RU2496434C2 - Reinforcing material for surgical sewing instrument - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine. Surgical unit includes working organ of surgical instrument, which contains clamping element and is made with possibility of introducing staples into tissue. Detachable sleeve is made with possibility of travel on distal end of clamping element for location around, at least, part of clamping element. Detachable sleeve has possibility of reverse travel on distal end of clamping device for separation from clamping device. Integral piece of reinforcing material contains first part and second part. Second part is fixed to sleeve in such a way that when sleeve is located around, at least, part of clamping element, working organ has possibility of introducing staples into first part of integral piece of reinforcing material and into tissue. Disconnecting device is located between first part and second part. Disconnecting device is made with providing possibility of separating first part from second part in such a way that first part remains connected to tissue by means of stables.

EFFECT: surgeon can fix piece of reinforcing material to working organ in a precise and fast way.

6 cl, 63 dwg

Description

State of the art

i. Technical field

The present invention relates to a reinforcing material for a surgical instrument and, in particular, to a reinforcing material made with the possibility of detachable attachment to the node of the working body of the surgical instrument.

ii. Description of the Related Art

A surgical instrument, such as, for example, a surgical stapling instrument, may be configured to lay brackets on tissue during a surgical procedure. In various embodiments, the implementation of the surgical stapling instrument may include a working body made with the possibility of positioning at the distal end of the surgical stapling instrument. The working body can be made with the possibility of installation inside and at least partial advancement through a catheter or trocar, which is inserted into the wall of the patient’s body, so that the surgeon can use the working body to perform procedures on the operated site. In various embodiments, the implement may comprise a first clamping member including a cassette of brackets, and a second clamping member including an anvil. The first and second clamping elements can be made with the possibility of sliding to each other to clamp the layers of fabric located between them and applying a compressive force to them. In at least one other embodiment, the bracket cassette may be configured to store the brackets, and the anvil may be configured to deform the brackets when they are pushed out of the bracket bracket.

In some cases, the fabric layers may be relatively thin, may have a high fluid content and / or may have an uneven thickness, which may cause the brackets to be misplaced inside the fabric. To alleviate this problem, you can use a piece of reinforcing material to support the fabric during compression and braces. In at least another embodiment, a piece of reinforcing material may be detachably attached to at least one of the first or second clamping elements before they are inserted into the area to be operated. In various embodiments, a piece of reinforcing material can be used to distribute the compressive force exerted by the anvil over the surface area of the reinforcing material to create a more uniform compression profile within the fabric. In at least one other embodiment, a uniform compression profile of the tissue may increase the likelihood of proper placement of brackets in the tissue.

In various embodiments, it may be difficult for a surgeon to attach a piece of reinforcing material to the compressive elements of a working body. In at least one other embodiment, a piece of reinforcing material can be attached to one of the compressing elements by means of an adhesive configured to hold a piece of reinforcing material so that it can be detached or separated, i.e. detachable way. In such an embodiment, the surgeon must very carefully align the piece of reinforcing material with the compressing element, since the adhesive can immediately attach the reinforcing material to the compressing element in the wrong position. In such circumstances, it may be necessary to remove a piece of reinforcing material from the clamping member and replace it with a new piece of reinforcing material. As a result, the surgeon can spend valuable time on the placement and alignment of the reinforcing material with the clamping element of the working body. Accordingly, improvements are needed over the prior art.

SUMMARY OF THE INVENTION

In at least one form of the present invention, a piece of reinforcing material and / or a working organ of a surgical instrument may contain elements that help the surgeon or other clinical physician to center and attach a piece of reinforcing material to the working organ. In at least one other embodiment, a piece of reinforcing material may comprise at least one element protruding from it, which element may be adapted to come into contact with the cavity of the bracket formed in the bracket cassette and / or the anvil hole, formed in the anvil. In at least one such embodiment, said element can be installed in the cavity of the bracket and / or the hole of the anvil according to the principle of friction and / or pressure connection in order to hold a piece of reinforcing material in the bracket cassette and / or anvil with the possibility of its detachment. In various embodiments, a recess or slot may be formed in the cassette of the brackets and / or anvil, which recess may be configured to receive a portion of a piece of reinforcing material and to hold a piece of reinforcing material so that it can be detached. In at least one other embodiment, the piece of reinforcing material may comprise a protrusion, which protrusion can be detachably engaged with the channel of the cutting element in the bracket cassette and / or anvil. In such an embodiment, the protrusion may be adhered to the channel, for example, by the principle of compression joint, friction joint and / or otherwise.

