEASING A LAYER OF MATERIAL FROM A SURGICAL END The U.S. Patent Application Serial of EFFECTOR " (attorney number END6232USCIP4/070348CIP4) Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；And

Entitled " STAPLE CARTRIDGE COMPRISING A RELEASABLE PORTION " (attorney number END7200USNP/120302 U.S. Patent Application Serial Number) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.

Certain exemplary embodiments will now be described, to understand the structure, function, system of apparatus as disclosed herein on the whole The principle and purposes and method made.One or more examples of these embodiments are shown in the accompanying drawings.The common skill of this field Art personnel will be understood that specifically describing herein and being illustrated in the device and method in attached drawing is unrestricted exemplary reality Example is applied, and the range of multiple embodiments of the invention is limited only by the appended claims.It is carried out in conjunction with an exemplary embodiment The feature for illustrating or describing, can be combined with the feature of other embodiments.These modifications and version are intended to It is included within the scope of the present invention.

" various embodiments ", " some embodiments ", " one embodiment " or " embodiment " that this specification refers in the whole text etc., It means in combination with the specific characteristics, structures, or characteristics described in the examples and is included at least one embodiment.Therefore, this theory Phrase " in various embodiments " that bright book occurs in the whole text, " in some embodiments ", " in one embodiment " " are implementing Example in " etc. be not necessarily all referring to identical embodiment.In addition, in one or more embodiments, specific features, structure or characteristic It can combine in any suitable manner.Therefore, under unconfined situation, the specific spy that shows or describe in conjunction with one embodiment Sign, structure or characteristic can be entirely or partly in conjunction with the feature of one or more other embodiments, structure or characteristics.These are repaired It is intended to be included within the scope of the present invention for reshaping formula and version.

Terms used herein " nearside " and " distal side " be relative to manipulation surgical instruments handle portions clinician and Speech.Term " nearside " refers near the part of clinician, and term " distal side " then refers to the portion far from clinician Point.It is also understood that for the sake of succinct and be clear, can be used herein in conjunction with attached drawing such as " vertical ", "horizontal", "upper" and The spatial terminology of "lower" etc.However, surgical instruments can use in many orientations and positions, and these terms not limit It is property and/or absolutization.

The present invention provides various for executing the example of laparoscopic surgery operation and minimally invasive surgical procedures Property device and method.However, those skilled in the art are it will be readily understood that various method and apparatus disclosed herein can For including for example being combined with open surgery in many surgical operations and application.With continued reference to this specific embodiment party Formula, those skilled in the art will be further understood that, various instruments disclosed herein can in any way in insertion body, By nature aperture, pass through the notch being formed in tissue or puncturing hole etc..The working portion or end effector of instrument Part can be plugged directly into patient's body or can be inserted by the device that enters with service aisle, and the end of surgical instruments executes Device and elongated shaft can be promoted by service aisle.

In fig. 1 and 2, surgical stapling and cutting off apparatus 8010 may include anvil block 8014, which can be around it to carefully The pivotal attachment of long nail channel 8016 and be repeatedly opened and be closed.Nail administration assembly 8012 may include anvil block 8014 and channel 8016, wherein component 8012 can be proximally attached on the elongated shaft 8018 to form execution part 8022.Work as nail administration assembly When 8012 closure or when being at least substantially closed, sufficiently small cross section can be presented in execution part 8022, which is suitable for making Nail administration assembly 8012 is inserted into across trochar.In various embodiments, component 8012 can be by being connected to the shank of axis 8018 8020 manipulations.Shank 8020 may include user control such as knob 8030, which makes elongated shaft 8018 and nail administration assembly 8012 longitudinal axis for surrounding axis 8018 rotate.Closure trigger 8026 can be depressed to be closed nail administration assembly 8012, this is closed Closing trigger can be in 8036 front wall of pistol grip around the closure trigger pin 8152 (Fig. 3) laterally coupled across shank shell 8154 It pivots.In various embodiments, when closure trigger 8026 is clamped, closure release button 8038 can be present in shank outward On 8020, so that release button 8038 can be depressed to unclamp closure trigger 8026 and open nail administration assembly 8012, More detailed description as follows.The firing trigger 8034 that can be pivoted before closure trigger 8026 can make nail administration assembly 8012 same When cut off and suture and be clamped in tissue therein.In all cases, firing trigger can be used in more detailed description as follows 8034 use multiple firing schedules to reduce the size for the power that every stroke needs to be applied by surgical hand.In certain implementations In example, shank 8020 may include the rotatable right indicator wheel 8040 and/or left indicator wheel 8041 that can indicate percussion progress (Fig. 3).For example, percussion traveling may need three complete firing schedules of firing trigger 8034, thus indicator wheel completely 8040 and 8041 can respectively rotate up to one third circle in every stroke of firing trigger 8034.It is as follows to retouch in more detail It states, if it is desired, percussion trip lever 8042 allows trigger system to bounce back before complete percussion traveling is completed manually, and In addition, if trigger system is blocked and/or failed, percussion trip lever 8042 allows surgeon or other clinicians Trigger system is set to bounce back.

Referring to Fig. 1 and Fig. 3, elongated shaft 8018 may include external structure, which includes moving back and forth on longitudinal direction Closed tube 8024, the closed tube push in response to the nearside of the closure trigger 8026 of shank 8020 and make anvil block 8014 towards its Closed position pivots.Elongated passageway 8018 can be connected to shank 8020 by the frame 8028 (Fig. 3) inside closed tube 8024.Frame Frame 8028 is rotatably engaged to shank 8020, so that the rotation of knob 8030 (Fig. 1) can be such that execution part 8022 rotates.Specifically Referring to Fig. 3, knob 8030 can be made of two half-shells, the two half-shells may include one or more inward projections 8031, should Protruding portion can extend across the elongated side opening 8070 of one or more of closed tube 8024 and engage frame 8028.Therefore, it revolves Button 8030 and frame 8028 can be rotated together or simultaneously, so that the rotation position of knob 8030 determines execution part 8022 Rotation position.In various embodiments, the longitudinal length long enough of longer opening 8070, so that closed tube 8024 is able to carry out Longitudinal closing motion and open movement.About the closing motion for generating closed tube 8024, referring primarily to Fig. 3 and Fig. 5, closure triggering The upper part 8160 of device 8026 can push forward closed yoke 8162 (Fig. 4) via closed connecting rod 8164.Closed connecting rod 8164 At its distal end by closure yoke pin 8166 can pivotably be attached to closed yoke 8162, and in its proximal end By closed connecting rod pin 8168 can pivotably be attached at portion.In various embodiments, closure trigger 8026 can quilt Closure trigger extension spring 8246 is advanced into open position, which is proximally connected to the upper of closure trigger 8026 Portion part 8160 and the shank shell 8154 formed by right half-shell 8156 and left shell half 8158.Applied by extension spring 8246 Tension can be applied to the closing force of closure trigger 8026 and overcome, to promote yoke 8162, closed connecting rod 8164 towards distal side With closed tube 8024.

When closure trigger 8026 is activated or is depressed as described above, if it is desired, closure release button 8038 can quilt It is located so that surgeon or other clinicians can press closure release button 8038, and makes closure trigger 8026 Unactuated state can be back to the rest part of surgical instruments.In various embodiments, closure release button 8038 can lead to Cross central transverse pivot 8173 and be connected to pivot locking arm 8172 so that can release button 8038 and lock arm 8172 it Between passing movement.Referring again to Fig. 3, compressed spring 8174 can proximally bias closure release button 8038, that is, such as from the right side Observation, around the central biasing clockwise of transverse pivot 8173, and the upper part 8160 of closure trigger 8026 may include tool There is the proximal tooth top 8170 of rear recess 8171.When closure trigger 8026 is depressed, pivot locking arm 8172 can be straddled closely On side tooth top 8170, and when closure trigger 8026 reaches its fully depressed position, it should be understood that rear recess 8171 exists In pivot locking arm 8172 in the following, the pivot locking arm causes to fall and break in the urgent of compressed spring 8174 into rear recess 8171 and will be rear recessed Mouth 8171 is locked.At this point, the manual depression of closure release button 8038 makes the rotation and from rear recess upwards of pivot locking arm 8172 It is rotated out of in 8171, so that closure trigger 8026 be unlocked and closure trigger 8026 is enable to be back to its non-clamping position It sets.

Once closure trigger 8026 is proximally clamped as described above, firing trigger 8034 can be pulled to pistol type and hold 8036, trigger shaft 8032 is promoted from shank 8020 towards distal side.In various embodiments, firing trigger 8034 can surround Firing trigger pin 8202 pivots, and the right half-shell 8156 and left shell half 8158 which is horizontally through shank 8020 are simultaneously It is engaged with them.When firing trigger 8034 is activated, link-type can be promoted to be driven firing lock 8150.Link-type transmission Firing lock 8150 can be forced to the non-firing position of retraction, the spring 1 by spring 8184) it is attached to the pistol type of shank 8020 Handle 8036 and one of the connecting rod for 2) being attached to such as link-type transmission firing lock 8150, more detailed description as follows.Bullet Spring 8184 may include the non-athletic tail end 8186 for being connected to shell 8154, and be connected to the fortune of the proximal end 8190 of steel band 8192 Dynamic end 8188.The end 8194 for being set to distal side of steel band 8192 connects before attaching to multiple connecting rod 8196a into 8196d Attachment features structure 8195 on bar 8196a, multiple connecting rod 8196a to 8196d form link-type rack gear 8200.Link-type Rack gear 8200 can be to be flexible, so that it can easily retract in pistol grip 8036 and minimize shank 8020 Length, and straight rigid toothed component is formed, which can be transferred to and/or be transferred through percussion for significant percussion force Bar 8032.More detailed description as follows, firing trigger 8034 can be during the first actuations of firing trigger 8034 with One connecting rod 8196a engagement, engages during the second actuation of firing trigger 8034 with second connecting rod 8196b, touches in percussion The third time activating of hair device 8034 is engaged with third connecting rod 8196c, and in the 4th actuating of firing trigger 8034 Period engages with fourth link 8196d, and wherein each actuating of firing trigger 8034 all can be by link-type rack gear 8200 towards remote Side promotes incremental amount.In various embodiments, the right side can be made as multiple strokes to supplement above, firing trigger 8034 Indicator wheel 8040 and left indicator wheel 8041 rotate, to indicate distance that link-type rack gear 8200 has promoted.

Referring now to Fig. 3 and Fig. 5, anti-inversion organization 8250 can prevent combination stretching/compressing spring 8184 from making link-type tooth Item 8200 bounces back between firing schedule.In various embodiments, the adjacent first connecting rod 8196a of connection sliding tube 8131 and company Trigger shaft 8032 is connected to transmit firing action.Trigger shaft 8032 extends proximally out the proximal end of frame 8028 and extends through Cross the through-hole 8408 of anti-down flap 8266.Through-hole 8408 is sized to when with 8032 vertical alignment of trigger shaft slidably Trigger shaft 8032 is received, and it is motionless to tighten trigger shaft 8032 in through-holes.Lower tabs attachment 8271 is from frame The lower lip of the proximal end of frame 8028 extends proximally, and extends through the hole 8269 on the lower edge of anti-down flap 8266.It should Lower tabs attachment 8271 low portion of anti-down flap 8266 is drawn to it is adjacent with frame 8028 so that working as trigger shaft 8032 anti-down flaps 8266 when being promoted towards distal side are vertical, and the anti-down flap 8266 when trigger shaft 8032 attempts to bounce back Top can be made to tilt backwards to bound state.Anti-reverse compression spring 8264 is constrained by the proximal end of frame 8028 towards distal side, And the top section for proximally abutting anti-down flap 8266, so that anti-down flap 8266 is biased to lock state.Anti-turn Cam tube 8268 resists spring biasing and slidably surround connection sliding tube 8131 and adjacent anti-down flap 8266.It is attached to anti-down The anti-reversing yoke 8256 proximally outstanding of rotating cam pipe 8268 extends beyond closed yoke 8162.

Referring to Fig. 3, the automatic retracted mechanism 8289 of connecting rod triggering is integrated in surgical stapling and cutting off apparatus 8010, so that Knife bounces back at the end of complete percussion is advanced.For this purpose, distal link 8196d includes tang 8290, when distal link 8196d is pushed away When entering in the rack passage 8291 (Fig. 3) formed in closed yoke 8162, the tang 8290 is upward.It is aligned the tang 8290 to start the bottom proximal cam 8292 on anti-reversing trip lever 8248 (Fig. 6).Referring specifically to fig. 6, in right half-shell 8156 and left shell half 8158 in the movement of structural constraint anti-reversing trip lever 8248 that is formed.It is respectively formed in right half-shell 8156 The hole 8294 that pin socket 8296 and circular pegs 8293 between left shell half 8158 pass through longitudinal elongation is received, 8294 shape of hole At in the anti-reversing trip lever 8248 in 8292 distal side of bottom proximal cam, to allow longitudinal translation and around circular pegs 8293 rotations.In right half-shell 8156, the channel proximally opened include with upwards and towards the partially communicating nearside of distal side angulation Horizontal component, this upwards and towards distal side at angle part receive anti-reversing trip lever 8248 proximal end near to the right after Pin 8297, to assign upward rotation when anti-reversing trip lever 8248 reaches the farthest side section of its translation.Once anti- It reverses trip lever 8248 to be assembled, is formed in the barrier structure for being located at 8248 nearside of anti-reversing trip lever in right half-shell 8156 Just anti-reversing trip lever 8248 is prevented proximally to move, so that rear pin 8297 to the right is maintained at as described above and proximally beats In the channel opened.

As to supplement above, referring now to Fig. 3 and Fig. 7, the distal end 8254 of anti-reversing trip lever 8248 because And be forced to towards distal side and downwards, so that preceding pin 8298 to the right is fallen into the ladder knot for being formed in and opening in right half-shell 8156 towards distal side In structure 8299, this is engaged through the hole for being fixed to compressed spring 8300 (Fig. 3) and being located at preceding pin 8298 and longitudinal elongation to the right Hook 8301 to the left in anti-reversing trip lever 8248 between 8294 and realize.The other end of compressed spring 8300 is attached To the hook 8302 (Fig. 6) being formed in right half-shell 8156 at the immediately above closer and lower position of closed yoke 8266.Compression Spring 8300 thus downwardly and rearwardly pulls the distal end 8254 of anti-reversing trip lever 8248, makes preceding pin 8298 to the right It is locked to when being promoted towards distal side in the hierarchic structure 8299 opened towards distal side.Therefore, once being released, referring to Fig. 7, anti-turn Trip lever 8248 just keeps forward, being held vertically throughout anti-down flap 8266, so that link-type rack gear 8200 be enable to bounce back.When Upward reset when closed yoke 8266 then bounces back in the case of free end actuator 8012, on closed yoke 8266 Tang 8303 contacts the bottom distal cam 8305 of anti-reversing trip lever 8248, and preceding pin 8298 to the right is opened from towards distal side Hierarchic structure 8299 lift so that anti-reverse compression spring 8264 can be by anti-reverse cam tube 8268 and anti-reversing trip lever 8248 are proximally pushed to their retraction position (Fig. 6).

In various embodiments, referring to Fig. 1 to Fig. 3, firing trigger 8034 can operate in any suitable manner Ground is bonded to link-type rack gear 8200.Referring specifically to Fig. 2 and Fig. 3, firing trigger 8034 surrounds and is connected to hitting for shell 8154 Trigger pin 8202 is sent out to pivot.When firing trigger 8034 towards pistol grip 8036 depress when, firing trigger 8034 it is upper Portion part 8204 is moved toward the far side around firing trigger pin 8202, thus the firing trigger extension spring that will proximally place 8206 (Fig. 3) are stretched, which is proximally connected to the upper part 8204 and shell of firing trigger 8034 Between 8154.During each firing trigger pushes, the upper part 8204 of firing trigger 8034 is via spring biasing 8210 engagement link formula rack gear 8200 of side detent mechanism.When firing trigger is released, side detent mechanism is from link-type rack gear 8200 are disengaged, and firing trigger may return to non-depressed i.e. non-firing position.In use, extremely by connecting rod 8196a Inclined-plane 8284 towards nearside and to the right of the 8196d in each is formed by inclined right rail and is connect by gemmule claw assembly 8285 It closes.Specifically, ratchet slide block 8270 (Fig. 3 and Fig. 4) has lower left quarter guide part and right lower quadrant guide part 8272, which leads In the left track 8274 (Fig. 3) formed into part and right lower quadrant the guide part respectively closed yoke 8266 below rack passage 8291 It is slided in the right track 8275 in closed yoke guide rail 8276, which is parallel to rack passage 8291 and is attached To rack channel cover 8277, which closes the opening part to the right of the rack passage 8291 in closed yoke 8266, institute It states and opens the distal side that part is located at 8270 direction of travel of ratchet slide block to the right.In Fig. 3 into Fig. 5, compressed spring 8278 is attached In the hook 8279 in the top proximal position on closed yoke guide rail 8276 and positioned at the distal end of ratchet slide block 8270 Between hook 8280 on right side, this makes ratchet slide block 8270 proximally be pulled into the upper part with firing trigger 8034 8204 contacts.

Referring specifically to Fig. 3, pawl block 8318 is located on ratchet slide block 8270, pivots around vertical rear pin 8320, after this Pin 8320 passes through the left proximal turning of pawl block 8318 and ratchet slide block 8270.It kicks out of block groove 8322 and is formed in pawl block In the distal part of 8318 top surface, to receive by normal pin 8326 can pivotably be fixed on therein kick out of Block 8324, the bottom apex of the normal pin 8326 extend to the ratchet spring groove 8328 on the top surface of ratchet slide block 8270 In.Ratchet spring 8330 in ratchet spring groove 8328 extends to vertical 8326 right side of preceding pin, and pawl block 8318 is forced to exist It rotates counterclockwise to when viewed from above and is engaged with inclined right rail 8282.Kick out of the small wind spring 8332 in block groove 8322 Force and kick out of block 8324 and rotated clockwise when viewed from above, make its proximal end be forced with above rack passage 8291 The wavy antelabium 8334 formed in closed yoke 8266 contacts.As shown in figure 5, ratchet spring 8330 has more compared with small wind spring 8332 Strong mechanical dominance means that pawl block 8318 is easy to engage with the block 8324 of kicking out of rotated clockwise.In Fig. 3, when percussion is touched When hair device 8034 is fully depressed and starts to be released, kicks out of block 8324 and encounter wavy antelabium when ratchet slide block 8270 bounces back Ridge 8336 in 8334 forces and kicks out of block 8324 and rotate clockwise when viewed from above, thus pawl block 8318 is kicked out of and It is not engaged with link-type rack gear 8200.The shape backstop for kicking out of block groove 8322 kicks out of block 8324 to perpendicular to wavy antelabium 8334 Orientation rotate clockwise, keep this to be disengaged to eliminate ratcheting noise during being fully retracted.

In Fig. 3, Fig. 4, Fig. 8 and Figure 12, surgical stapling and cutting off apparatus 8010 may include manual retract mechanism 8500, should Manual retract mechanism 8500 provides the manual releasing of firing lock, manual retrieving, and (Figure 13 is into Figure 15) in a kind of pattern Automatic retracted is also executed at the end of complete percussion is advanced.Referring now to Fig. 3 and Fig. 8, specifically, preceding idler gear 8220 and company The dentation upper left surface 8222 of rod-type rack gear 8200 engages, wherein preceding idler gear 8220, which also engages, has smaller right-side ratchet tooth The rear idler gear 8230 of wheel 8231.Preceding idler gear 8220 and rear idler gear 8230 are rotationally attached to before being located at Shank shell 8154 on idler shaft 8232 and rear idler wheel axis 8234.Each end of rear idler wheel axis 8232 extends through Corresponding right half-shell 8156 and left shell half 8158 are crossed, and is attached to left indicator wheel 8040 and right indicator wheel 8041, and Idler gear 8230 after being rotated freely in shank shell 8154 due to rear idler wheel axis 8234 and being bonded to bonding pattern, because This indicator wheel 8040,8041 and rear idler gear 8230 rotate together.Link-type rack gear 8200, preceding idle running can be advantageously selected Gear relationship between gear 8220 and rear idler gear 8230, so that dentation upper surface 8222 has intensity tooth ruler appropriate It is very little, and make during link-type is driven the complete percussion traveling of firing lock 8150, the rotation of rear idler gear 8230 is not More than a circle.Gear mechanism 8502 is other than intuitively indicating firing schedule or progress, it may also be used for so that knife is bounced back manually.? In various embodiments, the lesser right-side ratchet gear 8231 of rear idler gear 8230 extends to the wheel of manual retrieving lever 8042 In hub 8506, specifically, the vertical longitudinally-aligned slit 8508 (Fig. 8) divided is aligned with by wheel hub 8506.Wheel hub 8506 Cross through hole 8510 is connected to upper grooves 8512.Front part 8514 is shaped as the locking pawl for receiving and proximally guiding 8516, which surrounds the transverse bolt 8518 to the right being formed in the distal end of upper grooves 8512 and pivots. Rear portion 8520 be shaped as receive L shape spring tab 8522, the spring tab 8522 force locking pawl 8516 downwards with The lesser ratchet gear 8231 in right side engages.Barrier structure 8524 (Fig. 6) projects into upper grooves 8512 from right half-shell 8156； When manual retrieving lever 8042 is downward (Figure 10), which prevents locking pawl 8516 from engaging lesser right side spine Wheel gear 8231.Wind spring 8525 (Fig. 3) forces manual retrieving lever 8042 downward.

In use, as Fig. 9 and Figure 10 describe, combination stretching/compressing spring 8184 can be with the connecting rod that is located in distal side Formula rack gear disconnects.In Figure 11 and Figure 12, when manual retrieving lever 8042 is promoted, locking pawl 8516 is rotated clockwise And it is no longer blocked the prevention of structure 8524, and engage lesser right-side ratchet gear 8231, so that rear idler gear 8230 be made to exist It is rotated clockwise when from left sides.Therefore, the preceding response counterclockwise of idler gear 8220, makes link-type rack gear 8200 bounce back.This Outside, curved ridges 8510 to the right are prominent from wheel hub 8506, are sized to contact anti-reversing trip lever 8248 and make to prevent It reverses trip lever to move toward the far side, to discharge anti-inversion organization 8250 when manual retrieving lever 8042 rotates.

In Figure 13 into Figure 15, the automatic retracted mechanism 8600 of surgical stapling and cutting off apparatus can be in complete firing schedule knot Automatic retracted is integrated in the preceding idler gear 8220a with tooth 8602 when beam；The preceding idler gear 8220a is in cam 8606 In circular groove 8604 in movement, until the object that meets with obstruction until the nearly whole rotation for corresponding to three firing schedules Until.In such situations, ridge 8610 to the right is rotated upwardly to contact bottom cam groove 8612, so that anti-turn discharges thick stick Bar 8248a is moved toward the far side.Referring specifically to Figure 13, anti-reversing trip lever 8248a includes the distal side operated as described above End 8254.The circular pegs 8293 and pin socket 8296 being formed between right half-shell 8156 and left shell half 8158 are formed through the bottom of in The hole 8294a of general rectangular in the subsequent anti-reversing trip lever 8248a of portion's cam 8192 is received, to allow longitudinal flat The downward lock motion of the distal end 8254 of shifting and anti-reversing trip lever 8248a.In right half-shell 8156, horizontal court The rear pin to the right near channel reception anti-reversing trip lever 8248a proximal end that nearside is opened.

In operation, before percussion in figs. 13 and 14, at link-type rack gear 8200 and anti-reverse cam tube 8268 In retraction position, thus when anti-reverse compression spring 8264 tilts anti-down flap 8266 proximally, by anti-inversion organization 8250 lockings.Automatic retracted mechanism 8600 is in original state, at this time anti-reversing trip lever 8248a bounce back, connecting rod 8196a with Preceding idler gear 8220a contact.Tooth 8602 is in six-o ' clock position, and the total travel of circular groove 8604 carries out counterclockwise, to the right The just adjacent teeth 8602 of ridge 8610.After a firing schedule, link-type rack gear 8200 made a distal link 8196b to Upper movement is to contact with preceding idler gear 8220a.The circular groove 8604 that tooth 8602 has passed through fixed cam 8606 has advanced three / mono- circle.After the second firing schedule, the link-type rack gear move upwards another connecting rod 8196c for preceding idle running tooth Take turns 8220a contact.The circular groove 8604 that tooth 8602 has passed through fixed cam 8606 has been advanced 2/3rds circles.It is fired in third After stroke, link-type rack gear 8200 moves upwards another distal link 8196d to contact with preceding idler gear 8220a. Tooth 8602 has surrounded 8604 whole process of circular groove and proceeds to be contacted with obstruction mentioned above, so that starting cam 8606 is inverse Hour hands rotate (when being observed from the right), contact ridge to the right with anti-reversing trip lever 8248a.In Figure 15, prevent Reversing trip lever 8248a, which makes a response it, have been moved toward the far side, and is beaten to being locked to preceding pin 8298 to the right towards distal side In the hierarchic structure 8299 opened and discharge anti-inversion organization 8250.What similar surgery suturing appliance was announced on August 1st, 2006 It is disclosed in United States Patent (USP) 7,083,075, the complete disclosure of the patent is herein incorporated by reference.

Referring to Figure 16, the nail administration assembly 9012 of surgery suturing appliance 9010 is implemented function such as: organizationally being clamped, is led to It crosses along axis 9016 relative to the longitudinal two kinds of different motions transmitted downwards of pedestal 9070 to drive nail and cuts off tissue.The pedestal 9070 are proximally attached to the shank of surgery suturing appliance, are coupled to the shank to be rotated about longitudinal axes.For outer The exemplary multiple-pass shank of section's suture and cutting off apparatus is in co-pending and jointly owned entitled " SURGICAL STAPLING INSTRUMENT INCORPORATING A MULTISTROKE FIRING POSITION INDICATOR AND It is described in more detail in the U.S. Patent Application Serial Number 10/374,026 of RETRACTION MECHANISM ", the patent Shen Disclosure please is incorporated by reference accordingly to be incorporated herein.Meet the combinable single firing schedule of other application of the invention, Such as in co-pending and jointly owned entitled " SURGICAL STAPLING INSTRUMENT HAVING SEPARATE The U.S. Patent Application Serial Number 10/441 of DISTINCT CLOSING AND FIRING SYSTEMS ", described in 632, The disclosure of the patent application is incorporated by reference accordingly to be incorporated herein.

Referring specifically to Figure 17, the distal end of pedestal 9070 is attached to nail channel 9018.Anvil block 9022 is pivoted with nearside End 9072, the nearside hub switch side 9072 is can pivotably be received in the proximal end 9074 of nail channel 9018, just It is located at the distal side of itself and 9070 joint of pedestal well.When anvil block 9022 pivots downwards, anvil block 9022 makes tissue contacting surface 9028 and cartridge movement of the forming pit 9026 towards opposite, further more detailed description as follows.The hub switch side of anvil block 9022 9072 include closure feature structure 9076, the closure feature structure 9076 at its pivotal attachment with nail channel 9018, but Distal side at its pivotal attachment with nail channel 9018.Therefore, (its distal end includes engaging closure spy to closed tube 9078 Levy the shape of a hoof hole 9080 of structure 9076) selectively open movement is assigned to anvil block 9022 during nearside longitudinal movement, and And closing motion is assigned to anvil block 9022 during the longitudinal movement of distal side, the closed tube 9078 is in response to closure trigger in pedestal It is slided on 9070, it is similarly as described above.Pedestal 9070 promotes and firing action is guided to pass through longitudinally reciprocating motion from shank Two cuttves and trigger shaft 9090.Specifically, pedestal 9070 includes longitudinal trigger shaft slit 9092, the longitudinal direction trigger shaft slit 9092 receive the portions of proximal of two cuttves and trigger shaft 9090, are in particular laminated tapered trigger shaft 9094.It should be appreciated that layer Press tapered trigger shaft 9094 that can be replaced by solid trigger shaft and/or any other suitable material.

E type crossbeam 9102 is the distal part of two cuttves and trigger shaft 9090, is conducive to individually be closed and fire, and Anvil block 9022 and elongate staple channel 9018 are separated during percussion.Referring specifically to Figure 17 and Figure 19, in addition to any attachment is handled Outside such as solder brazing or adhesive, two cuttves and trigger shaft 9090 are also hung down by the spill being proximally formed in E type crossbeam 9102 The straight formation of attachment hole 9104, the attachment hole 9104 reception are presented by the tapered trigger shaft 9094 of lamination in distal side corresponding convex Shape attachment members 9106, to make each part by being suitable for the selected of its different function (such as intensity, flexibility, frictional force) Material and method are formed.E type crossbeam 9102 can be formed advantageously by the material with suitable material attribute.This material is used for shape Top pin 9110, a pair of of intermediate pin 9112 and base pins or stabilizer blade 9114 in a pair, and sharp cutting edge can be obtained 9116.In addition, holding integrated molding top guide part 9118 proximally outstanding and the centre of each vertical end of cutting edge 9116 Guide part 9120 also defines organization aggregation area 9122, facilitates before cutting off tissue to guide to sharp cutting edge 9116.Intermating guides 9120 are also used to connect by the staged central member 9124 of adjacent wedge-shaped slides 9126 (Figure 20) Merge percussion nail administration assembly 9012, to realize nail forming, more detailed description as follows by nail administration assembly 9012.These Feature structure (for example, top pin 9110, intermediate pin 9112 and bottom supports 9114) is integrally formed with E type crossbeam 9102, compared with It is assembled with multiple components, is conducive to the structure for producing needs with tolerance tightened up relative to each other, so that it is guaranteed that in the percussion phase Between and/or with during the various locking feature structure effective interactions of nail administration assembly 9012, realize desired operation.

In Figure 21 and Figure 22, nail administration assembly 9012 is illustrated as in opened condition, and E type crossbeam 9102 returns completely at this time Contracting.During assembly, the lower leg 9114 of E type crossbeam 9102 is dropped through the broadening hole 9130 in nail channel 9018, and E type is horizontal Beam 9102 is then pushed into, so that E type crossbeam 9102 is along the lower tracks 9132 being formed in nail channel 9018 towards remote Slideslip.Specifically, lower tracks 9132 include narrower slots 9133, which is opened on the lower surface of nail channel 9018 Slit 9134 is widened, to form the T shape of reversion in lateral cross, as specifically described in Figure 22 and Figure 23；The narrower slots 9133 are connected to broadening hole 9130.Once each component for being connected to the tapered trigger shaft 9094 of lamination in nearside is assembled, this A little components just no longer allow lower leg 9114 proximally to march to broadening hole 9130 and allow to be disengaged from the broadening hole.Ginseng See Figure 24, is laminated tapered trigger shaft 9094 and is conducive to user for nail administration assembly 9012 across trochar insertion.Specifically, when When E type crossbeam 9102 is fully retracted, E type crossbeam 9102 just lifts in the portion 9136 that is downwardly projected of farther side.This is by dashing forward downwards Portion 9136 is subjected to displacement to realize in certain point out, at this point, broadening hole of the protruding portion 9136 in nail channel 9018 It is ejected upwards in 9130 proximal.Referring now to Figure 25, tapered trigger shaft 9094 is laminated also by including more nearside Upward projection 9138 can be coupled to the operation of certain locking feature structures in nail channel 9018 to enhance.The more nearside Upward projection 9138 is driven downwards during the initial part of firing schedule by pedestal 9070.Specifically, 9140 quilt of transverse bar It is limited between the square holes 9142 in pedestal 9070 (Figure 17).The clamp spring 9144 of transverse bar 9140 is surrounded to tenesmus Keep a part for being laminated tapered trigger shaft 9094 prominent from longitudinal trigger shaft slit 9092 towards distal side, it is ensured that when appropriate A little advantageous locking feature structures are engaged.When upward projection 9138 contacts clamp spring 9144, the motive force is more bright The part that is aobvious or being limited only to firing schedule.

In Figure 21 and Figure 22, E type crossbeam 9102 bounces back, and top pin 9110 is located at the pivot proximal end of anvil block 9022 In neighbouring anvil block pit 9150.The vertical anvil block slot 9152 (Figure 16) opened downwards lateral widening in anvil block 9022 is anvil Seat inner tracks 9154, capture the top pin 9110 of E type crossbeam 9102, such as when which promotes during percussion towards distal side Described in Figure 24 and Figure 25, so that anvil block 9022 and nail channel 9018 clearly be separated.Therefore, when E type crossbeam 9102 returns After contracting, surgeon can be repeatedly opened and be closed nail administration assembly 9012, until wherein to be stapled and cutting to being trapped in Until the placement of tissue and orientation please oneself, and E type crossbeam 9102 reduces even for diameter and rigidity accordingly reduces Nail administration assembly 9012 also contributes to tissue and appropriately positions.In Figure 16, Figure 17, Figure 20, Figure 21, Figure 23 and Figure 29, nail application Component 9012 is shown to have the replaceable nail bin 9020 including wedge-shaped slides 9126.Longitudinally-aligned and parallel is multiple downward The wedge slot 9202 (Figure 23) of opening receives and the corresponding wedge piece 9204 of 9126 one of wedge-shaped slides.In Figure 23 to Figure 25 In, therefore wedge-shaped slides 9126 jack up multiple staple drivers 9206 upwards, the multiple staple drivers 9206 can drive in nail Vertical sliding motion in dynamic device groove 9208.In the exemplary version, each staple drivers 9206 include two vertical contact pins, each Vertical contact pin translates up in corresponding nail hole 9210 or cavity 9024, is squeezed upwards with will rest against the nail 9023 on vertical contact pin Out, and deform nail 9023 against the staple forming surface 9214 (Figure 25) of anvil block 9022.It is limited to the nail of neighbouring nail channel 9018 In storehouse 9020 center percussion groove 9216 (Figure 17) allow wedge-shaped slides 9126 bottom horizontal portion 9218 (Figure 20) with And the intermediate pin 9112 of E type crossbeam 9102 passes through.Specifically, nail bin pallet 9220 (Figure 17 and Figure 23) is attached to polymer nail bin Body 9222 is simultaneously positioned below；The polymer staple cartridge body 9222 has staple drivers groove 9208 formed therein, nail hole 9210 fire groove 9216 with center.When following closely 9023 therefore in either side forming, sharp cutting edge 9116 enters vertical logical Slot 9230, other than the only farthest side end of the vertical through slot, which passes through the longitudinal axis of nail bin 9020.

Nail administration assembly 9012 is fired to start as Figure 25 describes.In Figure 25, by two cuttves and trigger shaft 9090 It proximally pulls, is until being downwardly projected portion 9136 and upwardly and rearwardly jacking up the intermating guides 9120 on E type crossbeam 9102 Only, as a result, when anvil block 9022 is opened, new nail bin 9020 can be inserted into nail channel 9018, as Figure 16 and Figure 21 describe. In Figure 26, two cuttves and trigger shaft 9090 promote a small distance towards distal side, when clamp spring 9144 acts on lamination gradually When the upward projection 9138 of the trigger shaft 9094 of contracting, the broadening hole of lower tracks 9132 can be fallen by being downwardly projected portion 9136 In 9130.Intermating guides 9120 are prevented due to generating in the staged central member 9124 for resting in wedge-shaped slides 9126 It is further rotated down, so that the intermediate pin 9112 of E type crossbeam is maintained in center percussion groove 9216.In Figure 27, Two cuttves and trigger shaft 9090 are fired towards distal side, to promote wedge-shaped slides 9126 so that nail 9023 shapes, while using cutting edge of a knife or a sword The cutting edge 9116 of benefit cuts off the tissue 9242 being clamped between anvil block 9022 and nail bin 9020.Then, in Figure 28, two cuttves It bounces back with trigger shaft 9090, leaves the wedge-shaped slides 9126 of distal side positioning.In Figure 29, intermediate pin 9112 is allowed to flat downwards It moves on in the latch groove 9240 formed in nail channel 9018 (referring also to Figure 22 and Figure 25).Therefore, work as wedge-shaped slides When 9126 (not being shown in FIG. 29) do not position (that is, the missing of nail bin 9020 or nail bin 9020 exhaust) proximally, if intermediate pin 9112 encounter the distal side edge of latch groove 9240, and operator will receive tactile instruction.Similar surgery suturing appliance exists It is disclosed in the United States Patent (USP) 7,380,696 that on June 3rd, 2008 announces, the complete disclosure of the patent is incorporated by reference Herein.

In various embodiments, turning now to Figure 30 to Figure 38, surgical instruments 12000 may include shank 12010, from shank 12010 axis 12020 extended and the end effector 12040 that can be removably attached on axis 12020, it is as follows into One step more detailed description.Shank 12010 may include trigger 12014, which can be activated to execute following behaviour Make: 1) being closed end effector 12040 and firing member 12,043 2) is advanced through end effector 12040 towards distal side. Although Figure 30 is not shown into Figure 38, shank 12010 may include any suitable driving system, which is configured to The rotary motion of trigger 12014 is transmitted, and the rotary motion is converted into firing member 12023 and extends through axis 12010 Linear movement.In use, trigger 12014 can be activated by the pistol grip 12012 towards shank 12010, to hit It sends out component 12023 to promote along longitudinal axis 12039 towards distal side in axis 12020, and works as axis firing member 12023 and end When actuator firing member 12043 is operatively coupled, further more detailed description as follows, axis firing member 12023 it is remote Side movement can be passed to end effector firing member 12043.When end effector firing member 12043 is promoted towards distal side When, end effector firing member 12043 be just configured to engagement include anvil block the first jaw 12040a and/or including Second jaw 12040b of staple cartridge channel, and make at least one jaw court in the first jaw 12040a and the second jaw 12040b The movement of another jaw.As to supplement above, referring primarily to Figure 30 to Figure 32, end effector 12040 can be in transverse direction In being assembled to axis 12010 on the direction of longitudinal axis 12039.For example, end effector 12040 can (for example) perpendicular to Axis 12010 is assembled on the direction of longitudinal axis 12039.In such cases, end effector 12040 can be towards axis 12010 movements, so that the frame 12041 of end effector 12040 is engaged and connected to frame 12021, and to fire The proximal end 12044 of component 12043 engages the distal end 12024 for being coupled to firing member 12023.Pedestal 12021 can Including being defined in channel 12022 therein, which is configured to slidably receiving axis firing member 12023 and limits Longitudinal axis 12039.In order to which end effector frame 12041 to be aligned with pedestal 12021, in various embodiments, end is held The proximal end 12045 of row device frame 12041 and the distal end 12025 of pedestal 12021 may include that can (for example) end be made to hold The cooperation dovetail feature structure of 12040 relative axle 12020 of row device orientation.Pedestal 12021, which may also include, is defined in peace therein Hole 12026 is filled, these mounting holes 12026 are configured to receive prominent from the installation of the extension of end effector frame 12041 Portion 12046 out.Due to mounting characteristic structure 12026 and 12046, and/or the cooperation dovetail feature of end 12025 and 12045 Structure, so in all cases, end effector 12040 can be fixedly secured to axis 12020.In various embodiments In, surgical instruments 12000 may also include lock lining ring 12030, which is configured to end effector 12040 are locked on axis 12020.Referring now primarily to Figure 34 to Figure 36, lock lining ring 12030 can unlocked position (Figure 34 and Figure 35) moved between latched position (Figure 36).When lock lining ring 12030 in its unlocked position (referring to Figure 34), can be by end Actuator 12040 is assembled into axis 12020.Once end effector 12040 is engaged with axis 12020, lock lining ring 12030 can held It slides, end effector 12040 is locked in place on interconnection between portion's actuator 12040 and axis 12020. More specifically, at least one embodiment, lock lining ring 12030 can limit inner hole 12031, which may be structured to The outer periphery of end effector 12040 and axis 12020 can be closely received.In certain embodiments, surgical instruments 12000 can Including spring or biasing member, the spring or biasing member, which are configured to that lining ring 12030 will be locked, is biased to its latched position. In such embodiments, the bias force that clinician can resist spring is proximally pulled lining ring 12030 is locked, then release lock Lining ring 12030 allows spring to be back to its latched position for lining ring 12030 is locked.

Referring again to Figure 30 to Figure 38, and referring primarily to Figure 32 and Figure 33, surgical instruments 12000 may include that joint motions connect First 12050.In various embodiments, actuated articulation joints 12050 are configured to allow the remote of end effector 12040 Side section is pivoted around the axis that actuated articulation joints 12050 limit.In this embodiment, end effector 12040 may include It is fixedly secured to the portions of proximal of axis 12020 and can surround what actuated articulation joints 12050 be rotated relative to portions of proximal Distal part.In certain embodiments, surgical instruments 12000 may include lock, which is configured to engagement end portion actuator 12040 distal part is simultaneously disengaged with the distal part of end effector 12040.For example, end effector 12040 can wrap Include end effector lock section points 12047, end effector lock section point 12047 can be pushed towards distal side with by end effector 12040 distal part is locked to appropriate location, and/or can proximally be pulled the distal portion so that end effector 12040 Decompose lock.Surgical instruments 12000 may also include lock actuator 12060 (for example) adjacent with shank 12010, the lock actuator 12060 can proximally be pulled, proximally to pull end effector lock section point 12047.In such an embodiment, lock actuating Device 12060 can be operatively coupled with the lock section points 12027 for extending through axis 12020, which is operatively coupled, Or end effector lock section point 12047 can be operably coupled to.In the embodiment as at least one, when end executes When device 12040 is assembled to axis 12020, the proximal end 12048 of end effector lock section point 12047 can be assembled to lock section point 12027 distal end 12028.In the embodiment as at least one, end effector lock section point 12047 can be held in end While row device firing member 12043 is assembled to axis firing member 12023, it is assembled to lock section point 12027.

In various embodiments, as described above, nail bin may include warehouse, which includes multiple being defined in nail therein Chamber.Warehouse may include platform and top platform surface, wherein each nail cavity can limit opening in platform surface.Institute also as above It states, nail can be positioned in each nail cavity, so that nail is stored in warehouse until it is projected from warehouse.In various realities It applies in example, in nail by before projecting from warehouse, nail can be installed in warehouse, so that nail does not protrude into above platform surface. In such embodiments, when nail is located in below platform surface, nail is damaged and/or a possibility that premature contact destination organization It can reduce.In all cases, nail can move between non-firing position and firing position, in non-firing position, nail not from Warehouse is prominent；In firing position, nail exposes from warehouse and can contact the anvil block for being located in nail bin opposite.In various implementations In example, anvil block and/or the nail shapes pit being defined in anvil block can be positioned so that one preset distance of anomaly platform surface, thus So that nail is deformed into a scheduled forming height when nail is disposed from warehouse.In some cases, anvil block and nail bin are trapped in Between tissue thickness variable.Therefore, thicker tissue can be trapped in certain nails, and relatively thin tissue can be captured In certain other nails.In either case, the clamping pressure of tissue is applied to by nail or power (for example) can be different because of nail, Or it can be different between the nail and the nail of the nail row other end of nail row one end.In some cases, anvil block and nail be can control Gap between storehouse platform, so that nail applies a certain the smallest clamping pressure in each nail.However in some such feelings Under shape, the significant changes of the clamping pressure in different nails be there will still likely be.

In use, as to supplement above, and referring primarily to Figure 39, for example, anvil block (such as anvil block 10060) can be transported Move the closed position opposite with nail bin 10000.More detailed description as follows, anvil block 10060 can will be organized against tissue thickness Compensating part 10020 positions, and in various embodiments, such as tissue thickness compensation part 10020 is pressed to support section 10010 Platform surface 10011.Once anvil block 10060 is appropriately positioned, so that it may which deployment nail 10030, this is also shown in FIG. 39.? In various embodiments, as described above, nail percussion sliding part 10050 can be from the proximal end 10001 of nail bin 10000 towards distal end portion Portion 10002 moves, as shown in figure 40.When sliding part 10050 is pushed into, sliding part 10050 can contact staple drivers 10040 simultaneously Staple drivers 10040 are lifted up in nail cavity 10012.In at least one embodiment, sliding part 10050 and staple drivers 10040 can respectively include one or more slopes or inclined surface, the one or more slope or inclined surface can cooperate so that Staple drivers 10040 are moved upwards from their non-firing position.In the embodiment as at least one, each staple drivers 10040 may include at least one inclined surface, and sliding part 10050 may include one or more inclined surfaces, so that When sliding part 10050 is promoted in nail bin towards distal side, slide member tilts surface can be slided below driver inclined surface It is dynamic.When staple drivers 10040 are lifted up in their own nail cavity 10012, staple drivers 10040 can will be followed closely 10030 are lifted up, so that nail 10030 can be by the opening in nail platform 10011 (Figure 41) from their nail cavity 10012 Middle exposing.In illustrative percussion sequence, accessible first nail 10030 of sliding part 10050 and start by the first nail 10030 to On lift.When sliding part 10050 is promoted towards farther side, sliding part 10050 can start other nail 10030 and any Other follow-up nails are lifted with sequential order.Sliding part 10050 can drive up nail 10030, so that with opposite anvil block The leg 10032 of the nail of contact is deformed into desired shape, and projects from support section 10010.In all cases, as A part of percussion sequence, sliding part 10050 can be such that multiple nails move upwards simultaneously.

Referring to fig. 49 to Figure 54, each nail 10030 can be deformed into so that wherein limiting a constricted zone 10039.For example, every A nail 10030 may include base portion 10031 and one or more legs 10032 from the extension of base portion 10031.It, can when these legs deform The restriction that cooperates with base portion 10031 can capture tissue T and tissue thickness compensation part 10020 in the region.In constricted zone In 10039, tissue thickness compensation part 10020 can apply pressure to tissue T, and in some cases, depending on tissue T thickness not The different compression height with presentation.In some cases, tissue thickness compensation part 10020 can be filled flexibly by 10030 limit of nail Gap in fixed constricted zone 10039, i.e. free space.

As described above and referring to fig. 41, when nail 10030 is in their non-firing position, 10030 nail leg 10032 is followed closely It may extend into 10011 top of platform surface of support section 10010.In various embodiments, when nail 10030 is in them not When firing position, the top of nail leg 10032 or any other part of nail leg 10032 convex may not wear tissue thickness compensation part 10020 top tissue contacting surface 10021.When nail 10030 moves to from their non-firing position their firing position When, the top of nail leg convex may wear tissue contacting surface.In various embodiments, the top of nail leg 10032 may include can Incision and the pointed tip for piercing tissue thickness compensation part 10020.In certain embodiments, tissue thickness compensation part 10020 can Including multiple holes, the multiple hole is configured to accommodate nail leg 10032 and allows nail leg 10032 relative to tissue thickness Compensating part 10020 slides.In certain embodiments, support section 10010 may also include from the multiple of the extension of platform surface 10011 Guide part 10013 (Figure 41).Guide part 10013 can be positioned so that it is adjacent with the nail cavity opening in platform surface 10011, to make Obtaining nail leg 10032 can at least partly be supported by guide part 10013.In certain embodiments, guide part 10013 can be positioned on nail At the proximal end and/or distal end of chamber opening.In various embodiments, the first guide part 10013 can be positioned on each nail At the first end of chamber opening, and the second guide part 10013 can be positioned at the second end of each nail cavity opening, to make The first nail leg 10032 of the sustainable nail 10030 of each the first guide part 10013 is obtained, and each second guide part 10013 can prop up Second nail leg 10032 of nail 10030.In at least one embodiment, referring to fig. 41, each guide part 10013 can be (for example) Including groove or slit, such as groove 10016, nail leg 10032 can be slidably received in the groove or slit.In various realities It applies in example, each guide part 10013 may include that can extend from platform surface 10011 and may extend into tissue thickness compensation part Anti-skid stud, protrusion, and/or spike in 10020.In at least one embodiment, more detailed description as follows, anti-skid stud are dashed forward It rises, and/or spike can reduce the relative motion between tissue thickness compensation part 10020 and support section 10010.In certain implementations In example, the top of nail leg 10032 be can be positioned in guide part 10013, and when nail 10030 is in their non-firing position It may not extend to above the top surface of guide part 10013.In at least this embodiment, guide part 10013 can be limited Guiding height, and when nail 10030 is in their non-firing position, nail 10030 may not extend to the guiding height Top.

In various embodiments, tissue thickness compensation part (such as tissue thickness compensation part 10020) for example can be by single material Tablet is constituted.In at least one embodiment, tissue thickness compensation part may include continuous sheet, which can cover The whole top platform surface 10011 of support section 10010, or do not cover entire platform surface 10011.In certain implementations In example, which can cover the nail cavity opening in support section 10010, and in other embodiments, which may include The opening that can be aligned with nail cavity opening or at least partly be aligned.In various embodiments, tissue thickness compensation part can be by multilayer Material is constituted.In some embodiments, tissue thickness compensation part may include compressible core and the wrappage around the compressible core.

