FR2838952A1 - Anvil device for setting of clips used as mechanical sutures in surgical applications includes a level structure on which are grooves for setting of the clips - Google Patents

Anvil device for setting of clips used as mechanical sutures in surgical applications includes a level structure on which are grooves for setting of the clips Download PDF

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Publication number
FR2838952A1
FR2838952A1 FR0205260A FR0205260A FR2838952A1 FR 2838952 A1 FR2838952 A1 FR 2838952A1 FR 0205260 A FR0205260 A FR 0205260A FR 0205260 A FR0205260 A FR 0205260A FR 2838952 A1 FR2838952 A1 FR 2838952A1
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France
Prior art keywords
crimping
staples
plane
grooves
bearings
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Pending
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FR0205260A
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French (fr)
Inventor
Franck Marie Houe Zinzindohoue
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Individual
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Individual
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Priority to FR0205260A priority Critical patent/FR2838952A1/en
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B2017/320052—Guides for cutting instruments

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The device includes a level rectilinear plane structure (1) on which are hollow grooves for setting of the clips (2). The planes of the level pass by an axis connecting a pair of grooves necessary for setting of a clip and are perpendicular to the plane of the setting of the clips.

Description

rigide munie de quatre crochets de maintien lateraux (15).rigid with four lateral holding hooks (15).

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La presente invention est une enclume en paliers pour sertissage d'agrafes, dont la forme permette ['application de plusieurs rangees d'agrafes ayant apres sertissage des  The present invention is an anvil in stages for crimping staples, the shape of which allows the application of several rows of staples having after crimping

prises d'epaisseurs differentes.taken at different thicknesses.

La suture mecanique est un procede connu et utilise en chirurgie. Wile fait appel un systeme d'agrafage soit plan-lineaire, soit plan-circulaire, perrnettant ['application de plusieurs alignements d'agrafes disposes en rangees paralleles a l' axe longitudinal des agrafes, dont le sertissage assure l'etancheite et la solidarisation de tissue ou materiaux entre eux. En chirurgie digestive en particulier, une suture etanche est definie par ['absence d'ecoulement des fluides d'un cote a l' autre de la suture. L' agrafage qui solidarise les tissue doit etre suffisamment lache pour permettre la vascularisation des berges de la suture (et done une cicatrisation) et eviter une traction excessive sur les mors des agrafes qui entramerait un lachage de la suture par necrose et dechirure du tissue trop fortement comprimes entre les mors des agrafes. L'agrafage doit neanmoins etre suffisamment serree pour permettre une suture etanche telle que defini precedemment. I1 existe plusieurs epaisseurs d'agrafes, soit pour suture mince de type vasculaire (environ 1 mm apres fermeture), soit pour suture de tissu d'epaisseur moyenne (environ 1.5 mm apres fermeture), soit pour suture de tissue epais (environ 2 mm apres fermeture). Le risque hemorragique par les berges des feuillets tissulaires sur une suture par agrafage est d'autant plus grand que le tissu suture est plus epais et plus richement vascularise. Cela conduit certains chirurgiens a preferer utiliser pour suturer des tissue d'une epaisseur donnee des agrafes de dimension inferieure a celle recommandee, cherchant ainsi le compromis optimal entre le risque de survenue d'une hemorragie et celui d'un lachage de  Mechanical suturing is a known procedure used in surgery. Wile uses a stapling system either planar-linear or planar-circular, permitting the application of several alignments of staples arranged in rows parallel to the longitudinal axis of the staples, the crimping of which ensures the sealing and the joining of tissue or materials between them. In digestive surgery in particular, a watertight suture is defined by the absence of flow of fluids from one side to the other of the suture. The stapling that secures the tissue must be loose enough to allow vascularization of the edges of the suture (and therefore scarring) and avoid excessive traction on the jaws of the staples which would cause a lacing of the suture by necrosis and tearing of the tissue too strongly compressed between the jaws of the staples. The stapling must nevertheless be sufficiently tightened to allow a watertight suture as defined above. There are several thicknesses of staples, either for thin vascular type sutures (approximately 1 mm after closure), or for sutures of medium thickness tissue (approximately 1.5 mm after closure), or for thick tissue sutures (approximately 2 mm after closing). The risk of hemorrhage from the edges of tissue sheets on a stapling suture is all the greater when the suture tissue is thicker and more richly vascularized. This leads some surgeons to prefer to use for suturing tissue with a given thickness of staples smaller than that recommended, thus seeking the optimal compromise between the risk of occurrence of hemorrhage and that of laceration of

la suture consecutif a ['attrition et l'ecrasement excessif des tissue des berges agrafees.  the suture consecutive to ['attrition and the excessive crushing of the tissue of the stapled banks.