In at least one form of the present invention, a piece of reinforcing material and a working body may contain interacting elements, such as, for example, sponges, which make it possible to hold the reinforcing material on the working body according to the latch principle. In various embodiments, the implementation of the working body may contain protruding from it elastic elements, and the elastic elements can be configured to come into contact with the parts of a piece of reinforcing material and hold the reinforcing material on the working body with the possibility of its detachment. In at least one other embodiment, the bracket cassette or anvil may comprise a plurality of retaining elements, wherein portions of a piece of the reinforcing element may be connected to the holding elements in a frictional manner to hold a piece of reinforcing material on the bracket cassette and / or anvil so that it can be detached .

In at least one form of the present invention, a piece of reinforcing material may be detachably attached to the sleeve, the sleeve may be configured to move brackets and / or anvil of the working member along the cassette. In at least another embodiment, the piece of reinforcing material may comprise a side portion that can be attached to the sleeve, and further a body portion configured to come into contact with the brackets when the brackets are ejected from the bracket bracket. In such an embodiment, the side portion may be used to releasably hold a portion of the body on the sleeve. In at least another embodiment, a recess and / or perforation can be made in the piece of reinforcing material between the side part and the body part, so that the part of the body can be separated from the side part. As a result, in at least one other embodiment, the perforation and / or recess may provide the ability to separate the sleeve from the reinforcing material after pushing the brackets into the body part.

In at least another form of the present invention, a packaging for a piece of reinforcing material can be used to quickly center and install the reinforcing material in the working body. In various embodiments, the package may comprise a first part, a second part, and a piece of reinforcing material that can be detachably attached to the first part. In at least one embodiment, the second part may be movable between a first position in which it is adjacent to a piece of reinforcing material and a second position. In various embodiments, a piece of reinforcing material can be opened when the second part is in the second position, so that the package can be installed between the clamping elements of the open working body to connect the open surface of the piece of reinforcing material with one of the clamping elements of the working body. In various embodiments, the reinforcing material may comprise an adhesive for holding the reinforcing material on one of the clamping elements. After a piece of reinforcing material is connected to one of the clamping elements, the second part can be peeled off from the working body to release the first part from the piece of reinforcing material.

In at least another form of the present invention, a piece of reinforcing material may be attached to the anvil and / or cassette brackets of the working body. In various embodiments, the anvil and / or cassette brackets may contain one or more holes or openings that can be configured to accommodate one or more fasteners to hold a piece of reinforcing material on the anvil or cassette brackets. In various embodiments, the fasteners can be released from the holes in the anvil and / or cassette brackets to allow a piece of reinforcing material to separate from the working body. The fasteners can also be made with the possibility of separation from a piece of reinforcing material, and they can consist of bioabsorbable material, so that they can dissolve inside the patient's body. In at least another embodiment, a piece of reinforcing material may be attached to the working body through one or more removable clips.

In at least another form of the present invention, a piece of reinforcing material configured to be releasably attached to a working member may comprise an inactive adhesive. In various embodiments, the surgeon can repeatedly install and center a piece of reinforcing material on the working body, and the non-activated adhesive does not adhere to the working body. After the surgeon achieves satisfactory alignment of the piece of reinforcing material on the working body, the surgeon can apply a reagent to the inactive adhesive. In various embodiments, the reagent can activate the adhesive, whereby the adhesive in a detachable manner attaches a piece of reinforcing material to a portion of the working body. In at least one other embodiment, the piece of reinforcing material may comprise a recess configured to accommodate the applicator so as to facilitate application of the reagent to the inactive adhesive.