In various embodiments, tissue thickness compensation part may include for compressible core to be releasably held support portion Divide 10010 wrappage.In the embodiment as at least one, nail bin may also include retainer fixture, the retainer fixture It is configured to that wrappage and compressible core is inhibited prematurely to separate with support section 10010.In certain embodiments, such as Upper described, tissue thickness compensation part can be removably attachable to support section 10010 by nail 10030.More specifically, also as above Described, when nail 10030 is in their non-firing position, the leg for following closely 10030 may extend into tissue thickness compensation part 10020 In, thus tissue thickness compensation part 10020 is releasably held into support section 10010.In at least one embodiment, it follows closely 10030 leg can its corresponding nail cavity 10012 side wall contact, wherein due between nail leg 10032 and side wall exist friction, Nail 10030 and tissue thickness compensation part 10020 can be held in place, until nail 10030 is deployed as stopping from nail bin 10000.When After nail 10030 is disposed, tissue thickness compensation part 10020 can be trapped in nail 10030 and be protected against the tissue T of suture It holds.When anvil block is subsequently moved into open position to discharge tissue T, support section 10010 is movable far from having been secured to tissue Tissue thickness compensation part 10020.In certain embodiments, adhesive can be used that tissue thickness compensation part 10020 can be removed Ground remains to support section 10010.In at least one embodiment, two-part adhesive can be used.In at least one embodiment In, wherein the first part of the adhesive can be placed on platform surface 10011, and the second part of the adhesive can quilt It is placed in tissue thickness compensation part 10020, is put so that being close to platform surface 10011 when tissue thickness compensation part 10020 When setting, first part can contact second part to enable the adhesive and separably bond tissue thickness compensation part 10020 To support section 10010.In various embodiments, any other suitable method can be used to separate tissue thickness compensation part Ground remains on the support section of nail bin.

In various embodiments, as to supplement above, sliding part 10050 proximally can be advanced to distal end portion in end Portion, all nails 10030 that will be mounted in nail bin 10000 are disposed completely.In at least one embodiment, referring now to Figure 44, Sliding part 10050 can be in the longitudinal cavity in support section 10010 by 10052 court of knife bar of firing member or surgical stapling device Distal side promotes.In use, nail bin 10000 can be inserted into the staple cartridge channel in surgical stapling device jaw, and firing member 10052 can be advanced to and contact with sliding part 10050, as shown in figure 44.When sliding part 10050 by firing member 10052 towards distal side When propulsion, sliding part 10050 can contact one or more staple drivers 10040 of recent side, and will nail 10030 as described above from The percussion of warehouse 10010 (that is, injection).As shown in figure 44, firing member 10052 may also include cutting edge 10053, when nail 10030 When being fired, which can be promoted by the cutter slit in support section 10010 towards distal side.In various embodiments, Corresponding cutter slit can extend across the anvil block for being located in 10000 opposite of nail bin, so that at least one embodiment, cutting It cuts sword 10053 and can extend between anvil block and support section 10010 and cut and be located between anvil block and support section 10010 Tissue and tissue thickness compensation part.In all cases, sliding part 10050 can be promoted by firing member 10052 towards distal side, until Until sliding part 10050 reaches the distal end of nail bin 10000.At this point, firing member 10052 can proximally bounce back.Some In embodiment, sliding part 10050 can proximally bounce back with firing member 10052, but in various embodiments, work as firing member When 10052 retraction, sliding part 10050 can be stayed in the distal end 10002 of nail bin 10000.Once firing member 10052 has filled Point retraction, anvil block can be again turned on, at this time can separate tissue thickness compensation part 10020 with support section 10010, and can will The remaining non-implanted portion (including support section 10010) for exhausting nail bin 10000 is removed from staple cartridge channel.

Nail bin 10000 will exhausted after staple cartridge channel removal, it, can be by new nail bin as to supplement above 10000 or any other suitable nail bin insertion staple cartridge channel in.In various embodiments, as to supplement above, nail bin Channel, firing member 10052 and/or nail bin 10000 may include cooperation feature structure, these cooperation feature structures can there has been no New not firing prevents firing member 10052 from promoting again towards distal side when nail bin 10000 is located in staple cartridge channel 10070.More Specifically, it when firing member 10052, which is advanced to, to be contacted with sliding part 10050, and is not hit when sliding part 10050 is in its nearside When sending out position, the support nose of firing member 10052 can be positioned on the support lugn on sliding part 10050 and/or on, from And firing member 10052 is made to be maintained at position upward enough, to prevent the lock or crossbeam that extend from firing member 10052 10054 fall into the lock crossbeam being limited in staple cartridge channel.It will not fall into lock crossbeam due to locking 10054 in such cases, So lock 10054 may not abut the distal side side wall of lock crossbeam when firing member 10052 promotes.When firing member 10052 When sliding part 10050 is pushed towards distal side, firing member 10052 can be supported due to leaning against the support nose on support lugn In its upward firing position.When firing member 10052 bounces back relative to sliding part 10050 as described above, due to supporting nose It does not rely on the support lugn of sliding part 10050, firing member 10052 can fall from its upward position.At at least one this In the embodiment of sample, surgical stapling device may include being configured to firing member 10052 being biased to its down position Spring and/or any other suitable biasing element.It, just cannot be again towards remote once firing member 10052 has been fully retracted Side is advanced through the nail bin 10000 exhausted.More specifically, when the moment of sliding part 10050 in the sequence of operation is left on nail When at the distal end in storehouse 10000, firing member 10052 just cannot keep position at an upper portion thereof by sliding part 10050.Therefore, As described above, lock beams 10054 will connect if again promoted firing member 10052 in the case where no replacement nail bin The side wall 10057 of lock crossbeam is touched, this will prevent firing member 10052 from being advanced in nail bin 10000 towards distal side again.In other words It says, once the nail bin 10000 exhausted is replaced with new nail bin, since new nail bin has the sliding part 10050 proximally positioned, Firing member 10052 can be kept position at an upper portion thereof and firing member 10052 is allowed to promote again towards distal side.

As described above, sliding part 10050 is configured to make staple drivers 10040 in the first non-firing position and It moves between two firing positions, is projected so that 10030 will be followed closely from support section 10010.In various embodiments, in nail 10030 After the injection of support section 10010, staple drivers 10040 can be in nail cavity 10012.In certain embodiments, support portion Dividing 10010 may include the one or more for being configured to that staple drivers 10040 is prevented to project or drop out from nail cavity 10012 Keep feature structure.In various other embodiments, sliding part 10050 is configured to staple drivers 10040 from tool There is the support section 10010 of nail 10030 to project.In the embodiment as at least one, for example, staple drivers 10040 can be by Bioabsorbable material and/or biocompatible materials (such as polyetherimide) are constituted.In certain embodiments, nail drives Dynamic device could attach on nail 10030.In the embodiment as at least one, staple drivers be can be molded in each nail 10030 On base portion and/or around, so that the staple drivers and nail are integrally formed.It submits on September 29th, 2006 entitled “SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING The U.S. Patent application of TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME " Sequence number 11/541,123 is incorporated by reference accordingly to be incorporated herein.

In all cases, as to supplement above, compressible tissue thickness compensation part can be relative under nail bin The movement of face rigid support portion, distortion, and/or deflection.In various embodiments, any other of support section and/or nail bin Suitably partially may include be configured between limitation tissue thickness compensation part and support section one of relative motion or Multiple feature structures.As described above, at least part of nail 10030 may extend into the platform surface 10011 of support section 10010 Top, wherein in some cases, the cross force for being applied to tissue thickness compensation part can (for example) be prolonged from support section 10010 The nail 10030 and/or anti-skid stud 10013 stretched are kept out.In all cases, nail 10030 is in the cross for keeping out tissue thickness compensation part To when movement can and/or bending tilted in nail cavity 10012, wherein in various embodiments, nail cavity 10012 and nail 10030 Size can be configured to and be configured to keep nail 10030 leg 10032 and opposite anvil block 10060 in forming pit it Between opposite alignment so that nail 10000 correctly shapes during following closely forming process.In various embodiments, 10030 are followed closely And/or anti-skid stud 10013 is configured to prevent or at least limit the transverse warping in tissue thickness compensation part 10020. In the embodiment as at least one, nail 10030 and/or anti-skid stud 10013 are for example configured to reinforce or limit The first surface or tissue contacting surface of tissue thickness compensation part relative to second surface, that is, bottom surface laterally and/or longitudinally Movement.In various embodiments, the nail bin and/or staple cartridge channel of nail bin is wherein located may include that at least one is minimizing twisting Component, this minimizing twisting component can be upwardly extended to limit the laterally and/or longitudinally movement of tissue thickness compensation part or distortion. As described above, the wrappage at least partly around tissue thickness compensation part can also prevent, or at least limitation tissue thickness compensation The laterally and/or longitudinally movement or distortion of part.

In various embodiments, nail bin may include multiple nail cavities, and each nail cavity accommodates the nail being positioned in, wherein nail cavity The anvil block that multiple rows can be arranged to, and be wherein located in nail bin opposite may include multiple nails corresponding with the nail cavity in nail bin Forming pit.In other words, anvil block may include multiple forming pit rows, wherein each forming pit can be positioned in nail bin Nail cavity opposite.In various embodiments, each forming pit may include the nail leg 10032 for being configured to receive nail 10030 Two forming cups and make nail leg 10032 wherein each forming cup is configured to receive nail leg 10032 Such as shapes or crimp towards another nail leg 10032.In all cases, nail leg 10032 may not enter forming cup or Forming cup is not properly entered, therefore nail leg 10032 may deform during percussion sequence.As described herein In various embodiments, anvil block may include the array or grid for being respectively configured to receive and formed the forming pit of nail leg. In the embodiment as at least one, the array of forming pit may include a certain amount of forming pit, these forming pits Quantity is more than the quantity of the nail accommodated in nail bin.In at least one embodiment, nail bin may include the nail of such as six lengthwise rows Chamber, wherein anvil block may include six row forming pits being aligned with six row nail cavities, and furthermore forming pit is located in forming pit Capable centre.For example, anvil block may include the first forming pit that can be positioned on the first nail cavity row on the side of anvil block Row can be positioned on the second forming pit row on the second nail cavity row of neighbouring first nail cavity row and be located in the first forming Forming pit row among pit row and the second forming pit row.

In various embodiments, as described above, for example, anvil block can move to closed position from open position, so as to against Tissue thickness compensation part (such as tissue thickness compensation part 10020) compressed tissue of nail bin.In all cases, in tissue thickness Before compensating part is relative to tissue positioning, tissue thickness compensation part can be positioned adjacent to the support section of nail bin.In some embodiments In, tissue thickness compensation part 10020 can be at such position: in the position, before anvil block moves to its closed position, group Knit the adjacent support section 10018 of thickness compensation part 10020.In some other embodiments, tissue thickness compensation part 10020 can be located In such position: in the position, there are gaps between tissue thickness compensation part 10020 and support section 10018.At least one In a such embodiment, anvil block can be such that tissue and tissue thickness compensation part 10020 shifts downwards, until tissue thickness compensation part 10020 adjacent support sections 10018, wherein anvil block is moveable to its closed position and generates compression within the organization at this time.If Surgeon is woven in the positioning between anvil block and nail bin to group and feels dissatisfied, openable anvil block, adjusts the position of anvil block and nail bin It sets, then closed anvil again.Since nail bin can carry out such positioning and repositioning relative to tissue, so in various situations Under, for example, the distal end of tissue thickness compensation part 10020 can be separated with support section 10010.Under some such situations, The distal end of tissue thickness compensation part 10020 can contact tissue, and from the removing of support section 10010 or relative to support section 10010 roll.In various embodiments, more detailed description as follows, nail bin may include being configured to mend tissue thickness It repays part and releasably holds one or more features structure below nail bin on support section.

In various embodiments, referring now to Figure 55, nail bin 10300 may include support section 10310, by support section The tissue thickness compensation part 10320 of 10310 supports, and the distal end 10302 including nose 10303,10303 quilt of nose It is configured to the distal end 10325 of tissue thickness compensation part 10320 being releasably held in appropriate location.At least one In a embodiment, nose 10303 may include the distal end 10325 for being configured to receive tissue thickness compensation part 10320 Slit 10305.In various embodiments, distal end 10325 be can be compressed or be wedged in slit 10305, so that When nail bin 10300 is relative to tissue positioning, distal end 10325 can be held in place.The embodiment as at least one In, slit 10305 can be along being parallel to or take at least substantially parallel to the direction of the platform surface 10311 of support section 10310 To.In various embodiments, slit 10305 can be horizontal relative to platform surface 10311.In various other embodiments, Referring now to Figure 56, nail bin 10400 may include support section, by the tissue thickness compensation part 10420 of support section support, and Distal end 10402 including nose 10403, the nose 10403 are configured to the remote of tissue thickness compensation part 10420 Side end 10425 is releasably held in appropriate location.In at least one embodiment, distal end 10425 may include from it The protruding portion of extension, and nose 10403 may include be configured to receive distal end 10425 protruding portion it is vertical narrow Slot 10405.In various embodiments, distal end 10425 and/or protruding portion extending therefrom can be compressed or are wedged in slit In 10405, so that distal end 10425 can be held in place when nail bin 10400 is relative to tissue positioning.Certain In embodiment, for example, tissue thickness compensation part 10420 may include slit (such as slit 10429), which is configured to Enough at least part in wherein reception nose 10403.In at least one embodiment, slit 10405 can along perpendicular to or extremely It is substantially perpendicular to the direction orientation of the platform surface 10411 of support section less.In various embodiments, referring now to Figure 57, Nail bin 10500 may include support section, by the tissue thickness compensation part 10520 of support section support, and including the remote of nose Side end 10502, the nose are configured to releasedly protect the distal end 10525 of tissue thickness compensation part 10520 It holds in place.In at least one embodiment, nose may include vertical slit 10505, which is configured to Enough receive the distal end 10525 of tissue thickness compensation part 10520.In various embodiments, distal end 10525 can be compressed Or be wedged in slit 10505, so that distal end 10525 can be protected when nail bin 10500 is relative to tissue positioning It holds in place.

In various embodiments, referring again to Figure 55, tissue thickness compensation part 10320 may include top surface 10324, should Top surface 10324 can be positioned on 10304 top of top surface of nose 10303.Figure 44 shows the top of tissue thickness compensation part Portion surface is located in another exemplary embodiment above nail bin nose, wherein the top of such as tissue thickness compensation part 10720 Portion surface 10721 is located in 10004 top of top surface of nose 10003.In use, referring again to Figure 55, tissue can be It is slided on the top surface 10304 of nose 10303, and in some cases, organizes accessible tissue thickness compensation part 10320 distal end 10325, and tissue thickness compensation part 10320 can be exerted a force to, to make tissue thickness compensation part 10320 are easy to remove from support section 10310.In the embodiments described herein, which can be by 10325 wedge of distal end The part entered in nose 10303 is kept out.Under any circumstance, once tissue is appropriately positioned relative to nail bin 13000, anvil block Closed position can be rotated to compress tissue and tissue thickness compensation part 10320 against support section 10310.At at least one In such embodiment, anvil block can be rotated to such position: in the position, anvil block contacts the top surface of nose 10303 10304, therefore anvil block can be prevented to further rotate.In all cases, due to the top surface of tissue thickness compensation part 10320 10324 are just being located in 10304 top of top surface of nose 10303, so when anvil block is just closed, top surface 10324 It can be pushed down towards support section 10310, and in some cases, for example, top surface 10324 can be pushed to nose 10303 10304 lower section of top surface.As described herein, it is disposed in the nail being contained in nail bin 10300 and organizes thickness After degree compensating part 10320 has been cut into, support section 10310 and the movable separate tissue thickness compensation part of nose 10303 10320, so that the distal end 10325 of tissue thickness compensation part 10320 can skid off slit 10305.

As described above, anvil block (such as anvil block 10060) can for example be rotated to closed position, in the closed position, anvil block The top nose surface 10004 of 10060 contacts nail bin (such as nail bin 10000).Once anvil block arrived its closed position, tissue Thickness compensation part (such as tissue thickness compensation part 10020) compressed amount will depend on tissue thickness inter alia and compensate The uncompressed thickness or height of part and the thickness of tissue.Referring now to Figure 42 and Figure 43, tissue thickness compensation part 10920 can The top surface for flushing or at least substantially flushing including the top surface 10004 with nose 10003.In such embodiments, The top surface of tissue thickness compensation part 10920 can be pushed to 10004 lower section of top surface of nose 10003.Referring now to Figure 47 and Figure 48, tissue thickness compensation part (such as tissue thickness compensation part 10820) for example may include top surface 10821.? Before tissue thickness compensation part 10820 is compressed by tissue T and anvil block 10060, which is located in top nose table 10004 lower section of face.In the case where tissue T is relatively thin, as shown in Figure 45 and 46, tissue thickness compensation part 10920 can be subjected to phase To small compression.Referring now to Figure 47 and Figure 48, when tissue T is relatively thick, tissue thickness compensation part 10820 can be subjected to larger Compression.In the case where the existing thinner part of tissue T also has thick part, as shown in Figure 47 and Figure 48, for example, tissue thickness is mended Repaying part 10820 can be positioned at below relatively thin tissue T when it is positioned at compared with below thick tissue T by compression larger quantities at it When compressed lesser amount.As described above, in this way, tissue thickness compensation part can compensate for different tissue thickness.

In various embodiments, referring now to Figure 58 and Figure 59, surgery suturing appliance may include 1) being configured to connect Receive the warehouse channel 16670 of nail bin 16600 and 2) the anvil block 16660 of warehouse channel 16670 can be pivotally coupled to. Nail bin 16600 may include support section 16610 and tissue thickness compensation part 16620, and wherein tissue thickness compensation part 16620 is remote Side end 16625 can releasably hold support section by the nose 16603 of 16600 distal end 16602 of nail bin 16610.In at least one embodiment, nose 16603 may include slit 16605, and can be made of flexible material.It is using In, referring primarily to Figure 58, nose 16603 can be bent downwards, to expand the opening of slit 16605.In certain embodiments, nose Portion 16603 may include notch or cut out 16606, which is configured to make nose 16603 to downwarp It is bent.Anyway, in all cases, the enlarged openings of slit 16605 can be conducive to the remote of tissue thickness compensation part 16620 Side end 16625 is inserted into slit 16605.Once tissue thickness compensation part 16620 suitably positions, nose 16603 can be released It puts.Since the material of composition nose 16603 has resilience, nose 16603 can return to or at least substantially return to it and do not bend State, and against the distal end 16625 of the trapping tissue thickness compensation part 16620 of platform surface 16611, as shown in figure 59.? In use, similarly as described above, when histokinesis of the support section 16610 far from suture, distal end 16625 can be led Pull out slit 16605.In all cases, when tissue thickness compensation part 16620 is separated with support section 16610, flexible nose Portion 16603 is configured to deflect.In various embodiments, referring again to Figure 59, tissue thickness compensation part 16620 can be wrapped Include the top surface 16621 for being aligned with the top surface 16604 of nose 16603 or being at least substantially aligned.

In various embodiments, referring now to Figure 60 to Figure 61, nail bin (such as nail bin 11400) for example may include that can be removed Ground is attached to the tissue thickness compensation part 11420 on support section 11410.In at least one embodiment, nail bin 11400 can wrap Include the one or more guarantors for being configured to remain to the longitudinal direction side of tissue thickness compensation part 11420 platform surface 11411 Holder bar 11413.In the embodiment as at least one, each retainer bars 11413 may include opposite arm 11418, should Opposite arm can limit channel 11416 between them.In such embodiments, one in arm 11418 is configured to It is enough to extend on tissue thickness compensation part 11420, and another arm 11418 is configured to from support section 11410 antelabium 11419 extended extend below.Referring primarily to Figure 60, the size in the channel 11416 of each retainer bars 11413 It can be set and be configured to apply compressive force to the vertical of tissue thickness compensation part 11420 before using nail bin 11400 To side.During use, referring primarily to Figure 61, nail bin 11400 be can be positioned in staple cartridge channel, once nail bin 11400 is appropriately Positioning, anvil block (such as anvil block 11460) are just for example moveable to the position of its compressible tissue thickness compensation part 11420.It is similar In described above, when tissue thickness compensation part 11420 is compressed, transverse direction or can extend to the outside, therefore make retainer bars 11413 It is separated with nail bin 11400.In some other embodiments, the closure of anvil block 11460 may not be made into retainer bars 11413 and nail Storehouse separation, or retainer bars 11413 may not be made to be kept completely separate with nail bin.In the embodiment as at least one, as above The propulsion trigger shaft, which passes through nail bin 11400, can be such that nail 10030 disposes from support section 11410, while squeeze 11460 He of anvil block Nail bin 11400 keeps them closer to each other, and to apply compressive force to tissue thickness compensation part 11420, which is enough Make 11420 extending transversely of tissue thickness compensation part and separates retainer bars 11413 with nail bin 11400.Once retainer bars 11413 separate with nail bin 11400, and support section 11410 can the movement of tissue thickness compensation part 11420 far from implantation and from hand Art position removes.

In various embodiments, as to supplement above, nail bin may include multiple fasteners, these multiple fastener quilts It is configured to releasably holding tissue thickness compensation part into the support section of nail bin.In certain embodiments, for example, branch Support part point may include the multiple holes being limited in platform surface.Wherein fastener can extend across tissue thickness compensation part and energy It is enough releasably retained in the hole of support section.In use, when nail is gradually projected from support section, fastener can be from Support section gradually discharges.In the embodiment as at least one, fastener can be implanted into tissue thickness compensation part, and And at least one embodiment, for example, fastener can be made of at least one bioabsorbable material.In some embodiments In, after tissue thickness compensation part has been implanted, and when support section is mended at least partially away from the tissue thickness of implantation When repaying part movement, fastener can be separated with support section.In various embodiments, referring now to Figure 130 to Figure 131, nail bin is (all Such as nail bin 11600) it for example may include the tissue thickness that support section 11610 is releasably attached to by multiple fasteners 11613 Compensating part 11620.Each fastener 11613 may include compensating in insertion tissue thickness compensation part 11620 and/or with tissue thickness The first end 11618 of part engagement, the second end 11618 that is engaged with support section 11610, and by first end 11618 It is connected to the connector 11616 of the second end 11618.In various embodiments, fastener 11613, which can extend across, is limited to branch Cutter slit 11615 in support part point 11610.In use, firing member 10052 can make blade move across support section Cutter slit 11615 in 11610 simultaneously cuts fastener 11613, to discharge tissue thickness compensation part from support section 11610 11620.In the embodiment as at least one, trigger shaft 10052 can be advanced to nail bin from the proximal end of nail bin 11600 11600 distal end, 1) as described above to promote sliding part 10050 and gradually percussion nail 10030 towards distal side；2) gradually Incision fastener 11613 and/or disconnect fastener 11613, so that tissue thickness compensation part 11620 is from support section 11610 Gradually discharge.In certain embodiments, similarly as described above, tissue thickness compensation part 11620 may include multiple separable areas Section.These multiple separable sections for example can remain to support section 11610 each by one or more fasteners 11613. If firing member 10052 stops among the proximal end and distal end of nail bin 11600, as illustrated in graph 130, then fastening Part 11613 can help to after the opening of anvil block 11660 and support section 11610 are moved far from tissue T mend tissue thickness The non-implant part for repaying part 11620 remains to support section 11610, as shown in Figure 131.In various embodiments, as to upper The supplement of text, the cutting edge 10053 of firing member 10052 are configured to incision fastener 11613 and/or make fastener 11613 disconnect.

In various embodiments, referring now to Figure 132, nail bin for example may include that (such as tissue is thick for tissue thickness compensation part Spend compensating part 15120), which may include multiple portions with different thickness.In at least one embodiment In, tissue thickness compensation part 15120 may include can have first thickness first part or interior section 15122a, from first What point 15122a extended can be respectively with the second part or middle section 15122b of second thickness, and from second part What 15122b extended can be respectively with the Part III or exterior section 15122c of third thickness.Implement as at least one In example, for example, third thickness is thick than second thickness, and second thickness is than first thickness thickness.However in various other realities It applies in example, any suitable thickness can be used.In various embodiments, the part 15122a of tissue thickness compensation part 15120 is extremely 15122c may include step with different thickness.In at least one embodiment, similarly as described above, nail bin may include more A nail row 10030 and multiple staple drivers with different height, these staple drivers can make nail 10030 be deformed into it is different at Shape height.It is also similar to described above, nail bin may include the first staple drivers 15140a, and first staple drivers 15140a can drive Dynamic 10030 to the first forming height of nail being supported on；Second staple drivers 15140b, second staple drivers 15140b can Drive 10030 to the second forming height of nail being supported on；And third staple drivers 15140c, the third staple drivers 15140c can drive the nail 10030 that is supported on to third forming height.In nail bin, for example, the first forming height can be short In the second forming height, the second forming height can be shorter than third forming height.In various embodiments, as shown in Figure 132, each Nail 10030 may include the i.e. non-firing height of identical or substantially the same unshaped.In some other embodiments, join now See that Figure 133, the first driver 15140a, the second driver 15140b and/or third driver 15140c are sustainable with difference The nail of unshaped height.In the embodiment as at least one, the first staple drivers 15140a is sustainable have first not at The sustainable nail 15130b with the second unshaped height of nail 15130a, the second staple drivers 15140b of shape height, and the The sustainable nail 15130c with third unshaped height of three staple drivers 15140c.Wherein, for example, the first unshaped height can Shorter than the second unshaped height, the second unshaped height can be shorter than third unshaped height.In various embodiments, referring again to The top of Figure 133, nail 15130a, 15130b and/or 15130c can be located at or be at least substantially positioned in identical plane, and In other embodiments, the top for following closely 15130a, 15130b and/or 15130c can not be located in identical plane.

In certain embodiments, referring now to Figure 154, nail bin may include the tissue thickness compensation part with multiple portions 15220, multiple part has different thickness.The tissue thickness compensation part 15220 can as described above by nail 15130a, 15130b and 15130c is implanted into against tissue T.In at least one embodiment, referring now to Figure 155,15130a, 15130b are followed closely And/or 15130c can be deformed to different forming heights.Wherein the first nail 15130a can shape as the first forming height, the second nail 15130b can shape as the second forming height, and third nail 15130c can shape for third forming height, and wherein, for example, First forming height can be shorter than the second forming height, and the second forming height can be shorter than third forming height.Contemplate other Embodiment, wherein nail 15130a, 15130b and 15130c can shape for any suitable forming height and/or it is any relative at Shape height.

As described above and referring to Figure 134, for example, nail bin (such as nail bin 10000) may include support section 10010 and tissue Thickness compensation part 10020.Plurality of nail 10030 can be stored at least partly in support section 10010, and when nail 10030 may extend into tissue thickness compensation part 10020 when being in its non-firing position.In various embodiments, when nail 10030 When in its non-firing position, it is not prominent from tissue thickness compensation part 10020 to follow closely 10030 top.When staple drivers 10040 such as When nail 10030 being made to move to its firing position from its non-firing position described in upper, tissue thickness's benefit can be pierced by following closely 10030 top It repays part 10020 and/or pierces upper layer or crust 10022.In certain alternative embodiments, do not hit when nail 10030 is in it When sending out position, following closely 10030 top convex can wear the top surface and/or crust 10022 of tissue thickness compensation part 10020.It is in office In a kind of situation, when nail 10030 is when being extended upward support section 10010 before disposing, nail 10030 can be also as described above It tilts and/or deflects relative to support section.

In various embodiments, referring now to Figure 140, for example, nail bin may include tissue thickness compensation part 13620 and Crust or top layer 13621.In the embodiment as at least one, for example, one or more absorbent cotton or retainer 13622 can It is embedded in crust 13621.In certain embodiments, each retainer 13622 may include being defined in one or more of holes 13629, when nail 13030 is in its non-firing position, one or more of holes 13629 are configured to hold wherein Receive nail 13030 nail leg 13032, as shown in Figure 140.In use, it as to supplement above, is not hit when following closely 13030 from it When hair position moves to its firing position, nail leg 10032 can be slid through hole 13629, the base portion until (for example) following closely 13030 13031 contact tissue thickness compensation parts 13620 and against the bottom surface of absorbent cotton 13622 by tissue thickness compensation part 13620 At least part compression until.In various embodiments, referring now to Figure 135, for example, nail bin may include tissue thickness's compensation Part 13120 and crust or top layer 13122.In the embodiment as at least one, for example, tissue thickness compensation part 13120 It may include the taper lug that can be upwardly extended from the top surface 13121 of tissue thickness compensation part 13120, protruding portion, and/or prominent Play 13128.When nail 13030 is in its non-firing position, protruding portion 13128 is configured to receive simultaneously encapsulated nail The top of 13030 nail leg 13032, as shown in Figure 135.Top layer 13122 may also include can be aligned or at least with protruding portion 13128 Taper lug, protruding portion, and/or the protrusion 13129 of substantial alignment.In use, nail leg 10032 can pierce protruding portion 13128 and 13129, and expose from tissue thickness compensation part 13120.In various embodiments, referring now to Figure 139, for example, nail Storehouse may include tissue thickness compensation part 13520 and crust or top layer 13522.In the embodiment as at least one, example Such as, crust 13522 may include the taper lug that can be upwardly extended from the top surface 13521 of tissue thickness compensation part 13520, dash forward Portion, and/or protrusion 13529 out.Similarly as described above, when nail 13030 is in its non-firing position, protruding portion 13529 can It is configured to receive the top of the simultaneously nail leg 13032 of encapsulated nail 13030, as shown in Figure 139.In use, nail leg 10032 Protruding portion 13529 can be pierced and exposed from crust 13522.

In various embodiments, referring now to Figure 136, for example, nail bin may include tissue thickness compensation part 13220 and Crust or top layer 13222.In the embodiment as at least one, for example, tissue thickness compensation part 13220 may include can be downward Extend to the taper scrobicula and/or groove 13128 in the top surface 13221 of tissue thickness compensation part 13220.In various implementations In example, when nail 13030 is in its non-firing position, the top of nail leg 13032 can extend across groove 13128, such as Figure 136 institute Show.In at least one embodiment, top layer 13222 may also include the cone that can be aligned with groove 13228 or at least substantially be aligned Shape scrobicula and/or groove 13229.In various embodiments, referring now to Figure 137, for example, nail bin may include tissue thickness's compensation Part 13320 and crust or top layer 13322.In the embodiment as at least one, crust 13320 may include can be to downward Reach the thick part 13329 in the top surface 13321 of tissue thickness compensation part 13320.In all cases, work as nail 13030 be in its non-firing position when, thick part 13329 be configured to wherein accommodate nail 13030 nail leg 13032 at least part, as shown in Figure 137.In such embodiments, thick part 13329 can keep nail leg 13032 just Position, make nail leg 13032 be aligned with the nail shapes pit for the anvil block for being located in 13320 opposite of tissue thickness compensation part or at least substantially Upper alignment.In various embodiments, referring now to Figure 138, for example, nail bin may include tissue thickness compensation part 13420 and outer Skin or top layer 13422.In the embodiment as at least one, crust 13422 may include can be from tissue thickness compensation part 13420 The thick part 13429 that upwardly extends of top surface 13421.In all cases, when nail 13030 is in its non-firing position When, thick part 13429 is configured to such as scheme in at least part for the nail leg 13032 for wherein accommodating nail 13030 Shown in 138.In such embodiments, nail leg 13032 can be held in place by thick part 13429, made nail leg 13032 and be located in The nail shapes pit of the anvil block on 13420 opposite of tissue thickness compensation part is aligned or is at least substantially aligned.

In various embodiments, referring now to Figure 141 and Figure 142, for example, nail bin may include tissue thickness compensation part 13720 and and crust or top layer 13721.In the embodiment as at least one, for example, tissue thickness compensation part 13720 It may include that the pyramid that can be upwardly extended from the top surface 13721 of tissue thickness compensation part 13720 and/or staged are convex Ear, protruding portion, and/or protrusion 13728.When nail 13030 is in its non-firing position, protruding portion 13728 is configured to Enough tops for receiving the simultaneously nail leg 13032 of encapsulated nail 13030, as shown in Figure 142.Similarly, top layer 13721 may include can with it is prominent Pyramid and/or staged lug, protruding portion, and/or protrusion 13729 that portion 13728 is aligned or is at least substantially aligned out. In various embodiments, crust 13721 may also include the one or more teeth 13727 upwardly extended from protruding portion 13729, These teeth are configured to be engaged against the tissue of the positioning of top layer 13721, and prevent or at least limit tissue, top layer 13721, and/or nail leg 13032 top between opposite laterally and/or longitudinally movement.In use, when nail 13030 from its When non-firing position moves to its firing position, nail leg 13032 can pierce protruding portion 13728 and 13729, and mend from tissue thickness Repay the exposing of part 13720.In various embodiments, referring now to Figure 143 and Figure 144, for example, nail bin may include tissue thickness's compensation Part 13820 and crust or top layer 13821.In the embodiment as at least one, for example, tissue thickness compensation part 13820 It may include that the pyramid that can be upwardly extended from the top surface 13821 of tissue thickness compensation part 13820 and/or staged are convex Ear, protruding portion, and/or protrusion 13828.When nail 13030 is in its non-firing position, protruding portion 13828 is configured to Enough tops for receiving the simultaneously nail leg 13032 of encapsulated nail 13030, as shown in Figure 144.Similarly, top layer 13821 may include can with it is prominent Pyramid and/or staged lug, protruding portion, and/or protrusion 13829 that portion 13828 is aligned or is at least substantially aligned out. In various embodiments, top layer 13821 may also include the one or more teeth extended downwardly into tissue thickness compensation part 13820 Shape object 13827, for example, these teeth are configured to prevent or at least limit top layer 13821 and tissue thickness's compensation Relatively transverse and/or longitudinal movement between part 13820.In use, it is hit when nail 13030 moves to it from its non-firing position When sending out position, nail leg 10032 can pierce protruding portion 13828 and 13829, and expose from tissue thickness compensation part 13820.

In various embodiments, referring now to Figure 145, for example, nail bin may include that (such as tissue is thick for tissue thickness compensation part Spend compensating part 13920), which may include being defined in ridge 13923 therein and paddy 13924, at least one In embodiment, paddy 13924 can be limited between ridge 13923.In various embodiments, each ridge 13923 can be having the same Highly, substantially the same height or different height.Similarly, each paddy 13924 may include identical depth, substantially Identical depth or different depth.In various embodiments, multiple nails 13030 can be stored at least partly in tissue thickness In compensating part 13920, so that the top of nail 13030 can be positioned in ridge 13923.The embodiment as at least one In, for example, following closely 13030 nail leg 13032 can not compensate from tissue thickness when nail 13030 is stored in its non-firing position Part 13920 and/or the crust being attached in tissue thickness compensation part 13920 or top layer 13921 are prominent.In various embodiments, Ridge 13923 and/or paddy 13924 can be laterally extended across nail bin.In the embodiment as at least one, nail bin may include longitudinal knife Slit.Its median ridge 13923 and paddy 13924 can extend transverse to and/or perpendicular to the direction of cutter slit.In all cases, Ridge 13923 is configured to for being held in place on the top of nail leg 13032, until nail 13030 is moved from its non-firing position Until its firing position.In various embodiments, referring now to Figure 146, tissue thickness compensation part and/or covering tissue thickness The crust of compensating part may include longitudinal ridge and/or paddy.In the embodiment as at least one, for example, tissue thickness compensation part It may include the top surface limited by ridge 14023 and paddy 14024, wherein paddy 14024 can be limited between ridge 14023.Each In kind embodiment, tissue thickness compensation part may include crust 14021, which may include being defined in multiple holes therein 14029, each hole is respectively configured to accommodate nail leg 13032.In certain embodiments, hole 14029 can be limited at In ridge 14023, wherein the top of nail leg 13032 can be positioned on 14028 lower section of vertex of ridge 14029, be positioned to and vertex 14028 It flushes, and/or is located in 14028 top of vertex.In certain embodiments, in addition to the above or instead of described above, For example, hole 14029 can be limited in paddy 14024.In certain embodiments, for example, each hole can be embossed and surround or at least portion It surrounds with dividing, which can enhance the crust and/or tissue thickness compensation part around hole.Under any circumstance, as to above Supplement, for example, crust 14021 can be attached in tissue thickness compensation part in any suitable manner, including use at least one Kind adhesive.

In various embodiments, referring now to Figure 148, for example, disposable loading unit 15900 may include anvil block 15960 With staple cartridge channel 15970, wherein staple cartridge channel 15970 can be rotated relative to anvil block 15960.The embodiment as at least one In, anvil block 15960 may not rotate.In certain embodiments, tissue can be positioned on anvil block 15960 and staple cartridge channel Between 15970, subsequent staple cartridge channel 15970 can be towards tissue rotation to clamp tissue against anvil block.It is real as at least one It applies in example, disposable loading unit 15900 may also include the tissue thickness compensation part for being configured to contact tissue 15920。

In various embodiments, referring now to Figure 149 to Figure 151, disposable loading unit 12900 may include load group Part, the charging assembly include the bottom part 12922 that can be removably attached on support section 12610, can be removed Ground is attached to the top section 12990 on anvil block 12560, and bottom part 12922 and top section 12990 are connected The flexible joint 12991 come.It is similarly as described above, it is longitudinal to keep guide rail 12825 that extend downwardly into from bottom part 12922 It is limited in the cutter slit 12615 in support section 12610, so that bottom part 12922 can be releasably retained Onto support section 12610.Similarly, longitudinal holding guide rail 12995 can be extended up to from top section 12990 is limited to anvil In cutter slit in seat 12560, so that top section 12990 can be releasably retained on anvil block 12560.Such as figure Shown in 150 and Figure 151, tissue thickness compensation part 12620 may be mounted to the bottom part 12922 of charging assembly, wherein for phase Position tissue thickness compensation part 12620 is come for support section 12610, clinician can make top section 12990 and base portion Divide 12922 to bend towards each other, charging assembly is located between anvil block 12560 and support section 12610, then release is bent Charging assembly, so that charging assembly can carry out resilient expansion against anvil block 12560 and bias top section 12990, and against Support section 12610 comes resilient expansion and biasing bottom part 12922.

In various embodiments, referring now to Figure 152, for example, nail bin (such as nail bin 14900) may include support section 14910, it further include the tissue thickness compensation part 14920 positioned against support section 14910 in addition to this.Similar to institute above It states, for example, support section 14910 may include the staple drivers that can be lifted away from upwards by nail deployment sliding part, to be lifted away from nail (such as Nail is 10030).These nails are at least partly fixed towards anvil block (such as, such as be located in the anvil block 10060 on 14900 opposite of nail bin) Position is in support section 14910.In certain embodiments, for example, support section 14910 may include six row nail cavities, such as outside Two row nail cavities, two row nail cavities of inside and the middle two rows nail cavity being located among inner row and outer skidding.Wherein anvil block 10060 may include the six row forming pits 10062 for being aligned with nail cavity or being at least substantially aligned.In various embodiments, inside Row nail cavity may include the staple drivers 14940a being positioned in, and center row nail cavity may include the staple drivers being positioned in 14940b, and outer skidding nail cavity may include the staple drivers 14940c being positioned in.Wherein in staple drivers 14940a Each may include the bracket 14949a for being configured to support nail 10030, and each of staple drivers 14940b can be wrapped The bracket 14949b for being configured to support nail 10030 is included, each of staple drivers 14940c may include being configured to It is capable of the bracket 14949c of support nail 10030.At the non-firing position of staple drivers, that is, when staple drivers 14940a extremely 14940c is rested upon when extending on the driver supporting element 14926 below support section 14910, compared to staple drivers The bracket 14949c of the bracket 14949b and staple drivers 14940c of 14940b, the bracket 14949a of staple drivers 14940a can It is positioned closer to anvil block 10060.In such position, the first forming distance can be limited at bracket 14949a and be positioned at bracket Between forming pit 10062 on 14949a；Second forming distance can be limited at bracket 14949b and be positioned at bracket Between forming pit 10062 on 14949b；Third forming distance can be limited at bracket 14949c and be positioned at bracket Between forming pit 10062 on 14949c.Wherein in various embodiments, for example, the first forming distance can be shorter than second Forming distance, and the second forming distance can be shorter than third forming distance.When staple drivers 14940a to 14940c from they When non-firing position (Figure 152) moves to their firing position, each staple drivers 14940a to 14940c can be disposed by nail Sliding part moves upwards equal or at least substantially equal distance towards anvil block 10060, so that the first driver It is followed closely 10030 drivings by 14940a by its corresponding 10030 the first forming height of driving of nail, the second driver 14940b accordingly Its corresponding nail 10030 is driven third forming height by the second forming height, third driver 14940c.Wherein, for example, first Forming height can be shorter than the second forming height, and the second forming height can be shorter than third forming height.It contemplates various other Embodiment, wherein the first staple drivers 14940a is by upward displacement first distance, the second staple drivers 14940b is by upward displacement Second distance, and third staple drivers 14940c is by upward displacement third distance.Wherein first distance, second distance and third One or more of distance can be different.

In various embodiments, referring again to Figure 152, relative to the tissue contacting surface 10061 of anvil block 10060, support The platform surface 14911 of part 14910 can be varied in height.In certain embodiments, which can be in transverse direction Upper generation, and at least one embodiment, for example, the height around the platform surface 14911 of inner row nail cavity can be higher than Around the height of the platform surface 14911 of outer skidding nail cavity.In various embodiments, the bottom of tissue thickness compensation part 14920 Surface 14922 be configured to be parallel to or at least substantially parallel to support section 14910 platform surface 14911.Make For to supplement above, tissue thickness compensation part 14920 can be also varied on thickness.Wherein at least one embodiment In, the top surface or tissue contacting surface 14921 of tissue thickness compensation part 14920 can be inside from its outer edge, that is, transverse edge Inclination.In the embodiment as at least one, due to described above, for example, tissue thickness compensation part 14920 can be positioned at It is relatively thin in region on inner row nail cavity and thicker in the region being positioned on outer skidding nail cavity.In various implementations In example, referring now to Figure 153, for example, the platform surface of support section 15010 may include staged platform surface.Wherein, example Such as, the highest step of the stepped surface can surround inner row nail cavity, and the minimum step of the stepped surface can be around outer Skidding nail cavity.In the embodiment as at least one, the step with intermediate altitude can surround center row nail cavity.In certain realities It applies in example, for example, tissue thickness compensation part (such as tissue thickness compensation part 15020) may include bottom surface, the bottom surface The platform surface of support section 15010 can be parallel to and abutted with the platform surface.In at least one embodiment, for example, group The top surface or tissue contacting surface 15021 for knitting thickness compensation part may include bowed, parabolical, and/or curved table Face, in the embodiment as at least one, this surface can extend to group from the first cross side of tissue thickness compensation part 15020 The second cross side of thickness compensation part 15020 is knitted, for example, vertex is aligned with the center of nail bin 15000 or is at least substantially aligned.

In various embodiments, it can fired as the nail percussion sliding part 10050 to supplement above, nail bin 10000 It is moved under the action of component (such as other places are shown) from the proximal end of nail bin 10000 towards the distal end 10002 of the nail bin, such as Shown in Figure 161 and Figure 162.When sliding part 10050 is pushed into, sliding part 10050 can contact staple drivers 10040 and limit Staple drivers 10040 are lifted up in nail cavity 10012 in the warehouse 10010 of nail bin 10000.In at least one embodiment In, sliding part 10050 and staple drivers 10040 can respectively include one or more slopes or inclined surface, the one or more Slope or inclined surface can cooperate so that staple drivers 10040 and the nail being supported on are transported upwards from their non-firing position It is dynamic.Nail bin 10000 may also include disk 10027, for example, the disk can at least partly about 10010 bottom of warehouse and at least partly Ground accommodates the staple drivers 10040 being located in warehouse 10010.Warehouse 10010, which may also include, is defined in longitudinal slit therein 10016, which is configured at least partly receive percussion when firing member passes through nail bin 10000 Component.

Turning now to Figure 163, the nail accommodated in staple cartridge body 10010 can be in the proximal end 10001 of nail bin 10000 and distal side It is fired in succession between end 10002.In various embodiments, for example, nail bin 10000 may include staple drivers 10040a, 10040b and 10040c, these staple drivers can be used predetermined mode and carry out percussion nail.For example, nail bin 10000 may include The nearside driver 10040c being located on the first side of longitudinal slit 10016, and it is located in the second of longitudinal slit 10016 Side, that is, the second nearside driver on opposite sides 10040c.Each driver 10040c is configured to fire two simultaneously Nail, that is, the nail of two recent sides.Such nail is located in the nail cavity labeled as 10012c.In fact, in longitudinal slit 10016 Every side subscript be denoted as in two nail cavities of 10012c, such nail cavity 10012c may include the distal side nail cavity labeled as 10013c With the nearside nail cavity for being labeled as 10014c.Reader will understand that nail cavity 10013c is located in the nail row different from nail cavity 10014c In.In fact, nail cavity 10013c and 10014c can be located in two most inner side nail rows, third outermost nail row will not driven The nail of device 10040c percussion.In addition, nail bin 10000 may include the midway drive being located on the first side of longitudinal slit 10016 Device 10040b, and it is located in second side the second medium drive 10040b i.e. on opposite sides of longitudinal slit 10016.Each Driver 10040b is configured to fire three nails simultaneously.Such nail is located in the nail cavity labeled as 10012b.It is true On, longitudinal slit 10016 every side subscript be denoted as 10012b three nail cavities in, such nail cavity 10012b may include label Distal side nail cavity for 10013b, the intermediate nail cavity labeled as 10014b and the distal side nail cavity labeled as 10015b.Reader will Solution, three nail cavities 10013b, 10014b and 10015b are all located in different nail rows.In addition, nail bin 10000 may include fixed Distal side driver 10040a of the position on the first side of longitudinal slit 10015, and it is located in second side of longitudinal slit 10015 Second distal side driver 10040a i.e. on opposite sides.Each driver 10040a is configured to fire four nails simultaneously. Such nail is located in the nail cavity labeled as 10012a.In fact, every side subscript in longitudinal slit 10016 is denoted as 10012a Four nail cavities in, such nail cavity 10012a may include labeled as 10013a two distal side nail cavities, labeled as in 10014a Between nail cavity and the distal side nail cavity labeled as 10015a.Reader will understand that nail cavity 10013a, 10014a and 10015a are all positioned In the array for extending across all three nail rows on 10016 side of longitudinal slit.In fact, being located in positioned at warehouse 10010 Farthest side nail in interior farthest side nail cavity 10013a is located in inner side nail row and outside nail row, and is located in relative to being in The farthest side nail cavity 10014a in intermediate nail cavity row between inside nail cavity row and outside nail cavity row extends towards distal side.Although above Only discuss several staple drivers 10040a, 10040b and 10040c, but nail bin 10000 may include any appropriate number of is used for The staple drivers of nail are projected from nail cavity.Such staple drivers can project two, three, four and/or more nails simultaneously.Specifically Referring to Figure 18, nail bin may include can for example support on it two nail one or more staple drivers 41040a, for example by It is configured to support one or more staple drivers 41040b of three nails on it, and/or is configured on it Support one or more staple drivers 41040c of four nails.In various embodiments, the last some nails being contained in nail bin Driver or farthest side staple drivers may include staple drivers 41040c, these drivers 41040c may include can be by last Two distal side supporting support 41041c being maintained in staple line are followed closely a bit.For example, driver 41040a to 41040c supports six nails Nail in line, and driver 41040c supports last some nails in four staple lines of those staple lines.Such nail can be along vertical It is directly aligned in the axis of cutting path (cutting path extends along a longitudinal axis), or is at least substantially aligned.Due to such nail With above-mentioned arrangement, they can provide various hemostasis beneficial effects.Last some nails in two other staple line can be by propping up Frame 41041b support.

It in various embodiments, may include for example being arranged in the nail platform of nail bin for the nail bin of surgical stapling device Layer, such as tissue thickness compensation part and/or buttress material.In use, when nail is fired, the layer and patient tissue can By these nail captures.Then, the layer can be separated with surgical stapling device, can be retained in patient's body when stitching unstrument is removed from patient It is interior.In certain embodiments, the distal end of the layer could attach on nail bin, so that the layer is just opposite when nail bin and the layer When patient tissue positioning, stablize relative to nail bin.

It is attached in some embodiments on nail bin in the distal end of the layer, which may include arranging towards distal side The layer is attached to the distal end on nail bin and cut away by cutting blade, the cutting blade.Figure 81 A to Figure 83 shows nail bin groupware 2300, which includes nail bin 2330 and the distal incision blade being arranged in the distal chamber 2332 of nail bin 2330 2324.More detailed description as follows, distal incision blade 2324 can never deployed position moves to deployment in distal chamber 2332 Position.In deployed position, cutting blade 2324 extends distal chamber 2332 to cut off the distal side for the layer 2306 being arranged on nail bin End 2316.

Referring to Figure 82 and Figure 83, in various embodiments, the distal part 2316 of layer 2306 can be by being trapped in nail bin Be attached on nail bin 2300 between 2300 and panel 2310, the panel 2310 from the nose 2308 of nail bin groupware 2300 proximally Extend.In certain embodiments, layer 2306 can be captured and being compressed between nail bin 2330 and panel 2310.In other words It says, the gap between nail bin 2330 and panel 2310 is smaller than the thickness of the distal part 2316 of the layer 2306 of positioning in the gap Degree, so that distal part 2316 is compressed between nail bin 2330 and panel 2310.In certain embodiments, referring to Figure 82 and figure 83, the distal part 2316 of layer 2306 may include one or more holes 2320.One or more bolts 2318 can prolong from panel 2308 Hole 2320 is stretched and passes through, with the distal part 2316 of trapping layer 2306.In certain embodiments, for example, the distal portion of layer 2306 Divide 2316 can be attached on nail bin 2330 by adhesive, welding, and/or hot riveting.