Actuellement aucun systeme ne permet ['application en 1 fois de plusieurs rangees  Currently no system allows the application in 1 time of several rows

d'agrafes dont l'epaisseur apres sertissage serait differente d'une rangee a l'autre.  of staples whose thickness after crimping would be different from one row to another.

L' utilisation d' une enclume en plusieurs paliers est [ ' innovation qui permet, a partir d' un seul chargeur d'agrafes, le sertissage de rangees agrafes d'epaisseurs differentes, et done  The use of an anvil in several stages is the innovation which allows, from a single staple loader, the crimping of rows of staples of different thicknesses, and therefore

exer,cant des compressions differentes sur un tissu d'epaisseur constante.  exer, cant different compressions on a fabric of constant thickness.

Subconsequemment, en disposant lenclume en paliers de sorte que la compression produite par le sertissage soit maximale du cote de la berge sectionnee de la suture on sertit les rangees d'agrafes tres serrees vers la berge sectionnee et les rangees les moins serrees de l'autre cote. On obtient ainsi une cicatrisation dans des conditions optimales  Consequently, by arranging the latch in stages so that the compression produced by the crimping is maximum on the side of the sectioned bank of the suture, the rows of very tight staples are crimped towards the sectioned bank and the rows less tight on the other side. Healing is thus obtained under optimal conditions

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entree les agrafes les moins fortement serties et une compression hemostatique sur la berge. Les rangees d'agrafes vent d'epaisseur progressivement decroissante d'un bord a l'autre de l'enclume par rapport a l' axe longitudinal des agrafes ce qui permet le sertissage d'agrafes exer,cant une pression progressivement croissante sur les rangees d'agrafes d'un palier a l'autre ce qui evite la dechirure produite par un ecrasement non progressif. Notre invention reprend le principe du dispositif classique de suture par plusieurs rangees d'agrafes ayant une epaisseur donnee. Notre innovation offre la possibilite a partir d'un chargeur d'agrafe unique de sertir sur une meme enclume des rangees d'agrafes dont  enter the less strongly crimped staples and hemostatic compression on the bank. The rows of staples wind with gradually decreasing thickness from one edge to the other of the anvil with respect to the longitudinal axis of the staples which allows crimping of exer staples, cant a progressively increasing pressure on the rows of 'staples from one level to another which avoids the tear produced by a non-progressive crushing. Our invention takes up the principle of the classic suturing device by several rows of staples having a given thickness. Our innovation offers the possibility from a single staple loader to crimp rows of staples on the same anvil.

l'epaisseur des prises apres sertissage soit differente d'une rangee a l'autre.  the thickness of the sockets after crimping is different from one row to another.

Dans le cas d'une enclume pour un dispositif de sertissage d'agrafes (Fig 1), ltenclume est faite de la juxtaposition de plusieurs paliers sur lesquels vent creuses les gorges dans lesquelles vent serties les rangees d'agrafes. Ces paliers peuvent etre plan rectilignes ou plan-courbes. La courbure des plan-courbe est dans le plan perpendiculaire au plan de sertissage des agrafes passant par l'axe de la padre de gorges necessaire au sertissage d'une des agrafes. En suivant ce plan courbe les gorges de sertissage des agrafes vent disposees selon des cercles ou arcs de cercles concentriques. Les paliers ont des hauteurs decroissantes d'un cote a l' autre le long de l' axe perpendiculaire au plan de sertissage des agrafes, formant une sorte d'escalier d'un bord a l'autre de l'enclume. Ainsi le sertissage des rangees d'agrafes est progressivement croissant d'un bord a l'autre et la  In the case of an anvil for a staple crimping device (Fig 1), the anvil is made of the juxtaposition of several bearings on which wind the grooves in which wind crimped rows of staples. These bearings can be rectilinear plane or plan-curved. The curvature of the plane-curve is in the plane perpendicular to the plane of crimping the staples passing through the axis of the pad of grooves necessary for crimping one of the staples. Following this curved plane, the crimping grooves of the wind clips are arranged in concentric circles or arcs of circles. The bearings have decreasing heights from one side to the other along the axis perpendicular to the plane of crimping of the staples, forming a sort of staircase from one edge to the other of the anvil. Thus the crimping of the rows of staples is progressively increasing from one edge to the other and the

section est faite du cote du sertissage le plus serre pour obtenir le resultat desire.  section is made on the side of the tightest crimp to obtain the desired result.