In at least another form of the present invention, the working body may comprise a retractable holding member for holding a piece of reinforcing material on the working body. In various embodiments, the holding member may move between a first or distal position and a second or proximal position. In at least another embodiment, the resilient member may be connected to a portion of the handle so that the surgeon can use the portion of the handle to extend the resilient member relative to the working member. In various embodiments, the resilient member can hold a piece of reinforcing material in place when the brackets are pushed through the reinforcing material. In at least another embodiment, the retaining element can be retracted relative to the working body, so that the reinforcing material can be separated from the working body, and the working body can be removed from the operated area.

Brief Description of the Drawings

The above and other features and advantages of the present invention, as well as methods for their implementation, will be apparent from the following description of embodiments of the present invention in combination with the accompanying drawings, in which:

Figure 1 - perspective of the node of the working body, made with the possibility of making contact, cutting, applying a bracket and applying a piece of reinforcing material to the fabric according to one non-limiting embodiment of the present invention;

Figure 2 is a perspective view of the working body assembly of Figure 1, after the working body has been used to come into contact, cut, brace and lay a piece of reinforcing material on the fabric according to one non-limiting embodiment of the present invention;

Figure 3 is a perspective view of a working body assembly attached to the distal end of a surgical instrument according to one non-limiting embodiment of the present invention;

Figure 4 is a perspective view of a working body assembly comprising at least one piece of reinforcing tissue, wherein the working body assembly is in an open configuration according to one non-limiting embodiment of the present invention;

Figure 5 is a perspective of the cassette of the brackets of the node of the working body of Figure 4, where the retaining material is releasably held on the working body;

Fig.6 is a perspective view with a spatial separation of the parts of the cassette brackets and reinforcing material of Fig.5;

Fig.7 is a perspective of the connecting element, made with the possibility of use together with the node of the working node of Fig.4;

Fig. 8 is a perspective view of the anvil of the working body assembly of Fig. 4, in which the anvil has at least one piece of reinforcing material held thereon in a detachable manner;

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

Figure 10 is a perspective view with a spatial separation of the details of the anvil and the reinforcing material of Fig;

11 is a perspective of a cassette of brackets and anvil of the node of the working body with attached pieces of reinforcing material according to one non-limiting embodiment of the present invention;

Fig is a perspective view with a spatial separation of the parts of the node of the working body containing the cassette brackets and the anvil, according to one non-limiting embodiment of the present invention;

Fig.13 is a perspective view with a spatial separation of the parts of the node of the working body of Fig.12, where some components were removed;

Fig - front view of the node of the working body with Fig;

Fig - perspective of the node of the working body according to one non-limiting embodiment of the present invention;

Fig is a partial perspective of the node of the working body with Fig, where some components were removed, and this node of the working body contains a retractable element, configured to detachably hold at least one piece of reinforcing material;

Fig.17 is a cross section of the node of the working body of Fig.15 along the line 17-17 of Fig.16;

Fig is a partial perspective view with a spatial separation of the parts of the node of the working body of Fig;

Fig.19-21 - side views of various cutting elements made for use with the node of the working body according to one non-limiting embodiment of the present invention;

FIG. 22 is a perspective view of a bracket cartridge with a piece of reinforcing material held thereon according to one non-limiting embodiment of the present invention; FIG.

Fig is a perspective view with a spatial separation of the parts of the cartridge brackets and a piece of reinforcing material with Fig, where a piece of reinforcing material contains many protruding from it elements;

Fig. 24 is a cross-sectional view taken along line 24-24 of Fig. 22, illustrating the contact of the elements of Fig. 23 with parenthesis cavities according to one non-limiting embodiment of the present invention;

FIG. 25 is a cross-sectional view of a piece of reinforcing material comprising elements connected to brace cavities of a bracket cartridge according to one non-limiting embodiment of the present invention; FIG.

FIG. 26 is an exploded view of FIG. 25 illustrating elements separated from parenthesis cavities of a bracket cartridge according to one non-limiting embodiment of the present invention; FIG.