The distal incision blade 2324 that the rest part of the distal part 2316 of layer 2306 and layer 2306 is cut off can be by cloth It sets in the distal chamber 2332 of nail bin 2330.Distal chamber 2332 and distal incision blade 2324 can be oriented so that distal incision Blade 2324 can be at the position of the position being attached on nail bin 2330 relative to distal part 2316 more nearside by layer 2306 Distal part 2316 cut off.For example, with reference to Figure 82 and Figure 83, distal incision blade 2324 can be relative to by distal part The distal part 2316 of layer 2306 is cut at the position of 2316 bolts 2318 being attached on nail bin 2330 and the more nearside of hole 2320 It is disconnected.Therefore, when distal incision blade 2324 cuts off the distal part 2316 of layer 2306, the rest part of layer 2306 can be from nail Storehouse release.

Distal incision blade 2324 may include cam 2322, which can release distal incision blade 2324 far Side chamber 2332.Guide rail and/or channel 2334 in the engageable distal chamber 2332 of cam 2322, the guide rail and/or channel 2334 can The movement of cam 2322 and distal incision blade 2324 is limited in specific direction when blade 2324 extends distal chamber 2332. Guide rail and/or channel 2334 are illustrated as the nail platform 2302 perpendicular to nail bin 2330 in Figure 82 and Figure 83.In this arrangement, It, can be from distal chamber when the never deployed position of distal incision blade 2324 (Figure 82 is shown) moves to deployed position (Figure 83 is shown) 2332 extend along the direction of the nail platform 2302 perpendicular to nail bin 2330.In various embodiments, guide rail and/or channel 2334 can It is arranged to the nail platform 2302 relative to nail bin 2330 into any proper angle.For example, guide rail and/or channel 2334 can be by cloth The nail platform 2302 relative to nail bin 2330 is set at 30 ° of angles, so that distal incision blade 2324 is along relative to nail bin 2330 nail platform 2302 extends distal chamber 2322 at the distal direction part at 30 ° of angles.

In order to dispose distal incision blade, cam 2322 can be pushed by firing member 2326.For example, firing member 2326 can It is disposed in the slit in nail bin 2330 (such as cutter slit 2304).Firing member 2326 may include that can connect with cam 2322 It closes so that the cam face 2328 and 2329 that cam 2322 and distal incision blade 2324 are shifted towards layer 2306.Firing member 2326 can move toward the far side from unactuated position to actuated position relative to cam 2322 and distal incision blade 2324, with deployment Cutting blade 2324 simultaneously cuts off the distal part of layer 2,306 2316.Figure 82 shows the firing member in unactuated position 2326, in the unactuated position, cam face 2328 and 2329 is not yet engaged with cam 2322.In various embodiments, when hitting Hair component 2326 is when being in unactuated position, and one or two of cam face 2328 and 2329 of firing member 2326 can be with Cam contact, as long as distal incision blade 2324 is not pushed out distal chamber 2332.When firing member 2326 moves toward the far side To when actuated position, the cam face 2328 of firing member 2326 is engaged with cam 2322 shown in Figure 83, by cam 2322 It is gradually pushed to deployed position with distal incision blade 2324, so that distal incision blade 2324 is by the distal portion of layer 2306 Divide 2316 cuttings.

As described above, guide rail and/or channel 2334 in the engageable distal chamber 2332 of cam 2322.In addition, guide rail and/or Channel 2334 can be arranged at an angle relative to the nail platform 2302 of nail bin 2330.In various embodiments, guide rail and/or Channel 2334 can be arranged into such angle, this angle, which to work as from distal chamber 2332, disposes distal incision blade 2324 When, cam 2322 and blade 2324 move toward the far side.In all cases, arrangement guide rail can come in the following manner at this angle The size of power needed for reducing actuating firing member 2326: along firing member 2326 move along longitudinal axis by cam 2322 It is aligned with the component motion of blade 2324.With such angle arrangement guide rail can also reduce cam 2322 and firing member 2326 it Between and/or cam 2322 and guide rail in distal chamber 2332 and/or a possibility that stick together between channel 2324.

In various embodiments, firing member 2326 can never be caused by cutting blade 2312 and/or staple drivers 2340 Dynamic position moves toward the far side actuated position.In various embodiments, firing member 2326 can be with tissue cutting blade 2312 And/or staple drivers 2340 are integral, so that firing member 2326 and tissue cutting blade 2312 and/or staple drivers 2340 travel across nail bin 2330 along the longitudinal axis of nail bin 2330 together.In various other embodiments, firing member 2326 can separate with tissue cutting blade 2312 and/or staple drivers 2340.In such embodiments, cutting blade 2312 is organized And/or staple drivers 2340 can push firing member 2326 across nail bin 2330.Alternatively, in firing member In the 2326 such embodiments separated with tissue cutting blade 2312 and/or staple drivers 2340, firing member 2326 can be positioned At the distal end of nail bin 2330, firing member 2326 is in unactuated position at this time, as shown in Figure 82.Work as cutting blade 2312 and/or staple drivers 2340 when reaching the distal end of nail bin 2330, the cutting blade 2312 and/or staple drivers 2340 Nail bin 2330 can be travelled across, then shifts firing member 2326 onto actuated position, as shown in Figure 83.In all these embodiments In, organizing cutting blade 2312 and/or staple drivers 2340 to move upwards in the side along 2330 longitudinal axis of nail bin can be by distal side Cutting blade 2324 is disposed along the direction for being different from tissue cutting blade and/or staple drivers 2340.

In various embodiments, until the firing schedule of tissue cutting blade 2312 and/or staple drivers 2340 is completed Or be almost completed, it just disposes distal incision blade 2324 and cuts off the distal part 2316 of layer 2306.In such embodiment In, the distal part 2316 of layer 2306 can remain attached on nail bin 2330, and stablize layer 2306 relative to nail bin 2330, Until most of even all of nails have been fired by staple drivers 2340 and/or until patient tissue and layer 2306 have been cut by tissue Cutting blade 2312 is cut off.In various other embodiments, distal incision blade 2324 can be deployed in tissue cutting blade 2312 and/or staple drivers 2340 start to cut off the distal part 2316 of layer 2306 before their firing schedule.For example, hitting Sending out component 2326 can be transported by the first brake function of the firing trigger of surgical stapling device from the unactuated position shown in Figure 82 Move the actuated position shown in Figure 83.The subsequent actuating of firing trigger can make tissue cutting blade 2312 and/or staple drivers 2340 movements.Therefore, the distal part 2316 of layer 2306 can tissue cutting blade 2312 cut off patient tissue before and/or can It is separated before nail trapping layer 2306 and patient tissue from nail bin 2330.As another example, firing member 2326 can be by outer First trigger-actuated of section's instrument, and organize cutting blade 2312 and/or staple drivers 2340 that can be caused by the second trigger It is dynamic.

As described above, the nose 2308 of nail bin groupware 2300 may include panel 2310, the panel 2310 is from 2308 court of nose Nearside extension and at least partly distal part 2316 of coating 2306.Panel 2310 may include inward-facing surface 2309, The inward-facing surface 2309 can facing layer 2306 distal part 2316.In certain embodiments, in distal incision blade When 2324 cutting distal part 2316, the inner surface 2309 of panel 2310 can support the distal part 2316 of layer 2306.Each In the case of kind, when distal incision blade 2324 is disposed, distal incision blade 2324 finally can be with inward-facing surface 2309 Contact, thus completely cuts through the remainder of the distal part 2316 of layer 2306 and layer 2306.

Panel 2310 can also protect patient tissue, protect it from the injury of distal incision blade 2324.In all cases, not It is cut off by tissue cutting blade 2312 and/or face can not crossed by the uninfluenced patient tissue that the stapling from nail bin 2330 is closed The exterior surface 2311 of plate 2310.In such cases, panel 2310 can protect these uninfluenced tissues, protect it from distal side Cutting blade 2324 injures.For example, as shown in Figure 83, panel 2310 can be positioned on the distal incision knife for extending distal chamber 2332 Between the patient tissue of the exterior surface 2311 of piece 2324 and close panel 2310, so that these patient tissues are not exposed to Distal incision blade 2324.

Referring now to Figure 77 to Figure 79, nail bin 20000 may include warehouse 20010 and be releasably attached to warehouse Tissue thickness compensation part 20020 on 20010.Nail bin 20000 may include any suitable cloth of nail, nail cavity and/or staple drivers It sets.Staple drivers pass through nail bin 20000 after by sliding part or firing member percussion, towards distal side with by tissue thickness compensation part 20020 at least part and at least part of patient tissue capture in nail, as described elsewhere herein.For brevity, Herein not to reader repeat with follow closely, nail cavity and the related explanation of staple drivers.Referring now primarily to Figure 77 and Figure 77 A, nail bin 20000 may include sliding part 20060, which is promoted by firing member 20050 towards distal side.In firing member 20050 Certain point during being distally advanced with sliding part 20060, sliding part 20060 are for example configured to mend tissue thickness It repays part 20020 to discharge from warehouse 20010, as shown in Figure 78 and Figure 79.For example, the distal end of tissue thickness compensation part 20020 20022 can be releasably held by flexible clamp 20013 and retaining pin 20072 onto the distal end of warehouse 20010, wherein Sliding part 20060 can overcome the holding of retaining pin 20072 to act on, or recall from retaining pin.Flexible clamp 20013 can be constructed For that tissue thickness compensation part 20020 can be firmly fixed against the platform 20015 of warehouse 20010.In such cases, soft Property clamp 20013 can provide tissue thickness compensation part 20020 enough clamping forces, and tissue thickness compensation part 20020 is protected It holds in place.Tissue thickness compensation part 20020 can also be securely held on warehouse 20010 by retaining pin 20072.Example Such as, referring to Figure 77 and Figure 77 A, the distal end 20022 of tissue thickness compensation part 20020 may include being defined in hole therein 20023, which can receive retaining pin 20072, and be attributed between retaining pin 20072 and the side wall in hole 20023 Interaction, retaining pin 20072 can prevent tissue thickness compensation part 20020 sliding between clamp 20013 and storehouse platform 20015 Out.In addition, retaining pin 20072 and clamp 20013 can cooperate and limit the movement of tissue thickness compensation part 20020, and various In the case of, the top of retaining pin 20072 can abut clamp 20013, or can be positioned so that closely adjacent with clamp.

In use, as the position to supplement above, retaining pin 20072 can be recalled due to sliding part 20060 and under Drop, as shown in Figure 78 and Figure 79.More specifically, retaining pin 20072 can extend from cam 20070.Wherein cam 20070 can dispose Or it rests upon from the elastic component i.e. spring 20012 that the disk 20011 being attached on warehouse 20010 extends；And work as sliding part When 20060 engagement cam 20070, which can push down on cam 20070 and retaining pin 20072, to compress bullet Spring 20012.Warehouse 20010 may include being defined in guide part 20018 therein, which limits cam 20070 along substantially Vertical path is moved perpendicular to the path of storehouse platform 20015.In various embodiments, sliding part 20060 may include cam Actuator 20062, the cam actuator 20062 are lifted away from surface 20063 relative to staple drivers and extend towards distal side.Once pin 20072 position has fully declined, and tissue thickness compensation part 20020 can be slided and from clamp 20013 relative to storehouse platform 20015 It skids off.In all cases, pin 20072 can decline enough amounts, but still at least partly protrude from storehouse platform 20015.At it In the case of him, pin 20072 can drop to 20015 lower section of storehouse platform.In either case, sliding part 20060 is cam-actuated Device 20062 and staple drivers are lifted away from surface 20063 and enable to retaining pin 20072 in the last one nail or the nail quilt of farthest side Sliding part 20060 fully declines while percussion.In other cases, the cam actuator 20062 of sliding part 20060 and nail drive Dynamic device is lifted away from surface 20063 and is configured to so that being fired in the nail of the last one nail or farthest side by sliding part 20060 Before, retaining pin 20072 fully declines.In other other, the cam actuator 20062 and nail of sliding part 20060 Driver, which is lifted away from surface 20063, can be such that retaining pin 20072 is fired in the nail of the last one nail or farthest side by sliding part 20060 It just fully declines afterwards.Although cam 20070 is described herein as having a retaining pin 20072, multiple retaining pins 20072 can extend from cam 20070, these retaining pins can respectively releasably hold tissue thickness compensation part 20020 On warehouse 20010.Therefore, tissue thickness compensation part 20020 may include that can receive the appropriate number of hole of retaining pin 20072 20023。

Referring now to Figure 80 and Figure 81, for example, nail bin 21000 may include warehouse 21010, be releasably secured to warehouse 21010 tissue thickness compensation part 21020 and the sliding part that tissue thickness compensation part 21020 can be discharged from warehouse 21010 21060.Similar described above, sliding part 21060 may include that staple drivers are lifted away from surface 21063.Staple drivers are lifted away from surface 21063 are configured to staple drivers and the nail that is supported on towards being located in 21020 opposite of tissue thickness compensation part Anvil block lift.Also similar to described above, sliding part 21060 may also include cam actuator 21062.Cam actuator 21062 It can act on clamp 21013, clamp 21013 allowed no longer to remain to the distal end 21022 of tissue thickness compensation part 21020 The platform surface 21015 of warehouse 21010.More specifically, clamp 21013 may include the cam extended downwardly into warehouse 21010 21072.Wherein when sliding part 21060 is advanced through nail bin 21000 towards distal side, cam 21072 can be by cam actuator 21062 Engagement.When cam actuator 21062 engages cam 21072, cam 21072 can be lifted up simultaneously by cam actuator 21062 Bend clamp 21013 far from the distal end 21022 of tissue thickness compensation part 21020, as shown in Figure 81.At this point, warehouse 21010 can move far from tissue thickness compensation part 21020.In other words, tissue thickness compensation part 21020 is from warehouse 21010 Before release, is just followed closely by one or more and be implanted into patient tissue.In this case, it is discharged by tissue thickness compensation part 21020 Afterwards, warehouse 21010 can be moved far from the tissue thickness compensation part 21020 of implantation and be removed from operative site.

Surface 21063 is lifted away from as the cam actuator 21062 and staple drivers to supplement above, sliding part 21060 Enable to cam 20072 the last one nail or farthest side nail by sliding part 20060 fire while sufficiently increase with It is enough to reduce the clamping force applied by clamp 21013.In other cases, 21062 He of cam actuator of sliding part 21060 Staple drivers are lifted away from surface 21063 and are configured to so that the nail of the last one nail or farthest side is hit by sliding part 21060 Before hair, cam 21072 is sufficiently increased to be enough to reduce the clamping force applied by clamp 21013.In other other situations Under, the cam actuator 21062 and staple drivers of sliding part 21060 are lifted away from surface 21063 and enable to cam 20072 last What the nail of one nail or farthest side was enough to reduce to be applied by clamp 21013 by sufficiently increasing after the percussion of sliding part 21060 Clamping force.Although clamp 21013 is described herein as having a cam 21072 extending therefrom, multiple cams 21072 can extend from clamp 21013, these cams respectively can be lifted away from clamp 21013 so that tissue thickness compensation part 20020 from Warehouse 20010 discharges.

As to supplement above, sliding part or firing member across nail bin can terminate in the movement in sliding part towards distal side When or at the end of, and/or at the end of the firing schedule of firing member, tissue thickness compensation part is discharged from warehouse.It changes Sentence is talked about, and tissue thickness compensation part can discharge while all or almost all nails is finished from nail bin percussion from warehouse.? In various other embodiments, tissue thickness compensation part can first nail be recent side nail from nail bin fire while or before It is discharged from warehouse.One such exemplary embodiment is drawn in Figure 90 into Figure 92, and the figures illustrate nail bins 22000.Class Be similar to it is described above, nail bin 22000 may include warehouse 22010 and be releasably secured to warehouse 22010 tissue thickness mend Repay part 22020.Although nail bin 22000 may also include nail percussion sliding part as described above, which may not discharge Tissue thickness compensation part 22020；On the contrary, nail bin 22000 may also include actuator 22011, which can be in percussion structure When the firing schedule of part starts, promoted by firing member towards distal side.The various other embodiments announced herein are disclosed for court The device of distal side propulsion actuator.But for brevity, these other realities related with the embodiment are not repeated to reader herein Apply example.Under any circumstance, actuator 22011 may include cam support 22012 extending therefrom, the cam support 22012 can when actuator 22011 is in its unactuated position supporting cam wheel 22070, as shown in Figure 90.In addition, nail bin 22000 may also include biasing member i.e. spring 22074.Biasing member, that is, the spring 22074 can be similarly in actuator 22011 When its unactuated position shown in Figure 90, kept against cam support 22012 or offset cam 22070.Work as cam 22070 be in such position when, from cam 22070 extend retaining pin 22072 can be remote with tissue thickness compensation part 22020 The hole 22023 limited in side end 22022 engages and extends through the hole 22023, so that it is similarly as described above, it keeps Pin 22072, and/or the retaining pin 22072 cooperated with the clamp 22013 extended from warehouse 22010 can compensate tissue thickness Part 22020 is held in place.

When actuator 22011 is promoted by firing member towards distal side, referring now to Figure 91, cam support 22012 can court Distal side promotes, so that cam support 22012 may no longer supporting cam wheel 22070.In such cases, spring 22074 can by 22070 biased downward of cam so that retaining pin 22072 be biased to no longer with tissue thickness compensation part 22020 engagements, or at least part is not engaged with tissue thickness compensation part 22020.In at least one situation, spring 22074 can By 22070 biased downward of cam, so that retaining pin 22072 is located in 22015 lower section of platform of nail bin 22010.Any In the case of, actuator 22011 is promoted towards distal side can all be such that tissue thickness compensation part 22020 discharges from warehouse 22010.In other words It says, although 22072 position of retaining pin declines, clamp 22013 still can provide chucking power to tissue thickness compensation part 22020, thus So that tissue thickness compensation part 22020 remains held against in nail platform 22015；However, once in tissue thickness compensation part 22020 Apply enough relative to force between warehouse 22010, tissue thickness compensation part 22020 can skid off below clamp 22013.As To supplement above, tissue thickness compensation part 22020 can be hit in the nail of recent side from nail bin 22000 from the release of warehouse 22010 Occur before hair, occur simultaneously with the percussion, and/or occurs immediately after the percussion.In such cases, tissue is discharged in advance Even if thickness compensation part 22020 makes tissue thickness compensation part 22020 (for example) in the case where only part fires nail bin 22000 It can be discharged from warehouse 22010.

Referring now to Figure 84 to Figure 87, end effector assembly 5000 may include the first jaw and the second pincers shown in other places Mouth 5002.In various embodiments, the second jaw 5002 may include storehouse component.The storehouse component include fastener warehouse 5050, with And it is releasably secured to the tissue thickness compensation part 5058 of fastener warehouse 5050.Referring primarily to Figure 84, fastener warehouse 5050 securing member chambers 5054 that can have storehouse platform 5052 and be limited in storehouse platform 5052.In addition, the second jaw 5002 can example It such as include fastener (such as surgical staples) that these fasteners can be removably positioned in securing member chamber 5054.For example, these Fastener can be located in each securing member chamber 5054 of warehouse 5050 in a manner of it can project.In certain embodiments, storehouse Body 5050 may include slit 5056, which can be from the portions of proximal 5004 of the second jaw 5002 towards the second jaw 5002 Distal part 5006 extend.In various embodiments, percussion component 5030 can be translated along the slit 5056 of warehouse 5050.Example Such as, percussion component 5030 can be translated in slit 5056 during firing schedule, and can during firing schedule by fastener from Securing member chamber 5054 projects.

Referring primarily to Figure 84, Figure 86 and Figure 87, firing component 5030 may include trigger shaft (Figure 84), cutting edge 5036, cross Bar 5038 and stabilizer blade 5044 (Figure 86 and Figure 87).When percussion component 5030 is fired during firing schedule across the second jaw When 5002, cutting edge 5036 can be cut by tissue cutting and/or by tissue thickness compensation part 5058.For example, cross bar 5038 can incite somebody to action First jaw is kept relative to warehouse 5050, and stabilizer blade 5044 can keep percussion component 5030 relative to warehouse 5050.? In various embodiments, cutting element 5036 can for example be remained the platform with fastener cartridge 5050 by cross bar 5038 and stabilizer blade 5044 5052 is vertical.Referring primarily to Figure 29 A and Figure 29 B, the cunning in warehouse 5050 can be engaged during firing schedule by firing component 5030 Moving part 5034.Firing component 5030 can push sliding part 5034 towards distal side for example during firing schedule, thus by fastener It is projected from securing member chamber 5054.

Referring primarily to Figure 84, tissue thickness compensation part 5058 can be by least one connector 5080a, 5080b can release The mode put is fixed to warehouse 5050.In certain embodiments, multiple connector 5080a, 5080b can be by tissue thickness compensation parts 5058 are fixed to warehouse 5050.For example, proximal connector 5080a can be at the portions of proximal 5004 of the second jaw 5002 by tissue Thickness compensation part 5058 is fixed to warehouse 5050, and distal connector 5080b can be in the distal part of the second jaw 5002 Tissue thickness compensation part 5058 is fixed to warehouse 5050 at 5006.In certain embodiments, connector in addition can will be organized Thickness compensation part 5058 is fixed to warehouse 5050.In such embodiments, for example, other connector can be along 5050 length of warehouse At least part separate, and can be positioned between proximal connector 5080a and distal connector 5080b.

Referring still primarily to Figure 84, connector 5080a and 5080b can be by tissue thickness compensation parts 5058 relative to warehouse 5050 It keeps.When connector 5080a and 5080b split, no longer work by cutting, displacement or because of other reasons when, tissue thickness's compensation Part 5058 can be discharged from warehouse 5050.In certain embodiments, percussion component 5030 is during firing schedule along fastener cartridge When slit 5056 in 5050 translates, connector 5080a and 5080b can be overcome.During this firing schedule, component is fired 5030 not only cleavable tissues being clamped between the first jaw and the second jaw 5002, and can also be by fastener from securing member chamber 5054 move in clamped tissue.In various embodiments, percussion component 5030 can be during firing schedule by sliding part 5034 (Figure 86 and Figure 87) are pushed towards distal side.Sliding part 5034, which can have, is capable of the convex of driver in jointing fastener chamber 5054 Wheel surface or slope 5042.When slope 5042 engages driver, slope can push driver towards platform 5052, so that fastening Part is projected from securing member chamber 5054.In addition, percussion component 5030 can be during firing schedule by 5058 He of tissue thickness compensation part Connector 5080a, 5080b cutting.

Referring primarily to Figure 84, the cutting edge 5036 of percussion component 5030 can for example when firing schedule starts or start for a moment By proximal connector 5080a after youngster, and can for example at the end of firing schedule or will at the end of by distal connector 5080b Cutting.In certain embodiments, sliding part 5034 (Figure 86 and Figure 87) can cut proximal connector 5080a in cutting edge 5036 Later, and before cutting edge 5036 is by distal connector 5080b cutting, project fastener from securing member chamber 5054.Herein In class embodiment, if percussion component 5030 does not complete firing schedule, the cutting edge 5036 for firing component 5030 may be It stops before reaching distal connector 5080b, and tissue thickness compensation part 5058 can be in the distal part of the second jaw 5002 Warehouse 5050 is remained fixed at 5006.In certain embodiments, tissue thickness compensation part 5058 can remain fixed to warehouse 5050, until distal connector 5080b is cut or otherwise overcome distal connector by operator.For example, operator can By introducing other surgical instruments and/or step in surgical operation, to overcome distal connector 5080b.

Referring also to Figure 84 to Figure 87, in various embodiments, the second jaw 5002 can be when firing schedule starts or beginning Overcome connector 5080a and 5080b afterwards a little while.In other words, the element of the second jaw 5002 can be when firing schedule starts Or after starting a little while, overcome any another between proximal connector 5080a, distal connector 5080b and the two connectors Outer connector.For example, the second jaw 5002 and/or storehouse component may include actuator 5010, which can fastened Part overcame distal connector 5080b before securing member chamber injection.Actuator 5010 can overcome distal connector 5080b, and Even if firing schedule premature end, that is to say, that for example percussion component 5030 is in the distal part for reaching the second jaw 5002 Before 5006, tissue thickness compensation part 5358 can also be discharged from warehouse 5050.In various embodiments, actuator 5010 may include Bottom side 5016 (Figure 85 A to Figure 85 C) and side wall 5018 (Figure 84 and Figure 85 D).Side wall 5018 can extend from bottom side 5016, and surround At least part of warehouse 5050 extends.Bottom side 5016 and/or side wall 5018, which may extend past, to be located in securing member chamber 5054 Fastener, or extend around the fastener that is located in securing member chamber.In addition, actuator 5010 can be relative to 5050 quilt of warehouse Movably keep.For example, actuator 5010 can be transported from pre-actuated position (Figure 85 A) to actuated position (Figure 85 B and Figure 85 D) It is dynamic.In certain embodiments, the slit in the engageable warehouse 5050 of side wall 5018 of actuator 5010, so that actuator 5010 move in slit, to slide relative to warehouse 5050.When actuator 5010 is moved relative to warehouse 5050, actuating Device 5010 can be slided relative to the fastener in the securing member chamber 5054 for being located in warehouse 5050.For example, actuator 5010 can be slided The dynamic fastener by securing member chamber 5054, and/or slided around these fasteners.

Referring primarily to Figure 85 A to Figure 85 C, actuator 5010 may include slit 5012, which can be from the second jaw 5002 portions of proximal 5004 extends towards distal part 5006.Slit 5012 in actuator 5010 can be for example and in warehouse 5050 Slit 5056 (Figure 84) is corresponding and/or alignment.In addition, percussion component 5030 is during firing schedule along in warehouse 5050 Slit 5056 translates and/or when translating in slit 5056, can also be translated along the slit 5012 in actuator 5010 and/or Translation in slit 5012.In various embodiments, the engageable actuator 5010 of component 5030 is fired, when firing schedule starts Or start afterwards to move toward the far side actuator 5010 a little while.In such embodiments, percussion component 5030 can be in the second pincers Actuator 5010 is activated at the portions of proximal 5004 of mouth 5002.For example, when actuator 5010 is activated and moves toward the far side, The distal end of actuator 5010 can cut distal connector 5080b, or otherwise overcome distal connector 5080b. In other words, actuator 5010, which proximally activates, can be achieved release of the tissue thickness compensation part 5058 from warehouse 5050 towards distal side. In various embodiments, actuator 5010 can only be shifted towards distal side to overcome distal connector 5080b.In at least one embodiment In, actuator 5010 can be before overcoming distal connector 5080b, such as shifts about 1mm.In certain embodiments, actuator 5010 can be before overcoming distal connector 5080b, such as shifts about 0.5mm to about 5mm.

Referring primarily to Figure 85 A and Figure 85 B, when percussion component 5030 during one section of firing schedule in non-firing position and portion When moving between point firing position, actuator 5010 can be moved from pre-actuated position (Figure 85 A) to actuated position (Figure 85 B).? In various embodiments, actuator 5010 can be for example including release stop part, such as positioner tab 5022.It is opposite to fire element It can suspend due to encountering positioner tab 5022 in the traveling of actuator 5010.In other words, positioner tab 5022 Percussion component 5030 can be allowed to temporarily cease relative to the traveling of actuator 5010.For example, in actuator 5010 from pre-actuated position When being moved to actuated position, positioner tab 5022 can engaging slide part 5034 and/or percussion component 5030, to will hit It sends out component 5030 to keep relative to actuator 5010, so that actuator 5010 and percussion component 5030 move together.For example, Referring primarily to Figure 86 and Figure 87, the bottom side 5016 of actuator 5010 may include positioner tab 5022, and sliding part 5034 may include groove or groove 5040.In various embodiments, when sliding part 5034 is located in the close of the second jaw 5002 When in side section 5004, groove 5040 can receive tab 5022.For example, when the percussion never firing position of component 5030 moves to Firing position, therefore when actuator is correspondingly pulled to actuated position (Figure 85 B) from pre-actuated position (Figure 85 A), groove 5040 It can be aligned with tab 5022.In various embodiments, at least one tab 5022 can be positioned on slit 5012 in actuator 5010 The either side of (Figure 85 A to Figure 85 C), and the engageable sliding part 5034 of each tab 5022.

Referring primarily to Figure 85 A, when percussion component 5030 and sliding part 5034 (are schemed during firing schedule along slit 5056 84) when translating, sliding part 5034 can engage positioner tab 5022.For example, positioner tab 5022 can fire When stroke starts or beginning engages sliding part 5034 afterwards a little while and connects.In certain embodiments, positioner tab 5022 can position Near the proximal end of actuator 5010, and when firing schedule starts, the engageable positioner tab of sliding part 4034 5022.When trigger shaft 5032 moves toward the far side and positioner tab 5022 is engaged with the groove 5040 in sliding part 5034 (Figure 86 and Figure 87), actuator 5010 can be driven towards distal side and/or be shifted towards distal side.In certain embodiments, referring primarily to Figure 85 B, actuator 5010 can be moved toward the far side for example, until it reaches the hard stop part 5060 being defined in warehouse 5050. Hard stop part 5060 can be for example at the distal part 5006 of the second jaw 5002, and actuator 5010 can be prevented further It moves toward the far side.In various embodiments, fastener (is schemed from the securing member chamber 5054 of warehouse 5050 in percussion component 5030 84) before projecting, actuator 5010 can be adjacent with hard stop part 5060.In some embodiments, urgent in percussion component 5030 When firmware chamber 5054 projects at least one fastener, and/or in percussion component 5030 from the injection of securing member chamber 5054 at least one After a fastener, 5010 ability of actuator is adjacent with hard stop part 5060.

Referring primarily to Figure 85 D, when actuator 5010 is pushed by sliding part 5034 and/or percussion component 5030 towards distal side, The cleavable distal connector 5080b of actuator 5010, or otherwise overcome distal connector 5080b, in the second jaw Tissue thickness's compensation 5058 is discharged from warehouse 5050 at 5002 distal part 5006.In certain embodiments, actuator 5010 may include recess 5024, fix for receiving distal connector 5080b, and by distal connector.In actuator 5010 When shifting towards distal side to hard stop part 5060, recess 5024 can fix distal connector 5080b.In addition, actuator 5010 can For example including the cutting edge 5020 along recess 5024.In certain embodiments, actuator 5010 is towards hard stop part 5060 When movement, distal connector 5080b can be pushed between hard stop part 5060 and the cutting edge 5020 of actuator 5010.Various In embodiment, when cutting edge 5020 is pushed into and/or when towards hard stop part 5060, cutting edge 5020 can be by distal connector 5080b cutting.In such embodiments, when firing schedule starts or after starting a little while, and in fastener from securing member chamber Before 5054 (Figure 84) percussion, distal connector 5080b can be cut by the cutting edge 5020 of actuator 5010.In some embodiments In, when firing component 5030 from least one fastener of injection of securing member chamber 5054, and/or it is urgent in percussion component 5030 After firmware chamber 5054 projects at least one fastener, cutting edge 5020 can cut distal connector 5080b.In various embodiments In, actuator 5010 can overcome distal connector 5080b under the premise of not cutting distal connector 5080b.For example, actuating Device 5010 can make distal connector 5080b separate or stretch distal connector, so that distal connector 5080b no longer will Tissue thickness compensation part 5058 is fixed relative to warehouse 5050.

In various embodiments, proximal connector 5080a can be cut by the nearside cutting edge of actuator 5010.Similarly, Other connector along 5050 length of warehouse arrangement can be when firing schedule starts or after starting a little while by actuator 5010 Cutting, or otherwise overcome effect.In addition to this or alternatively, the cutting edge 5036 for firing component 5030 can connect nearside Device 5080a and/or the cutting of other connector are connect, or other modes can be used and overcome proximal connector 5080a and/or other Connector.For example, firing the cutting of component 5030 before the injection of the securing member chamber 5054 (Figure 84) of warehouse 5050 in fastener Sword 5036 can cut proximal connector 5080a, and the cutting edge 5020 of actuator 5010 can cut distal connector 5080b.

Referring primarily to Figure 87, sliding part 5034 and/or percussion component 5030 can overcome positioner in actuator 5010 The obstruction of tab 5022.When sliding part 5034 and/or percussion component 5030 overcome the obstruction of positioner tab 5022, percussion Component 5030 and sliding part 5034 can be moved relative to actuator 5010.For example, percussion component 5030 can be by 5034 court of sliding part Distal side pushes, so that actuator 5010 moves toward the far side, until hard stop part 5060 prevents actuator 5010 further towards distal side It moves (Figure 85 A, Figure 85 C and Figure 85 D).Referring also to Figure 87, when the further distal movement of actuator 5010 is prevented from, percussion Component 5030 can push dynamic sliding part 5034 with sufficiently large, so that the deformation of positioner tab 5022, deflection, and/or from cunning Groove 5040 in moving part 5034 separates.For example, each tab 5022 may comprise cantilever, foot is being applied with to sliding part 5034 After enough big longitudinal forces, which can be bent downwards, to be disengaged with groove 5040.It pushes and slides in percussion component 5030 Moving part 5034 when being disengaged sliding part 5034 with positioner tab 5022, fires component 5030 and sliding part 5034 can It is moved relative to actuator 5010.In various embodiments, positioner tab 5022 can be sufficiently rigid to disconnect, with When actuator 5010 is shifted towards distal side to hard stop part 5060, the power of the percussion component 5030 application is born；And when actuating When device 5010 reaches hard stop part 5060, pawl tab 5022 can be sufficiently flexible, was applied with not needing motor and/or operator Big power is with regard to deflectable.In all cases, the power for being applied to positioner tab 5022 be more than predetermined power it Afterwards, positioner tab allows trigger shaft 5032 to pass through warehouse 5050.

Referring now to Figure 29 A and Figure 29 B, end effector assembly 5100 may include the first jaw (such as other places are shown) and Two jaws 5102.In various embodiments, the second jaw 5102 and/or can be positioned on fastener cartridge assembly therein may include cause Dynamic device 5110.Actuator 5110 can be for example relative to the fastener warehouse of fastener cartridge assembly such as fastener warehouse 5050 (figure 84) it slides or shifts.In addition, in certain embodiments, actuator 5110 may include can be at least partly around warehouse 5050 The bottom wall 5116 and side wall 5118 of positioning.When fixing actuator 5110 by relative to warehouse 5050, bottom wall 5116 and/or side wall 5118 may extend past the fastener being located in securing member chamber 5054 (Figure 84), or tight in securing member chamber around being located in Firmware extends.In various embodiments, actuator 5110 may include slit 5112, the slit 5112 along bottom wall 5116 at least one Part extends.In addition, side wall 5118 may include antelabium 5122 and/or antelabium 5124, which can slidably engage warehouse 5050.For example, antelabium 5122 can extend around warehouse 5050 and extend to narrow in the platform 5052 (Figure 84) of warehouse 5050 In seam.In addition, antelabium 5124 can the side for example along warehouse 5050 extend in slit.In various embodiments, work as actuator 5110 relative to warehouse 5050 move when, antelabium 5122,5124 can slide in slit.In such embodiments, antelabium can Such as the relative motion between constraint and/or restriction actuator 5110 and warehouse 5050.When actuator 5110 is relative to warehouse When 5050 movement, actuator 5110 can be slided relative to the fastener in the securing member chamber 5054 for being located in warehouse 5050.For example, Actuator 5110 can slide through the fastener in securing member chamber 5054, or slide around the fastener.

Referring also to Figure 29 A and Figure 29 B, actuator 5110 can for example include at the portions of proximal 5104 of the second jaw 5102 Discharge stop part, such as positioner 5114.Referring primarily to Figure 29 A, positioner 5114 may include positioner arm 5120, should Positioner arm 5120 can operationally keep the sliding part 5134 of warehouse 5050 (Figure 84).For example, sliding part 5134 can wrap Groove 5144 is included, and the engageable groove 5144 of positioner arm 5120 is to protect sliding part 5134 relative to actuator 5110 It holds.In various embodiments, positioner 5114 can have multiple positioner arms 5120, which can It is maintained in the groove 5144 of sliding part 5134.Positioner arm 5120 can for example extend from the opposite side of actuator 5110, And sliding part 5134 can be for example located among positioner arm 5120.In certain embodiments, when positioner arm 5120 When being maintained in the groove 5144 (Figure 29 A) of sliding part 5134, percussion component 5030 can be pushed against sliding part 5134, and Actuator 5110 can be made to shift towards distal side.Positioner arm 5120 can be sufficiently rigid, in actuator 5110 by percussion group When part 5030 is pushed towards distal side, sliding part 5134 is kept relative to actuator 5110.Then, actuator 5110 can be abutted for example Hard stop part, such as hard stop part 5060 (Figure 84 to Figure 85 B and Figure 85 D), which can prevent actuator 5110 into one Step moves toward the far side.

It is hit referring primarily to Figure 29 B as adjacent hard stop part 5060 (Figure 84 to Figure 85 B and Figure 85 D) of actuator 5010 Hair component 5030 can push sliding part 5134 to pass through positioner 5114.In other words, percussion component 5030 can promote sliding part 5134 overcome positioner arm 5120.In such embodiments, positioner arm 5120 may be sufficiently flexible, with flexure to The groove 5144 of sliding part 5134 is disengaged, and allow percussion component 5030 along the slit 5112 in actuator 5110 from Pass through between positioner arm 5120.Similar to actuator 5010, actuator 5110 may include sword, which can for example work as actuator 5110 by percussion component 5030 towards distal side when being shifted, and by distal connector, is similar to distal connector 5080b (Figure 84 and figure It 85D) cuts, or otherwise overcomes distal connector.Then, it fires component 5030 and sliding part 5134 can be for example along slit 5112 translations, and fastener can be made to project from the securing member chamber 5054 of warehouse.In various embodiments, actuator 5110 can be first Overcome distal connector and/or other connector, then fastener is just fired from fastener cartridge 5050.In some embodiments In, in fastener before the percussion of fastener cartridge 5050, actuator 5110 can overcome distal connector and/or other connection Device.

Referring now to Figure 87 A and Figure 87 B, end effector assembly 5200 may include the first jaw (such as other places are shown) and Two jaws 5202.In various embodiments, the second jaw 5202 and/or fastener cartridge assembly can for example including actuator 5210, The actuator 5210 can be slided relative to fastener warehouse such as fastener warehouse 5050 (Figure 84).In addition, in some embodiments In, actuator 5210 may include bottom wall 5216 and side wall.Side wall can be positioned for example, at least partially around warehouse 5050.Actuator 5210 may include slit 5212, which extends along at least part of bottom wall 5216.In addition, actuator 5210 can be opposite It is movably kept in warehouse 5050.When actuator 5210 is moved relative to warehouse 5050, actuator 5210 can be relative to The fastener movement being located in the securing member chamber 5054 of warehouse 5050.It is positioned at tightly for example, actuator 5210 can slide through Fastener in firmware chamber 5054, or slided around the fastener.

In various embodiments, percussion component 5030 can translate and/or narrow during firing schedule along slit 5212 Translation in slot 5212.Similar to actuator 5010 and 5110, actuator 5210 may include release stop part 5214.In various implementations In example, release stop part 5214 may include frangible portion 5220, which can be for example the bridgeware across slit 5212.It is main Will be referring to Figure 87 A, release stop part 5214 can be abutted by firing component 5030, and actuator 5210 is pushed towards distal side.Then, it causes Dynamic device 5210 can abut hard stop part, and such as hard stop part 5060 (Figure 84 to Figure 85 B and Figure 85 D), which can prevent Actuator 5210 further moves toward the far side.It can when percussion component 5030 reaches hard stop part 5060 referring primarily to Figure 87 B Make discharge stop part 5214 frangible portion 5220 disconnect, percussion component 5030 can during firing schedule along slit 5212 after It is continuous to move toward the far side.Frangible portion 5220 can be sufficiently rigid, in actuator 5210 towards distal side to hard 5060 (figure of stop part When 85D) shifting, the power of the percussion component 5030 application is born；And it can be reached firmly with working as actuator 5210 to be frangible enough When stop part 5060, does not need motor and/or operator applies excessive power and can disconnect.In various embodiments, it is fastening For part before the percussion of fastener cartridge 5050, actuator 5210 can overcome distal connector 5080b and/or other connector.? In some embodiments, actuator 5210 can at least one fastener from securing member chamber fire when, and/or at least one fastening Part after securing member chamber percussion, just overcomes distal connector and/or other connector.

Referring now to Figure 88 and Figure 89, end effector assembly 5300 may include the first jaw (such as other places are shown) and second Jaw 5302.In various embodiments, the second jaw 5302 may include warehouse 5350 and be releasably secured to warehouse 5350 Tissue thickness compensation part 5358.Similar to the second jaw 5002, the second jaw 5302 can be for example including fastener such as surgery Nail, the fastener can be removably positioned in the securing member chamber of warehouse 5350.For example, fastener being capable of side can project Formula is located in each securing member chamber.In certain embodiments, warehouse 5350 may include slit 5356 (Figure 88), the slit 5356 It can extend from the portions of proximal 5304 of the second jaw 5302 towards distal part 5306.In various embodiments, component 5030 is fired It can be translated along the slit 5356 of warehouse 5350.Firing component 5030 can be for example during firing schedule in fastener cartridge 5350 Translation in slit, and can project fastener from securing member chamber for example during firing schedule.Percussion component 5030 can for example exist The sliding part 5334 (Figure 89) in warehouse 5350 is engaged during firing schedule, and can be for example during firing schedule by sliding part 5334 push towards distal side.In addition, percussion component 5030 and/or actuator 5310 can be such that tissue thickness compensates during firing schedule Part 5358 is discharged from warehouse 5350.

Referring also to Figure 88 and Figure 89, tissue thickness compensation part 5358 may include main body 5360, from main body 5360 extend it is close Side installation part 5362 and the distal side installation part 5364 extended from main body 5360.Referring primarily to Figure 89, for example, pin 5366 can prolong The opening 5356a that nearside installation part 5362 enters in warehouse 5350 is extended through, so that pin 5366 is in the second jaw 5302 Tissue thickness compensation part 5358 is releasably held relative to warehouse 5350 at portions of proximal 5304.Pin 5366 can for example rub Cooperate and/or is snapped in opening 5356a.It in certain embodiments, can be for example using one or more adhesives by pin 5366 are maintained in opening 5456a.It in some embodiments, can be for example by least part of warehouse 5350 and/or pin 5366 It welds.In various embodiments, tissue thickness compensation part 5358 may include multiple nearside installation parts 5362, these nearsides peace Piece installing can be releasably secured to warehouse 5350 in the either side of slit 5356 (Figure 88) or two sides in warehouse 5350.? In some embodiments, distal side installation part 5364 can be fixed to warehouse for example at the distal part 5306 of the second jaw 5302 5350.Distal side installation part 5364 can be fixed for example via at least one adhesive between distal side installation part 5364 and warehouse 5350 To warehouse 5350.In addition to this or alternatively, distal side installation part 5364 can for example pass through at least one pin and/or other fastening Part is fixed to warehouse 5350.

Referring primarily to Figure 89, actuator 5310 can be looped around on distal side installation part 5364, and may extend into the second jaw Sliding part 5334 in 5302.In various embodiments, actuator 5310 can for example including can extend through warehouse 5350 and/ Or the cable or rope in the channel 5346 limited in the second jaw 5302 and/or sliding part 5334.In various embodiments, Sliding part 5334, which moves toward the far side, can pull actuator 5310, to pierce the distal side installation part of tissue thickness compensation part 5358 5364.For example, actuator 5310 can have first end 5316 fixed to sliding part 5334, be fixed in warehouse 5350 Two ends 5318 and the ring 5320 between first end 5316 and the second end 5318.Ring 5320 can be for example looped around On distal side installation part 5364.In various embodiments, ring 5320 can be in part of the distal side installation part 5364 fixed to warehouse 5350 It is wrapped between the main body 5360 of tissue thickness compensation part 5358 on distal side installation part 5364.In certain embodiments, second End 5318 can be securely fixed in warehouse 5350, so that ring 5320 surrounds distal side when first end 5316 moves Installation part 5364 is tightened.In various embodiments, the second jaw 5302 and/or warehouse 5350 can for example including button, pin and/ Or castor, such as the first button 5312 and the second button 5314.Actuator 5310 can for example wind the first button 5312 and second Button 5314.The orientation that the position of button 5312,5314 and actuator 5310 surround button 5312,5314 makes actuator 5310 Ring 5320 can surround distal side installation part when sliding part 5334 moves toward the far side during firing schedule with percussion component 5330 5364 tighten.In addition, ring 5320 can pierce distal side installation part 5364 when ring 5320 is tightened around distal side installation part 5364, so that The main body 5360 of tissue thickness compensation part 5358 discharges at the distal part 5306 of the second jaw 5302 from warehouse 5350.Cause This, in view of said circumstances, distal side installation part 5364 can be disengaged during firing schedule starts with warehouse.

In various embodiments, when the distal side installation part 5364 of tissue thickness compensation part 5358 is discharged from warehouse 5350, The pin 5366 that the nearside installation part 5362 of tissue thickness compensation part 5358 is fixed to warehouse 5350 can be from the opening of warehouse 5350 5356 releases.For example, pin 5366 can be discharged from opening 5356 when firing schedule starts or after starting a little while.Pin 5366 can Such as it is cut and/or is cut off by the cutting edge 5036 of percussion component 5030, and/or can be pushed away by the element of percussion component 5030 Out and/or displace opening 5356.In such embodiments, when both nearside installation part 5362 and distal side installation part 5364 are from warehouse After 5350 releases, tissue thickness compensation part 5358 can be discharged when firing schedule starts or after starting a little while from warehouse 5350. In other words, actuator 5310 in percussion component 5030 and/or sliding part 5334 by fastener from the fastener in warehouse 5350 Before chamber projects, tissue thickness compensation part 5358 can be discharged from warehouse 5350.In some embodiments, it is incited somebody to action in actuator 5310 Tissue thickness compensation part 5358 before the release of warehouse 5350 and/or when, firing component 5030 and/or sliding part 5334 can be from Securing member chamber projects at least one fastener.

Fastener cartridge assembly may include warehouse, which includes slit and multiple securing member chambers.The fastener cartridge assembly is also It may include multiple fasteners, wherein each fastener is removably positioned in securing member chamber.The fastener cartridge assembly can also wrap The percussion element that can be moved along slit, the tissue thickness compensation part and installation part for being releasably secured to warehouse are included, wherein Tissue thickness compensation part is fixed to warehouse by installation part, and wherein installation part is located in some fastener in multiple fasteners Distal side.The fastener cartridge assembly may also include the cable being located between percussion element and installation part, and wherein cable is configured to Installation part is disconnected when firing element and moving toward the far side along slit.When cable disconnects installation part, tissue thickness compensation part It can be discharged from warehouse.Before removing fastener from securing member chamber, cable disconnects installation part.The fastener cartridge assembly may be used also Including channel, wherein cable extends through the channel.

Referring now to Figure 93 A to Figure 93 D, end effector assembly 5600 may include the first jaw (such as other places are shown) and Two jaws 5602.In various embodiments, the second jaw 5602 may include fastener warehouse 5650 and be releasably secured to The tissue thickness compensation part 5658 of second jaw 5602 and/or fastener warehouse 5650.In certain embodiments, fastener warehouse It 5650 and is releasably secured to the tissue thickness compensation part 5658 of fastener warehouse 5650 and may make up fastener cartridge assembly.It is main The securing member chamber 5654 can there is storehouse platform 5652 referring to Figure 93 A, warehouse 5650 and be defined in storehouse platform 5652.Separately Outside, the second jaw 5602 can be removably positioned in fastener for example including fastener (such as surgical staples), the fastener In chamber 5654.For example, single fastener can be located in each securing member chamber 5654 of warehouse 5650 in a manner of it can project. Referring still primarily to Figure 93 A, warehouse 5650 may include the ridge 5648 extended from storehouse platform 5652.Ridge 5648 can be for example around fastener At least part of chamber 5654 extends.In various embodiments, when fastener is located in securing member chamber 5654, fastener It top can be prominent from securing member chamber 5654.In such embodiments, when fastener is projected from securing member chamber 5654, at least partly Ground can support the top of fastener, and/or the top of guidance fastener around the ridge 5648 that securing member chamber 5654 positions.At certain In a little embodiments, referring also to Figure 93 A, warehouse 5650 may include slit 5656, which can be from the close of the second jaw 5602 The distal part 5606 of side section 5604 towards the second jaw 5602 extends.In various embodiments, percussion component 5630 can edge Warehouse 5650 slit 5656 translate.For example, percussion component 5630 can translate during firing schedule along slit 5656, and Fastener can be projected from securing member chamber 5654 during firing schedule.