Dans le cas d'une enclume pour un dispositif de double sertissage d'agrafes et section dans le meme temps, l'enclume est faite de la juxtaposition de deux enclumes a paliers pour dispositif de sertissage simple comme decrit precedemment. Ces deux enclumes a paliers pour dispositif de sertissage simple vent juxtaposees de part et d'autre d'un plan de symetrie parallele au plan de sertissage des agrafes. I1 s'agit d'une symetrie en miroir et les paliers vent de hauteur croissante vers le plan de symetrie et decroissante vers les bords de l'enclume de section et double suture. Une gorge est creusee au centre, dans le plan de symetrie, pour le passage du dispositif de section. (Fig 2). Les paliers peuvent etre plan-reGtilignes ou plan-courbes. La courbure des plan-courbe est dans le plan perpendiculaire au plan de sertissage des agrafes passant par l'axe de la padre de gorges necessaire au sertissage d'une des agrafes. En suivant cette courbure les gorges de  In the case of an anvil for a device for double crimping of staples and section at the same time, the anvil is made of the juxtaposition of two bearing anvils for simple crimping device as described above. These two anvils with bearings for a single wind crimping device juxtaposed on either side of a plane of symmetry parallel to the crimping plane of the staples. It is a mirror symmetry and the wind bearings of height increasing towards the plane of symmetry and decreasing towards the edges of the anvil of section and double suture. A groove is hollowed out in the center, in the plane of symmetry, for the passage of the section device. (Fig 2). The bearings can be plan-straight or plan-curved. The curvature of the plane-curve is in the plane perpendicular to the plane of crimping the staples passing through the axis of the pad of grooves necessary for crimping one of the staples. Following this curvature the gorges of

sertissage des agrafes vent dispose selon des cercles ou arcs de cercles concentriques.  crimping of the staples wind arranges according to circles or arcs of concentric circles.

Selon une variante non illustree le nombre de rangees de gorge de sertissage des  According to a variant not illustrated, the number of rows of crimping grooves of the

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agrafes par pallier est variable.staples per step is variable.

Les dessins annexes illustrent ['invention:  The accompanying drawings illustrate the invention:

La figure 1 represente en coupe le dispositif de ['invention pour un agrafage simple.  Figure 1 shows in section the device of the invention for simple stapling.

La figure 2 represente en coupe le dispositif de ['invention pour un agrafage double avec section au centre des lignes d'agrafes le long du plan de symetrie. En reference a ces dessins, le dispositif comporte une structure en paliers (1), a la surface desquels vent creusees les gorges de sertissage des agrafes (2). Sur la figure 2, la  Figure 2 shows in section the device of the invention for a double stapling with section in the center of the staple lines along the plane of symmetry. With reference to these drawings, the device comprises a stepped structure (1), at the surface of which the crimping grooves of the staples (2) wind. In Figure 2, the

gorge du dispositif de section (3) se trouve dans le plan de symetrie.  groove of the section device (3) is in the plane of symmetry.

A titre d'exemple non limitatif, les paliers peuvent etre au nombre de 2 ou plus.  By way of nonlimiting example, the bearings may be 2 in number or more.

Le dispositif selon ['invention est particulierement destine a la realisation des  The device according to the invention is particularly intended for the realization of

sutures chirurgicales.surgical sutures.

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Claims (4)