Fig. 27 is a cross-sectional view of the working body assembly in an exploded state, where the working body assembly comprises holding elements protruding from the anvil and the cassette of the working body brackets, these elements being configured to hold a piece of reinforcing material in a releasable manner according to one non-limiting embodiment of the present invention;

Fig. 28 is a cross-sectional view of the working body assembly in an exploded state, where the working body assembly comprises holding elements protruding from the anvil and the cassette of the working body brackets, these elements being configured to hold a piece of reinforcing material in a releasable manner according to one non-limiting embodiment of the present invention;

29 is a cross-sectional view of a working member illustrating a piece of reinforcing material that is located inside the working member, the piece of reinforcing material comprising recesses according to one non-limiting embodiment of the present invention;

Fig. 30 is a cross-sectional view of a working member illustrating a piece of reinforcing material that is located inside the working member, the piece of reinforcing material comprising perforations and recesses according to one non-limiting embodiment of the present invention;

Fig - perspective parts of a piece of reinforcing material from Fig in the process of their removal from the intermediate part;

Fig. 32 is a cross-sectional view of an anvil with a reinforcing material connected to a slot of a cutting member according to one non-limiting embodiment of the present invention;

Fig. 33 is a cross-sectional view of a bracket cassette including a piece of reinforcing material that is releasably held thereon, according to one non-limiting embodiment of the present invention;

Fig. 34 is a cross-sectional view of a piece of reinforcing material detachably mounted on an anvil according to one non-limiting embodiment of the present invention;

Fig. 35 is a detailed view of a piece of reinforcing material held releasably on an anvil according to one non-limiting embodiment of the present invention;

Fig. 36 is a detailed view of a piece of reinforcing material held releasably on an anvil according to one non-limiting embodiment of the present invention;

Fig. 37 is a detailed view of a piece of reinforcing material held releasably on an anvil according to one non-limiting embodiment of the present invention;

Fig. 38 is a perspective view of a packaging assembly comprising a piece of reinforcing tissue during placement of the packaging assembly in an open operative member of a surgical instrument according to one non-limiting embodiment of the present invention;

Fig. 39 is a perspective view of the packaging assembly of Fig. 38, illustrating the position in which the working body closes the package and a piece of reinforcing material;

FIG. 40 is a perspective view of the packaging of FIG. 39, illustrating a piece of reinforcing material connected to an anvil of a working member, as well as a process for removing packaging from a piece of reinforcing material according to one non-limiting embodiment of the present invention;

Fig. 41 is a perspective view of a packaging assembly for a piece of reinforcing material in a sterile outer packaging according to one non-limiting embodiment of the present invention;

Fig. 42 is a perspective view of the inner packaging of the packaging assembly of Fig. 41 in an unopened position;

Fig. 43 is a perspective view of the packaging of Fig. 42 in a partially open position;

Fig. 44 is a perspective view of the packaging of Fig. 42 in an open position;

Fig. 45 is a perspective view of the packaging of Fig. 42 located in an open working body;

Fig. 46 is a perspective view of the package of Fig. 45, in which the package is partially removed from the working body;

Fig. 47 is a perspective view of an applicator assembly for a piece of reinforcing tissue, wherein the applicator assembly is mounted inside a working body of a surgical instrument according to one non-limiting embodiment of the present invention;

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

Fig. 49 is a plan view of an applicator assembly according to one non-limiting embodiment of the present invention;

FIG. 50 is a perspective view of a reinforcing material applicator assembly according to one non-limiting embodiment of the present invention; FIG.

Fig. 51 is another perspective view of the applicator assembly of the reinforcing material of Fig. 50;

Fig. 52 is a perspective view of the applicator assembly of the reinforcing material of Fig. 50 installed in the working body of a surgical instrument;

Fig. 53 is a perspective view of the applicator assembly of the reinforcing material of Fig. 50, illustrating the position in which it is partially removed from the working body;

Fig. 54 is a perspective view of an applicator of a reinforcing material configured to lay at least one piece of reinforcing material on an operative member of a surgical instrument according to one non-limiting embodiment of the present invention;

Fig is a perspective view with a spatial separation of the parts of the applicator of the reinforcing material with Fig;

Fig. 56 is a longitudinal sectional view of the applicator of the reinforcing material of Fig. 54, where some components have been removed;

Fig. 57 is a perspective view of the applicator of the reinforcing material of Fig. 54, where some components are removed;