Referring also to Figure 93 A to Figure 93 D, firing component 5630 may include trigger shaft 5632, cutting edge 5636,5638 and of cross bar Stabilizer blade 5644.When percussion component 5630 is fired during firing schedule across the second jaw 5602, cutting edge 5636 can be incited somebody to action Tissue cuts and/or cuts tissue thickness compensation part 5658.Slit in the engageable first jaw anvil block of cross bar 5638, will Component 5630 is fired to keep relative to the first jaw；And the slit that stabilizer blade 5644 can be engaged for example in the second jaw 5602 is (all Such as the slit 5656 in warehouse 5650), the first jaw is kept relative to warehouse 5650.In various embodiments, cross bar 5638 and/or stabilizer blade 5644 can for example by fire component 6530 cutting edge 5636 remain the platform with fastener cartridge 5650 5652 is vertical.Referring primarily to Figure 93 A and Figure 93 D, the cunning in warehouse 5650 can be engaged during firing schedule by firing component 5630 Moving part 5634.Fire component 5630 can for example during firing schedule by sliding part 5634 towards distal side push, by fastener from Securing member chamber 5654 projects.In various embodiments, sliding part 5634 can be for example with the drive in engageable securing member chamber 5654 Cam face or the slope 5642 of dynamic device and/or fastener.When slope 5642 engages driver, slope 5642 can be by driver It is pushed towards platform 5652, so that corresponding fastener is projected from securing member chamber 5654.In addition, in various embodiments, percussion group Part 5630 can cut tissue thickness compensation part 5658 during firing schedule.

Referring primarily to Figure 93 A and Figure 93 B, tissue thickness compensation part 5658 may include storehouse contact surface 5662 (Figure 93 A) and Tissue contacting surface 5664 (Figure 93 B).Storehouse contact surface 5662 for example can be fixed to warehouse when tissue thickness compensation part 5658 When 5650 (Figure 93 B), positioned against storehouse platform 5652.In addition, for example when tissue is clamped in the first jaw and the second jaw When between 5602, tissue contacting surface 5664 can be positioned against tissue.Referring primarily to Figure 93 A, tissue thickness compensation part 5658 can Including installation part 5660.In various embodiments, installation part 5660 can be that can for example extend from tissue thickness compensation part 5658 The fin of rectangle or triangle.In addition, installation part 5660 can be the cut out portion of tissue thickness compensation part 5658, this notch Divide and leaves space 5666 corresponding with the shape of installation part 5660 in tissue thickness compensation part 5658.When tissue thickness compensates When part 5658 is positioned relative to warehouse 5650, installation part 5660 can be for example aligned with the slit 5656 of warehouse 5650.In addition, working as group When knitting the storehouse contact surface 5662 of thickness compensation part 5658 and being positioned to adjacent with the platform 5652 of warehouse 5650, installation part 5660 can It extends in slit 5656.In various embodiments, when tissue thickness compensation part 5658 is fixed to warehouse 5650, installation part 5660 can be friction fit into slit 5656.Installation part 5660 can by least part of tissue thickness compensation part 5658 relative to Warehouse 5650 is kept.For example, storehouse contact surface 5662 can be against warehouse when installation part 5660 is friction fit into slit 5656 5650 platform 5652 positions.

In various embodiments, tissue thickness compensation part 5658 may include can be aligned with the slit 5656 of warehouse 5650 it is more A installation part 5660.For example, at least one installation part 5660 can be positioned in the portions of proximal 5604 of the second jaw 5602, and At least one installation part 5660 can be positioned in the distal part 5606 of the second jaw 5602.In various embodiments, installation part 5660 can separate along at least part of 5658 length of tissue thickness compensation part.For example, slit 5656 can be from the second jaw The longitudinal slit that the distal part 5606 of 5602 the 5604 to the second jaw of portions of proximal 5602 extends.Installation part 5660 can be such as It is friction fit into longitudinal slit 5656, and tissue thickness compensation part 5658 can be made to be fixed to warehouse 5650.

Referring primarily to Figure 93 A and Figure 93 D, sliding part 5634 may include tongue 5640, which can be from sliding The distal part 5606 of part 5634 towards the second jaw 5602 is prominent.When percussion component 5630 pushes sliding part during firing schedule When 5634, tongue 5640 can be moved along the slit 5656 in warehouse 5650.Referring primarily to Figure 93 D, tongue 5640 can be neighbouring The storehouse contact surface 5664 of tissue thickness compensation part 5658 is moved along slit 5656.In addition, tongue 5640 can be against positioning Installation part 5660 in slit 5656 and move.In various embodiments, installation part 5660 can be deflectable.Work as tongue When 5640 pushing installation part 5660, tongue 5640 can make installation part 5660 be deflected to the main body with tissue thickness compensation part 5658 Alignment, or be at least substantially aligned.For example, installation part 5660 can in succession partially when tongue 5640 moves in warehouse 5650 It goes in the correspondence space 5666 limited in tissue thickness compensation part 5658.When installation part 5660 deflects away from slit 5656, Tissue thickness compensation part 5658 can no longer be fixed to warehouse 5650 and/or discharge from warehouse 5650.In various embodiments, it slides Part 5634 and/or another element for firing component 5630 can make installation part 5660 deflect away from slit 5656, so that tissue thickness Compensating part 5658 is no longer fixed to warehouse 5650 and/or discharges from warehouse 5650.

Referring now to Figure 94, it is similar to end effector assembly 5600, end effector assembly 5700 may include the first pincers Mouth (such as other places are shown) and the second jaw 5702.In various embodiments, the second jaw 5702 may include fastener warehouse 5750, And it is releasably secured to the tissue thickness compensation part 5758 of warehouse 5750 and/or the second jaw 5702.In some embodiments In, fastener warehouse 5750 and the tissue thickness compensation part 5758 for being releasably secured to warehouse 5750 can for example constitute fastener Storehouse component.Similar to warehouse 5650, warehouse 5750 can have storehouse platform 5752, be limited in storehouse platform 5752 for keeping fastening The securing member chamber 5754 of part, the ridge 5748 at least partly around securing member chamber 5754, and/or the nearside from the second jaw 5702 The slit 5756 that the distal part 5706 of part 5704 towards the second jaw 5702 extends.In various embodiments, warehouse 5750 can Including the bridgeware 5780 for traversing slit 5756 or extending across slit 5756.Bridgeware 5780 can be for example frangible and/or can Isolated bridgeware.In certain embodiments, bridgeware 5780 may be, for example, it is thin can breaking part, and can be solid form Absorbable material, such as PGA, PCL, PGA/PCL, PLA/PCL and/or TMC.Bridgeware 5780 can have hole 5782, the hole 5782 can at least partly extend through bridgeware 5780.

Referring also to Figure 94, in various embodiments, percussion component 5630 can be translated along the slit 5756 of warehouse 5750.Example Such as, percussion component 5630 can during firing schedule along slit 5756 translate, and can during firing schedule by fastener from Securing member chamber 5754 projects.Firing component 5630 may include trigger shaft 5632, cutting edge 5636, cross bar 5638 and stabilizer blade 5644. When fire component 5630 fired during firing schedule across the second jaw 5702 when, cutting edge 5636 can will tissue and/or Tissue thickness compensation part 5758 is cut.Slit in the engageable first jaw anvil block of cross bar 5638, by the first jaw relative to Warehouse 5750 is kept, and stabilizer blade 5644 can for example engage the slit (slit in such as warehouse 5750 in the second jaw 5702 5756) component 5630, will be fired to keep relative to the second jaw 5702.In various embodiments, cross bar 5638 and/or stabilizer blade 5644 for example cutting edge 5636 can be remained it is vertical with the platform 5752 of fastener cartridge 5750.

Referring also to Figure 94, tissue thickness compensation part 5758 may include storehouse contact surface 5762 and tissue contacting surface.Storehouse connects Touching surface 5762 can be for example when tissue thickness compensation part 5758 be fixed to warehouse 5750 and/or the second jaw 5702, against storehouse Platform 5752 positions.In addition, tissue contacting surface can be for example clamped between the first jaw and the second jaw 5702 when tissue When, it is positioned against tissue.In various embodiments, tissue thickness compensation part 5758 may include installation part 5760.Installation part 5760 It can be protrusion, pin, tab, and/or the column that can for example extend from the storehouse contact surface 5762 of tissue thickness compensation part 5758.Peace Piece installing 5760 can be right with the hole 5782 of bridgeware 5780 for example when tissue thickness compensation part 5758 is positioned relative to warehouse 5750 It is aligned together or at least substantially.In addition, the storehouse contact surface 5762 when tissue thickness compensation part 5758 is positioned to and warehouse 5750 Platform 5752 it is adjacent when, installation part 5760 can extend at least partly into hole 5782.In various embodiments, when tissue is thick When degree compensating part 5758 is fixed to warehouse 5750, installation part 5760 can be friction fit into hole 5782.Installation part 5760 can incite somebody to action Tissue thickness compensation part 5758 keeps and/or fixes relative to warehouse 5750 and/or the second jaw 5702.For example, working as installation part 5760 when being friction fit into the hole 5782 of bridgeware 5780, and storehouse contact surface 5762 can be fixed against the platform 5752 of warehouse 5750 Position.

In various embodiments, fastener cartridge 5750 may include multiple bridgewares that the slit 5756 across warehouse 5750 extends 5780.Bridgeware 5780 can at least part for example along 5756 length of slit separate.For example, slit 5756 can be from second The longitudinal slit that the distal part 5706 of the 5704 to the second jaw of portions of proximal 5702 of jaw 5702 extends.In addition, various In embodiment, tissue thickness compensation part 5758 may include the multiple installation parts that can be aligned with the bridgeware 5780 of warehouse 5750 5760.For example, at least one installation part 5760 can be positioned on when tissue thickness compensation part 5758 is positioned relative to warehouse 5750 In the portions of proximal 5704 of second jaw 5702, and at least one installation part 5760 can be positioned on the remote of the second jaw 5702 In side section 5706.In various embodiments, installation part 5760 can be along at least part of 5758 length of tissue thickness compensation part It separates.Installation part 5760 can be for example friction fit into slit 5756, and tissue thickness compensation part 5758 can be made to be fixed to storehouse Body 5750 and/or the second jaw 5702.

Component is fired when percussion component 5630 moves during firing schedule along slit 5756 referring also to Figure 94 The 5630 cleavable tissue thickness compensation part 5758 of cutting edge 5636 and/or the first pincers for being clamped in end effector assembly 5700 Mouth and the tissue between the second jaw 5702.In addition, percussion component 5630 can when firing component 5630 across the movement of slit 5756 Separate bridgeware 5780.For example, firing the cutting edge of component 5630 when firing component 5630 across the movement of slit 5756 5636 can be such that bridgeware 5780 ruptures, or bridgeware is cut.In various embodiments, when percussion component 5630 is in firing schedule When period moves in slit 5756, cutting edge 5636 can be by each cutting in succession of bridgeware 5780.Once 5780 quilt of bridgeware The cutting of cutting edge 5636 ruptures under the effect of cutting edge 5636, and tissue thickness compensation part 5758 can no longer be fixed to warehouse 5750 And/or it is discharged from warehouse 5750.In certain embodiments, cutting edge 5636 can make the installation aligned during firing schedule Part 5760 ruptures, or the installation part 5760 aligned is cut.In various embodiments, sliding part and/or percussion component 5630 another element can make bridgeware 5780 rupture or cut bridgeware 5780, by tissue thickness compensation part 5758 from storehouse Body 5750 discharges.

Referring now to Figure 95 and Figure 96, it is similar to end effector assembly 5600, end effector assembly 5800 may include First jaw (such as other places are shown) and the second jaw 5802.In various embodiments, the second jaw 5802 may include fastener cartridge Body 5850 and the tissue thickness compensation part 5858 for being releasably secured to warehouse 5850 and/or the second jaw 5802.Certain In embodiment, fastener warehouse 5850 and the tissue thickness compensation part 5858 for being releasably secured to fastener warehouse 5850 can To constitute fastener cartridge assembly.Similar to warehouse 5650, warehouse 5850 can have storehouse platform 5852, be limited in storehouse platform 5852 It is configured to receive the securing member chamber 5854 of fastener, the ridge positioned around at least part of securing member chamber 5854 5848, and/or can extend from the distal part 5806 of portions of proximal 5804 towards the second jaw 5802 of the second jaw 5802 narrow Slot 5856.In various embodiments, warehouse 5850 may include traversing slit 5856 or at least partly extending across slit 5856 Bridgeware 5880.Bridgeware 5880 can be for example frangible and/or separable bridgeware.In certain embodiments, it bridges Part 5880 may include first leg 5884 and the second supporting leg 5886.Referring primarily to Figure 96, first leg 5884 can be for example from warehouse 5850 the first side extends in slit 5856, and the second supporting leg 5886 for example can extend to slit from second side of warehouse 5850 In 5856.First leg 5884 and the second supporting leg 5886 can be angularly oriented relative to the axis of slit 5856, and first Leg 5884 can be for example orientated relative to the second supporting leg 5886 at about 90 degree.In certain embodiments, first leg 5884 and/or Second supporting leg 5886 can deflect.In various embodiments, bridgeware 5880 may include such as first leg 5884 and second Gap between leg 5886.

Referring also to Figure 95 and Figure 96, in various embodiments, percussion component 5630 can along warehouse 5850 slit 5856 it is flat It moves.For example, percussion component 5630 can translate during firing schedule along slit 5856, and can will be fastened during firing schedule Part is projected from securing member chamber 5854.Firing component 5630 may include trigger shaft 5632, cutting edge 5636, cross bar 5638 and stabilizer blade 5644.When percussion component 5630 is fired during firing schedule across the second jaw 5802, cutting edge 5636 can will be organized And/or tissue thickness compensation part 5858 is cut.Slit in the engageable first jaw anvil block of cross bar 5638, relative to warehouse 5850 keep the first jaw, and stabilizer blade 5644 can for example engage the slit in the second jaw 5802 (in such as warehouse 5850 Slit 5856), to keep percussion component 5630 relative to the second jaw 5802.In various embodiments, cross bar 5638 and/or branch Foot 5644 can for example remain cutting edge 5636 vertical with the platform 5852 of fastener cartridge 5850.

Referring also to Figure 95 and Figure 96, tissue thickness compensation part 5858 may include storehouse contact surface 5862 and tissue contact table Face.Such as when tissue thickness compensation part 5858 is fixed to warehouse 5850 and/or the second jaw 5802, storehouse contact surface 5862 can It is positioned against storehouse platform 5852.In addition, tissue connects for example when tissue is clamped between the first jaw and the second jaw 5802 Touching surface can position against tissue.In various embodiments, tissue thickness compensation part 5858 may include installation part 5860.It is similar to Installation part 5760, installation part 5860 can be for example can be from the prominent of the storehouse contact surface 5862 of tissue thickness compensation part 5858 extension It rises, pin, tab, and/or column.Such as when tissue thickness compensation part 5858 is positioned relative to warehouse 5850, installation part 5860 can Gap between the supporting leg 5884 and 5886 of bridgeware 5880 is aligned.In addition, when the storehouse of tissue thickness compensation part 5858 contacts When surface 5862 is positioned to adjacent with the platform 5852 of warehouse 5850, installation part 5860 can be bridged 5884 He of supporting leg of part 5880 5886 is fixed.In various embodiments, when tissue thickness compensation part 5858 is fixed to warehouse 5850, installation part 5860 can rub Wiping is cooperated in the gap between supporting leg 5884 and 5886.Engage with bridgeware can be relative to storehouse for installation part in second jaw 5802 Body 5850 keeps tissue thickness compensation part 5858.For example, once installation part 5860 is friction fit into the supporting leg of bridgeware 5880 It, can be fixed against the platform 5852 of warehouse 5850 by storehouse contact surface 5862 between 5884 and 5886.

In various embodiments, referring primarily to Figure 95, fastener cartridge 5850 may include that the slit 5856 across warehouse 5850 prolongs The multiple bridgewares 5880 stretched.Bridgeware 5880 can at least part for example along 5856 length of slit separate.For example, slit 5856 can be from the longitudinal direction that the distal part 5806 of the 5804 to the second jaw of portions of proximal 5802 of the second jaw 5802 extends Slit.In addition, in various embodiments, tissue thickness compensation part 5858 may include that can be aligned with the bridgeware 5880 of warehouse 5850 Multiple installation parts 5860.For example, when tissue thickness compensation part 5858 is positioned relative to warehouse 5850 and/or the second jaw 5802 When, at least one installation part 5860 can be positioned in the portions of proximal 5804 of the second jaw 5802, and at least one installation part 5860 can be positioned in the distal part 5806 of the second jaw 5802.In various embodiments, installation part 5860 can be thick along tissue At least part of degree 5858 length of compensating part separates.Installation part 5860 can be for example friction fit into bridgeware 5880, and Tissue thickness compensation part 5858 can be made to be fixed to warehouse 5850.

Referring also to Figure 95 and Figure 96, when percussion component 5630 moves during firing schedule along slit 5856, percussion group The cleavable tissue thickness compensation part 5858 of cutting edge 5636 of part 5630 and/or it is clamped in the first of end effector assembly 5800 Tissue between jaw and the second jaw 5802.In addition, can make to bridge when firing component 5630 when passing through the movement of slit 5856 Part 5880 separates.For example, the cutting edge 5636 of percussion component 5630 can when firing component 5630 when passing through the movement of slit 5856 To deflect the supporting leg 5884 and 5886 of bridgeware 5880, and/or separate the supporting leg of bridgeware.In various embodiments, when hitting When hair component 5630 moves in slit 5856 during firing schedule, cutting edge 5636 can deflect each bridgeware 5880 in succession Supporting leg 5884 and 5886 so that each bridgeware 5880 separate.Once the supporting leg 5884 and 5886 of bridgeware 5880 is cut Sword 5636 deflects, and bridgeware 5880 can discharge the correspondence installation part 5860 of tissue thickness compensation part 5858.Along warehouse By each installation part 5860 after the release of each bridgeware 5880, tissue thickness compensation part 5858 can be fixed no longer 5850 length It is discharged to warehouse 5850 and/or from warehouse.In certain embodiments, cutting edge 5636 can will align during firing schedule Installation part 5860 cut, or make the installation part 5860 aligned rupture.In various embodiments, it sliding part and/or hits Another element of hair component 5630 can be such that bridgeware 5880 separates, and tissue thickness compensation part 5858 is discharged from warehouse 5850.

Referring now to Figure 97 to Figure 100, it is similar to end effector assembly 5600, end effector assembly 5900 may include First jaw, that is, anvil block 5910 (Figure 99 and Figure 100) and the second jaw 5902.In various embodiments, the second jaw 5902 can wrap It includes fastener warehouse 5950 and is releasably secured to the tissue thickness of fastener warehouse 5950 and/or the second jaw 5902 Compensating part 5958.In certain embodiments, fastener warehouse 5950 and it is releasably secured to the tissue thickness of warehouse 5950 Compensating part 5958 can for example constitute fastener cartridge assembly.Referring primarily to Figure 98, fastener warehouse 5950 can have storehouse platform 5952 With the securing member chamber being limited in storehouse platform 5962.Installation cavity 5948 and/or securing member chamber 5954 can for example be limited to storehouse platform In 5952.In various embodiments, installation cavity 5948 and securing member chamber 5954 can have same or similar structure and/or geometry Shape.Second jaw 5902 can be removably positioned in fastening for example including fastener (such as surgical staples), the fastener In part chamber 5954.In certain embodiments, warehouse 5950 may include slit 5956, which can be from the second jaw 5902 The distal part 5906 of portions of proximal 5904 towards the second jaw 5902 extends.

Referring also to Figure 97 to Figure 100, in various embodiments, percussion component 5630 can be during firing schedule along warehouse 5950 slit 5956 translates, and can project fastener from securing member chamber 5954 during firing schedule.When percussion component 5630 during firing schedule when being fired across end effector assembly 5900, and cutting edge 5636 can will tissue and/or tissue Thickness compensation part 5958 is cut.Slit 5912 (Figure 99 and Figure 100) in the engageable anvil block 5910 of cross bar 5638, relative to storehouse Body 5950 keeps the first jaw, and stabilizer blade 5644 can for example engage the slit in the second jaw 5902 (in such as warehouse 5950 Slit 5956), with relative to the second jaw 5902 keep percussion component 5630.In various embodiments, cross bar 5638 and/or Stabilizer blade 5644 can for example remain cutting edge 5636 vertical with the platform 5952 of fastener cartridge 5950.

Referring also to Figure 97 to Figure 100, tissue thickness compensation part 5958 may include storehouse contact surface 5962 (Figure 97) and tissue Contact surface 5964 (Figure 98 and Figure 99).Such as when tissue thickness compensation part 5958 is fixed to warehouse 5950 and/or the second jaw When 5902, storehouse contact surface 5962 can be positioned against storehouse platform 5952.In addition, for example when tissue is clamped in anvil block 5910 and When between two jaws 5902, tissue contacting surface 5964 can be positioned against tissue.In various embodiments, tissue thickness compensation part 5958 may include installation part 5960.Similar to installation part 5760 and/or installation part 5860, for example, installation part 5960 can be energy Enough protrusion, pin, tab, and/or columns extended from the storehouse contact surface 5962 of tissue thickness compensation part 5958.In some embodiments In, tissue thickness compensation part 5958 can for example including can be adjacent with installation part 5960 groove 5970.Groove 5970 can for example with Installation part 5970 is vertically aligned.Referring primarily to Figure 99, the tissue that groove 5970 can be limited at tissue thickness compensation part 5958 is connect It touches in surface 5964, and can extend towards installation part 5960.In various embodiments, the thin slice of tissue thickness compensation part 5958 can example It is such as located between groove 5970 and installation part 5960.

Such as when tissue thickness compensation part 5958 is positioned relative to warehouse 5950, installation part 5960 can be with storehouse platform 5952 In installation cavity 5948 be aligned.In addition, the storehouse contact surface 5962 when tissue thickness compensation part 5958 is positioned to and warehouse 5950 Platform 5952 it is adjacent when, installation part 5960 can be positioned in installation cavity 5948.In various embodiments, when tissue thickness compensates When part 5958 is fixed to warehouse 5950, installation part 5960 can be friction fit into installation cavity 5948.Installation part 5960 and installation Chamber 5948 is bonded together with a friction fit, can keep at least the one of tissue thickness compensation part 5958 relative to warehouse 5950 Part.For example, when installation part 5960 is friction fit into installation cavity 5948, it can be by storehouse contact surface 5962 against warehouse 5950 Platform 5952 it is fixed.

Referring primarily to Figure 97 and Figure 98, fastener cartridge 5950 may include the multiple installation cavitys being limited in storehouse platform 5952 5948.In certain embodiments, corresponding installation cavity 5948 can be defined in storehouse platform 5952 in the either side of slit 5956.The One installation cavity 5948 can for example be limited to the first longitudinal side of warehouse 5950, and corresponding second installation cavity 5948 can be limited for example It is scheduled on the second longitudinal side of warehouse 5950.For example, first pair of corresponding installation cavity 5948 can be positioned on the close of the second jaw 5902 In side section 5904 and/or second pair of corresponding installation cavity 5948 can be positioned on the distal part of the second jaw 5902 In 5906.In various embodiments, securing member chamber 5954 can be positioned between corresponding mounted in pairs chamber 5948, that is to say, that It is closer from slit 5956；And it can be positioned on mounted in pairs chamber 5948 and the second jaw at 5902 portions of proximal 5904 of the second jaw Between mounted in pairs chamber 5948 at 5902 distal parts 5906, that is to say, that in the middle section of warehouse 5950.Separately Outside, in various embodiments, tissue thickness compensation part 5958 may include can be aligned with the installation cavity 5948 of warehouse 5950 it is multiple Installation part 5960.For example, at least one installation part 5960 can be positioned in the portions of proximal 5904 of the second jaw 5902；And extremely A few installation part 5960 can be positioned in the distal part 5906 of the second jaw 5902.In various embodiments, a pair of of installation Part 5960 can be positioned in the portions of proximal 5904 of the second jaw 5902；And a pair of of installation part 5960 can be positioned on the second jaw In 5902 distal part 5906.Installation part 5960 can be for example friction fit into installation cavity 5948, and can make tissue thickness At least part of compensating part 5958 is fixed to warehouse 5950.

Referring primarily to Figure 99 and Figure 100, installation part 5960 can be removed during firing schedule from installation cavity 5948.Various In embodiment, be movably positioned in driver 5920 in installation cavity 5948 can during firing schedule by installation part 5960 from peace It behave affectedly 5948 injections.For example, driver 5920 can be positioned in each installation cavity 5948.During firing schedule, the second jaw Component 5630 and/or the element of sliding part are fired in 5902 for example to be engaged with driver 5920, so that 5920 direction of driver Storehouse platform 5952 and/or towards tissue thickness compensation part 5958 move.Driver 5920 during exercise, can for example will be located into peace The installation part 5960 behaveing affectedly in 5948 is pushed towards platform 5952 and/or tissue thickness compensation part 5958.In various embodiments, Being defined in groove 5970 corresponding with the installation part 5960 being pushed out in tissue thickness compensation part 5958 can receive the peace being pushed out Piece installing 5960.For example, installation part 5960 can be pushed in groove 5970 by driver 5920.Installation part 5960 can be for example squeezed into In groove 5970, groove is deformed into, and/or is compressed into groove 5970.Once installation part 5960 during firing schedule from Installation cavity 5960 is removed and is pushed into corresponding groove 5970, and tissue thickness compensation part 5958 can no longer be fixed to warehouse 5950 and/or from warehouse 5950 discharge.

In various embodiments, referring now to Figure 62 to Figure 66, nail bin 13000 may include warehouse 1310, tissue thickness's benefit Repay part 13020 and it is multiple fire connector, these can fire connector and be configured to tissue thickness compensation part 13020 It releasably holds on warehouse 13010, further more detailed description as follows.Warehouse 13010 may include proximal end 13011, distal end 13012 and platform 13015, the platform 13015 are configured to supporting tissue thickness compensation on it Part 13020.Warehouse 13010 may include one or more proximal stops 13013 extending therefrom, which can be by structure It makes as that can stop or tissue thickness compensation part 13020 is prevented proximally to move.Similarly, warehouse 13010 may include one or Multiple distal side stop parts 13014, the distal side stop part are configured to stop or prevent tissue thickness compensation part 13020 It moves toward the far side.Referring primarily to Figure 63, warehouse 13010, which may also include, is defined in multiple nail cavities 13016 therein.In various implementations In example, nail bin 13000 may include multiple connectors 13030 and 13040, these connectors are configured to mend tissue thickness Part 13020 is repaid to releasably hold on warehouse 13010.For example, each connector 13030 may include that can be positioned at nail cavity Multiple chamber plugs 13031 in 13016, and the company extended between chamber plug 13031 and on tissue thickness compensation part 13020 Extension bar 13032.In at least one embodiment, chamber plug 13031 can be closely adhered in nail cavity 13016.In certain implementations In example, chamber plug 13031 pressure cooperation and/or can be snapped in nail cavity 13016.For example, each connector 13040 can wrap Chamber plug 13031 and head extending therefrom 13042 are included, wherein head 13042 can be at least partly in tissue thickness compensation part Extend on 13020.Referring again to Figure 63, tissue thickness compensation part 13020 can for example, is defined in tissue thickness compensation part One group of nearside recess 13023 in 13020 proximal end 13021, the nearside recess can receive proximally connector 13030 The chamber plug 13031 of extension；Intermediate recesses 13024, each intermediate recesses 13024 can be received to be extended from intermediate connector 13040 Chamber plug 13031；And it is defined in one group of distal side recess in the distal end 13022 of tissue thickness compensation part 13020 13025, which is configured to receive the chamber plug 13031 extended from distal connector 13030.

In use, sliding part or firing member can be advanced through nail bin 13000 towards distal side, will be positioned in nail cavity Nail in 13016 projects.In various embodiments, wherein the nail cavity 13016 of nail is located can clog without chamber plug 13031. In certain embodiments, wherein the nail cavity of chamber plug 13031 is located may not be located nail wherein.Although being not shown, In some embodiments, nail cavity may include fastener and the chamber plug 13031 that is positioned in.Referring again to Figure 65 and Figure 66, nail Nail can be also supported on not firing for they for example including multiple staple drivers 13050, these staple drivers 13050 by storehouse 13000 Position.For example, staple drivers 13050 and nail can be lifted up (that is, court when firing member is advanced through nail bin towards distal side The platform 13015 of warehouse 13010 and lifted towards the anvil block for being located in 13020 opposite of tissue thickness compensation part).Similarly, At least some of staple drivers 13050 can contact the chamber plug 13031 being located in some nail cavities 13016, and by these chambers Plug 13031 is lifted up towards anvil block.When nail is lifted up by staple drivers 13050, the nail leg of these nails may pass through tissue Thickness compensation part 13020, across the tissue being located in tissue thickness compensation part 13020 and anvil block, and be located in group Knit the anvil block contact of opposite side.Then staple drivers 13050 can drive nail against anvil block, so that nail deformation, will organize Thickness compensation part 13020 and tissue are trapped in wherein.When chamber plug 13031 is lifted up by staple drivers 13050, anvil block can hinder Only chamber plug 13031 moves upwards.In such cases, referring primarily to Figure 63, chamber plug 13031 may deform, deflects, and/or break It opens.In certain embodiments, chamber plug 13031 can may cause chamber plug 13031 for example including one or more recesses, the recess and exist Specific position deformation, deflection and/or disconnection therein.In all cases, entire chamber plug 13031 or at least substantially entire chamber Plug 13031 can project under the driving of staple drivers 13050 from nail cavity 13016.At this point, connector 13030 and/or 13040 can Tissue thickness compensation part 13020 is no longer connected to warehouse 13010, therefore, warehouse 13010 can be far from against tissue implantation Tissue thickness compensation part 13020 move.

In use, as to supplement above, firing member can be from the proximal end 13011 of nail bin 13000 towards nail The distal end 13012 in storehouse 13000 promotes.Warehouse 13010 may include longitudinal slit 13019, which is constructed For at least part that can receive firing member slidably therein.Firing member can will be positioned when promoting towards distal side Some nails in the nail 13016 of recent side project, and then fire the connector 13030 of recent side.Nearest side-connector 13030 Percussion the proximal end 13021 of tissue thickness compensation part 13020 can be discharged from warehouse 13010.In other embodiments, it hits The connector of recent side can be fired before firing any nail by sending out component.Under any circumstance, firing member can be towards distal side into one Step promotes, and will follow closely and project from nail cavity 13016, and then fire intermediate connector 13040 again.At this point, can only retain tissue thickness Degree compensating part 13020 remains to the farthest side-connector 13030 on warehouse 13010.Once firing member is by the company of farthest side The percussion of device 13030 is connect, tissue thickness compensation part 13020 can be no longer attached on warehouse 13010.Above-mentioned percussion sequence describes Nail bin is fired completely or thoroughly.Other situations that the nail that may also occur accommodating in nail bin is not fired completely.Such In the case of, tissue thickness compensation part 13020 is remained in the connector on warehouse 13010 some can not be fired.When complete At the part of nail bin 13000 in use, openable anvil block, and the tissue thickness that warehouse 13010 is pulled away from part implantation is compensated Part 13020.In such cases, the connector not fired is configured to skid off nail cavity 13016, even if they always not by Percussion is also such.Under any circumstance, for example, connector 13030 and 13040 can by any suitable biocompatibility and/ Or bioabsorbable material is constituted.

As to supplement above, firing member can be by structure for example including cut portion (such as knife), this cut portion It makes as can be when firing member is advanced through nail bin 13000 towards distal side, by tissue thickness compensation part 13020 and tissue cross. In such cases, be also structured to can be crosscutting by the connecting rod 13032 of connector 13030 for cut portion.

In various embodiments, referring now to Figure 101 and Figure 102, can for example will include using nail bin application device 10880 Support section 10810 and the nail bin of tissue thickness compensation part 10,820 10800 are loaded into staple cartridge channel.It is similarly as described above, Nail bin application device 10880 for example can also be configured to can by Top tissue thickness compensation part 10890 relative to anvil block (such as Anvil block 10060) positioning, so that anvil block 10060 can contact tissue thickness compensation part 10890 simultaneously when anvil block 10060 is closed It is engaged with tissue thickness compensation part.In at least one embodiment, tissue thickness compensation part 10890 may include from tissue thickness Multiple holding legs 10895 that the top surface 10891 of compensating part 10890 extends, the holding leg are configured to engagement anvil block 10060 and tissue thickness compensation part 10890 is releasably held on anvil block.In the embodiment as at least one, leg 10895 can be arranged to lengthwise rows, wherein each leg 10895 may include at least one foot, which is able to enter limit It is engaged due to the cutter slit 10065 in anvil block 10060 and with the cutter slit 10065.In certain embodiments, the one of leg 10895 A little feet can extend in one direction, and other feet can extend in another direction.In at least one embodiment, some feet can be along phase Anti- direction extends.

Under any circumstance, once anvil block 10060 is engaged with tissue thickness compensation part 10890, referring now to Figure 102 and Figure 103, anvil block 10060 can be again turned on, and then clinician can be such that nail bin application device 10880 compensates far from tissue thickness Part 10820 and 10890 moves.Then, referring to Figure 104, Top tissue thickness compensation part 10890 can be positioned on the first of target tissue On side, and tissue thickness compensation part 10820 (may include Lower tissue thickness compensation part) can be positioned on second side of the tissue On.After tissue thickness compensation part 10820 and 10890 suitably positions, referring now to figure 105, for example, the knife of firing member Sword (such as blade 10053) can be advanced through above-mentioned target tissue and tissue thickness compensation part.

In various embodiments, referring now to Figure 106, nail bin application device (such as application device 12280) can for example be wrapped The tissue thickness compensation part 12290 being detachably mounted to thereon is included, which can be similar to quilt described above It is inserted into staple cartridge channel (as shown in Figure 106 A), and when anvil block 10060 moves to closed position, is engaged with anvil block 10060. Application device 12280 may include shank 10084, be used to position tissue thickness compensation part 12290 relative to nail bin.In addition, applying It may include multiple legs 10081 with device 10084, which can be fixed to nail bin for tissue thickness compensation part 12290.At at least one In such embodiment, tissue thickness compensation part 12290 may include the multiple holding structures upwardly extended from its top surface 12291 Part 12295.Wherein each holding member 12295 may include multiple flexible legs 12296, which is configured to insertion anvil In cutter slit 10065 in seat 10060.Referring primarily to Figure 107 and Figure 108, the flexible leg 12296 of each holding member 12295 It can be separated by gap 12298, so that flexible leg 12296 is in insertion cutter slit 10065, flexible leg can inwardly be bent, and Once the widened foot of leg 12296 has passed through cutter slit 10065, leg 12296 can then return elastically outward.In various implementations In example, the widened foot of flexible leg 12296 can scratch behind the opposite holding antelabium 12297 being defined in anvil block 10060 Song, and since leg 12296 and antelabium 12297 interact, tissue thickness compensation part 12290 can be held anvil block 10060.Then, nail bin application device 12280 can be moved far from tissue thickness compensation part 12290, as shown in 106B.It is using In, once tissue thickness compensation part 12290 for example by from the nail that nail bin 10000 is disposed against tissue be implanted into, anvil block 10060 It can be opened again, and when anvil block 10060 moves away from the tissue thickness compensation part 12290 of implantation, holding member 12995 leg 12296 can inwardly be bent, so that the leg can be pulled out from cutter slit 10065.

As outlined above, end effector assembly may include nail bin, anvil block, and be located among nail bin and anvil block extremely Few a piece of buttress material.In at least one embodiment, referring now to Figure 109 to Figure 111, a piece of buttress material is (such as Buttress material 336) it is configured to be snapped at least one of nail bin 322 and/or anvil block (not shown), with It is releasably held in the piece buttress material in end effector.Referring to Figure 110 and Figure 111, nail bin 322 may include first Side wall 302 and second sidewall 304, wherein at least one side wall in the first side wall 302 and second sidewall 304 may include from its to The antelabium 306 of outer extension.In various embodiments, buttress material 336 may include first edge or the first side 308, the second side Edge or second side 310 and at least one lip at least partly extended along the length of first edge 308 and second edge 310 Edge 312.In at least one embodiment, referring to Figure 111, antelabium 312 be configured in snap-fit fashion with antelabium 306 engagements, buttress material 336 is releasably held on nail bin 322.

As to supplement above, referring to Figure 111, buttress material 336 may include surface 316, which is constructed For can with 328 adjacent positioned of platform of nail bin 322, or against nail bin 322 platform 328 position.In at least one implementation In example, side edge 308 and 310 may include side wall, which can extend along the direction of apparent surface 316 perpendicularly or transversely.? In such embodiment, antelabium 312 can extend from these side walls, so that antelabium 312 can be behind the antelabium 306 of nail bin 322 It is locked mutually with antelabium 306.In various embodiments, when disposing nail from nail bin 322, the antelabium 312 of buttress material 336 can It is disengaged from the antelabium 306 of nail bin 322.More specifically, the nail can be contacted with buttress material 336, to branch when disposing nail Support object material 336 applies upward power, and separates buttress material 336 with nail bin 322.It is therefore advantageous that when as above Described to be disposed when following closely and/or when opening end effector from nail bin 322, buttress material 336 can be separated with nail bin 322 automatically.

In various embodiments, referring to Figure 110 and Figure 111, a piece of buttress material may include extending therefrom at least one A component, the component are configured to buttress material releasably holding one of nail bin and/or anvil block On.In at least one embodiment, component 318 can be from buttress material 336 along the direction perpendicular or transverse to surface 316 Extend.In various embodiments, component 318 can in a manner of frictional fit or pressure cooperation with nail cavity 320 and/or anvil block pit One of engagement, this piece buttress material is releasably held on one of nail bin and anvil block.Similar to above Described, in various embodiments, the nail disposed from nail cavity 320 can apply upward power to buttress material 336, and make component 318 separate with nail cavity 320.In various embodiments, pierceable component 318 and/or buttress material 336 are followed closely, by the support Object material is fixed to tissue, as outlined above.

As shown in Figure 110, a piece of buttress material may include more than one component (i.e. protruding portion) extending therefrom, be used for This piece buttress material is remained into one of nail bin and anvil block.In various embodiments, referring now to Figure 112 and Figure 113, More than one component 318 ' can for example extend from this piece buttress material 336 '.In at least one embodiment, component 318 ' can It is pressure fitted into the nail cavity 320 ' of nail bin 322 ' and/or in the anvil block pit of anvil block (not shown), so that component 318 ' This piece buttress material band is remained to friction in nail bin and/or anvil block, as outlined above.As retouched in further detail herein It states, in addition to the nail cavity of nail bin and the anvil for being used to receive the protruding portion (or holding member) extended from a piece of buttress material of anvil block Outside seat pit, nail bin and/or anvil block can also include slit or hole wherein.

In certain embodiments, more detailed description as follows, support section may include keeping feature structure, the holding feature Structure is configured to gradually discharge tissue thickness compensation part from support section when nail is gradually fired from nail bin.Now Referring to Figure 114, nail bin (such as nail bin 11200) for example may include support section 11210, which includes can quilt It is configured to releasably holding tissue thickness compensation part 11220 (Figure 115) into holding feature structure 11213 thereon. In various embodiments, keep feature structure 11213 that can for example be located in the end of each nail cavity 11212, wherein each guarantor Holding feature structure 11213 may include being defined in guide groove 11216 therein, which is configured to slideably Receive the nail leg 10032 of nail 10030.In such embodiments, both nail leg 10032 and holding feature structure 11213 can be by structures It makes as that can releasably hold tissue thickness compensation part 11220 on support section 11210.

In use, referring now to Figure 115, the staple drivers 10040 being contained in support section 11210 can be by sliding part 10050 drive up as described above.Wherein staple drivers 10040 are configured to contact and keep feature structure 11213, make It keeps feature structure 11213 at least partly to separate with support section 11210, and makes to keep feature structure 11213 outward and remote It is shifted from nail 10030 and nail cavity 11212.Feature structure 11213 is kept to separate with support section 11210 and/or shifting outward When, keep feature structure 11213 that can be no longer able to tissue thickness compensation part 11220 remaining to support section 11210, therefore, Tissue thickness compensation part 11220 can be discharged from support section 11210.Similarly as described above, tissue thickness compensation part 11220 can Such as it when nail 10030 is gradually projected from nail bin towards anvil block (such as anvil block 11260), is gradually discharged from support section 11210.? In various embodiments, such as when the top surface of staple drivers 10040 and the platform surface 11211 of support section 11210 are flat altogether Face or it is at least substantially coplanar when, staple drivers 10040 can with keep feature structure 11213 contact.In such embodiments, Nail 10030 be shaped as they be fully formed or while complete firing configuration and/or before, tissue thickness compensation part 11220 can discharge from support section 11210.

In the embodiment as at least one, referring primarily to Figure 116, driver 10040 can be overdriven, to make 11211 top of platform surface must be pulled to so that nail 10030 is fully formed, and driver 10040 is being overdriven period, It can make to keep feature structure 11213 to disconnect and separate support section 11210.In various embodiments, it referring again to Figure 115, protects Holding feature structure 11213 can extend or dangle on nail cavity and arrive nail cavity before separating or being displaced outwardly from nail cavity 11212 In, so that driver 10040 when reaching exactly to platform surface 11211, can be contacted with feature structure 11213 is kept.? In any case, once tissue thickness compensation part 11220 is discharged from support section 11210, referring now to Figure 116, support portion Divide 11210 can move far from the tissue thickness compensation part 11220 of implantation.

Referring now to Figure 117, the fastener cartridge assembly 6002 being used together with end effector assembly may include warehouse 6050 and it is releasably secured to the tissue thickness compensation part 6058 of warehouse 6050.Similar to warehouse 5650, for example, warehouse 6050 may include that can guide the slit 6056 of percussion component propulsion and/or fastener can be removably retained in warehouse Securing member chamber 6054 in 6050.In various embodiments, warehouse 6050 can be for example including protruding portion 6048, such as column, installation Part, tab and/or ridge.When tissue thickness compensation part 6058 is positioned relative to storehouse platform, protruding portion 6048 can be from warehouse 6050 Storehouse platform extend and enter in tissue thickness compensation part 6058.In various embodiments, warehouse 6050 may include flat from storehouse The multiple protruding portion 6048 that platform extends.Protruding portion 6048 can be for example along the length positioning of warehouse 6050, and can for example be located in phase Between adjacent securing member chamber 6054.

Referring also to Figure 117, in various embodiments, tissue thickness compensation part 6058 can surround tissue thickness compensation part 6058 6048 thermoforming of protruding portion.For example, tissue thickness compensation part 6058 can be positioned relative to the storehouse platform of warehouse 6050.Tissue Thickness compensation part 6058 once positions, so that it may sufficiently high temperature is heated to, so that tissue thickness compensation part 6058 becomes Shape, to conform to the shape of the storehouse platform including 6048 shape of protruding portion extending therefrom.Tissue thickness compensation part 6058 can example It is such as locally heated, and can for example be heated to glass approximate and/or close to the material for constituting tissue thickness compensation part 6058 Change transition temperature.Tissue thickness compensation part can for example be heated to about 90 DEG C to about 120 DEG C.In certain embodiments, tissue is thick Degree compensating part can for example be heated to about 75 DEG C to about 150 DEG C.Once tissue thickness compensation part 6058 has been deformed and has been bonded and surrounded Protruding portion 6048, so that it may remove heat source or mitigate heat supply, and tissue thickness compensation part 6058 can cool down.Can for example it make Tissue thickness compensation part 6058 is subjected to raised temperature about 2 seconds to about 5 seconds, so that it surrounds 6048 fully deformed of protruding portion.? In the case of other, tissue thickness compensation part 6058 can for example be made to be subjected to raised temperature about 1 second to about 10 seconds, so that it is around prominent 6048 fully deformed of portion out.Tissue thickness compensation part 6058 after the cooling period, can for example be punctured into closer to protruding portion 6048 and/or More tightly surround protruding portion 6048.In various embodiments, the tissue thickness compensation part 6058 of thermoforming can be prevented and/or be limited Length of the tissue thickness compensation part 6058 along warehouse 6050 and transverse shift and/or buckling between securing member chamber 6054.

In addition to this or alternatively, tissue thickness compensation part 6058 can surround and be removably positioned in securing member chamber 6054 In fastener at least part thermoforming.For example, tissue thickness compensation part 6058 can extend to above storehouse platform around nail Leg thermoforming.Referring also to Figure 117, in various embodiments, fastener cartridge assembly 6002 may include surrounding warehouse 6050 extremely At least part of lid or shell 6060.Shell 6060 can for example extend around the bottom, side, and/or storehouse platform of warehouse 6050. Shell 6060 for example can be fixed to warehouse 6050 by pin 6062.In addition, in various embodiments, shell 6060 can be for example comprising gold Belong to material, such as 300 series of stainless steel, 400 series of stainless steel, titanium, and/or medical grade aluminium.Metal shell 6060 can for example have Conducive to the heat transmitting in warehouse 6050 and/or protruding portion 6048, to improve thermoforming effect.

Referring now to Figure 118, the fastener cartridge assembly 6102 being used together with end effector assembly may include warehouse 6150 and it is releasably secured to the tissue thickness compensation part 6158 of warehouse 6050.Similar to warehouse 5650, warehouse 6150 can Including the slit 6156 that can for example guide percussion component to promote and, for example, fastener can be removably retained in warehouse Securing member chamber 6154 in 6150.Warehouse 6150 may also include the ridge 6146 (being similar to ridge 5648) extended from storehouse platform 6152. Ridge 6146 can for example extend around at least part of securing member chamber 6154.In various embodiments, when fastener is located in tightly When in firmware chamber 6154, the top of the fastener can be prominent from securing member chamber 6148.In such embodiments, when fastener is urgent When firmware chamber 6154 projects, the top of fastener can be supported at least partly around the ridge 6146 that securing member chamber 6154 positions, The top of guidance fastener and/or.In various embodiments, warehouse 6150 may include at least partly about securing member chamber 6154 Multiple ridges 6146.For example, spine 6146 can prolong at least about the proximal end and/or distal end of each securing member chamber 6154 It stretches.

Referring also to Figure 118, in various embodiments, fastener cartridge assembly 6102 can for example including around warehouse 6150 extremely Few a part positions and is similar to the lid or shell 6160 of shell 6060.Shell 6160 can be for example around the bottom of warehouse 6150 And/or side extends, and for example can be fixed to warehouse 6150 by pin 6162.In various embodiments, shell 6160 can be wrapped for example Include protruding portion 6148, such as column, installation part, tab and/or ridge.Protruding portion 6148 can extend over the storehouse platform of warehouse 6150 6152.In various embodiments, when relative to storehouse platform position tissue thickness compensation part 6158, protruding portion 6148 be may extend into In tissue thickness compensation part 6158.In various embodiments, shell 6160 may include multiple protruding portion 6148 extending therefrom.It is prominent Portion 6148 can be for example along the length positioning of shell 6160 out, and can for example position around the periphery of warehouse 6150.

Similar with tissue thickness compensation part 6058, tissue thickness compensation part 6158 can surround the protruding portion 6148 of shell 6160 Thermoforming.In various embodiments, tissue thickness compensation part 6158 can be wider than shell 6160, so that tissue thickness compensates A part of part 6158 extends beyond the periphery of warehouse 6150.In such embodiments, tissue thickness compensation part 6158 can be such as It is thermally formed to the protruding portion 6148 around the periphery of warehouse 6150.In addition to this or alternatively, tissue thickness compensation part 6158 can Such as the nail leg for being thermally formed to ridge 6146 and/or extending from securing member chamber 6154.In various embodiments, shell 6160 can be such as Comprising metal material, such as 300 series of stainless steel, 400 series of stainless steel, titanium and/or medical grade aluminium, to be conducive to hot transmitting And improve thermoforming effect.

Referring now to Figure 119 and Figure 120, end effector assembly 6200 may include the first jaw or anvil block 6210 and second Jaw 6202.Second jaw 6202 may include warehouse 6250, and be releasably secured to the tissue thickness compensation part of warehouse 6250 6258.Similar to warehouse 5650, warehouse 6250 can be for example including securing member chamber 6254 and capable of being removably positioned in fastener Fastener (such as surgical staples) in chamber 6254.In various embodiments, surgical staples 6290 can position in securing member chamber 6254 On driver 6220.Referring primarily to Figure 119, when driver 6220 is in pre- firing position, following closely 6290 a part can determine Position is in securing member chamber 6254.In various embodiments, nail 6290 may include base portion 6292 and the leg from the extension of base portion 6292 6294a and 6294b.First leg 6294a can for example extend from the first end of base portion 6292, and the second leg 6294b can be such as Extend from the second end of base portion 6292.In various embodiments, when driver 6220 is in pre- firing position and follows closely 6290 When in preformed configuration, following closely 6290 base portion 6292 be can be positioned in securing member chamber 6254, and follow closely 6290 leg 6294a and 6294b can be extended in tissue thickness compensation part 6258 from securing member chamber 6254.