Revendicationsclaims 1- Dispositif pour sertissage d'agrafes caracterise par une structure en paliers plan-rectilignes sur lesquels vent creusees les gorges de sertissage des agrafes. Les plans des paliers passent par l'axe reliant la padre de gorges necessaire au sertissage d'une des agrafes et vent perpendiculaires au plan de sertissage des agrafes. 2- Dispositif pour sertissage d'agrafes caracterise par une structure en paliers plancourbes sur lesquels vent creusees les gorges de sertissage des agrafes. Les paliers vent dans des plans paralleles a un plan perpendiculaire au plan de sertissage des agrafes et qui passe par l'axe reliant la padre de gorges necessaire au sertissage d'une des agrafes. La courbure de chaque palier est dans un plan perpendiculaire au plan de sertissage des agrafes et qui passe par l'axe reliant la padre de gorges necessaire au sertissage d'une des agrafes sur ce palier. En suivant cette courbure les gorges de sertissage des agrafes vent creusee en suivant des cercles ou arcs de cercles concentriques.  1- Device for crimping staples characterized by a structure in plane-rectilinear bearings on which the grooves for crimping staples are hollow. The plans of the bearings pass through the axis connecting the pad of grooves necessary for crimping one of the staples and wind perpendicular to the crimping plane of the staples. 2- Device for crimping staples characterized by a structure in plancourbe bearings on which wind digs the grooves for crimping staples. The bearings wind in planes parallel to a plane perpendicular to the plane of crimping the staples and which passes through the axis connecting the padre of grooves necessary for crimping one of the staples. The curvature of each bearing is in a plane perpendicular to the plane of crimping the staples and which passes through the axis connecting the pad of grooves necessary for crimping one of the staples on this bearing. Following this curvature, the crimping grooves of the staples are hollowed out by following circles or arcs of concentric circles. 3- Dispositif selon l'une des revendications 1 ou 2, caracterise en ce que les  3- Device according to one of claims 1 or 2, characterized in that the paliers ont des hauteurs decroissantes suivant une direction parallele a l'axe  bearings have decreasing heights in a direction parallel to the axis perpendiculaire au plan de sertissage des agrafes, formant en coupe une sorte d'escalier.  perpendicular to the plane of crimping of the clips, forming in section a kind of staircase. 4- Dispositif caracterise en ce que deux dispositifs selon la revendication 3 vent juxtaposes de part et d'autre d'un plan de symetrie qui est parallele au plan de sertissage des agrafes. I1 s'agit d'une symetrie en miroir et les paliers les plus teas vent les plus  4- Device characterized in that two devices according to claim 3 wind juxtaposed on either side of a plane of symmetry which is parallel to the crimping plane of the staples. It is a mirror symmetry and the teasest bearings wind the most eloignes du plan de symetrie, formant en coupe une sorte de pyramide a degree.  away from the plane of symmetry, forming in section a sort of a degree pyramid. - Dispositif selon la revendication 4 caracterise en ce que une gorge est creusee dans le plan de symetrie au centre des paliers les plus hauts, pour le passage d'un  - Device according to claim 4 characterized in that a groove is hollowed in the plane of symmetry at the center of the highest bearings, for the passage of a dispositif de section.section device. 6- Dispositif selon la revendication S caracterise en ce que le nombre de gorges de sertissage des agrafes creusees par palier est variable dans les 2 directions plan de  6- Device according to claim S characterized in that the number of grooves for crimping the hollow clips per bearing is variable in the 2 plane directions of
FR0205260A 2002-04-26 2002-04-26 Anvil device for setting of clips used as mechanical sutures in surgical applications includes a level structure on which are grooves for setting of the clips Pending FR2838952A1 (en)

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Cited By (20)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1754445A3 (en) * 2005-08-15 2007-04-11 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US7398908B2 (en) 2005-08-15 2008-07-15 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US7401721B2 (en) 2005-08-15 2008-07-22 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US7926691B2 (en) 2008-04-14 2011-04-19 Tyco Healthcare Group, L.P. Variable compression surgical fastener cartridge
US8028884B2 (en) 2008-04-22 2011-10-04 Tyco Healthcare Group Lp Cartridge for applying varying amounts of tissue compression
US8091756B2 (en) 2008-05-09 2012-01-10 Tyco Healthcare Group Lp Varying tissue compression using take-up component
US8100310B2 (en) 2008-04-14 2012-01-24 Tyco Healthcare Group Lp Variable compression surgical fastener apparatus
US8152041B2 (en) 2009-10-14 2012-04-10 Tyco Healthcare Group Lp Varying tissue compression aided by elastic members
US8186556B2 (en) 2008-05-09 2012-05-29 Tyco Healthcare Group Lp Variable compression surgical fastener apparatus
US8205780B2 (en) 2007-03-22 2012-06-26 Tyco Healthcare Group Lp Apparatus for forming variable height surgical fasteners
US8231040B2 (en) 2008-04-14 2012-07-31 Tyco Healthcare Group Lp Variable compression surgical fastener cartridge
US8231041B2 (en) 2008-04-14 2012-07-31 Tyco Healthcare Group Lp Variable compression surgical fastener cartridge
US8348972B2 (en) 2007-07-11 2013-01-08 Covidien Lp Surgical staple with augmented compression area
US8464922B2 (en) 2008-05-09 2013-06-18 Covidien Lp Variable compression surgical fastener cartridge
US8579938B2 (en) 2008-07-23 2013-11-12 Covidien Lp Staple for use in surgical procedures
US8579178B2 (en) 2005-08-15 2013-11-12 Covidien Lp Surgical stapling instruments including a cartridge having multiple staples sizes
US8967446B2 (en) 2008-05-09 2015-03-03 Covidien Lp Variable compression surgical fastener cartridge
US9016541B2 (en) 2008-05-09 2015-04-28 Covidien Lp Varying tissue compression with an anvil configuration
US9636111B2 (en) 2007-05-07 2017-05-02 Covidien Lp Method of stapling tissues with a staple assembly
US11426162B2 (en) 2018-02-27 2022-08-30 Covidien Lp Powered stapler having varying staple heights and sizes