Fig. 58 is a perspective view of an alternative applicator of reinforcing material configured to lay at least one piece of reinforcing material on the operative member of a surgical instrument according to yet another non-limiting embodiment of the present invention;

Fig.59 is a perspective view with a spatial separation of the parts of the applicator of the reinforcing material with Fig.58;

Fig. 60 is a longitudinal sectional view of the applicator of the reinforcing material of Fig. 58, where some components are removed;

Fig.61 is a perspective of the applicator of the reinforcing material of Fig.58, where some components are removed;

Fig. 62 is a perspective view of a piece of reinforcing material according to one non-limiting embodiment of the present invention; and

Fig. 63 is a cross-sectional view of a piece of reinforcing material of Fig. 62 along line 63-63 of Fig. 62.

Detailed description

The following are some examples of implementation to provide a common understanding of the principles of the structure, functions, manufacture and use of the devices and methods disclosed herein. One or more of these embodiments is illustrated in the accompanying drawings. It will be apparent to those skilled in the art that the devices and methods specifically described in this section and illustrated in the accompanying drawings are non-limiting embodiments, and the scope of various embodiments of the present invention is determined only by the appended claims. Some features illustrated or described in conjunction with one embodiment may be combined with features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.

Referring to Fig.1-2, in various embodiments, the implementation of the working body of a surgical instrument may contain at least one piece of reinforcing material "B", which is detachably attached to it. In at least one other embodiment, the working member may be configured to come into contact and clamp the fabric “T”, open the paper clips in the fabric, and cut the fabric and a piece of reinforcing material. In a similar embodiment, after that, the working body can be removed from the fabric, leaving brackets and a piece of reinforcing material that were attached on both sides of the "I" cut. In various embodiments, a surgical instrument may comprise a pen assembly, an operative assembly, an instrument shaft, and at least one piece of reinforcing material detachably attached to the pen assembly. Referring to FIG. 3, in at least one other embodiment, the handle assembly 12 can be attached to the first or proximal end 13 of the tool shaft 16 and, in addition, the working organ assembly 14 can be attached to the second or distal end 15 Barrel 16 tool. In various embodiments, the implementation of the node 14 of the working body and at least part of the barrel 16 of the instrument can be configured to be inserted at least partially through a catheter or trocar in the patient’s body during a surgical procedure with a minimum level of intervention. Various surgical instruments are described in detail in US patent application No. 11 / 329,020 "Surgical instrument with a manipulating working body", filed January 10, 2006; US Patent Application No. 11 / 343,321, "Surgical Cutting and Stapling Tool with Locking Stitch Lock Mechanism," filed January 31, 2006; and U.S. Patent Application No. 11 / 529,935, "Surgical Brackets with Attached Leading Elements and Stapling Instruments for Their Use," filed September 29, 2006, the disclosures of which are incorporated herein by reference.

In various embodiments, the implementation of the node of the working body of the surgical instrument may contain a first clamping element and a second clamping element, and at least one of the first and second clamping elements can be configured to move relative to the other clamping element, so that the tissue can be clamped between them. Referring to FIGS. 4-11, the first clamping member 20 may comprise a bracket cassette 22, and, in addition, the second clamping member 24 may comprise an anvil 26. In at least one other embodiment, the bracket cassette 22 may comprise a multi-cavity base 28 30 brackets. Anvil 26 may comprise an anvil lid 27 and an anvil face 32, wherein the anvil face 32 may comprise a plurality of anvil holes 34. In various embodiments, each bracket cavity 30 may be removably stored within the bracket, and each anvil hole 34 may be configured to deform at least a portion of the bracket during ejection. In various embodiments, the implementation of at least one element of the cassette brackets and anvil may contain one or more gripping elements or ridges 35, which can be made with the possibility of holding tissue inside the working body.