In various embodiments, referring also to Figure 119 and Figure 120, each nail leg 6294a, 6294b can be in base portions 6292 and every It include barb between the top 6299a of a nail leg 6294a, 6294b.Barb can be for example sharp and/or sharp protrusion, all Such as spine.In various embodiments, the line footpath of nail can be for example, about 0.0069 inch, about 0.0079 inch and/or about 0.0089 Inch.The line footpath of barb can be for example, about 0.001 inch.In some cases, barb can for example between about 0.0005 inch and Between about 0.003 inch.In certain embodiments, the first lower barb 6296a can be positioned on the first nail leg 6294a, and Second lower barb 6296b can be positioned on the second nail leg 6294b.Lower barb 6296a, 6296b can be positioned on base portion 6292 With nail leg 6294a, between the top 6299a of 6294b, 6299b.In addition, the first upper barb 6298a can be positioned on the first nail leg On 6294a, and the second upper barb 6298b can be positioned on the second nail leg 6294b.Upper barb 6298a, 6298b can be It is positioned at lower barb 6296a on corresponding nail leg 6294a, 6294b, between 6296b and top 6299a, 6299b.Work as driving When device 6220 is in pre- firing position and follows closely 6290 in preformed configuration, 6290 at least one barb 6296a is followed closely, 6296b, 6298a, 6298b can be positioned in tissue thickness compensation part 6258.In such embodiments, barb 6296a, 6296b, Tissue thickness compensation part 6258 for example can be caught and/or be kept relative to warehouse 6250 by 6298a, 6298b.It is embedded in tissue thickness The barb 6296a, 6296b, 6298a, 6298b of compensating part 6258 for example can prevent and/or limit tissue thickness compensation part 6258 Relative to storehouse platform transverse movement, and/or it can such as prevent tissue thickness compensation part 6258 far from the promotion of storehouse platform.Except this it Outside or alternatively, in various embodiments, barb can be positioned on the top 6299a of nail leg 6294a.6294b, at 6299b.

Referring primarily to Figure 120, when driver 6220 moves to firing position, nail 6290 can be removed from securing member chamber 6254 And/or it projects.In addition, tissue thickness compensation part 6258 and tissue T can be clamped in the anvil block of end effector assembly 6200 Between 6210 and warehouse 6250.Nail shapes pit 6214 in anvil block 6210 can for example make nail 6290 be configured to B shape.In addition, nail 6290 at least one barb 6296a, 6296b, 6298a, 6298b can for example engage the tissue being clamped in nail 6290.Barb 6296a, 6296b, 6298a, 6298b can catch and/or remain trapped in the tissue T in nail 6290.

Referring now to Figure 121 to Figure 124, fastener 6390 can in securing member chamber 6350 by with end effector assembly one The lock driver 6320 (Figure 123 and Figure 124) used is acted to releasably hold.In various embodiments, fastener 6390 can wrap The leg 6394a and 6294b for including base portion 6392 and extending from base portion 6392.First leg 6394a can be for example from the of base portion 6392 One end extends, and the second leg 6394b can for example extend from the second end of base portion 6392.In certain embodiments, lock drives Dynamic device 6320 can releasably hold the base portion 6392 of fastener 6390.In various embodiments, lock driver 6320 can wrap Lock 6340 is included, which releasedly can hook and/or keep base portion 6392.Lock 6340 may be, for example, flexible , and the base portion 6392 that can for example bend with release fasteners 6390.In various embodiments, driver 6320 and/or lock are locked Button 6340 can be for example made of plastics such as polyetherimide, had glass filler or be free of glass filler, so that lock 6340 can sufficiently flexible deformation and/or plastic deformation.

Referring primarily to Figure 123 and Figure 124, the storehouse for being defined in warehouse 6350 can be movably positioned in by locking driver 6320 In securing member chamber 6354 in platform 6352.Lock driver 6320 can move in securing member chamber from latched position (Figure 123) Unlocked position (Figure 124).Sliding part and/or driver in warehouse 6350 can engage lock driver during firing schedule 6320, so that lock driver 6320 moves to unlocked position from latched position.In various embodiments, fastener 6390 can be when lock Lock driver 6320 is fixed to when driver 6320 is in the locked position, and can be when lock driver 6320 moves to unlocked position It is discharged from lock driver 6320.After lock driver 6320 moves to unlocked position from latched position, fastener 6390 can be urgent Firmware chamber 6354 projects.The key 6353 adjacent with securing member chamber 6354 can for example allow fastener 6390 to be released from lock driver 6320 It puts.The antelabium that key 6353 can extend internally for at least part at for example urgent 6354 edge of firmware chamber.In various embodiments, Key 6353 can have cam face 6355.After lock driver 6320 moves to unlocked position from latched position, 6340 are latched Flange 6344 can be adjacent with the cam face 6355 of key 6353.In such embodiments, when lock 6340 is against cam face When 6355 movement, cam face 6355 can make 6340 flexure of lock, so that hook 6342 is by the base portion 6392 of fastener 6390 Release.In various embodiments, hook 6342 can rotate upwards, to discharge base portion 6392.For example, hook 6342 can rotate upwards, from And its opening upwards is made to be directed toward tissue thickness compensation part 6358, and base portion 6392 is made to may pass through the movement of this opening upwards And it is final far from lock driver 6320.

Referring also to Figure 123 and Figure 124, tissue thickness compensation part 6358 can be releasably secured to warehouse 6350 Storehouse platform 6352.When lock driver 6320 is in the locked position (Figure 123), nail leg 6394a and 6394b can be from securing member chambers 6354 extend in tissue thickness compensation part 6358.Nail leg 6394a and 6394b for example can keep tissue relative to storehouse platform 6352 Thickness compensation part 6358, and for example can prevent and/or limit tissue thickness compensation part 6358 and cross occurs relative to storehouse platform 6352 To movement.In addition, (the figure when lock driver 6320 moves to unlocked position and fastener 6390 is projected from securing member chamber 6354 124), lock 6340 can be with the base portion 6392 of release fasteners 6390, so that fastener 6390 can be with lock driver 6320 It is disengaged with warehouse 6350.When the fastener 6390 being removedly positioned in securing member chamber 6354 fastens accordingly from them Part chamber 6354 projects and when being disengaged with warehouse 6350, tissue thickness compensation part 6858 can no longer be fixed to warehouse 6350 and/ Or it is discharged from warehouse 6350.

Referring now to Figure 125 to Figure 129, end effector assembly 6400 may include the first jaw and/or the (figure of anvil block 6410 127 to Figure 129) and the second jaw 6402.Second jaw 6402 may include fastener warehouse 6450 and releasedly consolidate Determine to the second jaw 6402 and/or the tissue thickness compensation part 6458 of tissue thickness compensation part 6458.In certain embodiments, tightly Firmware warehouse 6450 and the tissue thickness compensation part 6458 for being releasably secured to warehouse 6450 can for example constitute fastener cartridge group Part.In various embodiments, warehouse 6450 may include storehouse platform 6452 and extend through at least part of narrow of warehouse 6450 Slot 6456.Chamber can be limited in storehouse platform 6452, and be entered in warehouse 6450.It is put down for example, securing member chamber 6454 can be limited to storehouse In platform 6452, and (Figure 126 A to Figure 129) of fastener 6490 can be received wherein.Fastener 6490 can be removably positioned in In securing member chamber 6454.For example, single fastener 6490 can be removably positioned in each securing member chamber 6454, and can be It is projected during firing schedule from securing member chamber 6454.In addition, lock chamber 6448 can be defined in storehouse platform 6452, and can connect wherein Receive lock 6440.For example, individually lock 6440 can be movably positioned in each lock chamber 6448, and can during firing schedule from Latched position (Figure 127 and Figure 128) moves to unlocked position (Figure 129).

Referring primarily to Figure 126, lock 6440 may include base portion 6444 and hook 6442, which can be movable relative to base portion 6444 Ground positioning.For example, hook 6442 can move in the hole that at least part for passing through base portion 6444 is formed.Hook 6442 can for example connect Receive and/or keep connector 6480.Hook 6442 can be for example by liquid crystal polymer (LCP), nylon, polyetherimide, polycarbonate And/or ABS is constituted.Connector 6480 may be, for example, suture.In certain embodiments, connector can be for example by PDS, PGA/ PCL, PLLA/PCL, TMC/PCL, PGA and/or PCL are constituted.In various embodiments, hook 6442 is being embedded or partially embedded in base After in portion 6444, connector 6480 is can be constrained in hook 6442.Connector 6480 can for example be maintained at hook 6442 and base portion 6444 Between.When hook 6442 is subsequently lifted or when by part lift-off base portion 6444, connector 6480 can be for example no longer by 6442 beam of hook It ties up, and can for example move to be disengaged with lock 6440.In various embodiments, when hook 6442 is by least partly lift-off base portion After 6444, connector 6480 with lock 6440 slidably to be disengaged.

Referring primarily to Figure 126 A, connector 6480 can extend from tissue thickness compensation part 6458.Tissue thickness compensation part 6458 can for example with 6480 frictional fit of connector, and/or with connector 6480 together thermoforming.In various embodiments, when When lock 6440 is in the unlocked position, connector 6480 can be passed through to the hook 6442 of lock 6440.Connector 6480 is being passed through into hook When 6442, tissue thickness compensation part 6458 can move to appropriate location relative to warehouse 6450.For example, tissue thickness compensation part 6458 can be positioned in the storehouse platform 6452 of warehouse 6450.Referring primarily to Figure 127, once tissue thickness compensation part 6458 relative to Warehouse 6450 positions, and lock 6440 can move to latched position from unlocked position.For example, lock 6440 hook 6442 is embeddable or portion Divide insertion base portion 6444, so that lock 6440 surrounds connector 6480 and/or constraint connector 6480.In various embodiments In, lock 6440 and/or driver 6420 can be for example including springs, which can be biased to unlocked position for lock 6440.Work as lock 6440 when being in the locked position, and tissue thickness compensation part 6458 for example can be fixed to warehouse by the engagement of connector and lock 6450。

Referring primarily to Figure 128 and Figure 129, key can be moved during firing schedule along at least part of warehouse 6450. The key may be, for example, sliding part 6434 and/or the element for firing component.In various embodiments, sliding part 6434 can go in percussion It is engaged during journey with the driver in the chamber in warehouse 6450.Sliding part 6434 can by driver towards storehouse platform 6452 and/or It is pushed towards tissue thickness compensation part 6458, fastener is projected from securing member chamber 6454 and/or makes lock 6440 from locking bit It sets and moves to unlocked position.Referring primarily to Figure 128, sliding part 6434 can during firing schedule with the driver in lock chamber 6448 6420 engagements.Sliding part 6434 can be such that driver 6420 transports towards storehouse platform 6452 and/or towards tissue thickness compensation part 6458 It is dynamic.In addition, driver 6420 can make lock 6440 move to unlocked position from latched position referring primarily to Figure 129.For example, driving Hook 6442 can be released base portion 6444 by device 6420.When hook 6442 is subsequently lifted base portion 6444, connector can no longer be locked 6440 constraints.In such embodiments, tissue thickness compensation part 6458 can for example be not affixed to warehouse 6450 and/or from warehouse 6450 releases.

Referring now to Figure 67, tissue thickness compensation part 17050 for example may include first part 17052 and opposite first The second part 17054 that part 17052 extends.Tissue thickness compensation part 17050 may make up the part of nail bin groupware.In some feelings Under condition, the warehouse that tissue thickness compensation part 17050 can be attached on nail bin groupware.It in some cases, can be by tissue thickness Compensating part 17050 is assembled into the anvil block of surgery suturing appliance.Under any circumstance, first of tissue thickness compensation part 17050 It can be compressible for dividing 17052.In use, first part 17052 can be trapped in out of, nail bin projects nail, and can be to The tissue being trapped in nail applies compressing force.The second part 17054 of tissue thickness compensation part 17050 can extend across first Part 17052, wherein second part 17054 may include the proximal end 17053 and distal end extended from first part 17052 17055.More detailed description as follows, second part 17054 can be flexible not as good as first part 17052, and/or compares first part 17052 is more rigid.Referring now to Figure 68, nail bin groupware 17000 may include warehouse 17010, and the warehouse is therein including being defined in Multiple nail cavities and the multiple nails being stored at least partly in nail cavity.As shown in Figure 68, tissue thickness compensation part 17050 is mountable To warehouse 17010.

Nail bin groupware 17000 may include nearside installation part 17060 and distal side installation part 17070, the nearside installation part 17060 The proximal end 17053 of second part 17054 can be releasably held warehouse 17010,17070 energy of distal side installation part It is enough that the distal end 17055 of second part 17054 is releasably held into second part 17054.Nearside installation part 17060 can Including single component or more than one component.As shown in Figure 68, nearside installation part 17060 may include the first installation part part 17060a and the second installation part part 17060b, these installation part parts can at least partly capture second part 17054 simultaneously Second part 17054 is kept against warehouse 17010.Turning now to Figure 69, each installation part part 17060a and 17060b can Including key 17062, which can releasably be fixed on the keyway 17012 being defined in warehouse 17010 It is interior.The size of each key 17062 and each keyway 17012 can be configured to can to allow the side wall of keyway 17012 to key 17062 Apply retentivity, thus removal of the resisting bond 17062 from keyway 17012.In all cases, key 17062 can be releasedly Pressure cooperation and/or snap fit are in keyway 17012.In at least one situation, key 17062 can be for example including widened End 17063, the end can be releasedly clamped between the side wall of keyway 17012.As shown in Figure 68 and Figure 69, each Installation part part 17060a and 17060b may include window 17064, which can at least partly receive second part 17054 Proximal end 17053.In such cases, the side wall of window 17064 can engage tissue thickness compensation part 17030, and will Tissue thickness compensation part 17030 presses to the platform 17014 of warehouse 17010.In addition, at least part of second part 17054 can It is accommodated in installation part part 17060a and 17060b.

Similarly as described above referring again to Figure 68 and Figure 69, distal side installation part 17070 may include window 17074, the window The size of mouth 17074 can be configured to and can receive at least part of the distal end 17055 of second part 17054.Together Sample is similarly as described above, and the side wall of window 17074 can engage tissue thickness compensation part 17030, and tissue thickness is compensated Part 17030 presses to the platform 17014 of warehouse 17010.In addition, at least part of second part 17054 can be accommodated in installation In part part 17070.Distal side installation part part 17070 may include one or more pin 17072 extending therefrom, which can be with Releasable mode is fixed in the one or more pin holes 17011 being defined in warehouse 17010.Each pin 17070 and each The size of pin hole 17011 can all be configured to and the side wall of pin hole 17011 is enabled to apply retentivity to pin 17072, thus Resist removal of the pin 17072 from pin hole 17011.In all cases, each pin 17072 can releasedly pressure cooperation and/ Or snap fit is in pin hole 17011.

Nail bin 17000 is assembled, it, can be first by tissue thickness compensation part 17030 against warehouse at least one situation 17010 platform 17014 positions, and nearside installation part 17060 and distal side installation part 17070 can be assembled into warehouse 17010. Nearside installation part 17060 and distal side installation part 17070 be assembled into warehouse 17010, to catch as described above against warehouse 17010 Obtain or trap tissue thickness compensation part 17050.Nearside installation part 17060 and distal side installation part 17070 can be caught also as described above It wins the second place the end of part 17074, and the end is releasably held on warehouse 17010.In some cases, nearside is pacified Piece installing 17060 and/or distal side installation part 17070 are configured at least part of first part 17052 being trapped in Wherein.Although the tissue thickness compensation part 17050 that Figure 67 to Figure 69 describes only includes two parts, it can also be envisaged that tissue thickness Compensating part includes the various alternate forms of more than two part.For example, tissue thickness compensation part may include compressible first Divide 17052 and extends through second parts 17054 of two or more rigidity therein.In addition, for example, tissue thickness Compensating part may include can with two or more of any suitable arrangement (being such as arranged to two or more layers) Compression section.

Once the assembling of nail bin 17000 finishes, so that it may be assembled into surgical stapling device.It, can benefit at least one situation Nail bin 17000 is removedly kept with the channel in the end effector for being limited to surgical stapling device, then again by nail bin 17000 Operative site inserted into the patient.When nail bin 17000 is inserted into operative site and/or is manipulated in operative site, Nearside installation part 17060 and/or distal side installation part 17070 are configured to remain to tissue thickness compensation part 17050 On warehouse 17010.The second part 17054 of tissue thickness compensation part 17050 can make tissue thickness compensation part 17050 enough just Property so that tissue thickness compensation part 17050 does not become to separate from warehouse 17010, until nearside installation part 17060 and/or One or more of distal side installation part 17070 is cut open and/or separates from warehouse 17010, more detailed description as follows.Due to Second part 17054 is rigid, so in all cases, predominantly or exclusively to the of tissue thickness compensation part 17050 The attribute of a part 17052 makes a choice, so that tissue thickness compensation part 17050 has desired tissue compensation characteristic.Make In, the second part 17054 of tissue thickness compensation part 17050 can be resisted between proximal end 17053 and distal end 17055 Relative motion resist proximal end 17053 and in all cases and distal end 17055 move towards each other.

In all cases, once nail bin 17000 has been properly positioned, so that it may firing member 17030 be promoted to pass through Nail bin 17000, to dispose the nail being removably positioned in nail bin 17000.Nail bin 17000 may include movable member 17034, The movable member 17034 can distal end portion by firing member 17030 from the proximal end of nail bin 17000 towards nail bin 17000 Portion promotes.As to supplement above, movable member 17034 be configured to non-firing position and firing position it Between the nail being removedly stored in warehouse 17010 is lifted.Firing member 17030 can also be for example including cut portion (such as Knife 17032), which is configured to when firing member 17030 is advanced through nail bin 17000 towards distal side, will The tissue cross being just sewn.Knife 17032 can also be configured to that nail bin can be advanced through towards distal side in firing member 17030 It is when 17000, tissue thickness compensation part 17050 is crosscutting.Referring primarily to Figure 67 and Figure 68, the proximal end of second part 17054 17053 can be cut off by knife 17032.In the embodiment as at least one, tissue thickness compensation part 17050 can be along at least partly Ground is at least partly cut off by the longitudinal axis that the recess 17057 being defined in second part 17054 limits, or is cut completely It is disconnected.As shown in Figure 68, recess 17057 can be aligned or at least basic with the longitudinal knife slot 17015 for extending through warehouse 17010 Upper alignment.Once knife 17032 is at least partly crosscutting by the proximal end 17053 of second part 17054, second part 17054 It proximally installation part 17060a, 17060b can at least partly discharge, or release.In such cases, tissue thickness compensates Part 17050 can become to separate with warehouse 17010.For example, firing member 17030 at least partly can be promoted or be fully advanced Across nail bin 17000, by at least partially or fully implanting tissue of tissue thickness compensation part 17050, and due to tissue thickness By at least partly crosscutting, tissue thickness compensation part 17050 can be sufficiently flexible for compensating part 17050, especially second part 17054 To skid off nearside installation part part 17060a, 17060b and distal side installation part 17070.In use, in all cases, exist Firing member 17030 at least partly percussion and tissue thickness compensation part 17050 at least partly be implanted into after, firing member 17030 can retract to its nearside or starting position, and middle warehouse 17010 can then be pulled away from the tissue thickness compensation part of implantation 17050.For example, if warehouse 17010 is pulled away from tissue thickness compensation part 17050 by axis along longitudinal direction, such as by least portion Divide crosscutting tissue thickness compensation part 17050 can buckling, and the proximal end of the tissue thickness compensation part 17050 It can be moved towards one another with distal end.

Referring now to Figure 70 to Figure 72, tissue thickness compensation part 17150 may include compressible portion 17152 and extend Across compressible portion 17152 and/or from compressible portion 17152 extend installation part part 17154.Compressible portion 17152 may include proximal end 17153, and the thickness of the proximal end 17153 is smaller than the main body of tissue thickness compensation part 17150 The thickness of part 17156.In the embodiment as at least one, proximal end 17153 can be for example including tapered portion.Again Referring to Figure 70 to Figure 72, nail bin groupware (such as nail bin 17100) for example may include nearside installation part 17160, the nearside installation part 17160 are configured to that the installation part part 17154 of tissue thickness compensation part 17150 is releasably fixed to storehouse Body 17010.Nearside installation part 17160 may include one or more locks 17162 extending therefrom, these locks 17162 can be received In the one or more keyholes 10112 being defined in warehouse 17110.In the embodiment as at least one, Mei Gesuo 17162 may include leg and the foot from leg extension, and wherein leg is configured to lateral when lock 17162 is inserted into keyhole 17112 Flexure then springs back or at least substantially recoils to its non-flexure configuration, so that foot can be releasably engaged keyhole 17112 side walls move to keyhole side wall rear.Similarly as described above, nearside installation part 17160 may also include chamber 17164, The chamber 17164 is configured to receive the nearside installation part part 17154 of tissue thickness compensation part 17150.Chamber 17164 can quilt It is configured to pressing to nearside installation part part 17154 into the platform of warehouse 17110, and by tissue thickness compensation part 17150 Proximal end is held in place.In all cases, firing member such as firing member 17030 is for example configured to It is enough to be promoted in firing member 17030 to cut the when incision nearside installation part 17160 of tissue thickness compensation part 17150.At least Under such circumstances, incision nearside installation part 17160 can discharge tissue thickness compensation part 17150 from warehouse 17110 one kind.Again The secondary embodiment described referring to Figure 68, for example, firing member 17030 is configured to across being defined in nearside installation part portion Divide the slit between 17060a and 17060b, and at least some cases, nearside installation part part 17060a can be passed through, 17060b is without cutting wherein.

Referring now to Figure 73 to Figure 76, as to supplement above, for tissue thickness compensation part to be releasably held Nearside installation part to warehouse may include first part 17260a and second part 17260b, first part 17260a and second Part 17260b can limit longitudinal gap i.e. slit 17267 after being assembled into warehouse, the gap of the longitudinal direction or slit 17267 Size can be configured to that firing member 17030 can allow for pass through between first part 17260a and second part 17260b.Class It is similar to described above, each of first part 17260a and second part 17260b may comprise chamber 17264, the chamber 17264 are configured at least partly receive tissue thickness compensation part and hold it in appropriate location.It is also similarly to Described above, each of first part 17260a and second part 17260b may comprise lock 17262 extending therefrom, should Lock 17262 is configured to engage with warehouse.

As described above, nail bin groupware may include the installation part of nearside or the installation part or attachment of attachment part and distal side Point, wherein the installation part of nearside or attachment part are configured to the proximal end of tissue thickness compensation part remaining to warehouse Proximal end on, and the installation part in distal side or attachment part are configured to the distal end of tissue thickness compensation part It remains in the distal end of warehouse.In some other embodiments, nail bin groupware may be only at least one nearside installation part Or at least one distal side installation part, for tissue thickness compensation part to be remained to warehouse.Turning now to Figure 147, storehouse component 17300 may include warehouse 17310 and tissue thickness compensation part 17350, and wherein the distal end of tissue thickness compensation part 17350 can Including being configured to be releasably attached to the distal end 17355 of warehouse 17310.The embodiment as at least one In, the distal end of warehouse 17310 may include lockhole 17011, which is configured to receive at least one distal side Installation part is simultaneously attached to warehouse 17310.Not in addition reader will be appreciated that, at least for the embodiment, storehouse component 17300 Including the nearside installation part for the proximal end of tissue thickness compensation part 17350 to be installed to warehouse 17310.In various situations Under, distal end 17355 can be integrally formed with the main part 17356 of tissue thickness compensation part 17350, or alternatively, can be attached It is connected to the main part 17356.

In various embodiments, referring now to Figure 156 and Figure 157, nail bin groupware such as nail bin 10400 for example may include storehouse Body 10410, the warehouse include being configured to releasably hold tissue thickness compensation part 10450 to arrive appropriate location Distal end or nose 10419.Similarly as described above, tissue thickness compensation part 10450 may include being installed to second part 10454 first part 10452, wherein second part 10454 may include being configured to releasedly be protected by nose 10419 The distal end 10455 held.In all cases, the nose 10419 of warehouse 10410 and platform 10414 can limit between them A fixed slit 10418, the slit 10418 are configured to receive distal end 10455.Nose 10419 can be by elastic material Constitute, the size of the elastic material can be configured to and be configured to allow the biasing of nose 10419 with distal end 10455 engagements.In use, referring to Figure 157, after tissue thickness compensation part 10450 is at least partly implanted into, warehouse 10410 far from tissue thickness compensation part 10450 when moving, and nose 10419 can be to be sufficiently flexible, to allow tissue thickness to compensate Part 10450 skids off below nose 10419.Turning now to Figure 158, as to supplement above, first layer 10452 can be by that can press Contracting foam is constituted, and may be mounted to the second layer 10454.In all cases, using one or more adhesives by first layer 10452 are installed to the second layer 10454.First layer 10452 is installed to the second layer 10454, so that 10455 He of distal end The recess 10457 being defined in distal end 10455 is still exposed.In addition, first layer 10452 is installed to the second layer 10454, So that first layer 10452 is laterally centered relative to the vertical central axis 10459 limited by the second layer 10454.

As described above, nail bin groupware may include at least partly being stored in movable firing member therein, this can be transported Dynamic firing member is configured between non-firing position and firing position lift the nail being stored in nail bin groupware It rises.Turning now to Figure 159 and Figure 160, nail bin groupware 10500 may include warehouse 10510, tissue thickness compensation part 10550 and The movable firing member or sliding part 10034 being slideably stored therein.Sliding part 10034 may include limiting thereon One or more slopes 10035, which is configured to that not hitting from them will be followed closely in use Hair position is lifted up firing position.Before use, sliding part 10034 can be releasably locked at appropriate location.Extremely In few such embodiment, before sliding part 10034 is promoted towards distal side, tissue thickness compensation part 10550 can be by cunning Moving part 10034 is releasably held in proximal position, will follow closely and tissue thickness's compensation is projected and cut from nail bin groupware 10500 Part 10550.Tissue thickness compensation part 10550 may include one or more tab or positioner 10557 extending therefrom, this is prominent Piece or positioner 10557 can be releasably engaged sliding part 10034.For example, sliding part 10034 may include one or more Groove 10037, positioner 10557 can be positioned in the groove 10037, until sliding part 10034 is applied sufficiently large power So that sliding part 10034 overcomes the retentivity applied from positioner 10557 to it.In use, positioner 10557 can It is configured to for sliding part 10034 being held in place, the longitudinal direction until being applied to sliding part 10034 towards distal direction Until percussion force has been more than threshold force, wherein sliding part 10034 can be slided towards distal side when percussion force is more than threshold force, and Positioner 10557 sufficiently can be bent or be deformed so that sliding part 10034 can slide whereby.In at least one embodiment, Positioner 10557 can be positioned on the nail cavity nearside being defined in warehouse 10510 and/or be located in and is stored in warehouse 10510 Nail nearside so that sliding part 10034 can be releasably retained nail nearside non-firing position.Sliding part 10034 towards distal side once promote, and sliding part 10034 can be promoted towards nail.

As to supplement above, referring again to Figure 159 and Figure 160, warehouse 10510 may include that one or more holdings are narrow Slot 10517, these keep slit 10517 to be configured to receive at least part of positioner 10557.More specifically Ground at least in the illustrated embodiment when sliding part 10034 is in the non-firing position of its nearside, is defined in warehouse 10,510 1 The holding slit 10517 of side can be aligned with the groove 10037 for being defined in 10034 respective side of sliding part, so that positioner 10557 can synchronize and be located in the holding slit 10517 and groove 10037 of alignment.In the embodiment as at least one, limit Side wall due to the holding slit 10517 in warehouse 10510 can support positioner 10557, and at least inhibit positioner 10557 separate with groove 10037 too early.As described above, sliding part 10034 can be promoted towards distal side, make groove 10037 no longer with spine Pawl 10557 is aligned；However, at least in the illustrated embodiment, after sliding part 10034 at least partly promotes, pawl 10557 still can be aligned and/or be positioned in slit 10517 with slit 10517 is kept.Referring primarily to Figure 159, including detent Device 10557, slider groove 10037 and storehouse keep the first arrangement of slit 10517 that can be disposed in the of sliding part 10034 Side, including the second positioner 10557, and the second slider groove 10037 and the second storehouse keep the second of slit 10517 Arrangement can be disposed in second side or the opposite side of sliding part 10034.

The some embodiments of nail bin can for example including be located at nail platform on flexible layer (such as tissue thickness compensation part and/ Or buttress material), wherein can be arranged to make the top of non-percussion nail to extend in the layer nail.In certain other embodiments In, flexible layer may make up compressible and/or squeezable nail bin, which can plant patient's body, and in being trapped in nail When deform and/or compression.If surgeon, nurse, technician or other users (one or more users) unintentionally will In the flexible layer or implantable nail bin, the flexible layer and/or implantable nail bin can also examples for thumb or the pressing of other finger As deformed and/or compressing.Such deformation and/or compression prevent nail bin from using again.

Retainer is usually assembled in nail bin, this can help user that successfully nail bin is loaded into surgical stapling device. The retainer can also cover nail platform and any flexible layer, thus avoid user from compressing unintentionally, squeeze the flexible layer and/ Or deform the flexible layer.However, user is not fully attached to the end effector of surgical stapling device in nail bin sometimes In before, prematurely nail bin retainer is removed.In the case where removing nail bin retainer too early, the flexible layer person of being likely to be used Damage.

Figure 164 to Figure 167 shows the embodiment attached to the retainer 10000 of nail bin 10010.Referring to Figure 166 and Figure 167, nail bin 10010 may include be arranged in its storehouse platform 10011 flexible layer 10020 (such as tissue thickness compensation part and/ Or buttress material).As shown in Figure 167, nail 10030 can extend in exposed flexible layer 10020 from nail bin 10010.If Retainer 10000 is removed too early, and user can press unintentionally flexible layer 10020, while the push-in of nail bin 10010 end being held In the staple cartridge channel of row device, so that layer 10020 be compressed and/or deform layer 10020.

Figure 168 to Figure 173 shows the embodiment of retainer 2600, which can be locked on nail bin 2650, And it can not unlock and remove from nail bin 2650, until nail bin 2650 is fully inserted into the staple cartridge channel 2670 of end effector In.If Figure 168 is clearly shown that, the proximal end part 2604 of retainer 2600 may include movable cam portion 2616, These movable cam portions 2616 have lock tabs 2626 extending therefrom.Lock tabs 2626 extend to nail bin 2650 In slit 2652 (such as cutter slit), and engaged with slit 2652.Lock tabs 2626 are bonded in slit 2652, by retainer 2600 and nail bin 2650 be releasably held together.More detailed description as follows, in the cam portion 2616 of retainer 2616 With the keyed engagement in staple cartridge channel 2670, cause cam portion 2616 inward towards after flex relative to each other, lock tabs are only from slit 2652 are disengaged, so that retainer 2600 can be discharged and be removed from nail bin 2650.In addition, in various embodiments, such as Fruit nail bin 2650 is correctly rested upon in staple cartridge channel 2670, and cam portion 2616 can be only engaged by the keys.

As described above, in certain embodiments, the proximal end part 2604 of retainer 2600 may include cam portion 2616, each cam portion 2616 is attached in the main body 2606 of retainer 2600 by neck 2624.Cam portion 2616 can It is separated from each other by gap 2622.Cam portion 2616 can be along the side of arrow I (showing in Figure 172) when by inside compressing force To inside flexure, in addition, can also be along the direction of arrow O (being shown in Figure 170) around the flexiblely flexure outward of neck 2624.Lock Determining tab 2626 can extend from each cam portion 2618.More detailed description as follows, when lock tabs 2626 are arranged in nail bin It when on 2650, may extend into the slit 2652 (such as cutter slit) of nail bin 2650, and be releasably engaged with the slit 2652. Referring primarily to Figure 170 and Figure 171, cam portion can be biased in outside deflected position, so that extending from lock tabs 2626 Antelabium 2628 can be engaged with the ridge 2654 in the slit 2652 of nail bin 2650.Cam portion 2616 is being offset to flexure position outward When setting, the antelabium 2628 of lock tabs 2626 can be pushed to engage with the ridge 2654 in slit 2652, so that not depositing In the inside compressing force of the key from staple cartridge channel 2670, retainer 2600 is locked on nail bin 2650.

Referring primarily to Figure 170 to Figure 173, in various embodiments, the key of staple cartridge channel 2670 may include staple cartridge channel 2670 inner wall, which is inwardly compressed power to what the offer of cam portion 2616 was incremented by, so that cam portion 2616 can When retainer 2600 and nail bin 2650 are inserted into staple cartridge channel 2670, the direction along arrow I (showing in Figure 172) is inwardly scratched It is bent.For example, staple cartridge channel 2670 may include the first inner wall 2672 for limiting the first width, which is suitable in outside The cam portion 2616 of the offset position of flexure.Staple cartridge channel 2670 may include the second inner wall 2676 for limiting the second width, should Second width is suitable for the cam portion 2616 in the inside deflected position as shown in Figure 172.Staple cartridge channel 2670 can Including the intermediate inner wall 2674 being located among the first inner wall 2672 and the second inner wall 2676, which can be from first Width is transitioned into the second width.In use, nail bin 2650 and retainer 2600 are along the nearside side relative to staple cartridge channel 2670 It moves to and towards staple cartridge channel, to be inserted into staple cartridge channel 2670, such as the arrow P instruction in Figure 170 and Figure 172.It is main It will be referring to Figure 170 and Figure 171, when nail bin 2650 and retainer 2600 are moved towards staple cartridge channel 2670, cam portion 2616 Rounding end 2620 and exterior surface 2618 can be engaged with the first wall 2672 of staple cartridge channel 2670.As described above, certain In embodiment, the width that the first wall 2672 limits is suitable for the cam portion 2616 in the offset position bent outward.Each In kind other embodiments, the width that the first wall 2672 limits is suitable for the cam portion 2616 in inward portion deflected position, Wherein the amount of inward portion flexure is enough to make the antelabium 2628 of lock tabs 2626 not to be disengaged from the ridge 2654 of nail bin 2650, And unlock retainer 2600 from nail bin 2650.Referring now to Figure 172 and Figure 173, continue in nail bin 2650 and retainer 2600 When proximally being moved towards staple cartridge channel 2670 along the direction of arrow P, rounding end 2620 and exterior surface 2618 and midfeather 2674 engagements, then engage with the second wall 2676.Midfeather 2674 and the second wall 2676 can provide incremental power, make cam portion 2616 gradually inwardly flexures.Finally, cam portion 2616 will inwardly bend a certain amount, so that the lip of lock tabs 2626 Edge 2628 can be disengaged from the ridge 2654 in the slit 2652 of nail bin 2650.Once lock tabs 2626 are detached from from ridge 2654 Engagement, retainer 2600 is just unlocked from nail bin 2650, so that retainer 2600 can be removed from nail bin 2650.In various implementations In example, cam portion 2616 is inwardly bent, and makes lock tabs 2626 only when nail bin 2650 is fully inserted into staple cartridge channel 2670 Just it is disengaged from ridge 2654.

In certain embodiments, lockable retainer (retainer 2600 such as described above in association with Figure 168 to Figure 173) Also the nail bin of specific dimensions can be prevented to be inserted into the end effector for being intended to be used together from the nail bin of different specific dimensions.Example Such as, nail bin 2650 may include reference surface 2632, which can connect with the reference surface 2674 of staple cartridge channel 2670 It closes.The first predetermined distance from the reference surface 2632 of nail bin 2650 to cam portion 2616 can correspond to staple cartridge channel Second between 2670 reference surface 2674 and the wall 2672,2674 and 2676 including key of staple cartridge channel 2670 predefines Distance.The retainers of specific dimensions, nail bin and be intended to be used together with specific dimensions nail bin the first of staple cartridge channel in advance really It is first pre- to may differ from the different retainer of other size, nail bin and staple cartridge channel for set a distance and the second predetermined distance First determine distance and the second predetermined distance.In other words, the first of the nail bin, retainer and staple cartridge channel of every kind of size is pre- First determine that distance and the second predetermined distance may be different from the first pre- of the nail bins of other sizes, retainer and staple cartridge channel First determine distance and the second predetermined distance.Therefore, attempt nail bin and retainer are inserted into off size staple cartridge channel can It is logical that the reference surface of the wall and/or nail bin that can cause the cam portion of retainer that can not engage staple cartridge channel can not engage nail bin The reference surface in road.For example, nail bin 2650 can be arranged to retainer 2600 when being inserted into the staple cartridge channel that size is consistent, It engage cam portion 2616 can only with the second wall 2676 of staple cartridge channel 2670, so that working as reference surface 2632 and 2674 When being engaged with each other, lock tabs 2626 are disengaged from the slit 2652 in nail bin 2650.For example, if nail bin 2650 and holding Device 2600 is too short with respect to staple cartridge channel 2670, then, cam portion 2616 may not reach the second wall 2676, so that working as When reference surface 2632 and 2674 engages, lock tabs 2626 are disengaged from the slit 2552 in nail bin 2650.Therefore, it keeps Device 2600 will not unlock, and can not remove from nail bin 2650.On the contrary, for example, if 2600 phase of nail bin 2650 and retainer It is too long to staple cartridge channel 2670, then, the cam portion 2616 engaged with the second wall 2676 of staple cartridge channel 2670 can hamper respectively The reference surface 2632 of nail bin 2650 is hindered to engage with the reference surface 2674 of staple cartridge channel 2670.Therefore, nail bin 2650 cannot It is rested upon in staple cartridge channel 2670 completely.

Retainer 2600 not only includes the lock tabs 2626 extended from cam portion 2616, may also include and is arranged in holding A pair of of nearside tab 2612 near the proximal end 2602 of device 2600, and it is arranged in the distal end 2604 of retainer 2600 Neighbouring a pair of of distal side tab 2610.Nearside tab 2608 and distal side tab 2610 can extend from main body 2606, and can be with nail Storehouse 2650 engages and releasably holds nail bin 2650.In certain embodiments, nearside tab 2612 and distal side tab 2610 It can be engaged with nail bin 2650 and keep nail bin 2650, until nail bin 2650 is rested upon completely in staple cartridge channel 2670.In other words It says, nearside tab 2612 and/or distal side tab 2610 may act as another lock, which prevents retainer 2600 complete in nail bin 2650 It is removed before being rested upon in staple cartridge channel 2670 entirely from nail bin 2650.

Referring primarily to Figure 168, each nearside tab 2612 may include proximal lip 2614, and each distal side tab 2610 It may include distal lip 2610.Each proximal lip 2614 may include inward-facing angled surface 2615, and each distal side Antelabium 2610 may include inward-facing angled surface 2611.Proximal lip 2614 and the engageable nail bin 2650 of distal lip 2610 Cross side, and releasably hold the cross side of nail bin 2650.Nail bin 2650 and retainer 2600 are being inserted into staple cartridge channel When in 2670, inward-facing angled surface 2611 and 2615 can be engaged with the edge 2672 and 2678 of staple cartridge channel 2670.Nail The edge 2672 and 2678 of warehouse channel 2670 can be such that nearside tab 2612 and/or distal side tab 2610 bends outward, so that Proximal lip 2614 and distal lip 2610 are disengaged from the cross side of nail bin 2650.When proximal lip 2614 and distal lip 2610 from the cross side of nail bin 2650 when being disengaged, and releasable retainer 2600 simultaneously removes it from nail bin 2650.

Referring to Figure 174 to Figure 180, for example, the end effector 12 of surgical instruments can receive end effector insert 28010.In various embodiments, end effector insert 28010 may include compensating part main body 28012 and at least one fixture 28014a,28014b.In various embodiments, end effector insert 28010 can be for example including positioned at compensating part main body Nearside fixture 28014b at 28012 proximal end and the distal side at the distal end of compensating part main body 28012 Fixture 28014a.It, can be fixed at or near the distal end of anvil block 25060 by distally fixture 28014a referring primarily to Figure 177 To the anvil block 25060 of end effector 12.For example, distally fixture 28014a can be basic with the longitudinal slit 25062 of anvil block 25060 It is upper to be aligned and/or partially be located in the longitudinal slit 25062 of anvil block 25060.It, can be by nearside fixture referring primarily to Figure 178 28014b is fixed to the nail bin 25000 (Figure 179) in the lower jaw 25070 of end effector 12.It can be by nearside fixture 28014b Nail bin 25000 is fixed at or near the proximal end of nail bin 25000.For example, nearside fixture 28014b can be with nail bin 25000 In 25004 substantial alignment of longitudinal slit and/or can be positioned in the longitudinal slit 25004 in nail bin 25000.

Referring now to Figure 179 and Figure 180, the end that end effector insert 28010 can be inserted into surgical instruments is executed In device 12.In various embodiments, end effector insert 28010 at least part (such as compensating part main body 28012, Distally fixture 28014a and/or nearside fixture 28014b) it may be, for example, deformable and/or flexible.It is executed when by end When device insertion piece 28010 is inserted into end effector 12, distally fixture 28014a and/or nearside fixture 28014b are flexible or scratch It is bent.Once fixture 28014a and 28014b are bent, for example, fixture 28014a and 28014b can for example have return, it is initial unchanged The trend of shape configuration, and producible screen resilience or restoring force.In various embodiments, when end effector insert 28010 When being positioned in end effector 12, end effector insert 28010 can apply spring-load to end effector 12.? In some embodiments, end effector insert 28010 can be it is solid or substantially solid so that operator exists When end effector insert 28010 and nail bin 25000 are inserted into end effector 12, insertion piece 28010 can be firmly grasped.

In some embodiments, after the cutting of end effector 12 and/or tightening operation, end effector insert 28010 can remove from end effector 12.In other embodiments, end effector insert 28010 can cut and/or hit It is remained positioned in end effector 12 during hair operation.For example, being hit in the nail cavity 25002 (Figure 178) followed closely from nail bin 25000 It, can be by 25052 crosscut end actuator insertion piece 28010 of cutting element when hair.In various embodiments, end effector is inserted into Part 28010 may include the tissue thickness compensating material similar at least one of tissue thickness compensation part described herein.For example, End effector insert 28010 may include polymer composition, such as bioabsorbable biocompatible elastomers polymerization Object.End effector insert 28010 also may include bioabsorbable polymer, such as lyophilized polysaccharide, glycoprotein, elasticity Albumen, proteoglycans, gelatin, collagen and/or oxidized regenerated cellulose (ORC).In some embodiments, end effector is inserted Entering part 28010 may include at least one therapeutic agent, such as pharmaceutically active agents or drug.

Referring also to Figure 174 to Figure 180, end effector insert 28010 can be releasably attached to end effector On 12 and/or on the anvil block 25060 of end effector 12 and/or on nail bin 25000.Nearside fixture 28014b can be for example with can The mode of release is fixed to nail bin 25000 (Figure 178), and distally fixture 28014a for example can be fixed releasably To anvil block 25060 (Figure 177).In various embodiments, nearside fixture 28014b can be aligned with the slit 25004 of nail bin 25000 And/or it is positively retained in the slit 25004.In addition, in certain embodiments, distally fixture 28014a can be with anvil block 25060 Slit 25062 is aligned and/or is positively retained in the slit 25062.Referring primarily to Figure 179, in certain embodiments, by nail bin 25000 are located in lower jaw 25070 before (Figure 179), can releasably be fixed to nearside fixture 28014b Nail bin 25000.For example, nail bin 25000 and the end effector insert 28010 of attachment towards end effector 12 and/or When lower jaw 25070 moves and/or moves in end effector 12 and/or lower jaw 25070, distally fixture 28014a can be transported It moves to be aligned with the slit 25062 in anvil block 25060.In various embodiments, when nail bin 25000 and end effector insert 28010 when being located in end effector 12 (Figure 180), and distally fixture 28014a can be releasably engaged anvil block 25060.Far Side fixture 28014a can for example be slided into the slit 25062 of anvil block 25060.In various embodiments, make distally fixture Before or while 28014a is positioned relative to anvil block 25060, position nearside fixture 28014b relative to nail bin 25000.

When end effector insert 28010 for example by nearside fixture 28014b and distally fixture 28014a it is as described herein When being releasably fixed in end effector 12 like that, end effector insert 28010 can protect in end effector 12 It holds and tightens.In other words, the nearside fixture 28014b that the nail bin 25000 in opposite lower jaw 25070 is fixed can be for example along end Portion's actuator insertion piece 28010 applies traction force to the distally fixture 28014a fixed relative to anvil block 25060.In various implementations In example, the tension between nearside fixture 28014b and distally fixture 28014a can help end effector insert 28010 to be maintained at In end effector 12.

In various embodiments, when nail bin 25000 and end effector insert 28010 are located in end effector 12 When, nearside fixture 28014b can be positioned among the sliding part 25056 (Figure 178) and nail bin 25000 not fired.For example, not hitting The sliding part 25056 of hair can be in nearside fixture 28013b nearside.In certain embodiments, sliding part 25056 can fired for example It is moved toward the far side during stroke by nearside fixture 28014b, and nearside fixture 28014b can be made to deflect.In various embodiments, After sliding part 25056 deflects nearside fixture 28014b during firing schedule, nearside fixture 28014b can be from nail bin 25000 In slit 25004 discharge.In certain embodiments, (such as other places show the element of sliding part 25056 and/or trigger shaft 25050 Nearside fixture 28014b can be discharged from nail bin 25000 out).In addition, in nearside fixture 28014b after the release of nail bin 25000, Tension in end effector insert 28010 can at least partly be alleviated.It is applied on distally fixture 28014a being not present Traction force when, distally fixture 28014a can be discharged from anvil block 25060.Therefore, end effector insert 28010 can be from end Actuator 12 discharges, and for example, can stay in the tissue of patient in end effector 12 after patient's body removal.

In certain embodiments, the nearside of anvil block attachable layer such as tissue thickness compensation part and/or buttress material End can be for example releasably attached in the proximal end of nail bin, for the anvil block with nail bin pluggable in end effector It is aligned and is attached on the anvil block.In general, the attachable layer of anvil block can be arranged relative to nail bin towards the side of anvil block. For example, the layer that anvil block attaches can be disposed in the nail platform of nail bin and/or can be disposed on nail platform layer.Anvil block can be attached The proximal end of the layer connect could attach in the proximal end of nail bin or in the proximal end of nail platform layer.It is inserted by nail bin After the end effector of surgical stapling device, the layer that the anvil block of surgical stapling device can be attached against anvil block is closed, so that The attachable layer of anvil block is attached on anvil block.When being again turned on anvil block, the layer that the anvil block on current attachment to anvil block attaches can Nail bin is moved away from together with anvil block.In all cases, attachment layer can surround when moving together with anvil block and be attached to nail bin And/or the proximal end on nail bin layer pivots.In various other situations, attachment layer when being moved together with anvil block, this layer Proximal end can be separated from nail bin.At this point, wherein the attachable layer of anvil block be attached to the surgical stapling device on anvil block it is cleavable and Suture patient tissue.The attachable layer of anvil block can also be cut by the surgical stapling device, and be captured by nail.It is attached in anvil block Layer and patient tissue can be taken out the surgical stapling device from patient's body by after nail capture.It is still attached in the layer that anvil block attaches In various embodiments on to nail bin, which can be pulled away from from the layer, thus make the attachment between this layer and nail bin disconnected It opens.

Figure 181 and Figure 182 shows the embodiment of the nail bin groupware 2400 of the layer 2414 attached including anvil block.Anvil block can be attached The layer 2414 connect can be for example including tissue thickness compensation part and/or buttress material.The proximal end of the attachable layer 2414 of anvil block Portion 2416 could attach in the proximal end 2418 of staple cartridge body 2402.In various embodiments, nail bin groupware 2400 may include example The nail bin layer 2412 being such as arranged in the nail platform of staple cartridge body 2402, such as tissue thickness compensation part and/or buttress material.Storehouse Disk 2404 can for example, at least can be made of partially around staple cartridge body 2402 and metal material.Staple cartridge body 2402 is in its proximal end The groove 2408 that may include surface 2406 at 2418 and be defined in the surface 2406.Referring to Figure 181, in order to which anvil block is attached Layer 2414 be attached on staple cartridge body 2402, the proximal end part 2416 of layer 2414 that anvil block attaches can be positioned at groove On 2408.Next, as shown in Figure 182, for example, the tab 2410 extended from storehouse dish 2404 is deformable, so that they It protrudes into groove 2408, the proximal end part 2416 of the attachable layer 2414 of anvil block is trapped in the side of groove in groove 2408 Between wall and tab 2410.Tab 2410 can also for example in the bottom of groove 2408 and dash forward the attachable capture of layer 2414 of anvil block Between piece 2410.

In use, nail bin groupware 2400 shown in Figure 182 can be inserted into the nail bin of the end effector of surgical stapling device In channel.Next, the anvil block of end effector can be closed against the layer 2414 that anvil block attaches.The attachable layer of anvil block 2414 to be inserted into staple cartridge channel 2400 when nail bin groupware 2400 in the arrangement of staple cartridge body 2402, and anvil block is then closed When, the attachable layer 2414 of the anvil block can be correctly aligned with anvil block.In various embodiments, the face of the attachable layer 2414 of anvil block It may include on the adhesive and/or engagement anvil block for can adhere to anvil faces to attach anvil block to the surface of anvil block 2415 Layer 2414 be attached to one or more attachment features structures on anvil block.For example, the surface 2415 towards anvil block may include from Its one or more protrusion extended, the one or more protrusion can be engaged with the cutter slit of anvil block.In the layer that anvil block attaches After 2414 have been attached on anvil block, the layer 2414 that anvil block is attached with the anvil block being attached to thereon can be returned to open position together It sets.The attachable layer 2414 of anvil block is attached to the part on anvil block can be close on staple cartridge body 2402 around being attached to for this layer 2414 Side end 2416 pivots, so that layer 2414 can move together with anvil block.At this point, the surgical stapling device may include in staple cartridge body It the nail bin layer 2412 that is aligned on 2402 and is attached on anvil block and layer 2414 that the anvil block that is aligned with anvil block is attachable.