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US3252643A (en) * 1962-12-24 1966-05-24 Strekopytov Alexey Alexcevich Instrument for suturing living tissue
US3822818A (en) * 1973-02-20 1974-07-09 A Strekopytov Surgical instrument for joining osseous tissues by staples
US5655698A (en) * 1994-07-13 1997-08-12 Yoon; Inbae Surgical stapler with curved jaws
EP1090592A1 (en) * 1999-10-05 2001-04-11 Ethicon Endo-Surgery Surgical stapler having two staple forming surfaces
WO2001054594A1 (en) * 2000-01-24 2001-08-02 Ethicon Endo-Surgery (Europe) Gmbh Surgical stapling instrument

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3252643A (en) * 1962-12-24 1966-05-24 Strekopytov Alexey Alexcevich Instrument for suturing living tissue
US3822818A (en) * 1973-02-20 1974-07-09 A Strekopytov Surgical instrument for joining osseous tissues by staples
US5655698A (en) * 1994-07-13 1997-08-12 Yoon; Inbae Surgical stapler with curved jaws
EP1090592A1 (en) * 1999-10-05 2001-04-11 Ethicon Endo-Surgery Surgical stapler having two staple forming surfaces
WO2001054594A1 (en) * 2000-01-24 2001-08-02 Ethicon Endo-Surgery (Europe) Gmbh Surgical stapling instrument

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* Cited by examiner, † Cited by third party
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US8113406B2 (en) 2005-08-15 2012-02-14 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US7481349B2 (en) 2005-08-15 2009-01-27 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US7398908B2 (en) 2005-08-15 2008-07-15 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US8840004B2 (en) 2005-08-15 2014-09-23 Covidien Lp Surgical stapling instruments including a cartridge having multiple staples sizes
US7407075B2 (en) 2005-08-15 2008-08-05 Tyco Healthcare Group Lp Staple cartridge having multiple staple sizes for a surgical stapling instrument
US9675350B2 (en) 2005-08-15 2017-06-13 Covidien Lp Surgical stapling instruments including a cartridge having multiple staples sizes
US7472816B2 (en) 2005-08-15 2009-01-06 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US8123100B2 (en) 2005-08-15 2012-02-28 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US7588174B2 (en) 2005-08-15 2009-09-15 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staples sizes
US7726539B2 (en) 2005-08-15 2010-06-01 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US7726538B2 (en) 2005-08-15 2010-06-01 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US7828189B2 (en) 2005-08-15 2010-11-09 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US7837081B2 (en) 2005-08-15 2010-11-23 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US7837079B2 (en) 2005-08-15 2010-11-23 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US11202630B2 (en) 2005-08-15 2021-12-21 Covidien Lp Surgical stapling instruments including a cartridge having multiple staples sizes
US10342531B2 (en) 2005-08-15 2019-07-09 Covidien Lp Surgical stapling instruments including a cartridge having multiple staples sizes
US8070035B2 (en) 2005-08-15 2011-12-06 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US10105138B2 (en) 2005-08-15 2018-10-23 Covidien Lp Surgical stapling instruments including a cartridge having multiple staples sizes
US10105137B2 (en) 2005-08-15 2018-10-23 Covidien Lp Surgical stapling instruments including a cartridge having multiple staples sizes
US8113407B2 (en) 2005-08-15 2012-02-14 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staples sizes
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