In addition to the above, referring to FIGS. 4-11, the working body assembly 14 may comprise at least one piece of reinforcing material 36 and / or 36 ', which may be adapted to be installed between the first and second clamping elements and, for example, holding on the basis of 28 and / or the front surface 32 in a detachable manner (with the possibility of detachment). In at least one other embodiment, the surface of the piece of reinforcing material can be configured to come into contact with the fabric when the fabric is compressed between the first and second clamping elements. In such an embodiment, the surface of the reinforcing material can be used to distribute the compressive force across the fabric, remove excess fluid from the fabric and / or to improve the pivot point of the brackets. In various embodiments, one or more pieces of reinforcing material may be placed inside the assembly of the working body. Referring to FIG. 11, in at least one embodiment, one piece of reinforcing material 36a may be attached to the bracket cassette 22, and another piece of reinforcing material 36a 'may be attached to the anvil 24. In at least one other embodiment two pieces of reinforcing material 36 can be placed on the base 28 and one piece of reinforcing material 36 'can be placed on the front surface 32, for example. In various other embodiments, any suitable number of pieces of reinforcing material may be placed in the assembly of the working member. In any case, the piece (s) of the reinforcing material may consist of a material such as, for example, bioabsorbable material, biofragmentable material and / or soluble material, for example, so that the reinforcing material can dissolve, split into fragments and / or dissolve during the healing process . In at least one other embodiment, the piece (s) of the reinforcing material may at least partially consist of a drug, which may be configured to be gradually released to promote tissue healing, for example. In various other embodiments, the implementation of the piece (s) of reinforcing material may contain, for example, non-absorbable and / or insoluble material.

Referring to Fig.6, 7, 9 and 10, the node of the working body may contain at least one connecting element or retainer, which can be used to hold a piece of reinforcing material on the anvil and / or cassette brackets with the possibility of its separation. In at least another embodiment, each connecting element, such as, for example, connecting element 38 may comprise a body 40, which, for example, may have a cylindrical shape. In at least one such embodiment, the connecting member 38 may also include an outwardly extending head portion 42 configured to prevent or at least prevent the connecting member from slipping out of the hole or hole 44 in the piece of reinforcing material. In various other embodiments, the implementation of the connecting element may have any other configuration of a suitable shape to hold a piece of reinforcing material on the working body. In at least another embodiment, one or more of the connecting elements may comprise a clip that can be configured to hold the reinforcing material on the bracket cassette and / or anvil with the possibility of detachment.

Referring to Figs. 7 and 9, in various embodiments, the head portion 42 may include a recess 43, which may be configured to accommodate a drive, press, or any other suitable device. In at least one other embodiment, the actuator or press may come into contact with the recess 43 and be used, for example, to insert the connecting elements 38 through a piece of reinforcing material into the bracket cassette 28 and / or the anvil face 32. In at least one such embodiment, the base 28 and / or front surface 32 may include holes 46 that can be configured to receive at least a portion of the connecting elements, such as, for example, body 40. In various embodiments, the outer perimeter the bodies 40 and the inner perimeter of the hole 46 can interact to hold the connecting elements 38 on the anvil and / or cassette brackets by means of a friction or press connection. In addition to the foregoing, referring to FIGS. 6 and 10, a piece of reinforcing material may comprise preformed openings 44 that can be adapted to guide connecting elements 38 through them into openings 46. In at least one other embodiment, a piece of reinforcing material 36 can be placed adjacent to or on the base 28 and / or face 32 so that the holes 44 of the reinforcing material can be centered relative to the holes 46. In such circumstances, the last of the connecting elements 38 can be conducted through the openings 44 in the reinforcing material opening 46 to detachably hold a reinforcing material based on 28 and / or front surface 32.

In addition to the foregoing, the connecting element may comprise a thread with which a threaded connection with a cassette of brackets and / or anvil can be realized. In various embodiments, such a thread may comprise a self-tapping thread and / or it may be configured to come into contact with the thread inside the hole. In embodiments where self-threading fasteners are used, the fasteners can be used in combination with a piece of reinforcing material, brace cassettes and / or anvils that do not have preformed or pre-drilled holes. In any case, the fulcrum between the connecting elements and the holes of the anvil or bracket cassette may be sufficient to hold the reinforcing material in place, and at the same time allow the reinforcing material to separate from the bracket cassette and / or base when necessary. In at least one other embodiment, the outwardly extending head portion 42 may be designed so that it recesses into the chamfer surrounding hole 46 to provide a smooth or at least substantially smooth contact surface with tissue on the piece of reinforcing material. the likelihood of soft tissue catching on the connecting element.