When nail bin layer 2412 is aligned with staple cartridge body 2402, and the attachable layer 2414 of anvil block has been attached on anvil block and and anvil When seat alignment, can spare surgical stapling device cut and suture patient tissue.Staple cartridge body 2402 and nail bin layer 2412 can be positioned on Patient tissue side, and the layer 2414 that anvil block and anvil block attach can be positioned on the opposite side of patient tissue.Against trouble When person organizes location slit clutch, anvil block attachable layer 2414, which is attached on anvil block and staple cartridge body 2402, can make anvil block attachable Layer 2414 is stablized relative to anvil block.When being properly positioned surgical stapling device relative to patient tissue, anvil block can be closed, thus Will tissue capture be located at tissue side staple cartridge body 2402 and nail bin layer 2412 be located at the second opposite side of tissue anvil block and Between the attachable layer 2414 of anvil block.

After closing anvil block, patient tissue is trapped in staple cartridge body 2402 and nail bin layer positioned at tissue side at this time Between 2412 and the attachable layer 2414 of the anvil block positioned at the tissue other side and anvil block, which can be fired.For example, Staple drivers can be advanced through the staple drivers slit 2422 in staple cartridge body 2402 along distal direction, be stored in nail bin with percussion Nail and make these nail forming.Fired and the nail that shapes can capture the attachable layer 2414 of nail bin layer 2412, anvil block and this two Patient tissue between person.In addition, cutting blade can be advanced through cutter slit 2420 and anvil block in warehouse 2402 along distal direction In cutter slit.Cutting blade, can be by the patient between nail bin layer 2412, anvil block attachable layer 2414 and the two when promoting Tissue cutting.In various embodiments, staple drivers and cutting blade can promote simultaneously.In all cases, staple drivers can Cutting blade is guided, before the layer 2414 for attaching patient tissue, nail bin layer 2412 and anvil block is cut off, so that nail quilt Percussion and forming.

Patient tissue between nail bin layer, anvil block attachable layer 2414 and the two is captured and cut by cutting blade by nail After cutting, anvil block can be opened again.When anvil block is again turned on, it is attached on nail bin layer 2412 and patient tissue by nail this moment The attachable layer 2414 of anvil block can be separated with anvil block.For example, taking out surgical stapling when opening anvil block and/or from patient's body When device, since the layer 2414 that anvil block attaches can be held in place by nail and patient tissue, so that layer 2414 can quilt It is pulled away from the adhesive and/or attachment features structure for for example being remained to anvil block.In addition, the nearside for the layer 2414 that anvil block attaches End 2416 can be pulled away from staple cartridge body 2402, so that the proximal end 2416 with staple cartridge body 2402 separates.For example, in various situations Under, the proximal end 2416 of the attachable layer 2414 of anvil block is trapped in the prominent of groove 2408 in warehouse 2402 and storehouse dish 2404 Part between piece 2410 can be drawn out between tab 2410 and groove 2408.In various other situations, anvil block is attachable The part that can be trapped in from it between groove 2408 and the tab 2410 of storehouse dish 2404 of layer 2414 remove.For example, anvil block can The layer 2414 of attachment, which is trapped in the part between groove 2408 and tab 2410, can be crushed on dashing forward in the part of layer 2414 Piece 2410 is bottled up, the position that power needed for capable of thus reducing the remainder of tear-off layer 2414 and/or confining layers 2414 are torn It sets.For example, protruding into the tab 2410 of the attachable layer 2414 of anvil block for example can partly delineate, cuts and/or perforate in the layer 2414.It is separated in nail bin layer 2412 from staple cartridge body 2402, and the layer 2414 that anvil block attaches is separated from staple cartridge body 2402 and anvil block Later, which takes out from patient's body, but the layer 2412 and 2414 being implanted into can stay in patient's body.For example, layer Rows of staple can have been followed closely on 2412 and 2414, and/or different-thickness can be compressed by different nails, it is therefore an objective to captured to by nail Patient tissue at least apply the compression of minimum.

Referring also to Figure 181 and Figure 182, in various embodiments, the attachable layer 2414 of anvil block can be on being attached to anvil block And after anvil block is again turned on, separated from staple cartridge body 2402.As described above, nail bin groupware 2400 is inserted into staple cartridge channel and is incited somebody to action After anvil block presses to the attachable closure of layer 2414 of anvil block, layer 2414 can utilize the adhesive on its surface 2415 towards anvil block And/or attachment features structure is attached on anvil block.When being again turned on anvil block, the attachable layer 2414 of anvil block can be started shipment with anvil block one Dynamic separate staple cartridge body 2402.In all cases, the attachable layer 2414 of anvil block and anvil block move away from staple cartridge body 2402 together Layer 2414 can be captured to part between the groove 2408 in the tab 2410 and warehouse 2402 of storehouse dish 2404 from tab 2410 It is pulled out between groove 2408, so that the proximal end 2416 of layer 2414 can also move together with anvil block.

Figure 183 and Figure 184 shows another embodiment 2450 of nail bin groupware, this nail bin groupware 2450 includes that could attach to The layer 2464 that anvil block on staple cartridge body 2452 attaches.In this embodiment, the proximal end of the attachable layer 2464 of anvil block 2466 can be attached on surface 2472 from the attachment part 2470 that the surface of warehouse 2,452 2456 extends.What anvil block attached The proximal end 2466 of layer 2464 for example can be attached to surface 2472 using adhesive, ultrasonic welding, hot weld and/or hot riveting On.In various embodiments, nail bin groupware 2450 may include the nail bin layer 2462 being arranged on staple cartridge body 2462.In such implementation In example, attachment part 2470 can extend from the surface of warehouse 2,452 2456, so that surface 2472 is with nail bin layer 2462 towards anvil The surface 2467 of seat is substantially flush.Therefore, the attachable layer 2464 of anvil block can be substantially flat positioned at nail bin layer 2462 On surface 2467 and surface 2472 towards anvil block.In all cases, it is similar to above in association with described by Figure 181 and Figure 182 Embodiment, by nail bin groupware 2450 be inserted into end effector staple cartridge channel after, the anvil block of end effector can be closed, So that the side 2465 towards anvil block for the layer 2464 that anvil block and anvil block attach contacts.The attachable layer 2464 of anvil block towards anvil The layer 2464 that anvil block attaches can be attached on anvil block by adhesive and/or attachment features structure on the side 2465 of seat.It connects down Come, be again turned on anvil block, the attachable layer 2464 of anvil block can be around 2466 pivot of proximal end being attached on surface 2472 at this time Turn.Similar to above in association with Figure 181 and Figure 182 described embodiment, layer 2464 that can be attachable by nail bin layer 2462, anvil block Patient tissue cutting between the two, and stitch together.Then, be again turned on surgical stapling device anvil block and/or will be outer Section's stitching unstrument takes out from patient's body, and the attachable layer 2464 of anvil block can be separated with anvil block, and nail bin layer 2462 can be with staple cartridge body 2452 separation.In addition, the proximal end 2466 of the attachable layer 2464 of anvil block can with adhesive and/or be attached on surface 2472 The separation of other attachment features structures so that the attachable layer 2464 of anvil block can be implanted patient's body.

Referring also to Figure 183 and Figure 184, in various embodiments, after the layer 2464 that anvil block attaches is attached on anvil block When being again turned on anvil block, the portions of proximal 2466 of the attachable layer 2464 of anvil block can be separated with surface 2472.For example, anvil block can be attached The proximal end 2466 of the layer 2464 connect also could attach on anvil block.In the attachable layer 2464 of anvil block and the anvil block of attachment along remote When from the movement of the direction of staple cartridge body 2452 and/or nail bin layer 2462, the proximal end 2466 of layer 2464 can be drawn from surface 2472 It rises and is separated with surface 2472.In such embodiments, between nail bin layer 2462, anvil block attachable layer 2464 and the two Before patient tissue is cut and sutured, the attachable layer 2464 of anvil block can be separated first from nail bin.

Figure 185 and Figure 186 shows another embodiment 2500 of nail bin groupware, which includes nail bin layer 2506 and the attachable layer 2510 of anvil block.In the embodiment shown in Figure 185 and Figure 186, the attachable layer 2510 of anvil block is attached Onto nail bin layer 2506, rather than staple cartridge body 2502.For example, the layer 2510 that nail bin layer 2506 and anvil block attach respectively may include group Knit thickness compensation part and/or buttress material.The attachable layer 2510 of anvil block may include prolonging from the proximal end 2508 of layer 2510 The the first nearside tab portion 2512 stretched.First nearside tab portion 2512 could attach to the proximal end surface of nail bin layer 2506 On 2516.For example, the proximal end that is glue-bondable, welding and/or be over-molded onto nail bin layer 2506 of the first nearside tab portion 2512 On portion surface 2516.In certain embodiments, the attachable layer 2510 of anvil block may include prolonging from the first nearside tab portion 2512 The the second nearside tab portion 2514 stretched.Second nearside tab portion 2514 can for example utilize glued, welding and/or molded It is attached in the bottom surface 2518 of nail bin layer 2506.

Similar to above in association with Figure 181 to Figure 184 the embodiment described, nail bin groupware 2500 is being inserted into surgical stapling device After in the staple cartridge channel of end effector, when the anvil block of end effector is closed on the layer 2510 that anvil block attaches, anvil The surface 2511 towards anvil block of the attachable layer 2510 of seat can be attached to anvil block by adhesive and/or attachment features structure On.When being again turned on anvil block, the attachable layer 2510 of anvil block can move away from nail bin layer 2506 and staple cartridge body together with anvil block 2502.In all cases, when anvil block is again turned on, the attachable layer 2510 of anvil block can surround 2512 pivot of the first tab portion Turn.After the layer 2510 that anvil block attaches is attached on anvil block, end effector can be closed on patient tissue, so that nail Warehouse 2502 and nail bin layer 2506 are located in the first side of patient tissue, and the layer 2510 that anvil block and anvil block attach is located in patient Second opposite side of tissue.As described in above in association with Figure 181 and Figure 182, cutting blade can be advanced through the knife in warehouse 2502 Slit 2520, and staple drivers can be advanced through the staple drivers slit 2422 in warehouse 2502.Referring primarily to Figure 185, In some embodiments, the first tab portion 2512 and the second tab portion 2514 of the attachable layer of anvil block can be with cutter slits 2512 Alignment.For cutting blade when being advanced through cutter slit 2520, cutting blade can be by the first tab portion 2512 and the second projection piece Divide 2514 cuttings.In all cases, the first tab portion 2512 and the second tab portion 2514 are cut off by cutting blade The first tab portion 2512 and the second tab portion 2514 can be made to separate from nail bin layer 2506.Cutting blade and staple drivers It promotes, the patient tissue between the attachable layer 2510 of nail bin layer 2506, anvil block and the two, can be again by after cutting and suture Anvil block is opened, the layer 2510 for keeping anvil block attachable is separated with anvil block, and nail bin layer 2506 is separated with staple cartridge body 2502.As described above, The layer 2510 that anvil block in the embodiment of Figure 185 and Figure 186 attaches is attached on nail bin layer 2506, and is not attached to nail bin On body 2502.It therefore, there is no need to take measures to separate layer 2510 and staple cartridge body 2502 that anvil block attaches.In addition, anvil block can The first tab portion 2512 and/or the second tab portion 2514 of the layer 2510 of attachment can remain attached on nail bin layer 2506, Because the two layers are all captured by nail and implantable patient's body.For example, if cutting blade is not by the first tab portion 2512 It is separated with the second tab portion 2514 from nail bin layer 2506, then, the layer 2510 that nail bin layer 2506 and anvil block attach will pass through First tab portion 2512 and the second tab portion 2514 and the nail of forming are attached to each other in patient's body.

Referring also to Figure 185 and Figure 186, in various embodiments, staple cartridge channel, and anvil block have been inserted into nail bin groupware 2500 After attachable layer 2510 has been attached on anvil block, the first tab portion 2512 and the second tab portion 2514 can anvil block again When the layer 2510 that opening and anvil block and anvil block attach moves away from nail bin layer 2506, separated from nail bin layer 2506.For example, anvil block Attachable layer 2510 can be by the first tab portion 2512 and the second tab portion 2514 from nail with the anvil block that is attached on anvil block Clad 2506 pulls open, so that the first tab portion 2512 and the second tab portion 2514 are separated from nail bin layer 2506.

Figure 187 and Figure 188 shows another embodiment of the attachable layer of the anvil block being used together with surgical stapling device 2550.As explained below, the proximal end part 2554 of the attachable layer 2550 of anvil block could attach to the nearside of nail bin On end sections, for insertion into the end effector of surgical stapling device, and it is aligned with the anvil block of end effector and attached It is connected on the anvil block.When the stroke of cutting blade starts, the main body 2552 of the attachable layer 2550 of anvil block can be stitched by surgery The cutting blade of clutch is separated with nail bin.For example, cutting blade 2570 shown in Figure 188 can cut any patient tissue it Before, and the layer that any part of the main body 2552 of the attachable layer 2550 of anvil block before nail capture, is kept anvil block attachable 2550 separate from nail bin.

Referring primarily to Figure 187, the attachable layer 2550 of anvil block may include main body 2552 and proximal end part 2554.Nearside End sections 2554 include the attachment features structure 2556 on the proximal end part for could attach to nail bin.For example, attachment features Structure 2556 may include adhesive, pad, and/or rivet hot contact.Attachment features structure 2556 can also be for example including captured Part between the slit of nail bin and the tab of storehouse dish, as described in above in association with Figure 181 and Figure 182.The attachable layer of anvil block 2550 could attach on nail bin and be aligned with nail bin, and the nail cavity of such nail bin is aligned with the main body 2552 of layer 2550.In other words, When nail is fired from nail bin, nail will capture the main body 2552 of the attachable layer 2550 of anvil block.Similar to above in association with Figure 181 to figure 186 the embodiment described, can be by the nail bin groupware insertion surgery seam of the layer 2550 attached including the anvil block being attached on nail bin In the staple cartridge channel of clutch end effector.Then, the face for the layer 2550 that the anvil block of end effector can be attached in anvil block It is closed on the surface of anvil block 2553.Surface 2553 towards anvil block may include adhesive and/or attachment features structure, the bonding When anvil block presses to the surface 2553 towards anvil block and is closed, the layer 2550 that anvil block is attached can for agent and/or attachment features structure It is attached on anvil block to release.Next, being again turned on anvil block, the attachable layer 2550 of anvil block can surround together with anvil block at this time Attachment features structure 2556 pivots.Similar to above in association with Figure 181 to Figure 186 the embodiment described, nail bin can be for example including nail Clad, such as tissue thickness compensation part and/or buttress material.

The attachable layer 2550 of anvil block may include the first cross side 2566 and the second cross side 2568.First cross side 2566 Middle line 2564 can be therebetween limited with the second cross side 2568.In certain embodiments, the attachable layer 2550 of anvil block is attachable It is on to the anvil block of end effector and aligned, so that middle line 2564 and the knife in the cutter slit and nail bin in anvil block are narrow Slot alignment.The main body 2552 of the attachable layer 2550 of anvil block may include the first side to slit 2558, which positions to slit Extend near proximal end and from the first cross side 2566 and crossed the centre line 2564.The main body of the attachable layer 2550 of anvil block 2552 may also include the second side to slit 2560, second side to slit 2560 relative to the first side to slit 2558 proximally It positions and extends from the second cross side 2568 and crossed the centre line 2564.It first side can to slit 2560 to slit 2558 and the second side Coupling part 2562 is therebetween limited, which can be connected to layer for the main body 2552 for the layer 2550 that anvil block attaches 2550 proximal end part 2554.

Referring primarily to Figure 188, on the anvil block that the layer 2550 that anvil block attaches is releasably attached to end effector after, The end effector can be closed on patient tissue, the layer 2550 for attaching anvil block and anvil block is located at tissue side, nail bin And/or nail bin layer is located at the opposite side of tissue.Next, cutting blade 2570 can for example be advanced through the cutter slit in nail bin Cutter slit in (cutter slit 2418 shown in such as Figure 181 to Figure 185) and anvil block.The middle line of the attachable layer 2550 of anvil block 2564 can be aligned with cutter slit, so that cutting blade 2570 progressively cuts the attachable layer 2550 of anvil block along the middle line. Cutting blade 2570 is when the distal direction indicated along arrow D is advanced through the attachable layer 2550 of anvil block, cutting edge 2572 The proximal end part 2554 for cutting this layer 2550 first, then cuts open coupling part 2562, thus by the main body of layer 2550 2552 and the proximal end part 2554 of layer 2550 separate.The main body for the layer 2550 that cutting blade 2570 finally attaches anvil block 2552 cut open.After cutting blade 2570 is advanced through the attachable layer 2550 of anvil block, layer 2550 is divided into four.Anvil block can be attached The main body 2552 of the layer 2550 connect is separated from the portions of proximal 2554 of layer 2550.In addition, the main body for the layer 2550 that anvil block attaches 2552 are divided into two panels, and 2580 and 2582；The portions of proximal 2554 of the attachable layer 2550 of anvil block is divided into two panels, 2586 Hes 2588。

In all cases, the stitching unstrument may not be fired completely using the surgeon of surgical stapling device.For example, Referring to Figure 188, cutting blade 2570 and staple drivers may be only advanced to the master of the attachable layer 2550 of anvil block by surgeon The position of 2552 half of body.The example is continued discussing, when the cutting stroke of cutting blade 2570 starts, when blade 2570 is by layer When 2550 coupling part 2560 is cut off, the main body 2552 of the attachable layer 2550 of anvil block is discharged from nail bin.It is then cut out blade 2570 continue to promote along middle line 2564, until about half position of 2552 length of main body for the layer 2550 that anvil block attaches.On During stating process, staple drivers can also be promoted, half and trouble in the main body 2552 of the layer 2550 cut open by cutting blade 2570 Person tissue in percussion nail and make nail shape.The other half of attachable 2550 main body 2552 of layer of anvil block is not cut open, and not by Nail capture.Then cutting blade 2570 and staple drivers can be retracted, and is again turned on anvil block.When being again turned on anvil block, anvil Being captured by nail and be attached to the part on patient tissue of the main body 2552 of the attachable layer 2550 of seat can be separated from anvil block.Such as Upper described, in any nail by before firing, and cutting blade 2570 cuts off the main body 2552 of any patient tissue or layer 2550 Any part before, the main body 2552 for the layer 2550 that anvil block attaches is connected to the coupling part of proximal end part 2554 2560 can be severed.Therefore, the main body 2552 of layer 2550 is discharged from nail bin.When patient's body takes out surgical stapling device, anvil The remainder of main body 2552 can be pulled away from anvil by the part captured in the main body 2552 of the attachable layer 2550 of seat by patient tissue Seat.As described in this example, the attachable layer 2550 of anvil block is suitable for the incomplete percussion of surgical stapling device, because any from nail Before the nail in storehouse is fired and shaped in the main body of layer 2,550 2552, the coupling part 2560 of the attachable layer 2550 of anvil block can It is cut by cutting blade 2570.

The incomplete percussion of surgical stapling device is also suitable in conjunction with Figure 181 to Figure 186 embodiment described.In each case Under, it does not need to be separated layer and the nail bin that anvil block attaches with the cutting blade of surgical stapling device.Combining Figure 181 to Figure 184 In the embodiment of description, after part fires surgical instruments, it can be pulled away from the attachable layer of anvil block, keep it no longer attached with staple cartridge body It connects.In the embodiment for combining Figure 185 and Figure 186 to describe, the attachable layer of anvil block is attached on nail bin layer, and is not attached to nail On storehouse.As described above, the layer that nail bin layer and anvil block attach is implanted into the patient simultaneously.Therefore, whether surgical instruments hits completely It sends out to separate with the layer for attaching the anvil block in the embodiment in conjunction with described in Figure 181 to Figure 186 and has no to be associated with.

In all cases, surgeon can be used the second surgical instruments will be above in association with anvil described in Figure 181 to Figure 184 The attachable layer separation of seat.For example, in all cases, being somebody's turn to do if surgeon uses rapid wear tissue (such as lung tissue) Surgical stapling device, he may want to avoid the layer that firmly draw tissue can be attachable by surgical stapling device pull-off anvil block.? In such situation, surgeon can introduce another surgical instruments and such as grab when taking out surgical stapling device from patient's body Tool so that the attachable layer of the patient tissue and anvil block of suture remain stationary it is motionless.It is retouched above in association with Figure 185 to Figure 188 In the various embodiments of the attachable layer of the anvil block stated, surgeon can no longer need to introduce the second surgical tool can by anvil block The layer of attachment is separated from surgical stapling device.Referring again in conjunction with Figure 185 and Figure 186 the embodiment described, the attachable layer of anvil block 2510 are attached on nail bin layer 2506, which is also implanted patient's body.The attachable layer of anvil block is not attached to surgery On nail bin in stitching unstrument.Therefore, when taking out stitching unstrument from patient's body, do not need firmly to pull or pull patient tissue with Layer and nail bin that anvil block attaches are separated.Referring again to Figure 187 and Figure 188 the embodiment described is combined, in cutting blade When 2570 stroke starts, the main body 2552 for the layer 2550 that anvil block is attached is divided by cutting blade from surgical stapling device machinery From.Equally, after being cut with surgical stapling device and having sutured patient tissue, prepare to take out the surgical stapling device from patient's body When, also there is no attachments between the main body 2552 and the nail bin of surgical stapling device of the attachable layer 2550 of anvil block.Therefore, from trouble When taking out stitching unstrument in person's body, the main body for firmly pulling or pulling the layer 2550 that patient tissue can attach anvil block is not needed 2552 separate with nail bin.

Referring primarily to Figure 189 to Figure 190, the compensating part 27120 for sleeve 27110 may include main body 27122, the main body 27122 have the longitudinal protrusion 27124 extended along its at least part.Longitudinal protrusion 27124 can be limited for example along main body 27122 Middle line longitudinal path.In various embodiments, when sleeve 27110 is located on anvil block, longitudinal protrusion 27124 can be by anvil Longitudinal slit in seat receives.Referring primarily to Figure 191, longitudinal protrusion 27124 may include rounding protruding portion.For example, longitudinal protrusion 27124 cross section can form arc and/or partial circle.In other embodiments, longitudinal protrusion 27124 may include angular And/or stepped protruding portion.Compensating part 27120 can also be for example including edge 27126, which can be straight, is curved It is song, reeded, wavy, and/or zigzag.In various embodiments, edge 27126 may include gap 27128, These gaps 27128 can receive the lock extended from anvil block and extend when assembled sleeve 27110 is positioned on anvil block Portion.

As outlined herein, one or more fasteners that layer such as tissue thickness compensation part can for example be projected by nail bin are planted Enter in tissue.In addition as outlined herein, in all cases, at least part of this layer can be captured tissue by entire staple line In.For example, the proximal nail in staple line can be in at least part for wherein capturing this layer, and the farthest side nail in the staple line can also In at least part for wherein capturing this layer.In some cases, the portions of proximal of this layer can be relative to the recent side in staple line Nail extends proximally and/or the distal part of this layer can follow closely towards distal side relative to the farthest side in staple line and extend.It is using In, it can plant series of layers.It is at least one under such circumstances, these layers can be implanted into succession along cutting line.In some cases Under, layer can be implanted so that one layer is partly be overlapped with another layer.For example, the distal end of the first implant layer can be with the second implantation The proximal end overlapping of layer.Similarly, the distal end of the second implant layer can be Chong Die with the proximal end of third implant layer, with this Analogize.Therefore, certain fasteners can be in a part for wherein capturing two or more layers.Two or more are captured in nail Layer will increase is applied to follow closely in captured tissue pressure and/or augmenting tissue it is rigid, especially when several adjacent nails When capturing more than one layer.Referring now to Figure 192 to Figure 194, more detailed description as follows, tissue thickness compensation part 11050 can Including proximal end 11053 and distal end 11055, wherein proximal end 11053 and/or distal end 11055 may include one A or multiple strain reliefs part, the strain relief part can reduce the rigidity of tissue thickness compensation part 11050 and just be sewn Tissue rigidity.

Referring again to Figure 192 to Figure 194, the distal end 11055 of tissue thickness compensation part 11050 may include being defined in it In one or more slits 11058.Slit 11058 can be for example including the notch being defined in tissue thickness compensation part 11050 And/or recess.Slit 11058 can limit protruding portion or tab 11056, and the protruding portion or tab 11056 are configured to Relative to each other and/or the main part of tissue thickness compensation part 11050 is at least partly moved and/or is bent.In other words, Slit 11058 can locally eliminate tissue thickness compensation part 11050 and the below strain in tissue.In some cases, first The tab 11056 of tissue thickness compensation part 11050 can be Chong Die with the proximal end 11053 of minor microstructure thickness compensation part 11050. In all cases, slit 11058 allows the first tissue thickness compensation part 11050 and minor microstructure thickness compensation part 11050 It pivots relative to each other.In some cases, referring primarily to Figure 194, the tab 11056 of the first tissue thickness compensation part 11050 can It is Chong Die with the tab 11056 of minor microstructure thickness compensation part 11050.In all cases, two stacked distal ends 11055 In slit 11058 can also reduce the rigidity in inferior tissue.Although the embodiment that shows of tissue thickness compensation part 11050 only exists It include the arrangement of tab 11057 and slit 11058 in one end, but the tissue thickness compensation part can for example include on its both ends The arrangement of tab 11057 and slit 11058.

In certain embodiments, as to supplement above, each tab 11056 may include tapered profile.For example, every A tab 11056 may include base portion and the free end of end corresponding thereto, and wherein base portion is attached to tissue thickness compensation part In 11050 main body and there are base widths, which has end portion width, and wherein base widths may compare end portion width It is wide.In certain embodiments, end portion width is wide than base widths.Referring primarily to Figure 194, end 11055 may include multiple prominent Piece 11056, the tab have different configurations.For example, tab 11056 can have different length.As shown in Figure 194, for example, The tab 10056a of least significant end can have the first length, and the second tab 10056b can have second length longer than the first length, Third tab 10056c can have the third length longer than the second length, and the 4th tab 10056d can have longer than third length 4th length, the 5th tab 10056e can have fiveth length longer than the 4th length, and the 6th tab 10056f can have than The 6th long length of five length.In such embodiments, the nearlyr tab of distal end from tissue thickness compensation part 10050 10056 can become shorter.In other embodiments, 10056 length of tab can be arranged with any other suitable arrangement.

In all cases, as to supplement above, layer may include the edge on confining layers periphery.In some cases, It is straight, substantially straight, linear, and/or substantially linear that these edges can be.In some such cases, Layer edge can be in close contact and/or otherwise influence the tissue of surrounding.In addition, in some such cases, these edges It may be rigid, and can rigidly supporting tissue.In fact, certain and tissue of tissue by this layer of rigid support The adjacent part of other parts can not be supported by the layer, and transition is not present therebetween.Referring again to Figure 192 to Figure 194, tissue thickness The periphery of compensating part 11050 may include wavy configuration, which can organize downwards to provide the region with gradual change rigidity. The periphery of tissue thickness compensation part 11050 may include being defined in multiple recesses or groove 11059 therein, the recess or groove 11059 can limit tab 11057.Similarly as described above, tab 11057 can prolong from the main body of tissue thickness compensation part 11050 It stretches, and can be relative to bulk motion.It is also similarly to described above, each tab 11057 may include base portion end and free end Portion, the base portion end are attached in the main body of tissue thickness compensation part 11050, which can transport relative to base portion end It is dynamic.In some cases, the width of the base portion end for the width comparable tab 11057 that the free end of tab 11057 has is narrow, And in the case of other, the width that the free end of tab 11057 has may be wider than the width of the base portion end of tab 11057. Tab 11057 can be for example including any suitable configuration, such as semi-circular configuration, or at least partly bowed configuration.In view of It is described above, tissue below the main part of tissue thickness compensation part 11050 and/or the master for being fastened to tissue thickness compensation part The tissue of body portion can rigidly be supported by main part, the tissue of the lower section of contact pin 11057 and/or be fastened to the tissue of contact pin by Contact pin 11057 provides less rigid support, and tissue that is adjacent with tab 11057 but not being disposed below can not be organized Thickness compensation part 11050 supports.

Referring now to Figure 195 and Figure 196, nail bin groupware 11100 may include warehouse 11110 and be attached on warehouse 11110 Tissue thickness compensation part 11150.Nail bin groupware 11100 may also include one or more attachment members 11160, the attachment members 11160 can be releasably held in tissue thickness compensation part 11150 on warehouse 11110.In at least one situation, each Attachment members may include band, which extends around warehouse 11110 and tissue thickness compensation part 11150.In use, as To supplement above, firing member 10030 can be advanced through nail bin 11100 to cut tissue thickness compensation part 11150, then The nail being stored at least partly in warehouse 11110 is fired, and attachment members 11160 are cut off.Tissue thickness compensation part 11150 may include first end or proximal end 11157 and the second end or distal end 11155.Distal end 11155 It may include the protruding portion 11156 of elongation, which prolongs from the main part 11153 of tissue thickness compensation part 11150 It stretches.As shown in Figure 195, the protruding portion 11156 of the elongation can extend relative to the attachment members 11160 of farthest side towards distal side.Extremely Less in the illustrated embodiment, warehouse 11110 may include platform 11113, and the nail cavity of warehouse 11110 can be limited in the platform. In all cases, the main body 11153 of tissue thickness compensation part 11150 is configured to and is arranged such that it is covered Cover platform 11113 and the nail cavity being defined in warehouse 11110.In at least some cases, same as shown in Figure 195, elongation Protruding portion 11156 can extend from platform 11113 towards distal side, and extend relative to the nail cavity being limited in platform 11113 towards distal side.

In use, as to supplement above, tissue thickness compensation part 11150 can be fastened to tissue as described herein, And it can provide tissue thickness's compensation characteristic.Similarly as described above, the tissue below tissue thickness compensation part 11150 can quilt Tissue thickness compensation part 11150 and the nail rigid support for fixing the tissue, and the tissue around tissue thickness compensation part 11150 can It is not supported by tissue thickness compensation part 11150, and can be flexible.In such cases, unsupported flexible tissue and Tissue (i.e. transition tissue) between the tissue being rigidly supported below tissue thickness compensation part 11150 is likely to occur undesirable journey The strain of degree.Such strain may adversely affect transition tissue.For example, being fixed to for example when by tissue thickness compensation part When lung tissue, it may be torn in some cases close around the tissue (i.e. perienchyma) on tissue thickness compensation part periphery, Perienchyma's (i.e. end periphery tissue) especially neighbouring and/or around tissue thickness compensation part distal end.However, tissue The distal projections 11156 of thickness compensation part 11150 can supporting base end portion perienchyma.In other words, 11156 energy of distal projections Transition support is provided for end periphery tissue.The main body that the support of such transition is smaller than tissue thickness compensation part 11150 provides Support, and can mitigate and be adequately supported strain between tissue below unsupported tissue and tissue thickness compensation part 11150 Change.In all cases, distal projections 11156 can provide enlarged area, and power can not suture group in the enlarged area It knits and has sutured and transmit between tissue.Distal projections 11156 be configured to flexure and with unsupported tissue and tissue Thickness compensation part 11150 moves together.In all cases, distal projections 11156 can be relative to tissue thickness compensation part 11150 main part and/or unsupported histokinesis.

Referring again to Figure 195 and Figure 196, tissue thickness compensation part 11150, which may also include, is defined in its proximal end 11153 In recess 11157.Recess 11157 can be limited between the protruding portion 11158 that two extend towards distal side.Recess 11157 can example Such as there is any suitable shape, such as parabolic shape.Similarly as described above, the protruding portion 11158 extended towards distal side can Transition support is provided to proximal end perienchyma.Such transition support is smaller than the offer of 11150 main body of tissue thickness compensation part Support, and can mitigate and be adequately supported strain between tissue below unsupported tissue and tissue thickness compensation part 11150 Change.In all cases, proximal projections 11158 can provide enlarged area, and power can not suture group in the enlarged area It knits and has sutured and transmit between tissue.Proximal projections 11158 be configured to flexure and with unsupported tissue and tissue Thickness compensation part 11150 moves together.In all cases, two proximal projections 11158 can be compensated relative to tissue thickness The main part of part 11150, each other, and/or unsupported histokinesis.Also contemplate the proximal end from tissue thickness compensation part The various alternative embodiments for the more than two protruding portion that portion and/or distal end extend.

As shown in Figure 196, two or more tissue thickness compensation parts can be implanted into a manner of end to end along certain path 11150.In such cases, the distal end 11155 of the first tissue thickness compensation part 11150 can be with minor microstructure thickness compensation The proximal end 11153 of part 11150 is overlapped.Similarly, the distal end 11155 of minor microstructure thickness compensation part 11150 can be with The proximal end 11153 of third tissue thickness compensation part 11150 is overlapped.In all cases, the first tissue thickness compensation part 11150 distal projections 11156 can be aligned or at least substantially with the groove 11157 of minor microstructure thickness compensation part 11150 Alignment.In addition, in various embodiments, the size of distal projections 11156 and proximal flutes 11158 can be set to and by It is configured to so that they have basically the same size and/or shape.In all cases, distal projections 11156 It is configured to be located in the proximal flutes 11157 of adjacent tissue thickness compensation part 11150.

Turning now to Figure 29 3 and Figure 29 4, the end effector of surgery suturing appliance may include the first jaw and the second pincers Mouthful, which includes the warehouse channel 11390 being configured to wherein receiving nail bin 11300, which includes Anvil block 11391.Similar described above, nail bin 11300 may include warehouse 11310 and tissue thickness compensation part 11350.Nail bin 11300 may also include the tissue adjoining members 11355 being attached to thereon.In all cases, tissue adjoining members 13555 can It is removably attached on warehouse 11310.In addition to or substitution be removably attached on warehouse 11310 outer, tissue adjoining members 11355 can also be attached in tissue thickness compensation part 11350.In the embodiment as at least one, adjoining members are organized 11355 can be releasably secured to tissue thickness compensation part 11350.In use, similarly as described above, fastening Part can be disposed from warehouse 11310, by tissue thickness compensation part 11350 be fixed to be trapped in tissue thickness compensation part 11350 with Tissue T between anvil block 11391.In all cases, fastener can not pierce tissue adjoining members 11355.In other certain feelings Under condition, fastener can pierce tissue adjoining members 11355, and at least part capture for organizing adjoining members 11355 is existed Wherein, and by tissue adjoining members 11355 tissue T has been fixed to it.In either case, similarly as described above, tissue is adjacent At least part of connection member 11355 is configured to below unsupported tissue with tissue thickness compensation part 11350 By providing transition support between the tissue of fastener rigid support.Organize adjoining members 11355 can be for example with any suitable Shape, such as ligule.In at least one embodiment, tissue adjoining members 11355 may include one or more recesses 11358, The recess can limit tab 11356 between them.Once tissue thickness compensation part 11350 is positioned and secured to against tissue T Tissue T, tissue adjoining members 11355 be configured to relative to tissue thickness compensation part 11350 bend, and to group The adjacent tissue offer support of the distal end of thickness compensation part 11350 is provided.In all cases, for example, tissue adjoining members 11355 can bend relative to tissue thickness compensation part 11350, in addition, tab 11356 can relative to each other, tissue adjoining members 11355 main body, and/or tissue thickness compensation part 11350 flexure.

Referring again to Figure 29 3 and Figure 29 4, organize at least part of adjoining members 11355 can be with tissue thickness compensation part 11350 overlappings.In all cases, organize the part of adjoining members 11355 that can be for example attached by one or more adhesives Onto tissue thickness compensation part 11350.In some cases, organize at least part of adjoining members 11355 can be with warehouse The one or more nail cavities overlapping limited in 11310, so that adjoining members can will be organized from the nail that these nail cavities project 11355 at least part is trapped in wherein, and tissue adjoining members 11355 are fixed to tissue.Organize adjoining members 11355 at least part can be Chong Die with the nose 11311 of warehouse 11310.In all cases, adjoining members 11355 are organized This part can be for example attached on nose 11311 by one or more adhesives.In other cases, adjoining members are organized 11355 this part can be not attached on nose 11311.Referring primarily to Figure 29 4, at least the one of adjoining members 11355 is organized Part can be Chong Die with the distal part 11312 of nose 11311.In all cases, organize this part of adjoining members 11355 can To be not attached in the distal part 11312 of nose 11311.In at least some cases, organizing can between adjoining members 11355 Define gap.At least part of tissue adjoining members 11355 can freely extend from the nose 11311 of warehouse 11310.Herein In class embodiment, tissue adjoining members 11355 may include cantilever.

In use, as to supplement above, nail bin 11300 can be positioned on the first side of tissue T, and anvil block 11391 can be positioned on second side.The pivot 11392 that anvil block 11391 can then limit in the axis 11393 of surgery suturing appliance It is pivoted towards nail bin 11300.Once anvil block 11391 and nail bin 11300 suitably position, it is contained in nail in warehouse 11310 just It can therefrom project, pierce tissue thickness compensation part 11350, and tissue thickness compensation part 11350 is fixed to tissue T.Hereafter, Openable anvil block 11391, and end effector can be moved far from tissue T.In such cases, warehouse 11310 can be pulled away from Tissue thickness compensation part 11350, so that tissue thickness compensation part 11350 be made to stay in tissue T.Meanwhile organizing adjoining members 11355 can separate from nail bin 11300 together with tissue thickness compensation part 11350.Tissue adjoining members 11355 are attached to tissue Meaning in thickness compensation part 11350 is that tissue thickness compensation part 11350 can keep tissue adjoining members against tissue 11355.In all cases, tissue adjoining members 11355 can be biased by tissue thickness compensation part 11350 against tissue T.Example Such as, when histokinesis, stretching, extension and/or flexure, tissue adjoining members 11355 can flexibly support the tissue T of lower section, and will Pressure, stress and/or the strain of tissue are distributed in biggish region.

Referring again to Figure 29 3 and Figure 29 4, the end effector of surgical instruments may include tissue adjoining members, such as (example As) it is attached to the tissue adjoining members 11395 on anvil block 11391.In all cases, tissue adjoining members 11395 can be with group It is identical or at least substantially identical to knit adjoining members 11355.In at least one situation, tissue adjoining members 11395 may include The recess 11398 being defined between tab 11396.In use, tissue adjoining members 11395 can be for example using one or more Adhesive is attached on anvil block 11391, wherein organizing adjacent structure when anvil block 11391 is positioned and is closed therewith relative to tissue T Part 11395 can be positioned against tissue T.It is following closely after nail bin percussion, when being again turned on anvil block 11391, is organizing adjoining members 11395 It can separate and be remained attached in tissue T from anvil block 11391.In all cases, at least the one of adjoining members 11395 are organized Part can be for example trapped in out of, warehouse 11310 projects nail.In at least some such situations, adjoining members are organized 11395 can be at least partly be overlapped with the nail cavity limited in anvil block 11391, or extends on these nail cavities.In some cases Under, the tissue that one or more adhesives (such as activatable adhesive) can for example be located at tissue adjoining members 11395 contacts table On face, so that tissue adjoining members 11395 are adhered to tissue T.Under any circumstance, referring primarily to Figure 29 4, tissue adjoining Component 11355 and/or tissue adjoining members 11395 can be used to flexibly supporting tissue T.Utilizing tissue adjoining members 11355 in the embodiment of both tissue adjoining members 11395, and tissue adjoining members 11355 and 11395 can be by identical material Material or different materials are constituted.Tissue adjoining members 11355 and 11395 can be of similar shape and configuration or different shapes Shape and configuration.Tissue adjoining members 11355 and 11395 can also have same thickness or different thickness.It is adjacent that tissue may be selected This class feature of component 11355 and 11395, to provide desired support profiles to the tissue of positioning between them (profile).For example, this class feature may be selected, so that one in tissue thickness compensation part 11355 and 11395 is than another One rigidity is bigger.Meanwhile these characteristics may be selected, so that one in tissue thickness compensation part 11355 and 11395 It is bigger than another flexibility.

In all cases, tissue thickness compensation part may include multiple layers.For example, tissue thickness compensation part may include first Layer and the second layer.Such layer can be made of identical material or different materials.Some layers are configured to as tissue thickness It spends compensating part and different characteristics is provided.For example, tissue thickness compensation part may include the compressible of offer tissue thickness's compensation characteristic The bigger second layer of the rigidity of first layer and sustainable first layer.Referring primarily to Figure 197 and Figure 198, tissue thickness compensation part 11250 may include first layer 11251 and the second layer 11252.The second layer 11252 is compressible, and can provide tissue thickness's compensation Characteristic.First layer 11251 can be rigid, and the sustainable second layer 11252.The second layer 11252 can be for example against warehouse 11210 position and/or are attached on warehouse 11210.In some cases, first layer 11251 may include extending along a length thereof The size of vertical passage 11253, the vertical passage 11253 can be configured to and be configured to be releasably held in limit Due in the longitudinal knife slot 11215 in warehouse 11210.In all cases, the second layer 11252 can be fixed to first layer It 11251 and is held in place by first layer 11251.

Referring again to Figure 197 and Figure 198, compensating part 11250 may include multiple layers.In addition, the outer periphery of the second layer 11252 11218 can at least partly extend beyond the outer periphery 11220 of first layer 11251.In addition, first layer 11251 and the second layer 11252 may include different degrees of rigidity.For example, the second layer 11252 is more soft than first layer 11251.This arrangement can make Tissue thickness compensation part 11250 has sufficiently rigid interior zone and sufficiently flexible perimeter, and the interior zone is by the One layer 11251 and the composition of the second layer 11252, can be suitble to provide abundant support to nail 11260, the perimeter is by the second layer 11252 are constituted, and can be adapted to provide for enough flexibilities, so as to for example in tissue T and tissue thickness compensation part 11250 by nail 11260 Mitigate the burden for being applied to tissue T during and/or after capture.First layer 11251 and the second layer 11252 can be for example by adhesives It is bound up.Other for being attached to first layer 11251 on the second layer 11252 are also contemplated within the scope of this disclosure Attachment device.

As to supplement above, first layer 11251 may include interior section 11254 and at least partly around internal portion Divide 11254 exterior section 11256, outer portion 11256 is more soft than interior section 11254.For example, exterior section 11254 may include multiple slits 11210, which can increase the flexibility of exterior section 11254.In addition, as described above, The second layer 11252 is configured to more soft than first layer 11251.This arrangement can make tissue thickness compensation part 11250 Three regions with different rigidity, including the first interior zone, intermediate region and third region, that is, perimeter.Inside first Region has maximum rigidity, and interior zone is made of the interior section 11254 of first layer 11251；Intermediate region has middle rank Rigidity, intermediate region is made of the exterior section 11256 of first layer 11251 and the second layer 11252；Third region has the smallest Rigidity, third region are only made of the second layer 11252.

The second layer 11252 of tissue thickness compensation part 11250 can have fabric construction, which may include more fibres Dimension, the plurality of fibers can be woven into the fabric construction.Fabric construction can provide with the sufficiently flexible second layer 11252, with example Such as mitigate during and/or after tissue T and tissue thickness compensation part 11250 are captured by nail 11260 and is applied to the negative of tissue T Load.In addition, outer periphery 11218 can be made of fiber, which can provide hurtless measure tissue contacting surface, to make to apply as described above The burden being added in tissue T minimizes.Above-mentioned fabrics structure and fiber can be made of biocompatible materials.In addition, above-mentioned knit Object structure and/or fiber can be for example made of bioabsorbable material such as PLLA, PGA, PCL and/or their combination.

Referring to Figure 199 to Figure 20 1, staple cartridge channel is configured to receive nail bin 1060, and wherein nail bin 1060 can wrap Include warehouse 1062, storehouse platform 1064 and supporting element 1065.In addition, tissue thickness compensation part (such as tissue thickness compensation part 1100) It can be removedly located against storehouse platform 1064 or adjacent with storehouse platform 1064, as shown in Figure 199.

Referring again to Figure 199 to Figure 20 1, tissue thickness compensation part can be absorbed by tissue after being implanted into the patient.This Absorption process initially can make tissue thickness compensation part resolve into lesser, which includes Roughen Edges, and Roughen Edges can be to week It encloses tissue T and causes adverse effect.In order to mitigate these adverse effects, tissue thickness can be at least partly assembled by multiple 1140 Compensating part 1100, each of the piece has hurtless measure outer periphery, and can be bound up to form single structure, such as Figure 20 1 It is shown.The bind mode that piece 1140 forms tissue thickness compensation part 1100 makes absorption process make tissue thickness compensation part first 1100 resolve into several 1140, a possibility that Roughen Edges minimum occur to allow.For example, piece 1140 can have circular wheel Exterior feature, and can be bound up to form tissue thickness compensation part 1100 with thermal bond pattern.Also imagine within the scope of this disclosure Other profiles of piece 1140 and the other modes that piece 1140 is bound up.In one example, pass through adhesive 1143 Piece 1140 is bound up (referring to fig. 2 00).Compared with piece 1140, adhesive 1143 can be organized faster to absorb, so that piece 1140 can be separated from each other in the initial stage of absorption process.As shown in Figure 200, multiple 1140 can be arranged to a kind of stacked battle array Column, the end sections of one of piece 1140 can be Chong Die with the end sections of another piece 1140, so that can for example pass through Multiple 1,140 two end sections are releasedly attached to each other to together by adhesive.In some cases, multiple 1140 can be arranged to another stacked array, and wherein one in piece 1140 can be positioned on multiple 1140 and releasable Ground is attached on these pieces 1140, as shown in Figure 20 1.

02 to Figure 20 4 referring to fig. 2, as described above, tissue thickness compensation part can be after being implanted into the patient by group Absorption is knitted, and absorption process initially can make tissue thickness compensation part resolve into random small pieces.As described above, having by utilizing The outer peripheral small pieces of hurtless measure start, it can be achieved that the guidance of absorption process to generate with the outer peripheral small pieces of hurtless measure.Separately A kind of method may include that tissue thickness compensation part is transformed into following manner: can split into tool in the initial stage of absorption process There is the several lesser of hurtless measure periphery.For example, as shown in diagram 202, tissue thickness compensation part 1200 can be all for example including pattern Such as pattern 1212, which can be molded onto or be carved into tissue thickness compensation part 1200, to generate (for example) multiple circles Part 1210.The part 1210 can reduce the thickness of tissue thickness compensation part 1200 by the perimeter 1214 along circular portion 1210 And define, as shown in sectional view 202A.Therefore, along those of 1210 perimeter 1214 of circular portion in tissue thickness compensation part 1200 Part can be organized faster to absorb, this can make circular portion 1210 just be separated from each other in the initial stage of absorption process.Also at this It is contemplated in scope of disclosure including other patterns with other geometries and the multiple portions of hurtless measure outer periphery.Example Such as, as shown in Figure 20 3, tissue thickness compensation part 1200 ' can have pattern 1216, which includes multiple portions 1218, The profile of multiple part can longitudinally be extended along the length of tissue thickness compensation part 1200 ' with waveform curve.In another example In son, as shown in step 204, tissue thickness compensation part 1200 " may include pattern 1220, which may include multiple hexagons Part 1222.

Referring to fig. 2 05, as described above, tissue thickness compensation part such as tissue thickness compensation part 1250 can be for example along tissue T Such as 1002 capture of nail is followed closely, and is configured to for example after being implanted patient's body, in the initial rank of absorption process Section just resolves into several hurtless measure pieces such as piece 1226.These pieces 1226 once separate, so that it may move relative to each other and/or slide Dynamic, this will affect surrounding tissue T.In order to minimize the relative motion between the piece 1226, the nail 1002 of percussion can be made in sky Between on be arranged into tissue thickness compensation part 1250 so that nail 1002 can capture multiple 1226, as shown in Figure 20 5.This Kind arrangement can also aid in the structure that tissue thickness compensation part 1250 keeps substantially integrated, even if multiple 1226 were absorbing It is separated from each other in the initial stage of journey.Therefore, after being separated from each other in the initial stage in piece 1226 in absorption process, tissue thickness The tissue T that compensating part 1250 can continue to capture to nail 1002 provides support.

As to supplement above, referring now to Figure 20 6, the suction of another method guidance tissue thickness compensation part can be used Receipts process, which generates, has hurtless measure outer peripheral.For example, tissue thickness compensation part such as tissue thickness is mended as shown in Figure 20 6 Repaying part 1300 may include multiple slits 1310, these slits 1310 are strategically positioned, to enhance tissue as described above The flexibility of thickness compensation part 1300.In addition, tissue thickness compensation part 1300 can be partly divided into multiple portions by slit 1310 1312, multiple part can be separated from each other in the initial stage of absorption process.Slit 1312 can be along the outer periphery of part 1312 1314 reduce the width of tissue thickness compensation part 1300, as shown in Figure 20 6.The reduction of width may cause 1312 edge of multiple portions Outer periphery 1314 is faster absorbed, and may make tissue thickness compensation part 1300 is resolved into the initial stage of absorption process to separate Part 1312.

07A and Figure 20 7B referring to fig. 2, the end effector of surgery suturing appliance may include the first jaw and the second jaw, Wherein at least one jaw in the first jaw and the second jaw is configured to opposite another jaw movement.Certain In embodiment, which may include the first jaw with staple cartridge channel 1010 and with anvil block 1012 (Figure 20 7B) Second jaw, wherein anvil block 1012 can be pivoted for example towards staple cartridge channel 1010 and/or far from staple cartridge channel 1010.Staple cartridge channel 1010 are configured to receive nail bin 1020, which can for example be removably retained in staple cartridge channel 1010 It is interior.Other embodiments may include the nail bin for being not easy to remove from staple cartridge channel 1010.Nail bin 1020 may include warehouse 1022, storehouse platform 1024 and layer 1000, wherein as shown in Figure 20 7A, layer 1000 can removedly be positioned against storehouse platform 1024 or with Storehouse platform 1024 is adjacent.

Similar to other embodiments as described herein, referring again to Figure 20 7A and Figure 20 7B, warehouse 1022 may include multiple Nail cavity 1026 and the nail 1002 being located in each nail cavity 1026.Otherwise similar to other embodiments as described herein, nail 1002 It can be supported by the staple drivers 1028 being located in warehouse 1022.Wherein sliding part and/or firing member, which can be for example pushed into, wears Nail bin 1020 is crossed, staple drivers 1028 are lifted up in nail cavity 1026, and nail 1002 is projected from nail cavity 1026, such as Shown in Figure 20 7B.When following closely 1002 from the injection of nail cavity 1026, tissue T and/or layer 1000 can be captured by nail 1002, such as Figure 20 7B institute Show.

Layer 1000 can be made of biocompatible materials.In addition, layer 1000 can for example by bioabsorbable material such as PLLA, PGA, PCL and/or their combination are constituted.In at least one embodiment, layer 1000 may include tissue thickness's compensation Part, the tissue thickness compensation part may include internal compression feature structure, and internal compression feature structure is designed in 1000 He of layer Tissue T compensates the thickness of tissue T when being captured as described above by nail 1002.

Referring again to Figure 20 7B, layer 1000 may include tissue contacting surface 1003, which can be by structure It makes as layer 1000 and the sliding between the tissue T that this layer 1000 positions can be reduced.Against with tissue contacting surface 1003 The pressure that the tissue T of contact applies can depend in part on the contact area between tissue T and tissue contacting surface 1003.Due to this Kind pressure is inversely proportional with area, and therefore, reducing contact area can produce the higher pressure against tissue T, and can then produce Raw preferable sliding protection.Tissue contacting surface 1003 may include multiple anti-skid studs 1030, these anti-skid studs 1030 include smaller Contact area, wherein anti-skid stud 1030 can reduce layer 1000 and against this layer 1000 position tissue T between sliding.It can example The layer 1000 with anti-skid stud 1030 is such as produced by compression molding technology.Alternatively, layer 1000 can be first produced, then is for example passed through The laser and/or chemical etch technique that can produce multiple prominent structures form anti-skid stud 1030 in tissue contacting surface 1003. In addition, anti-skid stud 1030 be may include the micron order formed in tissue contacting surface 1003 using such as photoetching technique and/or be received Meter level structure.Photoetching technique generally can be used prefabricated photomask as motherboard, and micron order and/or nanometer can be obtained by the motherboard The final pattern of grade anti-skid stud.It also contemplates within the scope of this disclosure and is used to form micron order and/or nanoscale anti-skid stud The anti-skid stud 1030 that these technologies produce needs can be used in 1030 other technologies.In one example, it is lost using electron beam It carves art and produces anti-skid stud 1030.

Referring now to Figure 20 7C to Figure 22 4, anti-skid stud 1030 may include multiple shapes.For example, as shown in Figure 20 7C, tissue Contact surface 1003 may include cylindricality anti-skid stud 1038, these cylindricality anti-skid studs 1038 may include the base of square and/or rectangle Portion, and it is typically remote from the generallyperpendicular side of the extension of tissue contacting surface 1003.In addition, cylindricality anti-skid stud 1038 can be whole Usually relatively narrow top section or top 1040 are terminated in, as shown in sectional view 208.In addition, tissue contacting surface 1003 may include Conical anti-skid stud 1032 (as shown in Figure 21 8), pyramid anti-skid stud 1034 (as shown in Figure 21 9), and/or cheese are anti-skidding Follow closely 1042 (as shown in Figure 21 1).Pyramid anti-skid stud 1034 may include base portion and the inclination of square and/or triangle Side, these inclined sides usually can far from tissue contacting surface 1003 extend and terminate at top section 1036, such as Shown in sectional view 220.

Anti-skid stud 1030 can be spatially arranged in tissue contacting surface 1003 with predetermined pattern or array.Example Such as, anti-skid stud 1030 spatially can longitudinally extend along 1003 length of surface and multiple rows parallel to each other are disposed in tissue and connect It touches on surface 1003.Anti-skid stud 1030 also spatially can be arranged annularly.For example, anti-skid stud 1030 can be for concentric circles cloth It sets.Alternatively, anti-skid stud 1030 can be randomly located in tissue contacting surface 1003.

As to supplement above, the anti-skid stud 1030 that tissue contacting surface 1003 has may include multiple shapes, a variety of Height and/or a variety of space layout modes, avoid above-mentioned sliding with each region along tissue contacting surface 1003 to some extent. For example, nail 1002 is configured at the region for piercing and capturing tissue T and/or surrounding in tissue contacting surface 1003, It may need to avoid sliding to a greater degree.

09, Figure 21 0 and Figure 21 5 to Figure 21 7 referring to fig. 2, layer 1000 may include linear protrusion 1044, which can set It sets in tissue contacting surface 1003.Linear protrusion 1044 can longitudinally extend.For example, linear protrusion 1044 can be along the length of layer 1000 Degree extends parallel to each other, as shown in Figure 20 9.Alternatively, linear protrusion 1044 can extend along the width of layer 1000, such as Figure 21 5 It is shown.In addition, in length and breadth and lateral linear protrusion 1044 can be at cross path.For example, as shown in Figure 21 7, linear protrusion 1044 the first pattern 1046 can extend in parallel in tissue contacting surface 1003 with first direction, and linear protrusion 1044 Second pattern 1048 can extend in parallel in tissue contacting surface 1003 with second direction, and wherein first direction may vertical or base Perpendicular to second direction on this.In addition, linear protrusion 1044 can have shown in substantially consistent hatch region 210.Alternatively, Linear protrusion 1044 can have different hatch region (not shown).In some cases, the first pattern 1046 and the second pattern 1048 can be it is continuous or intermittent.

As to supplement above, layer 1000 may include non-linear shape protrusion, can be provided only in tissue contacting surface 1003 The non-linear shape protrusion, or setting is combined with linear protrusion 1044.In addition, and anti-skid stud 1030 combination, can tissue contact table Linear protrusion 1044 and/or non-linear shape protrusion are set on face 1003 to avoid sliding in desired limit.

13 and Figure 21 4 referring to fig. 2, layer 1000 may include multiple recess 1050, and multiple recess can be carved into tissue contact table In face 1003, as shown in Figure 22 3.Recess 1050 may include substantially consistent pod shape, as shown in Figure 22 4.Alternatively, recessed Falling into 1050 may include different depth, can avoid sliding to some extent along the multiple regions of tissue contacting surface 1003.One As for, deeper individual recesses can make the area locating for it more soft and make such area more easy disintegrating.In addition, in conjunction with anti-skid stud 1030 as described above, the multiple shapes and/or space layout mode that recess 1050 may include.In addition, layer 1000 may include The combination of the recess 1050 and anti-skid stud 1030 that are spatially arranged in tissue contacting surface 1003.In some cases, anti-skidding Nail 1030 and recess 1050 can be arranged with alternating pattern.

Referring again to Figure 22 3 and Figure 24 4, layer 1000 may include similar to the linear recessed of linear protrusion 1044 (as described above) Fall into 1052, threadiness recess can be for example along the longitudinal extension of the length of layer 1000 and parallel to each other, as shown in Figure 22 3.In addition, layer 1000 may include spatially for example being arranged in linear recess 1052 and the line in tissue contacting surface 1003 with alternating pattern The combination of shape protrusion 1044.In addition, the combination of threadiness recess 1052 and linear protrusion 1044 can referring now to Figure 22 1 and Figure 22 2 It is arranged with wave pattern 1054, as shown in Figure 22 1.

Referring now to Figure 24 4 to Figure 24 6, tissue thickness compensation part such as compensating part 22320 for example may include multiple first Chamber 22322a and multiple second chamber 22322b, the first chamber 22322a and the second chamber 22322b can respectively with nail shapes pit 22062a It is aligned with 22062b.Referring primarily to Figure 24 5, nail shapes pit 22062a and 22062b can be defined in separating on anvil block 22060 Stepped surface in.More specifically, for example, nail shapes pit 22062a can be defined in the first surface of anvil block 22060 In 22069a, and nail shapes pit 22062b can be defined in the second surface 22069b of anvil block 22060, wherein first surface 22069a can be positioned so that relative to second surface 22069b offset or it is higher.First chamber of tissue thickness compensation part 22320 22322a is big than the second chamber 22322b, wherein the first chamber 22322a may extend away get Bi at least one such embodiment Two chamber 22322b high.In view of described above, the first chamber 22322a can be extended up in the first nail shapes pit 22062a, and same When the second chamber 22322b can extend up in the second nail shapes pit 22062b.First chamber 22322a and/or the second chamber 22322b is configured to accommodate drug.

As to supplement above, the first chamber 22322a may be disposed to certain rows, and the second chamber 22322b may be disposed to difference Row.First chamber 22322a and/or the second chamber 22322b are configured to be closely adhered to nail shapes pit respectively In 22062a and/or nail shapes pit 22062b.In addition, tissue thickness compensation part 22320 can be assembled into anvil block 22060, from And the second layer 22327 of compensating part 22320 is positioned against the second surface 22069b of anvil block 22060.Referring now to Figure 24 7 With Figure 24 8, compensating part 22320 can be positioned so that it is adjacent with anvil block 22060 so that when anvil block 22060 towards nail bin 22000 move Position and when compressing the tissue T of both, compensating part 22320 can be adjacent with anvil block 22060.

It is similarly as described above referring now to Figure 22 4A and Figure 22 4B, layer 1000 also may be positioned to it is adjacent with anvil block 1012, So that layer 1000 can be with anvil block 1012 when anvil block 1012 shifts towards nail bin 1020 and compresses the tissue T of both It is adjacent.Be also similarly to it is described above, nail 1002 driven by staple drivers 1028 and from nail cavity 1026 injection after, layer 1000 can It is captured by nail 1002.Specifically, as shown in Figure 22 4A and Figure 22 4B, nail 1002 may include base portion 1060, the first deformable member 1062 and second deformable member 1064.First deformable member 1062 includes the first top 1063, the second deformable member 1064 include the second top 1065, when nail 1002 is driven and projected from nail cavity 1026 by staple drivers 1028, the second top 1065 can pierce together the corresponding nail shapes pit 1066 and 1068 that layer 1000 reaches them with the first top 1063.In addition, working as Top 1063 and 1065 is guided respectively when leaving nail shapes pit 1066 and 1068 on the return path, top 1063 and 1065 Layer 1000 can be respectively pierced again.

Referring again to Figure 22 4A, layer 1000 may include multiple portions 1070, and multiple part may include relative to layer 1000 Rest part reduce thickness.For example, as shown in Figure 22 4A, layer 1000 may include substantially consistent thickness " A ", and portion Dividing 1070 may include the thickness smaller than thickness " A ".In addition, layer 1000 can be aligned with nail bin 1020, so that once will nail 1002 percussions, the top 1063 and 1065 for following closely 1002 can be in the court of the top of deformable member 1062 and 1,064 1063 and 1065 Corresponding pit 1066 and 1068 advance when, pierce tissue T and layer 1000 whole thickness " A ", and can guided respectively from When opening nail shapes pit 1066 and 1068, the thickness of the reduction of part 1070 is pierced.The reduced thickness of part 1070 can promote It is pierced into tissue T again on the return path on top 1063 and 1065 from pit 1066 and 1068 respectively into top 1063 and 1065 In.

Referring now to Figure 22 4B, layer 1000 may include multiple protrusions 1080, and multiple protrusion may include relative to layer 1000 Rest part increase thickness.For example, layer 1000 may include substantially consistent thickness " A ", and dash forward as shown in Figure 22 4B Playing 1080 may include the thickness " A+B " bigger than thickness " A ".Layer 1000 can be aligned with nail bin 1020, so that once will nail 1002 percussions, the top 1063 and 1065 for following closely 1002 can be in the court of the top of deformable member 1062 and 1,064 1063 and 1065 When corresponding pit 1066 and 1068 is advanced, the thickness " A " of tissue T and layer 1000 is pierced.In addition, 1063 He of top of nail 1002 1065 can by respectively guiding leave pit 1066 and 1068 when, pierce layer 1000 thickness " A ", thus at least partly around The package of protrusion 1080 substantially wraps up deformable member 1062 and 1064.In other words, tissue T and protrusion 1080 can be captured Between each component in deformable member 1062 and 1064 and the base portion 1060 for following closely 1002.As to supplement above, dash forward Playing 1080 may be disposed to go, and be configured in the nail shapes pit for being closely adhered to anvil block 1020.For example, as schemed Shown in 224B, protrusion 1080 can have a curved profile, this curved profile be configured to nail shapes pit 1066 and 1068 pairing engagements.

As described above, some embodiments of surgical stapling device may include being arranged in the anvil faces of end effector Layer, such as buttress material and/or tissue thickness compensation part.The layer may be influenced vulnerable to movement and/or misalignment.For example, such as The layer is pulled across tissue when fruit surgeon positions surgical stapling device before suturing tissue, which will be relative to anvil block Movement.In certain embodiments, this layer may include for attaching it to the releasable holding feature structure on anvil block so that This layer is maintained at the position being aligned with anvil block always before being fired by surgical stapling device.In certain embodiments, releasable to keep Feature structure can plant patient's body.

In certain embodiments, referring now to Figure 22 5 to Figure 22 7, attachable (such as supporter material of layer 33420 of anvil block Material and/or tissue thickness compensation part) it may include shell 33426, the chamber being defined in shell 33,426 33424 and be located in chamber Core 33425 in 33424.In the embodiment as at least one, for example, shell 33426 may include by continuously squeezing out profile The film main body of formation, and core 33425 may include fibrous drug core (such as ORC).In at least one embodiment, shell 33426 may include one or more flexible legs 33423, which may be structured to be configured to prolong It reaches in the cutter slit 22063 being defined in anvil block 22060 and the layer 33420 that anvil block attaches is releasably held into anvil block On 22060.

In some other embodiments, 44 to Figure 24 8 referring to fig. 2, attachable (such as supporter material of layer 22320 of anvil block Material and/or tissue thickness compensation part) it could attach on anvil block 22060.In at least one embodiment, the attachable layer of anvil block 22320 may include chamber 22322a and/or chamber 22322b, which is configured to be closely adhered to nail shapes pit respectively In 22062a and/or 22062b.The attachable layer 22320 of anvil block can be releasably held relative to anvil block 22060 by fitting closely. In certain embodiments, the attachable layer 22320 of anvil block can be assembled into anvil block 22060, so that the layer that anvil block is attachable 22320 second layer 22327 is positioned against the second surface 22069b of anvil block 22060.In some other embodiments, join now See Figure 24 7 and Figure 24 8, the attachable layer 22320 of anvil block can be positioned so that it is adjacent with anvil block 22060 so that working as anvil block 22060 shift when compressing the tissue T of both towards nail bin 22000, and the attachable layer 22320 of anvil block can be with anvil block 22060 is adjacent

28 to Figure 23 4 referring to fig. 2, the layer that can make anvil block attachable with retainer are aligned and make with the anvil block of end effector The attachable layer of anvil block is attached on the anvil block of end effector.Referring primarily to Figure 22 9 and Figure 23 0, the attachable layer of anvil block 2030 may include main body 2034 and the protrusion 2036 from the extension of main body 2034.31 to Figure 23 4 referring to fig. 2, protrusion 2036 can be with ends Such as cutter slit of slit 2048 in portion's actuator anvil block 2042 engages.In certain embodiments, protrusion 2036 is than slit 2048 is wide, so that protrusion 2036 is compressed when being inserted into slit 2048.In certain embodiments, protrusion 2036 can be deformed into So that it is heaved outwardly, and squeeze the surface of slit 2048.Compressing force between protrusion 2036 and slit 2048 can provide by The attachable layer 2030 of the anvil block retentivity fixed relative to anvil block 2042.

The attachable layer 2030 of anvil block can be releasably attached on retainer 2000.Retainer 2000 can make anvil block can The layer 2030 of attachment is aligned with anvil block 2042 and the layer 2030 for keeping anvil block attachable is attached on anvil block 2042.Retainer 2000 Embodiment may include lid 2006 and from lid 2006 extend tab 2008 and 2010 (tab 2010 shows in Figure 22 8 to Figure 23 0 Out).As shown in Figure 22 9 and Figure 23 0, tab is configured to engagement nail bin 2020, and nail bin 2020 is releasably held To retainer 2000.Retainer may also include the grip portion 2002 extended from lid 2006, and user catches grip portion 2002 The layer 2030 that retainer 2000, nail bin 2020 and anvil block can be attached is inserted into the staple cartridge channel 2040 of end effector.

Retainer 2000 may also include the tab 2014 extended from lid 2006.In certain embodiments, retainer 2000 can Including two tabs 2014, a tab 2014 extends from each cross side of lid 2006.It is from Figure 22 8 it is clear that every A tab 2014 may include inward-facing groove 2016 and inward-facing angled surface 2018.29 and Figure 23 0 referring to fig. 2, anvil The lateral edge of the attachable layer 2030 of seat can be engaged with the groove 2016 in tab 2014.In various embodiments, work as anvil block When attachable layer 2030 is bonded in the slit 2016 of retainer 2000, the attachable layer 2030 of anvil block and retainer 2000 Lid 2006 can limit gap between them.The attachable layer 2030 of anvil block may be arranged on retainer 2000, so that the layer 2030 protrusion 2036 extends far from retainer 2000.From Figure 22 8 and Figure 23 1 it is clear that retainer 2000 can also wrap Include the ridge 2022 of the protrusion extended from lid 2006.From Figure 23 1 it is clear that the ridge 2022 of the protrusion of retainer 2000 can be with The protrusion 2036 of the attachable layer 2030 of anvil block is aligned.

In use, nail bin 2020 can be inserted into end effector by surgeon, nurse, clinician or other users Staple cartridge channel 2040, anvil block is closed on retainer, by anvil block attach layer from retainer discharge and layer is attached Onto anvil block, retainer then is removed from end effector again.Referring primarily to Figure 23 1 to Figure 23 4, user can firmly grasp retainer Nail bin 2020 is inserted into the staple cartridge channel 2040 of end effector by 2000 (by catching grip portion 2002).By nail bin When in the staple cartridge channel 2040 of 2020 insertion end effectors, the tab 2008 of retainer 2000 can connect with staple cartridge channel 2040 It closes.Figure 23 1 shows the nail bin 2020 being loaded into staple cartridge channel 2040, the layer that wherein retainer 2000 and anvil block attach 2030 are located at 2020 top of nail bin.Figure 23 1 is it also shows that the anvil block 2042 of end effector is located in the attachable layer 2030 of anvil block With 2000 top of retainer.Referring now to Figure 23 2, anvil block 2042 can be transported towards the attachable layer 2030 of retainer 2000 and anvil block It is dynamic.During exercise, the main body 2034 for the layer 2030 that the surface 2044 of anvil block 2042 can be attached with anvil block contacts anvil block 2042.This Outside, the ridge 2036 for the layer 2030 that the slit 2046 (such as cutter slit) of anvil block 2042 can be attached with anvil block engages.In addition, working as anvil When seat 2042 is moved towards nail bin 2020, the lateral edge 2050 of anvil block 2042 can keep the inward-facing angulation of tab 2014 with film The surface 2018 of degree engages, and tab 2014 is pushed out, so that can move away from anvil block towards internal channel 2016 can be attached The lateral edge of the layer 2030 connect.

Anvil block 2042, which continues the movement of layer 2030 attached towards anvil block, to push the layer 2030 that anvil block attaches to retainer 2000 lid 2006.In addition, the meeting of ridge 2022 of the protrusion of retainer 2000 exists when anvil block 2042 continues to move towards nail bin 2020 The protrusion 2036 of the attachable layer 2034 of anvil block will support the protrusion 2036 when engaging the slit 2046 of anvil block 2042.Institute as above It states, the protrusion 2036 for the layer 2030 that the ridge 2022 of the protrusion of retainer 2000 can make anvil block attachable deforms, so that anvil block The outer dimension of the protrusion 2036 of attachable layer 2030 extends outwardly.In other words, the layer 2030 attached in anvil block is dashed forward When playing the slit 2046 that 2036 enter anvil block 2042, the ridge 2022 of the protrusion of retainer 2000 can be pressed into anvil below protrusion 2036 The attachable layer 2030 of seat, causes protrusion 2036 to bloat and/or be expanded into the slit 2046 of anvil block 2042.The protrusion of expansion 2036 contact with slit 2046 and the ridge 2036 for the layer 2030 that anvil block attaches can be maintained in slit 2046.Slit 2046 can wrap Antelabium 2048 is included, antelabium 2048 can capture at least part of protrusion 2036, and protrusion 2036 is more securely maintained at anvil block In 2042 slit 2046.

Referring now to Figure 23 3, when anvil block 2042 is moved far from retainer 2000, anvil block 2042 is attached with anvil block Layer 2030 is together far from retainer 2000.As shown in Figure 23 4, in the attachable layer 2030 of anvil block 2042 and anvil block far from holding The layer 2030 and nail bin 2020 that after device 2000 moves, retainer 2000 can be removed from end effector, and make anvil block attachable It stays in the end effector.

Referring again to Figure 22 9 and Figure 23 0, in certain embodiments, the proximal end 2032 of the attachable layer 2030 of anvil block It could attach on nail bin 2020.For example, the layer 2030 that anvil block attaches can be attached to using adhesive, spot welding and/or hot riveting On nail bin 2020.In various embodiments, the layer 2030 that anvil block attaches is attached on anvil block 2042, and is again turned on anvil After seat 2042, the attachable layer 2030 of anvil block can be separated from nail bin 2020.In various other embodiments, the nail quilt in nail bin Before the layer 2030 that percussion and the anvil block occurred therewith attach is trapped in the nail of percussion, the attachable layer 2030 of anvil block can It remains attached on nail bin 2020.

Figure 23 5 shows the attachable layer 2030 of the anvil block separated with retainer 2000.Figure 23 6 and Figure 23 7 shows anvil block can The other embodiments of the layer of attachment.Figure 23 6 shows the anvil block including main body 2064 and discrete projections extending therefrom 2062 can be attached The layer embodiment 2060 connect.Figure 23 7 shows another anvil block including main body 2074 and discrete projections extending therefrom 2072 can The layer embodiment 2070 of attachment.For example, the main body that each discrete projections 2072 may include the layer 2070 attached from anvil block extends Bolt 2073 and from bolt 2073 extend cap 2075.In certain embodiments, cap 2075 can have bigger than bolt 2073 Size, so that cap can be in the lateral edge 2048 in 2042 slit 2046 of anvil block when protrusion 2072 is inserted into slit 2046 On extend.

Referring now to Figure 23 8 to Figure 24 3, the various embodiments of the attachable layer of anvil block may include that one or more can dispose Attachment features structure, these can dispose attachment features structure and can be formed in the main body of the attachable layer of anvil block.Figure 23 8 is to figure 240 show attachable 2080 embodiment of layer of anvil block, and the attachable layer 2080 of this anvil block includes main body 2082 and is formed in main body A series of in 2082 dispose attachment features structure 2084.By forming hole 2085 in main body 2082, can each dispose attached Connecing feature structure 2084 can form in main body 2082.It may include being attached to main body that attachment features structure 2084, which can each be disposed, Longitudinal portion 2086 on 2082 and the lateral part 2088 being attached on the longitudinal portion 2086.In various embodiments, Longitudinal portion 2086 can be attached in main body 2082 by articulated section 2087.Attachment features structure 2084 can each be disposed by surrounding Hole 2085 and articulated section 2087 allow that attachment features structure 2084 can be disposed transports between non-guidewire lumen and guidewire lumen It is dynamic, more detailed description as follows.In various other embodiments, articulated section 2087 may not be present.In such embodiments, may be used Disposing attachment features structure 2084 can for example be bent around longitudinal portion 2086, to transport between non-guidewire lumen and guidewire lumen It is dynamic.

Figure 23 8, which is shown, disposes attachment features structure 2084 in non-guidewire lumen, wherein it is special each to dispose attachment Sign structure 2084 is located substantially in 2082 plane of main body by the attachable layer 2084 of the anvil block limited.Figure 23 9, which is shown, to be in Guidewire lumen disposes attachment features structure 2084, extends by anvil block wherein can each dispose attachment features structure 2084 The plane that the main body 2082 of attachable layer 2080 limits.It can be around articulated section 2087 for example, attachment features structure 2084 can be disposed Rotation, to extend the plane limited by main body 2082.As shown in Figure 24 0, can dispose attachment features structure 2084 can be deployed to In the slit 2046 of anvil block 2042.Attachment features structure 2084 can be disposed when deployed, longitudinal portion 2086 may extend into anvil In the slit 2046 of seat 2042, and lateral part 2088 may be further extended in slit 2046.It in all cases, can portion The lateral part 2088 of administration's attachment features structure 2084 can be engaged with the antelabium 2048 in slit 2046, attachable to provide anvil block Layer 2080 and anvil block 2042 between stronger retentivity.In addition, the lateral part 2088 of attachment features structure 2084 can be disposed Engaging with the antelabium 2048 in slit 2046 can prevent from disposing attachment features structure 2084 back to non-deployed position.Certain In embodiment, the longitudinal portion 2086 that can each dispose attachment features structure 2084 may be than the narrow 2047 of slit 2046 It is short.It in such embodiments, can be to longitudinal portion 2086 when lateral part 2088 is engaged with the antelabium 2048 in slit 2046 Apply tension.The 2082 tight abutment anvil block 2042 of main body for the layer 2080 that tension in lateral part 2088 can attach anvil block It keeps.

Main body 2082 and it attachment features structure 2084 can be disposed can be formed by single main body.Then, can for example, by The mode that hole 2085 is cut in main body 2082, forms hole 2085 in main body 2082.Stamping tool, cutting blade, laser can be used Or any other suitable device cuts hole 2085.In various other embodiments, the attachable layer 2080 of anvil block and hole 2085 It can be formed in a mold.In certain embodiments, hole 2085 in main body 2082 and can be disposed between attachment features structure 2084 Including gap.In some other embodiments, hole 2085 is not mentioned in main body 2082 and can disposing between attachment features structure 2084 For gap.In various embodiments, for example, the layer that the anvil block between main body 2082 and longitudinal portion 2086 can be attached 2080 thinning or indentations, are consequently formed articulated section 2087.In various other embodiments, do not have to change main body 2082 and can portion Affix one's name to the thickness between the longitudinal portion 2086 of attachment features structure 2084, so that it may form articulated section.

Figure 23 8 to Figure 24 0 described hereinabove shows attachable 2080 embodiment of layer of anvil block, wherein can dispose attached Connecing feature structure 2084 all includes circular lateral part 2088.Lateral part 2088 can have other suitable shapes, including But it is not limited to triangle, ellipse and polygon.For example, Figure 24 1 to Figure 24 3 shows attachable 2090 embodiment of layer of anvil block, It includes respectively the lateral part 2098 with rectangular cross section that attachment features structure 2094, which can wherein be disposed,.Attachment can each be disposed Feature structure 2094 can be attached in main body 2092 by articulated section 2097.

In certain embodiments, the main body of the attachable layer of anvil block and can dispose attachment features structure may include it is flexible and/ Or elastic material.For example, referring again to Figure 23 8 to Figure 24 0, the main body 2082 of the attachable layer 2080 of anvil block and attachment can be disposed Feature structure 2084 may include flexible and/or elastic material.As another example, 41 to Figure 24 3, anvil block are attachable referring to fig. 2 Layer 2090 main body 2092 and can to dispose attachment features structure 2094 may include flexible and/or elastic material.Referring to fig. 2 38 to The attachable layer 2080 of the anvil block of Figure 24 0, when each slit disposed attachment features structure 2084 and be deployed to anvil block 2042 When in 2046 (such as cutter slits), lateral part 2088 can be bent and/or be deformed to pass through the narrow of slit 2046 2047.Then, the antelabium 2048 of slit 2046 is extended past in lateral part 2088 and enter the broad of slit 2046 When in 2049, lateral part 2088 can restore not bend and/or undeformed shape.Restore not bend in lateral part 2088 And/or during undeformed shape, lateral part 2088 can extend transverse in the broad 2049 of slit 2046.In transverse part After dividing 2088 to extend transverse in the broad 2049 of slit 2046, the narrow 2047 of slit 2046 can provide interference and match It closes, lateral part 2088 is inhibited to be pulled out slit 2046 easily.In other words, to lateral part 2088 is pulled out slit 2046, lateral part 2088 just suitably must bend and/or deform again, to pass through the narrow 2047 of slit 2046.? It, being sized such that the narrow 2047 of lateral part 2088 and/or slit 2046 in various embodiments: can Disposing pulling force needed for attachment features structure 2084 pulls out slit can be sufficiently large to position in anvil block 2042 relative to patient tissue When, so that the layer 2080 that anvil block attaches is not shifted from anvil block 2042.However, being captured in the layer 2080 that anvil block attaches by nail Afterwards, pulling force can be small enough so that the attachable layer 2080 of anvil block can be pulled away from from anvil block.

In various embodiments, the layer that anvil block attaches can be disposed attachment features by the cutting blade of surgical stapling device Structure cutting.Referring to fig. 2 40, cutting blade can travel across the slit 2046 of anvil block 2042.Cutting blade substantially can will be each Attachment features structure 2084 can be disposed to cut in half.The attachable layer 2080 of anvil block is removed from anvil block 2042 after it will follow closely percussion When, it is easy to each half block for disposing attachment features structure 2084 pulling out slit 2046.

It just can including anvil block disclosed in the attachable layer such as Figure 23 8 to Figure 24 3 of the anvil block of attachment features structure can be disposed For the layer of attachment, the layer that can make anvil block attachable with retainer is aligned with anvil block and makes that attachment features structure can be disposed and is deployed to In the slit of anvil block.Figure 25 1 to Figure 25 4 shows retainer 19700, but nail bin 19690 is installed to nail bin first by the retainer In channel 19740, the layer 2056 that anvil block attaches then is pressed into anvil block 19720.Retainer 19700 includes first part 2052 With second part 2054, wherein first part 2052 can be relative to second part 2054 along the direction that arrow Q and S are indicated (difference As shown in Figure 25 3 and Figure 25 4) movement.First part 2052 may include cam, which includes inverse salient angle 19646 and 19647, And salient angle 19642 and 19643.Second part may include the cam projection 19614 engaged with the cam of first part 2052 and 19616.As shown in Figure 25 1 and Figure 25 2, when by retainer 19700 be inserted into end effector it is middle when, 19614 He of cam projection 19616 engage with the inverse salient angle 16646 and 16647 of the cam of first part 2052.Referring now to Figure 25 3 and Figure 25 4, will follow closely After storehouse rests upon in the staple cartridge channel 19740 of end effector, first part 2052 can be along the direction of arrow Q relative to second Divide 2054 movements.First part 2052 moves along the direction of arrow Q leads to cam projection 19614 and 19616 and first part 2052 cam lobe 19642 and 19643 engages.Salient angle 19642 and 19643 pushes cam projection 19614 and 19616 open, Layer 2056 to push anvil block attachable with anvil block 19720 to contact.

Referring now to Figure 25 5 to Figure 25 8, in certain embodiments, nail bin can be installed in staple cartridge channel by retainer, will The attachable layer arrangement of anvil block is deployed as and anvil on anvil block, and by the attachment features structure of disposing of layer that anvil block attaches The configuration that seated connection closes.56 and Figure 25 7 referring to fig. 2,2110 embodiment of retainer may include grip portion 2112, towards nail bin part 2114 and towards anvil portion 2118.It can be spaced by supporting element 2116 towards nail bin part 2114 and towards anvil portion 2118 It opens, and may be disposed at an angle relative to each other.From Figure 25 8 it is clear that towards nail bin part 2114 and towards anvil block The angle that part 2118 can be arranged to can be similar to when anvil block 2150 is in a fully open position, staple cartridge channel 2160 and anvil Angle between seat 2150.It may include the first fixture 2124 towards nail bin part 2114 and extend from towards nail bin part 2114 Second fixture 2126.First fixture 2114 can be engaged with nail bin 2140, and nail bin 2140 is releasably held retainer 2110, As shown in Figure 25 5.Second fixture 2126 can be engaged with the staple cartridge channel 2160 of end effector, so that by retainer 2110 releasably hold staple cartridge channel 2160.It may include fixture 2120 towards anvil portion 2118, the fixture 2120 is opposite In the layer that anvil faces 2118 keep anvil block attachable, the attachable layer 2080 of anvil block shown in such as Figure 23 8 to Figure 24 0.Face May also include discrete projections 2122 to anvil portion 2118, the discrete projections relative to anvil block attach layer 2080 on can portion Affix one's name to the position positioning of attachment features structure 2084.As shown in Figure 25 5, when the layer 2080 for attaching anvil block is loaded into retainer 2110 towards on anvil portion 2118 when, the attachable layer 2080 of anvil block can first be shelved on 2122 top of discrete projections.

Referring to fig. 2 58, in certain embodiments, retainer 2110 is being inserted into end effector and is being sat by nail bin 2140 When being placed in staple cartridge channel 2160, the attachable layer 2080 of anvil block can be contacted with anvil block 2150.Once the attachable layer of anvil block 2080 contact with anvil block 2150, and retainer 2110 and nail bin 2140 may continue to move relative to anvil block 2150, until by nail bin 2140 rest upon completely in staple cartridge channel 2160.In such embodiments, retainer 2110 can court towards anvil portion 2118 The attachable movement of layer 2080 of anvil block simultaneously pushes against the layer 2080 that anvil block attaches so that from retainer 2110 towards Attachment features structure 2084 of disposing in layer 2080 can be pushed up and played by the discrete projections 2122 that anvil portion 2118 extends Guidewire lumen as described in above in association with Figure 23 8 to Figure 24 3.In various embodiments, retainer 2110 towards anvil portion Points 2118 each discrete projections 2122 may include inclined surface 2123, the inclined surface 2123 can with can dispose attachment features structure 2084 engagements.When retainer 2110 continues layer 2080 movement attachable relative to anvil block 2150 and anvil block, inclined surface 2123 Can with can dispose the progressive engagement of attachment features structure 2084, until attachment features structure 2084 can be disposed around articulated section 2087 In the slit 2152 for rotating and being deployed to anvil block 2150.As shown in Figure 25 8, the inclined surface 2123 of discrete projections 2122 can be simultaneously Support can each dispose longitudinal portion 2086 and the lateral part 2088 of attachment features structure, so that 2086 He of longitudinal portion Both lateral parts 2088 are deployed in the slit 2152 of anvil block 2150.

In some other embodiments, nail bin 2140 can be rested upon completely in staple cartridge channel 2160 using retainer 2110 In, the layer 2080 without keeping anvil block attachable is contacted with anvil block 2150.In such embodiments, nail bin 2140 rest upon completely in After in staple cartridge channel 2160, anvil block 2150 can be made to move from fully open position towards closed position, so that anvil block 2150 and anvil The attachable layer 2080 of seat contacts, and discrete projections 2122 are deployed to anvil block 2050 for that can dispose attachment features structure 2084 In slit 2052.

Figure 25 9 to Figure 26 2 shows another retainer embodiment 2170.Retainer 2170 may include towards nail bin part 2174 and towards anvil portion 2178, the two parts are supported part 2190 and are spaced apart, and are arranged at an angle relative to each other. Towards the engageable nail bin 2140 in nail bin part 2174 and releasably hold nail bin 2140.It is also engageable towards nail bin part 2174 The staple cartridge channel 2160 of end effector simultaneously releasably holds staple cartridge channel 2160.Towards can be disposed on anvil portion 2178 The attachable layer of anvil block, the layer 2080 such as attached above in association with the anvil block described of Figure 23 8 to Figure 24 0.Such as Figure 26 1 and figure 262 illustrate in greater detail, and may include hole 2182 towards anvil portion 2178, which is arranged in towards on anvil portion 2178 Anvil block attachable layer 2080 dispose the alignment of attachment features structure 2084.Each hole 2182 may include being arranged therein Cam 2202.Each cam 2202 can be attached to towards on anvil portion 2178 by flexible member 2204, so that cam 2202 can be rotated away from hole 2182 around flexible member 2204, and contact with that can dispose attachment features structure 2084.It is each convex Wheel 2202 may include curved surface 2203, which can will can progressively dispose attachment features structure 2084 and be deployed to anvil block In slit 2152 in 2150.Referring to fig. 2 61, cam 2202 start to remove from hole 2182 and with can dispose attachment features structure When 2084 contact, the curved surface 2203 of cam 2202 first can be with the lateral part 2088 that can dispose attachment features structure 2084 Contact, so that lateral part 2088 is deployed in the slit 2152 of anvil block 2150.Referring now to Figure 26 2, with cam 2202 continue to move out hole 2182, and the curved surface 2203 of cam 2202 can be with the longitudinal portion that can dispose attachment features structure 2086 2086 contacts, so that longitudinal portion 2086 is deployed in the slit 2152 of anvil block 2150.

It may include fixed part 2194 towards nail bin part 2174 and towards the supporting element 2190 between anvil portion 2178 With moveable portion 2196.Moveable portion 2196 can be operably linked to button 2192, and user presses lower button 2192, Move moveable portion 2196 relative to fixed part 2194.The moveable portion 2196 of supporting element 2190 may include a series of Cam face 2206, the cam face can be engaged with cam portion 2202, by 2202 introduction hole 2182 of cam portion.When can transport When dynamic part 2196 is proximally moved relative to fixed part 2194, cam face 2206 can allow cam 2202 as described above Hole 2182 is removed, and the attachment features structure 2084 of disposing of the layer 2080 attachable with anvil block contacts.

In certain embodiments, the moveable portion 2196 of supporting element 2190 can be biased in relative to fixed part 2194 Distal position, as shown in Figure 25 9.For example, spring or similar can be arranged between fixed part 2194 and moveable portion 2196 Object.The moveable portion 2196 of supporting element 2190 can be biased in the distal position relative to fixed part 2194 by spring.Each In kind of embodiment, bias force can be sufficiently large so that nail bin 2140 rest upon the power needed for staple cartridge channel 2160 will not Overcome bias force.Therefore, nail bin 2140 is rested upon into the institute in staple cartridge channel 2160 completely being applied with to button 2192 unintentionally In the case where the power needed, can dispose attachment features structure 2084 is less likely to be disposed by cam 2202.

It is releasably held in the various embodiments in surgical stapler anvil in the layer that anvil block attaches, anvil block can be attached The layer connect may include the layer for attaching patient tissue relative to anvil block and the stable other feature structure of anvil block.Referring now to Figure 24 9 and Figure 25 0, the anvil block shown attachable layer 22320a and 22320b are between anvil block 22060 and patient tissue T. The embodiment of anvil block attachable layer 22320a and 22320b can include from the prominent of main body extension in the side towards patient tissue T Play 2078.Protrusion 2078 can be pushed into or be pierced into tissue T, thus provide layer 22320a that tissue T and anvil block attach and Grip between 22320b.Layer 22320a and the 22320b sliding that the grip can prevent tissue from attaching relative to anvil block.

In various embodiments, after the surgical stapling device for being equipped with the attachable layer of anvil block is fired, above-mentioned holding The layer that feature structure can be attached with anvil block separates.In such embodiments, above-mentioned holding feature structure can be attached to one Or on multiple tie-downs.Tie-down can be attached on surgical stapling device or on another object that patient is external, so that suturing After device percussion, these holding feature structures can be taken out from patient's body by pullling tie-down.

In various embodiments, tissue thickness compensation part may include polymer composition.The polymer composition may include One or more synthetic polymers and/or one or more non-synthetic polymers.Synthetic polymer may include the absorbable of synthesis Polymer and/or the non-absorbable polymer of synthesis.In various embodiments, which may include (for example) biological Biocompatible foam.This biocompatible foam may include (for example) porous open celled foam and/or porous closed-cell foam.This life Object biocompatible foam can have uniform pore morphology, or can have gradient pore form (that is, entire depth of foam in one direction On, orifice size gradually increases into macropore).In various embodiments, which may include porous support, porous base Matter, gel-type vehicle, hydrogel matrix, solution matrix, thread matrix, tubulose matrix, composite interstitial substance, membrane matrix, Biostatic are poly- Close one of object and biodegradable polymers or a variety of and their combination.For example, tissue thickness compensation part may include The foam enhanced by thread matrix, or may include the foam with additional hydrogel layer, the additional hydrogel layer is in body It is stretched in the presence of liquid, organizationally to further provide for compressing.In various embodiments, tissue thickness compensation part can also be by material And/or the coating in the second layer or third layer is constituted, which stretches in the presence of body fluid, organizationally to further provide for pressing Contracting.Such layer can be hydrogel, for example, the hydrogel can be synthetic material and/or natural origin material, and can be biological durable Material and/or Biodegradable material.In certain embodiments, can be used can for example provide additional flexibility, rigidity, and/or The fibrous nonwoven material of intensity or fiber mesh type element enhance tissue thickness compensation part.In various embodiments, group Thickness compensation part is knitted with porous form, it such as, such as is small on a surface which, which shows gradient-structure, Hole, and be biggish hole on another surface.This form can be more preferable for tissue in-growth or hemostasis behavior.This Outside, which can also combine with the bio-absorbable section of variation.Short-term absorption profile may be more suitable for realizing hemostasis, and inhale for a long time Better organization healing may be implemented in receipts section will not leak again.

The example of non-synthetic polymer includes but is not limited to lyophilized polysaccharide, glycoprotein, elastin laminin, proteoglycans, bright Glue, collagen and oxidized regenerated cellulose (ORC).The example of the absorbable polymer of synthesis is including but not limited to poly- (lactic acid) (PLA), poly (L-lactic acid) (PLLA), polycaprolactone (PCL), polyglycolic acid (PGA), poly(trimethylene carbonate) (TMC), poly- Ethylene glycol terephthalate (PET), polyhydroxy-alkanoates (PHA), glycolide and the copolymer (PGCL) of 6-caprolactone, second The copolymer of lactide and trimethylene carbonate, poly- (decanedioic acid glyceride) (PGS), polydioxanone, poly- (ortho esters), Polyanhydride, polysaccharide, poly- (ester-acid amide), tyrosine-based polyarylate, tyrosine-based polyimide carbonate, tyrosine-based polycarbonate, Poly- (D, L- lactide-carbamate), poly- (B- hydroxybutyric acid), poly- (E- caprolactone), polyethylene glycol (PEG), poly- [two (carboxylics Phenoxyl) phosphonitrile], poly- (amino acid), intend poly- (amino acid), absorbable polyurethane and their combination.

In various embodiments, which may include (for example) by weight about 50% to about 90% The polymer composition of PLLA, and about 50% to about 10% by weight PCL polymer composition.At at least one In embodiment, which may include (for example) by weight about 70% PLLA, and by weight about 30% PCL.In various embodiments, which may include (for example) by weight about 55% to about 85% The polymer composition of PGA, and by weight 15% to 45% PCL polymer composition.In at least one embodiment, The polymer composition may include (for example) by weight about 65% PGA, and by weight about 35% PCL.Each In kind of embodiment, which may include the (for example) polymer of the PGA of about 90% to about 95% by weight Composition, and about 5% to about 10% by weight PLA polymer composition.

In various embodiments, the absorbable polymer of synthesis may include that bioabsorbable biocompatible elastomers are total Polymers.Suitable bioabsorbable biocompatible elastomers copolymer includes but is not limited to being total to for 6-caprolactone and glycolide Polymers (molar ratio of 6-caprolactone and glycolide is preferably about 30:70 to about 70:30, it is therefore preferable to 35:65 to about 65:35, And more preferably 45:55 to 35:65)；6-caprolactone and lactide are (including L- lactide, D- lactide, their blending Object or lactic acid copolymer) elastomer copolymer (molar ratio of 6-caprolactone and lactide is preferably about 35:65 to about 65: 35, and more preferably 45:55 to 30:70)；To dioxanone (1,4- dioxane -2- ketone) and lactide The elastomer copolymer of (including L- lactide, D- lactide and lactic acid) is (excellent to the molar ratio of dioxanone and lactide Selection of land is about 40:60 to about 60:40)；6-caprolactone and to the elastomer copolymer of dioxanone (6-caprolactone with to two The molar ratio of oxa- cyclohexanone is preferably about 30:70 to about 70:30)；To dioxanone and trimethylene carbonate Elastomer copolymer (is preferably from about 30:70 to about 70:30 to the molar ratio of dioxanone and trimethylene carbonate)；Three Carbonate and glycolide elastomer copolymer (molar ratio of trimethylene carbonate and glycolide is preferably from about 30: 70 to about 70:30)；Trimethylene carbonate and lactide are (including L- lactide, D- lactide, their blend or lactic acid Copolymer) elastomer copolymer (molar ratio of trimethylene carbonate and lactide is preferably from about 30:70 to about 70:30)； And their blend.In one embodiment, which is the copolymer of glycolide and 6-caprolactone.Another In one embodiment, which is the copolymer of lactide and 6-caprolactone.

It is published in the United States Patent (USP) 5 of entitled " the ELASTOMERIC MEDICAL DEVICE " on November nineteen ninety-five 21, 468,253 and it is published in entitled " the FOAM BUTTRESS FOR STAPLING APPARATUS " on December 4th, 2001 The disclosure of United States Patent (USP) 6,325,810 is respectively incorporated by reference accordingly to be incorporated herein.

In various embodiments, the absorbable polymer of synthesis may include (for example) can be with brand name VICRYL (polyglactic 910) from Ethicon, 90/10 Inc. commercially available poly- (glycolide-L- lactide) copolymer, can be with Brand name DEXON from American Cyanamid Co. commercially available polyglycolide, can with brand name PDS from Ethicon, Inc. commercially available polydioxanone, can be with brand name MAXON from American Cyanamid Co. commercially available poly- (glycolide-trimethylene carbonate) statistic copolymer, can with brand name MONOCRYL from One in 75/25 Ethicon commercially available poly- (glycolide-s-caprolactone) copolymer (poliglecaprolactone 25) Kind is a variety of.

The example of the non-absorbable polymer of synthesis includes but is not limited to polyurethane foam plastics, polypropylene (PP), poly- second Alkene (PE), polycarbonate, polyamide such as nylon, polyvinyl chloride (PVC), polymethyl methacrylate (PMMA), polystyrene (PS), polyester, polyether-ether-ketone (PEEK), polytetrafluoroethylene (PTFE) (PTFE), polytrifluorochloroethylene (PTFCE), polyvinyl fluoride (PVF), Fluorinated ethylene propylene (FEP), polyacetals, polysulfones and their combination.The non-absorbable polymer of synthesis may include but unlimited In elastomeric foams and porous elastomers, such as silicone, polyisoprene and rubber.In various embodiments, the conjunction At polymer may include can with brand name GORE-TEX Soft Tissue Patch from W.L.Gore&Associates, Inc. commercially available expanded PTFE (ePTFE), and can be obtained commercially available from Polyganics with brand name NASOPORE The copolyether ester polyurethane foam obtained.

The feature of the polymer composition of tissue thickness compensation part can be (for example) void fraction percent, pore size, and/or Hardness.In various embodiments, which can have the (for example) hole of about 30% to about 99% by volume Gap percentage.In certain embodiments, which can have (for example) by volume about 60% to about 98% Void fraction percent.In various embodiments, which can have (for example) by volume about 85% to about 97% void fraction percent.In at least one embodiment, which may include (for example) by weight about The PCL of 70% PLLA and by weight about 30%, and can have (for example) about 90% porosity by volume.? In at least one such embodiment, therefore, the polymer composition is by the copolymer comprising by volume about 10%.Extremely In few one embodiment, which may include (for example) by weight about 65% PGA and by weight about 35% PCL, and can have the (for example) void fraction percent of about 93% to about 95% by volume.In various embodiments In, which can have the porosity for being greater than 85% by volume.The polymer composition can have (for example) big About 5 microns to about 2000 microns of pore size.In various embodiments, which can have (for example) between big Pore size between about 10 microns to about 100 microns.In the embodiment as at least one, which can be wrapped Copolymer containing (for example) PGA and PCL.In certain embodiments, which can have (for example) between about 100 Micron is to the pore size between about 1000 microns.In the embodiment as at least one, which may include The copolymer of (for example) PLLA and PCL.According in some terms, the hardness of polymer composition can be indicated with Shore hardness, Xiao Family name's hardness can be defined as the material measured with hardometer (such as sclerometer) to the resistance of residual indentation.In order to assess to The durometer value for determining material, according to entitled " Standard Test Method for Rubber Property- The ASTM program D2240-00 (it, which is incorporated by reference, is incorporated herein) of Durometer Hardness ", uses penetrator Foot presses to material.Hardness head pressure feet can be pressed into material, (such as 15 seconds) be kept for the sufficiently long time, wherein then by closing Suitable scale reads reading.The reading for 0 can be obtained when pressure head foot pierces material completely according to scale type used；And And when pressure head foot does not penetrate material, the reading for 100 can be obtained.The reading dimensionless.It in various embodiments, can basis ASTM D2240-00 determines hardness using any suitable scale such as A class and/or OO class scale.In various embodiments In, the polymer composition of tissue thickness compensation part can have the Shore A Hardness value of (for example) about 4A to about 16A, this is hard Angle value is about 45OO to about 65OO within the scope of Shore OO.In the embodiment as at least one, the combination of polymers Object may include (for example) PLLA/PCL copolymer or PGA/PCL copolymer.In various embodiments, tissue thickness compensation part is poly- Polymer composition can have the Shore A Hardness value less than 15A.In various embodiments, the polymer group of tissue thickness compensation part The Shore A Hardness value less than 10A can be had by closing object.In various embodiments, the polymer composition of tissue thickness compensation part can With the Shore A Hardness value for being less than 5A.In certain embodiments, polymer material can have (for example) about 35OO to about The Shore OO composition value of 75OO.

In various embodiments, which can have at least two in the above-mentioned characteristic identified.Each In kind embodiment, which can have at least three kinds in the above-mentioned characteristic identified.The polymer composition can With (for example) 85% to 97% porosity, the Shore A of 5 microns to 2000 microns of pore size and 4A to 16A by volume The shore OO hardness value of hardness number and 45OO to 65OO.In at least one embodiment, for example, the polymer composition can Polymer composition comprising by weight 70% PLLA and by weight 30% PCL polymer composition, and have By volume 90% porosity, 100 microns to 1000 microns of pore size and 4A to 16A Shore A Hardness value and The shore OO hardness value of 45OO to 65OO.In at least one embodiment, for example, the polymer composition may include by weight The polymer composition of 65% PGA and by weight 35% PCL polymer composition, and have by volume 93% to 95% porosity, the Shore A Hardness value of 10 microns to 100 microns of pore size and 4A to 16A and 45OO are to 65OO's Shore OO hardness value.

In various embodiments, tissue thickness compensation part is releasably attached to nail bin using flowable attachment part And/or on anvil block.This flowable attachment part can be operationally associated with nail bin and/or anvil block.In various embodiments In, flowable attachment part can be set between tissue thickness compensation part and nail bin and/or anvil block.In various embodiments, group At least part for knitting thickness compensation part outer surface may include flowable attachment part.In various embodiments, adhesive is laminated Body may include tissue thickness compensation part and flowable attachment part.The adhesive phase laminate may include base and be located at substrate surface At least part on adhesive phase, which includes tissue thickness compensation part, which includes flowable attachment Point.The adhesive phase laminate may include tissue contacting surface and opposite surface, which includes that tissue thickness is mended Part is repaid, which includes flowable attachment part.The adhesive phase laminate can be releasably attached to nail bin and/or On anvil block.

In various embodiments, flowable attachment part can be such as pressure-sensitive viscous for example comprising flowable polymer composition Mixture (" PSA ").A effective amount of contact adhesive can be applied to tissue thickness compensation part, these contact adhesives are capable of providing Enough cohesive strengths are adhered to nail bin and/or anvil block to generate desired adhesion characteristic.Contact adhesive may have following One of characteristic is a variety of: (1) strong and lasting adherence；(2) with finger gently once pressing and can adhere to；(3) enough The ability being maintained on adherend；(4) enough cohesive strengths from adherend thoroughly to remove.In various embodiments, when to When flowable attachment part applies pressure, heat and/or stress, flowable attachment part is with regard to flowable.Such pressure and/or stress For example can directly apply by hand and/or by equipment (such as mechanical equipment), correspondingly, and can be manual processes and/or from Dynamic process.

In various embodiments, flowable attachment part may make accordingly temperature change and/or pressure change.Each In kind embodiment, when applying heat and/or pressure to flowable attachment part, flowable attachment part can be flowed to from first position The second position.In various embodiments, flowable attachment part is flowable under body temperature (37 DEG C) and/or under room temperature (25 DEG C). In various embodiments, flowable attachment part is flowable under body temperature (37 DEG C), but is not under room temperature (25 DEG C).Various In embodiment, flowable attachment part may be made temperature change accordingly, so that when tissue thickness compensation part is first When temperature, flowable attachment part is located at first position, and when tissue thickness compensation part is second temperature, flowable attachment Part is located at the second position.In various embodiments, second temperature is than the first temperature height.In various embodiments, the first temperature Degree can be room temperature, and second temperature is body temperature.In various embodiments, flowable attachment part may make pressure change Accordingly, so that when tissue thickness compensation part is by first pressure, flowable attachment part is located at first position, and When tissue thickness compensation part is by second pressure, flowable attachment part is located at the second position.In various embodiments, the second pressure Power is big than first pressure.In various embodiments, first pressure can be atmospheric pressure, and second pressure can be finger pressure Power.In various embodiments, flowable attachment part can be worked as from the first position flow direction when being in room temperature and/or atmospheric pressure Second position when in body temperature and/or finger pressure.In various embodiments, when to flowable attachment part apply pressure And/or when stress, flowable attachment part can flow to the second position from first (unstressed) position.

In various embodiments, flowable attachment part can flow in the gap in nail bin and/or anvil block.In various implementations In example, when applying heat to flowable attachment part and/or when pressure, flowable attachment part is flowable, and in nail bin and/or Extend on at least part without flowable attachment part on the surface of anvil block, and/or in filling nail bin and/or anvil block At least part in gap (such as, such as slit and/or nail cavity).In various embodiments, flowable attachment part can be in body Interior flowing, to fill at least part in the gap in nail bin and/or anvil block.In various embodiments, flowable attachment part It is flowable that flowable attachment part is made to include the shape complementary at least part in the gap in nail bin and/or anvil block.? In various embodiments, flowable polymer composition is flowable to fill at least part of slit and/or nail cavity in anvil block.? In various embodiments, when applying pressure to flowable attachment part, flowable attachment part can be flowed in gap, and in sky The shape of gap.It is not intended to bound to any specific theory, it is believed that with flowable attachment part by the sky in nail bin and/or anvil block Gap at least part filling can augmenting tissue thickness compensation part and nail bin and/or anvil block attachment intensity.

In various embodiments, flowable attachment part such as contact adhesive may become temperature change and/or pressure Be turned into it is corresponding out, to be moved between first position and/or first profile and the second position and/or the second profile.In various realities It applies in example, flowable attachment part can have the first position being spaced apart with nail bin and/or anvil block.In various embodiments, when When flowable attachment part is located at the second position, flowable attachment part is configured to penetrate into nail bin and/or anvil block Gap, and/or at least part in this of nail bin and/or anvil block gap is filled.As described herein, flowable attachment part Can be in the shape in gap so that when specifying flowable attachment part in the second profile, flowable attachment part include with The profile of gap complementation.In various embodiments, first position and/or first profile can be separated with nail bin and/or anvil block, and And the second position and/or the second profile can be contacted with nail bin and/or anvil block.In various embodiments, first position and/or first Profile may include neutrality (original) profile when in room temperature and/or atmospheric pressure, and the second position and/or the second profile It may include the profile complementary with the gap in nail bin and/or anvil block when in body temperature and/or finger pressure.Flowable attachment Partial profile is flowable, to reach the shape and/or size complementary with the gap in nail bin and/or anvil block.

In various embodiments, the method for tissue thickness compensation part being bonded to substrate (such as nail bin and/or anvil block) is big Body can include: tissue thickness compensation part is provided, flowable attachment part (such as contact adhesive) is for example applied to tissue thickness At least part on compensating part surface is spent, and contacts flowable attachment part with substrate.In various embodiments, by tissue The method that thickness compensation part is bonded to substrate may include that pressure is applied at least one of tissue thickness compensation part and substrate. Flowable attachment part can be flowed to from the first position on tissue thickness compensation part outer surface further include substrate outer surface and/or The second position of inner surface.Flowable attachment part can be contacted with substrate, and tissue thickness compensation part is made to be adhered to substrate.Various In embodiment, tissue thickness compensation part can be bonded to substrate by flowable attachment part.In various embodiments, flowable attachment Part can flow to such as slit and/or nail cavity at least one gap in substrate.In various embodiments, flowable attachment Divide when in the second position, at least part at least one gap in substrate can be filled.

In various embodiments, method tissue thickness compensation part being attached on substrate (such as nail bin and/or anvil block) It can generally include: by least one discrete globule of flowable polymer composition (such as contact adhesive) and/or discrete item Band is applied to the surface of tissue thickness compensation part, make substrate and flowable polymer composition at least one discrete globule and/ Or discrete bands contact, and by the substrate of flowable polymer composition and at least one discrete globule and/or discrete bands At least one the discrete globule and/or discrete bands for pressing to another flowable polymer composition, tissue thickness is compensated Part is releasably attached in substrate.In various embodiments, tissue thickness compensation part is attached to the side in substrate Method may include being applied at least one discrete globule and/or discrete bands of flowable polymer composition to mend in tissue thickness Repay the substrate on part periphery and/or central axis at the desired location of substrate.In various embodiments, by tissue thickness compensation part The method being attached in substrate may include by least one discrete globule of flowable polymer composition and/or discrete bands edge Longitudinal direction and/or transverse direction are applied in tissue thickness compensation part.

In various embodiments, tissue thickness compensation part is attached to the method in substrate may include at least partly base In painting amount desired in tissue thickness compensation part, pre-selected pattern and/or amount apply flowable polymer composition extremely A few discrete globule and/or discrete bands.The pattern and amount of application flowable polymer composition may be selected, to bear and face Bed doctor manipulates the associated stress of medical device (such as shear stress).In view of clinician convenient for manipulation and/or flowable poly- The preservation of polymer composition, being preferably selected as the pattern for applying flowable polymer composition and amount makes flowable polymer Amount balance on composition.In addition, when selection applies the pattern and amount of flowable polymer composition, it is contemplated that flowable poly- The composition of polymer composition.

In various embodiments, flowable attachment part tissue thickness compensation part can be partly attached to nail bin and/or Anvil block, and/or tissue thickness compensation part can be fully attached to nail bin and/or anvil block.The tissue thickness's compensation adhered to completely Part may include the complete of the flowable polymer composition (such as, such as contact adhesive) between tissue thickness compensation part and substrate Flood.In other words, the tissue thickness compensation part adhered to completely can not have any a part to be not coated with for tissue thickness compensation part can The tissue thickness compensation part of flowing copolymer composition.The tissue thickness compensation part of part attachment may include tissue thickness compensation part A effective amount of flowable polymer composition between substrate comprising tissue thickness compensation part is free of flowable polymer group Close at least part of object.The tissue thickness compensation part of part attachment can apply to flowable polymer composition than attachment completely The bigger shear stress of tissue thickness compensation part.Therefore, the shear property of flowable polymer composition and/or flowable poly- The pattern and amount of polymer composition can be selected as bearing to manipulate medical device by way of expectations by clinician.

It in various embodiments, can be by flowable polymer composition with one of continuous pattern and discontinuous pattern figure The form of case is applied to tissue thickness compensation part.In various embodiments, the continuous pattern of flowable polymer composition can wrap Include the discrete bands for the flowable polymer composition being applied at least part of tissue thickness compensation part.In various implementations In example, the continuous pattern of flowable polymer composition may include along at least part longitudinal direction of tissue thickness compensation part central axis Be arranged and/or along tissue thickness compensation part periphery at least part be arranged flowable polymer composition continuous globule. Flowable polymer composition can be used various other patterns and configuration is applied in substrate, such as cruciform pattern or other are right Linea angulata pattern, it is continuous in blocks or one layer continuous, or any other design of desired adhesion characteristic can be reached.In various implementations In example, the continuous pattern of flowable polymer composition can apply along the inner periphery of tissue thickness compensation part and/or outer periphery.? In various embodiments, the continuous pattern of flowable polymer composition can apply along the inner periphery of tissue thickness compensation part, thus So that flowable polymer composition is fixed along the central longitudinal axis of substrate when tissue thickness compensation part to be attached in substrate Position.In various embodiments, the continuous pattern of flowable polymer composition can apply along the inner periphery of tissue thickness compensation part, So that when tissue thickness compensation part to be attached in substrate, at least one of flowable polymer composition and substrate Gap (such as slit and/or nail cavity) alignment.In various embodiments, the continuous pattern of flowable polymer composition can be along group The outer periphery for knitting thickness compensation part applies, so that when tissue thickness compensation part to be attached in substrate, flowable polymerization Compositions are positioned along the outer periphery of substrate.In various embodiments, flowable polymer composition is applied to tissue thickness Compensating part, so that the interior section and/or peripheral border of substrate are free of flowable polymer composition.

In various embodiments, the discontinuous pattern of flowable polymer composition may include being separated from each other in substrate Flowable polymer composition multiple discrete globules and/or discrete bands.In various embodiments, flowable polymer group At least part of the multiple globules and/or band that close object can be when being pressurized and/or when stress is pinched together.Various In embodiment, the multiple globules and/or band that flowable polymer composition is pressed together can form flowable polymer The continuous pattern of composition.In various embodiments, the tissue thickness compensation part of part attachment can include that can flow on the surface thereof The multiple discrete globules being separated from each other and/or discrete bands of dynamic polymer composition, so that tissue thickness compensation part When being under pressure, at least part on surface is the free space without flowable polymer composition.It is this freely empty Between may include tissue thickness compensation part the part being in contact with each other without the globule and/or band of flowable polymer composition, And/or the globule of flowable polymer composition and/or the part of band are not applied in tissue thickness compensation part.In various implementations In example, free space can be the interior section and/or peripheral border of substrate.

In various embodiments, tissue thickness compensation part is attached to the method in substrate may include by flowable polymer At least one discrete bands of composition are applied in tissue thickness compensation part.In various embodiments, flowable polymer group The discrete bands for closing object can extend along a part of the central longitudinal axis of tissue thickness compensation part.In at least one embodiment In, the discrete bands of flowable polymer composition can be (all at least one gap in substrate in tissue thickness compensation part Such as slit and/or nail cavity) alignment a part apply.In various embodiments, tissue thickness compensation part is attached in substrate Method may include that multiple parallel discrete bands of flowable polymer composition are applied in tissue thickness compensation part.? In various embodiments, two discrete bands of flowable polymer composition can be along the opposite side edge of tissue thickness compensation part It is longitudinal to extend.In at least one embodiment, for example, each band in two discrete bands of flowable polymer composition It can be applied in tissue thickness compensation part with a part that at least one gap (such as slit and/or nail cavity) is aligned in substrate Add.In various embodiments, it can pre-select between band and/or the distance between side edge, so that will organize When thickness compensation part is attached in substrate, flowable polymer composition can flow at least one gap (such as anvil in substrate At least one nail cavity of seat) in.

In various embodiments, it can pre-select between multiple parallel discrete bands of flowable polymer composition Distance and/or the distance between side edge so that tissue thickness compensation part can be completely adhered to substrate, or be partially attached to Substrate.In various embodiments, the width of above-mentioned band can for example, at least be 1mm.In various embodiments, the width of band can Such as between about 0.5mm and about 1.5mm.In various embodiments, the width of band can be for example between about 1.0mm peace treaty Between 1.25mm.In various embodiments, the gap width between adhesive strings and/or between side edge can for example, at least be 1mm.In various embodiments, it can pre-select between band and/or the distance between side edge, so that tissue thickness compensates Part is partly attached to substrate, pre-selects adhesive based on the expection applied amounts in tissue thickness compensation part and adhesive-free is empty The ratio between.In various embodiments, the ratio between adhesive and adhesive-free space can be 1:10 to 10:1, such as 1:1,1:2,1: 3,1:4,1:5 and 2:3.

In various embodiments, example, it may require are as follows: the flowable minimum value of contact adhesive be 0.25mm.Various In embodiment, for example, the thickness that contact adhesive substrate includes may be between about 1.25mm and about 1.50mm.In certain realities It applies in example, for example, the thickness that contact adhesive substrate includes may be between about 0.5mm and about 0.75mm.

As described herein, in various embodiments, flowable attachment part may include flowable polymer composition.It can flow Dynamic polymer composition may include contact adhesive.Flowable attachment part may include contact adhesive layered product.In various realities It applies in example, flowable attachment part may include adhesive phase laminate, which includes tissue thickness compensation part and can Flowing copolymer composition.Polymer composition may include one or more synthetic polymers and/or one or more natural poly- Close object.Polymer composition can be bioabsorbable, biocompatibility and/or biodegradable.Natural polymer Example include but is not limited to lyophilized polysaccharide, glycoprotein, elastin laminin, proteoglycans, gelatin, collagen, fibrin, it is fine even Albumen, fibrinogen, elastin laminin, seralbumin, hemoglobin, ovalbumin, oxidized regenerated cellulose (ORC) and it Combination.The example of polysaccharide include but is not limited to hyaluronic acid, chondroitin sulfate, hydroxyethyl starch, hydroxyethyl cellulose, Hydroxypropyl cellulose, carboxymethyl cellulose, chitin/chitosan, agarose, alginates and their combination.Synthesized polymer The example of object including but not limited to poly- (lactic acid) (PLA), poly (L-lactic acid) (PLLA), polycaprolactone (PCL), polyglycolic acid (PGA), poly- (hydroxyacetic acid), poly- (hydroxybutyric acid), polyester, poly(trimethylene carbonate) (TMC), gather to benzene poly- (phosphine nitrile) Naphthalate (PET), polyhydroxy-alkanoates (PHA), glycolide and 6-caprolactone (PGCL) copolymer, glycolide With the copolymer, poly- (decanedioic acid glyceride) (PGS), polydioxanone, poly- (ortho esters), polyacids of trimethylene carbonate Acid anhydride, polyacrylamide, polysaccharide, poly- (ester-acid amide), tyrosine-based polyarylate, tyrosine-based polyimide carbonate, tyrosine-based are poly- Carbonic ester, poly- (B- hydroxybutyric acid), poly- (E- caprolactone), polyethylene glycol (PEG), gathers poly- (D, L- lactide-carbamate) Ethylene oxide, poly- (amino acid), intends poly- (amino acid), absorbable polyurethane, poly- methyl-prop at poly- [two (carboxyphenoxy) phosphonitriles] Olefin(e) acid hydroxyl ethyl ester, polyvinylpyrrolidone, polyvinyl alcohol, polyacrylic acid, poly- acetic acid esters, polycaprolactone, polypropylene, nylon, And their combination.

In various embodiments, flowable polymer composition may include the copolymer (PCL/ of 6-caprolactone and glycolide PGA).In various embodiments, flowable polymer composition may include the PGA of (for example) by weight about 50% to about 90% Polymer composition, and by weight about 50% to about 10% PCL polymer composition.In various embodiments, may be used Flowing copolymer composition may include the polymer composition of the (for example) PGA of by weight about 50% to about 75%, and by weight The polymer composition of the PCL of meter about 50% to about 25%.In various embodiments, flowable polymer composition may include The (for example) polymer composition of the PGA of by weight about 50% to about 60%, and the PCL of by weight about 50% to about 40% Polymer composition.In at least one embodiment, flowable polymer composition may include (for example) by weight about The polymer composition of 70% PGA, and by weight about 30% PCL polymer composition.In at least one embodiment In, flowable polymer composition may include the polymer composition of (for example) by weight about 64% PGA, and by weight The polymer composition of about 36% PCL.

In various embodiments, flowable polymer composition may include 6-caprolactone and lactide (including L- lactide, D- lactide, their blend and lactic acid copolymer) copolymer.In various embodiments, flowable polymer composition May include from 30:70 to 70:30 (such as, such as the PCL and PGA of 35:65 to 65:35,45:55 to 35:65 and 50:50) Molar ratio.In various embodiments, the amount of 6-caprolactone can be 30 to 45 molar percentages, and surplus is glycolide, such as, such as ε-caprolactone amount is 35 to 40 molar percentages, and surplus is glycolide.In various embodiments, contact adhesive may include [poly- (6-caprolactone -co- glycolide)] copolymer of 36:64 (moles/mole).In various embodiments, flowable polymer Composition may include to dioxanone (1,4- dioxane-2-ketone) and lactide (including L- lactide, D- lactide and Lactic acid) copolymer.In various embodiments, flowable polymer composition may include pair that molar ratio is 40:60 to 60:40 Dioxanone and lactide.In various embodiments, flowable polymer composition may include 6-caprolactone and to dioxy The copolymer of heterocycle hexanone.In various embodiments, it is 30:70 to 70:30 that flowable polymer composition, which may include molar ratio, 6-caprolactone and to dioxanone.

In various embodiments, tissue thickness compensation part and flowable attachment part may include same combination of polymers Object, or polymer composition not of the same race.In various embodiments, tissue thickness compensation part and flowable attachment part may include Same bioabsorbable material, such as the copolymer (PCL/PGA) of 6-caprolactone and glycolide.In various embodiments, group It knits thickness compensation part and flowable attachment part and difference may be present at least one characteristic aspect selected from following characteristics: substance group At, modulus, elongation, intrinsic viscosity, crystallinity and Bioabsorbable.In various embodiments, tissue thickness compensation part and Flowable attachment part may include same copolymer, which exists at least one characteristic aspect selected from following characteristics Difference: material composition, modulus, elongation, intrinsic viscosity, crystallinity and Bioabsorbable.For example, tissue thickness compensation part and Flowable attachment part all may include PCL/PGA copolymer, which suppose in the weight percent of 6-caprolactone and glycolide There are difference in terms of the molar ratio of face and/or 6-caprolactone and glycolide.In at least one embodiment, tissue thickness compensation part May include by weight about 50% PGA polymer composition and by weight about 50% PCL polymer composition, and And flowable attachment part may include by weight about 64% PGA polymer composition and by weight about 36% PCL Polymer composition.In at least one embodiment, tissue thickness compensation part may include mole of 6-caprolactone and glycolide Than the PCL/PGA copolymer for 50:50, and flowable attachment part may include that the molar ratio of 6-caprolactone and glycolide is The PCL/PGA copolymer of 36:64.

In various embodiments, the ε-in the concentration and tissue thickness compensation part of the 6-caprolactone in contact adhesive is in oneself The concentration (both concentration are respectively based on the weight of polymer composition) of ester can differ at least 1 weight %.In various embodiments In, the concentration of the 6-caprolactone in contact adhesive can differ at least 5 with the concentration of the 6-caprolactone in tissue thickness compensation part Weight %.In various embodiments, the ε-in the concentration and tissue thickness compensation part of the 6-caprolactone in contact adhesive is in oneself The concentration of ester can differ at least 10 weight %.In various embodiments, the concentration and tissue of the 6-caprolactone in contact adhesive The concentration of 6-caprolactone in thickness compensation part can differ at least 15 weight %.In various embodiments, in contact adhesive The concentration of 6-caprolactone can differ 1 to 15 weight % with the concentration of the 6-caprolactone in tissue thickness compensation part.In various implementations In example, the concentration of the 6-caprolactone in contact adhesive and the concentration of the 6-caprolactone in tissue thickness compensation part can differ 10 to 15 weight %.In various embodiments, the ε-in the concentration and tissue thickness compensation part of the 6-caprolactone in contact adhesive oneself The concentration of lactone can differ 14 weight %.In various embodiments, as described above, the concentration of the 6-caprolactone in contact adhesive It may be different from the concentration of the 6-caprolactone in tissue thickness compensation part, so that the 6-caprolactone in contact adhesive is dense Degree may be bigger than the concentration of the 6-caprolactone in tissue thickness compensation part or small.

In various embodiments, the polyethanol in the concentration and tissue thickness compensation part of the polyglycolic acid in contact adhesive The concentration of acid can differ at least 1 weight %.In various embodiments, the concentration of the polyglycolic acid in contact adhesive and tissue are thick The concentration of polyglycolic acid in degree compensating part can differ at least 5 weight %.In various embodiments, the poly- second in contact adhesive The concentration of alkyd can differ at least 10 weight % with the concentration of the polyglycolic acid in tissue thickness compensation part.In various embodiments In, the concentration of the polyglycolic acid in contact adhesive can differ at least 15 with the concentration of the polyglycolic acid in tissue thickness compensation part Weight %.In various embodiments, the polyethanol in the concentration and tissue thickness compensation part of the polyglycolic acid in contact adhesive The concentration of acid can differ at least 20 weight %.In various embodiments, the concentration and tissue of the polyglycolic acid in contact adhesive The concentration of polyglycolic acid in thickness compensation part can differ 1 weight % to 20 weight %.In various embodiments, contact adhesive In the concentration of polyglycolic acid can differ 15 weight % to 20 weight % with the concentration of the polyglycolic acid in tissue thickness compensation part. In various embodiments, the concentration of the polyglycolic acid in the concentration and tissue thickness compensation part of the polyglycolic acid in contact adhesive 16 weight % can be differed.In various embodiments, as described above, the concentration of the polyglycolic acid in contact adhesive may be different from The concentration of polyglycolic acid in tissue thickness compensation part, so that the concentration of the polyglycolic acid in contact adhesive may be than group The concentration for knitting the polyglycolic acid in thickness compensation part is big or small.

In various embodiments, the ε-in the concentration and tissue thickness compensation part of the 6-caprolactone in contact adhesive is in oneself The concentration of ester can differ at least 1 mole of %.In various embodiments, the concentration of the 6-caprolactone in contact adhesive and tissue are thick The concentration of 6-caprolactone in degree compensating part can differ at least 5 moles of %.In various embodiments, the ε-in contact adhesive oneself The concentration of lactone can differ at least 10 moles of % with ε-caprolactone concentration in tissue thickness compensation part.In various embodiments In, the concentration of the 6-caprolactone in contact adhesive can differ at least 15 with the concentration of the 6-caprolactone in tissue thickness compensation part Mole %.In various embodiments, the ε-in the concentration and tissue thickness compensation part of the 6-caprolactone in contact adhesive is in oneself The concentration of ester can differ 1 mole of % to 15 moles of %.In various embodiments, the concentration of the 6-caprolactone in contact adhesive with The concentration of 6-caprolactone in tissue thickness compensation part can differ 10 moles of % to 15 moles of %.In various embodiments, pressure-sensitive The concentration of 6-caprolactone in adhesive can differ 14 moles of % with the concentration of the 6-caprolactone in tissue thickness compensation part.Each In kind embodiment, as described above, the concentration of the 6-caprolactone in contact adhesive may be different from tissue thickness compensation part The concentration of 6-caprolactone, so that the concentration of the 6-caprolactone in contact adhesive may be than the ε-in tissue thickness compensation part The concentration of caprolactone is big or small.

In various embodiments, the polyethanol in the concentration and tissue thickness compensation part of the polyglycolic acid in contact adhesive The concentration of acid can differ at least 1 mole of %.In various embodiments, the concentration of the polyglycolic acid in contact adhesive and tissue are thick The concentration of polyglycolic acid in degree compensating part can differ at least 5 moles of %.In various embodiments, the poly- second in contact adhesive The concentration of alkyd can differ at least 10 moles of % with the concentration of the polyglycolic acid in tissue thickness compensation part.In various embodiments In, the concentration of the polyglycolic acid in contact adhesive can differ at least 15 with the concentration of the polyglycolic acid in tissue thickness compensation part Mole %.In various embodiments, the polyethanol in the concentration and tissue thickness compensation part of the polyglycolic acid in contact adhesive The concentration of acid can differ at least 20 moles of %.In various embodiments, the concentration and tissue of the polyglycolic acid in contact adhesive The concentration of polyglycolic acid in thickness compensation part can differ 1 mole of % to 20 moles of %.In various embodiments, contact adhesive In the concentration of polyglycolic acid can differ 15 moles of % to 20 moles of % with the concentration of the polyglycolic acid in tissue thickness compensation part. In various embodiments, the concentration of the polyglycolic acid in the concentration and tissue thickness compensation part of the polyglycolic acid in contact adhesive 16 moles of % can be differed.In various embodiments, as described above, the concentration of the polyglycolic acid in contact adhesive may be different from The concentration of polyglycolic acid in tissue thickness compensation part, so that the concentration of the polyglycolic acid in contact adhesive may be than group The concentration for knitting the polyglycolic acid in thickness compensation part is big or small.

In various embodiments, flowable polymer composition may include other optional component, further to improve The machinability and/or mechanical property and other characteristics of composition, for example, adherence, light fastness aging, resistance to oxidative aging, Heat-resistant aging and visual appearance.Such optional component may include other copolymers, and flowable polymer composition may include this Other copolymers are to obtain desired property, such as can enhance the adhesion or compatibility with substrate.In various embodiments, Such other optional component may include but be not limited to other polymers or copolymer, filler, crosslinking agent, tackifier, plasticizer, Pigment, dyestuff, antioxidant, colorant and stabilizer.In various embodiments, flowable polymer composition may include certain The tackifier of amount, amount press the total weight of polymer composition, are at least 0.1 weight %, at least 2 weight % or at least 5 weights Measure % and up to 10 weight %, 25 weight % or 50 weight %.In various embodiments, flowable polymer composition can wrap Containing a certain amount of plasticizer, amount presses the total weight of polymer composition, is at least 0.1 weight %, at least 2 weight % or extremely Few 5 weight % and up to 10 weight %, 25 weight % or 50 weight %.

In various embodiments, flowable attachment part may include flowable (plastically deformable) combination of polymers Object.In various embodiments, flowable polymer composition usually can be tacky under room temperature (for example, 20 DEG C to 25 DEG C), and Only applying modest pressure (such as finger pressure) to it can be releasably adhered to it in a variety of substrates, be attached to being formed Bonding in substrate.In various embodiments, flowable polymer composition up to 40 DEG C, up to 45 DEG C, up to 50 DEG C, it is more It up to 55 DEG C, and/or is solid at up to 60 DEG C.In various embodiments, flowable polymer composition is more than 40 DEG C, more than 45 DEG C, will melt more than 50 DEG C, more than 55 DEG C, more than 60 DEG C, and/or more than 120 DEG C, but it is non-degradable.In various embodiments, Flowable polymer composition is up to 600 DEG C, is up to 500 DEG C, is up to 400 DEG C, is up to 300 DEG C, is up to 240 DEG C, and/or be up to 180 DEG C it is all fusible and non-degradable.In various embodiments, flowable polymer composition is at 40.1 DEG C Within the temperature range of to 600 DEG C, it is fusible and non-degradable within the temperature range of 120 DEG C to 240 DEG C, and/or at a temperature of 180 DEG C.

In various embodiments, the characteristics of flowable polymer composition, can are as follows: the 0.1g/dL hexafluoro isopropyl of the composition Intrinsic viscosity of the alcoholic solution at 25 DEG C be 0.6g/dL to 4.0g/dL, 0.8g/dL to 3.2g/dL, 1.0g/dL to 2.4g/dL, And/or 1.6g/dL.In various embodiments, flowable polymer composition can not include gel.

In various embodiments, flowable polymer composition can have one of following characteristic or a variety of: crystallinity Percentage is less than about 25%, is less than about 15%, and from 15% to 25%；Elongation is greater than about 200, greater than about 500, with And from about 200 to about 500；Modulus is less than about 40,000psi, is less than about 20,000, and from about 20,000psi to about 40, 000psi。

In various embodiments, flowable attachment part may include being attached to the surface and/or side of tissue thickness compensation part One of bar, ribbon, band volume, tablet and membranoid substance on edge.In various embodiments, flowable attachment part It may include pressure sensitive adhesive tape, which includes adhesive and backing.In various embodiments, backing may include flexible backings One of material and not bending back lining materials.The example of flexible backing material includes but is not limited to plastic foil such as poly- third Alkene, polyethylene, polyvinyl chloride, polyester (polyethylene terephthalate), polycarbonate, polymethyl methacrylate (PMMA), cellulose acetate, Triafol T and ethyl cellulose.Foam-back can be used.Not bending back lining materials Example include but is not limited to metal, metallized polymeric film, be coated with tin indium oxide glass and polyester, PMMA plate, poly- carbonic acid Ester plate, glass or ceramic sheet material.In various embodiments, pressure sensitive adhesive tape may include release liner.In various embodiments, pass through Release liner is removed to exposure adhesive, pressure sensitive adhesive tape can be applied.

In various embodiments, can be used conventional coating techniques for example roller coating, flow coat, dip-coating, spin coating, spraying, blade coating and Flowable attachment part is applied to tissue thickness compensation part by extrusion coated.In various embodiments, flowable attachment part can Such as with about 1.25mm to the original depth of about 1.50mm.In some embodiments, flowable attachment part can for example with The original depth of about 0.5mm to about 0.75mm.It in various embodiments, can when applying pressure to flowable attachment part The final thickness having is such as at least 0.25mm.

In various embodiments, referring to fig. 2 63, flowable attachment part 30000 may include along tissue thickness compensation part The continuous strip of a part of longitudinally intermediate setting of 30010 central axises.The width of the band can for example, at least be 1mm.The band Width can be for example between about 0.5mm and about 1.5mm.The width of the band can be for example between about 1.0mm and about 1.25mm Between.The first position of flowable attachment part 30000 can be spaced apart with anvil block 30020, and flowable attachment part 30000 First profile may include neutral (original) profile.As shown in Figure 26 4, flowable attachment part 30000 can in anvil block 30020 Gap 30025 (for example, the slit being such as centrally located) alignment.As shown in Figure 26 5, when to flowable attachment part 30000 When application reaches the pressure of threshold level, flowable attachment part 30000 can be flowed into slit 30025, with firm with anvil block 30020 Affixed conjunction.Flowable attachment part 30000 can fill at least part of slit 30025, so that flowable attachment Divide 30000 shapes that slit 30025 can be presented.The second position of flowable attachment part 30000 can be contacted with anvil block 30020, And the second profile of flowable attachment part 30000 may include the profile complementary with slit 30025.Flowable attachment part 30000 can be releasably attached to tissue thickness compensation part 30010 on anvil block 30020.

In various embodiments, referring to fig. 2 66, flowable attachment part 30000 may include two and compensate along tissue thickness A part of longitudinally disposed and parallel to each other continuous strip of part 30010.The width of the band can for example, at least be 1mm.This The width of band can be for example between about 0.5mm and about 1.5mm.The width of the band can be for example between about 1.0mm peace treaty Between 1.25mm.Two sseparated bands can be spaced apart with the central axis of tissue thickness compensation part 30010 and side edge.Each The gap width of interband can for example, at least be 1mm, and each band gap width intermarginal with side can for example, at least be 1mm.The ratio between adhesive and adhesive-free space can be for example between about 1:4 and about 1:2.Adhesive and adhesive-free space it Than can for example, at least be 1:10.In all cases, the ratio between adhesive and adhesive-free space can be 0.In some cases, may be used It is expected that constant layer is across whole surface.The first position of flowable attachment part 30000 can be spaced apart with anvil block 30020, and The first profile of flowable attachment part 30000 may include neutral (original) profile.As shown in Figure 26 7, flowable attachment part 30000 can for example be aligned with nail cavity 30030.As shown in Figure 26 8, reach threshold value water when applying to flowable attachment part 30000 When flat pressure (such as finger pressure), flowable attachment part 30000 can flow into nail cavity 30030, then with 30020 shape of anvil block At secured engagement.Flowable attachment part 30000 can fill at least part of nail cavity 30030, so that flowable attached Socket part point 30000 can be able to be in the shape of nail cavity 30030.At least part of nail cavity 30030 can be free of flowable attachment part 30000.The second position of flowable attachment part 30000 can be contacted with anvil block 30020, and flowable attachment part 30000 The second profile may include the profile complementary with nail cavity 30030.Flowable attachment part 30000 can be by tissue thickness compensation part 30000 are releasably attached on anvil block 30020.

In various embodiments, referring now to Figure 26 9 to Figure 27 3, can for example will include using nail bin application device 30140 Support section 30102 and the nail bin of tissue thickness compensation part 30,110 30100 are loaded into staple cartridge channel.In various embodiments, Nail bin application device 30140 can be also structured to top can be made to organize in addition to nail bin 30100 can be located in staple cartridge channel Thickness compensation part 30110 is positioned relative to anvil block 30120.Nail bin application device 30140 may include that can release with lock protrusion The hammerlock 30141 engaged with putting, wherein lock protrusion extends from the support section 30102 of nail bin 30100, so that nail bin is applied The appropriate location on the tissue thickness compensation part 30110 of nail bin 30100 is positively retained at device 30140.In various embodiments In, Top tissue thickness compensation part 30110 can be removably attached in nail bin application device 30140, so that surgery The anvil block 30120 of instrument can be closed on application device 30140, be engaged with tissue thickness compensation part 30110, and keep tissue thick Degree compensating part 30110 is separated with nail bin application device 30140.In various embodiments, tissue thickness compensation part 30110 and/or Anvil block 30120 may include one or more holding feature structures, which is configured to tissue thickness Compensating part 30110 releasably holds anvil block.In various embodiments, keep feature structure may include adhesive sheet and/or Adhesive tab 30112.

In various embodiments, adhesive sheet and/or adhesive tab can be with a part of tissue thickness compensation part 30110 It is integrally formed.In various embodiments, tissue thickness compensation part 30110 can include at least one adhesive tab along its edge 30112.Adhesive tab 30112 may include release liner 30113.Referring to fig. 2 71, anvil block 30120 can be moved to closure position It sets, to engage tissue thickness compensation part 30110.Then, release liner 30113 can be removed, to expose adhesive tab 30112 Adhesive surface.Next, 72 and Figure 27 3 referring to fig. 2, can be fixed to anvil block simultaneously for the first end of adhesive tab 30112 And the second end of adhesive tab 30112 is fixed to anvil block, releasably by tissue thickness compensation part 30110 It is attached on anvil block.Adhesive tab 30112 can be pulled towards distal side, tissue thickness compensation part 30110 is applied from nail bin and is filled Set 30140 separation.After completing aforesaid operations, anvil block and nail bin 30100 can be determined relative to be stapled and/or incision tissue Position.Then, clinician can pull adhesive tab 30112, so that tissue thickness compensation part 30110 is separated from anvil block.

84 to Figure 28 8 referring to fig. 2, in various embodiments, tissue thickness compensation part 30210 can include along its distal side edge At least one adhesive tab 30212.Adhesive tab 30212 may include release liner 30213.As described herein, nail bin is applied It is configured to position Top tissue thickness compensation part 30210 relative to anvil block 30220 with device 30240.It can be removed Release liner 30213, to expose the adhesive surface of adhesive tab 30212.Adhesive tab 30212 can be turned down, and will It is fixed on anvil block 30220, so that tissue thickness compensation part 30210 is releasably attached to anvil block 30220.Then Adhesive tab 30212 can be pulled towards distal side, so that tissue thickness compensation part 30210 is separated from nail bin application device 30240.So Afterwards, anvil block 30220 and nail bin 30200 can be positioned relative to be stapled and/or incision tissue.89 to Figure 29 0 referring to fig. 2, In use, nail deployment sliding part can be advanced through towards distal side by nail bin by firing member, blade 30211 can be then promoted Across tissue thickness compensation part 30210, to cut at least part of adhesive tab 30212, and mend tissue thickness Part 30210 is repaid to be gradually disengaged from anvil block 30220.Clinician can dash forward adhesive before the nail bin 30200 for reloading new The remainder of piece 30212 is pulled away from anvil block 30220.

In various embodiments, adhesive sheet and/or adhesive tab can be separated with tissue thickness compensation part.Referring to figure 274 to Figure 27 6, at least one embodiment, adhesive tab 30312 (referring also to Figure 28 8 and Figure 29 2) can be arranged Between nail bin 30300 and tissue thickness compensation part 30310.Tissue thickness compensation part 30310 may include recess 30311, the recess Size be configured to and be configured to adhesive tab 30312 cooperate, can by tissue thickness compensation part 30310 Remain on anvil block 30320 to release.The first end of adhesive tab 30312 can be fixed to tissue adjacent to recess 30311 Thickness compensation part 30310, and the second end of adhesive tab 30312 can be fixed to anvil block 30320.As shown in Figure 27 7, The non-engagement recesses 30311 of adhesive tab 30312.Hereafter, can by anvil block 30320 and nail bin 30300 relative to be stapled and/or The tissue T of incision positions.

As described above, in use, nail deployment sliding part can be advanced through towards distal side by nail bin by firing member, so as to Nail is projected from nail bin as outlined above.When following closely deformation, each nail can catch a part of tissue thickness compensation part It obtains, against tissue top surface.At the same time, blade can be advanced through tissue thickness compensation part 30310 by firing member, Wherein at least one embodiment, blade can be advanced through tissue thickness compensation part 30310, so that tissue thickness compensation part 30310 move toward the far side, and are directed at adhesive tab 30312 as shown in Figure 27 7 to Figure 27 9 with recess 30311, with Just so that blade is cut tissue thickness compensation part 30310, and separate tissue thickness compensation part 30310 from anvil block 30320.Each In kind of embodiment, when nail moves to by staple drivers their firing position from their non-firing position as described above When, the tissue thickness compensation part 30310 without recess can move downward, as shown in Figure 28 0 and Figure 28 1, with adhesive tab 30312 are disengaged, and tissue thickness compensation part 30310 is separated from anvil block 30320.After having disposed nail, it can beat again Anvil block 30320 is opened, and is moved far from the tissue thickness compensation part 30310 of implantation, as shown in Figure 28 3.By comparing 2 He of Figure 28 Figure 28 3, reader is, it will be appreciated that tissue thickness compensation part 30310 can be fastened to tissue T as described above, and be cut by cutting element Enter.

In various embodiments, by removing the first release liner from first adhesive tab, so that exposure is flowable attached Socket part point (such as including contact adhesive), can apply flowable attachment part.Then first adhesive tab can be rolled into On the outer surface of substrate, or first adhesive tab is pressed on the outer surface of substrate in other ways.It then can be from Two adhesive tabs remove the second release liner, thus exposed pressure sensitive adhesive.Second adhesive tab can be pressed at this time On the outer surface of substrate and/or first adhesive tab.After contact adhesive is applied to tissue thickness compensation part, it is just It is placed to contact nail bin and/or anvil block.Tissue thickness compensation part can be fixed to substrate by contact adhesive.

Various embodiments described herein is described in the context of nail, these nails are removably stored in nail bin It is interior, it is used together with surgery suturing appliance.In some cases, nail may include wire rod, and the wire rod is in contact surgical stapling device It can be deformed when anvil block.Such wire rod can be (for example) made of metal (such as stainless steel) and/or any other suitable material.This Class embodiment and its teaching content can be applied to include fastener embodiment, which is removably stored in fastener cartridge It is interior, it is used together with any suitable fastening instrument.

Various embodiments described herein on being attached to nail bin and/or fastener cartridge, and/or with nail bin and/or fastening It is described in the context for the tissue thickness compensation part that part storehouse is used together.Such tissue thickness compensation part can be used for compensate from One end of nail bin to the other end tissue thickness change, for compensate capture one follow closely or fastener in tissue thickness compared with Capture another nail or fastener in tissue thickness variation.Such tissue thickness compensation part can also be used in compensation from nail The tissue thickness of the side in storehouse to the other side changes.Such embodiment and its teaching content can be applied to include being attached to nail bin And/or the embodiment for the one or more material layers being used together in fastener cartridge, and/or with nail bin and/or fastener cartridge.This Kind material layer may include buttress material.

Various embodiments described herein carries out in the context in linear end effector and/or linear fastener storehouse Description.Such embodiment and its teaching content can be applied to nonlinear end actuator and/or non-linear fastener cartridge, such as round Shape and/or contoured end effector.For example, various end effectors, including nonlinear end actuator, it is being filed in On 2 28th, 2011, the U.S. Patent Application Serial Number 13/036 of entitled " SURGICAL STAPLING INSTRUMENT ", There is disclosure in 647 (being now U.S. Patent Application Publication 2011/0226837), which is incorporated by reference simultaneously accordingly Enter herein.In addition, being filed in the U.S. Patent Application Serial Number of on September 29th, 2012 entitled " STAPLE CARTRIDGE " 12/893,461 (being now U.S. Patent Application Publication 2012/0074198) is incorporated by reference accordingly to be incorporated herein.It is filed in On 2 15th, 2008 entitled " END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING The U.S. Patent Application Serial Number 12/031,873 (being now United States Patent (USP) 7,980,443) of INSTRUMENT " also accordingly full text with Way of reference is incorporated herein.

It is all only at according to any patent, announcement or other public materials incorporated in this article in full or in part by reference are stated Incorporated material is not incorporated to this in existing definition described in the disclosure, statement or the conflicting range of other public materials Text.Therefore, in the case of necessary, the disclosure being expressly recited herein may replace it is any contradict therewith by reference simultaneously Enter the material of this paper.Any evidence state be herein incorporated by reference but with existing definition as described herein, statement or other disclosures Conflicting any material of material or part thereof does not only generate the journey of conflict between incorporated material and existing public material It is incorporated herein under degree.

It, can be in the spirit and scope of the disclosure to the present invention although invention was described as having exemplary design Further modified.Therefore this application is intended to cover any modification, purposes or the modified versions using general principles. In addition, this application is intended to cover belong to the known or used types different from the disclosure having in practical framework in fields of the present invention Formula.

Claims

1. a kind of nail bin, comprising:

Warehouse, the warehouse include platform；

Multiple nails, the multiple nail are removedly stored in the warehouse；With

Implantable layer assembly, the implantable layer assembly is located in above the platform, wherein the implantable layer assembly includes:

Compensation layer, the compensation layer are configured to when never firing position moves to firing position to the nail at least partly Ground is trapped in the nail, wherein the compensation layer includes the first length；With

Overlapping layer, the overlapping layer extend from the compensation layer, wherein the overlapping layer includes the second length, wherein described second Length is longer than first length, and wherein the overlapping layer be configured to it is Chong Die with the implantable layer of adjacent implantation.

2. nail bin according to claim 1, wherein the compensation layer is made of compressible foam.

3. nail bin according to claim 1, wherein the platform includes distal side platform end, wherein the compensation layer includes remote Side compensating end, wherein the overlapping layer includes distal side overlapping ends, and wherein the distal side overlapping ends extend beyond the distal side Platform end and the distal side compensating end.

4. nail bin according to claim 1, wherein the overlapping layer and the compensation layer include laminated material.

5. nail bin according to claim 1, wherein the overlapping layer includes the flexible end portion structure extended from the compensation layer Part.

6. a kind of nail bin, comprising:

Warehouse, the warehouse include platform；

Multiple nails, the multiple nail are removedly stored in the warehouse；With

Implantable layer, the implantable layer is located in above the platform, wherein the implantable layer includes:

Part is compensated, the compensation part is configured to be caught when never firing position moves to firing position in the nail It obtains in the nail；With

Lap, the lap extends from the compensation part, wherein the lap is configured to and phase The compensation of the implantable layer of neighbour's implantation partly overlaps.

7. nail bin according to claim 6, wherein the compensation section point is made of compressible foam.

8. nail bin according to claim 6, wherein the platform includes distal side platform end, wherein the compensation section point includes Distal side compensating end, wherein the lap includes distal side overlapping ends, and wherein the distal side overlapping ends extend beyond it is described Distal side platform end and the distal side compensating end.

9. nail bin according to claim 6, wherein the lap and the compensation section point include laminated material.

10. nail bin according to claim 6, wherein the lap includes the flexible ends extended from the compensation part Portion's component.

11. a kind of nail bin, comprising:

Warehouse, the warehouse include tissue scaffold platform, wherein the tissue scaffold platform include proximal end, distal end, And it is limited to multiple nail cavities between the proximal end and the distal end；

Multiple nails, the multiple nail are removedly stored in the warehouse；With

Implantable layer, the implantable layer are located in above the tissue scaffold platform, wherein the nail is configured to The nail never firing position captures at least part of the implantable layer wherein when moving to firing position, and its Described in can plant layer include the tissue support portion for extending beyond the distal end of the tissue scaffold platform.

12. nail bin according to claim 11, wherein the implantable layer includes:

Part is compensated, the compensation part is configured to be trapped in the nail；With

Lap, the lap extends from the compensation part, wherein the lap is configured to and phase The implantable layer overlapping of the implantable layer of neighbour's implantation.

13. nail bin according to claim 12, wherein the compensation section point is made of compressible foam.

14. nail bin according to claim 12, wherein the compensation section point includes distal side compensating end, wherein the overlapping portion Dividing includes distal side overlapping ends, and wherein the distal side overlapping ends extend beyond distal side platform end and distal side compensation End.

15. nail bin according to claim 12, wherein the lap and the compensation section point include laminated material.

16. nail bin according to claim 12, wherein the lap includes the flexibility extended from the compensation part End member.