In various embodiments, the implementation of the connecting elements can be made with the possibility of detachment from the working body and insert into the fabric with a piece of reinforcing material. In at least another embodiment, the head parts of the connecting elements can be configured to separate from the body parts of the connecting elements, so that the head parts can be inserted together with a piece of reinforcing material, and the body parts remain attached to the working body. In various other embodiments, the implementation of the connecting elements may remain in contact with the working body when a piece of reinforcing material is separated from the working body. In any case, in at least one other embodiment, the connecting elements can at least partially consist of at least one of a bioabsorbable material, a biofragmentable material and a soluble material, so that the connecting elements can be absorbed, split into fragments and / or dissolve inside the body . In various embodiments, the implementation of the connecting elements may contain a medicinal product, which can be performed so as to gradually stand out to facilitate the healing of tissue, for example. In various other embodiments, the implementation of the connecting elements may contain non-absorbable and / or insoluble material, such as, for example, plastic.

In various embodiments, the connectors may be arranged in any suitable arrangement or configuration. In at least one other embodiment, the connecting elements can be arranged, for example, along the outer perimeter of a piece of reinforcing material 36. In at least another embodiment, the connecting elements can be located close to one or more sides and / or edges of the piece of reinforcing material , for example, to prevent or at least prevent the peeling of the reinforcing material from the base of the bracket cassette and / or the front surface of the anvil when the working body is inserted through oakar or comes into contact with the cloth. In various embodiments, the connecting elements can be used in combination with any suitable adhesive, such as, for example, cyanoacrylate, to hold a piece of reinforcing material or at least a portion of the reinforcing material on the working body. In at least one other embodiment, the adhesive may be applied to the connecting elements before the connecting elements come into contact with the holes in the piece of reinforcing material, the bracket cassette and / or anvil.

Referring to FIGS. 12-14, in various embodiments, at least one resilient member may be used to releasably hold a piece of reinforcing material on the bracket cassette and / or anvil of the working member. In at least one embodiment, the at least one resilient member, such as, for example, resilient members 150 and 150 ', may include a first end, such as first ends 152 or 152', that is configured to attach to or form one integrally with the first and / or second clamping elements 120 and 124. In at least another embodiment, each elastic element 150 may include a second end, such as, for example, second ends 154 and 154 ', which are made to come into contact and retention times emnym manner piece reinforcing material such as reinforcing material piece 136 or 136 'on the first and / or second clamping elements. In various embodiments, the second end 154 may comprise a tip 158, which may be adapted to engage at least a portion of a piece of reinforcing material 136. In various embodiments, the tip 158 may have such a contour and / or may have a rough or grooved surface, for example, by friction to adhere to a piece of reinforcing material.

Referring to FIGS. 12-14, in various embodiments, a plurality of resilient elements may be provided on at least two sides of the clamping member to hold the side portions of the piece of reinforcing material on the clamping member. In at least one other embodiment, the first ends 152 of each individual elastic member 150 may be attached to each other by means of a connecting element, such as, for example, a connecting element or strip 156 or 156 '. In various embodiments, the connecting member 156 can be attached to the second clamping member 124 so that the connecting member 156 can support the elastic members 150. In various other embodiments, a plurality of elastic members 150 can be attached to the first and / or second clamping members without using connecting element. In such an embodiment, the first ends of the elastic elements can be attached, for example, directly to the first and / or second clamping elements.

In various other embodiments, the at least one elastic member can be biased toward a piece of reinforcing material so that the elastic elements can exert a holding force on the piece of reinforcing material and releasably hold the piece of reinforcing material on the first and / or second clamping elements. In at least another embodiment, the piece of reinforcing material may comprise a tissue contact portion 159 or 159 ′ and side portions 160 or 160 ′ extending in a substantially perpendicular and / or transverse direction relative to the tissue contact portion 159 or 159 ′ . In at least one such embodiment, the tissue-contacting portion 159 may be arranged to be adjacent to or in contact with the base 128 and, in addition, the side portions 160 may be abutted against the side walls 121 of the first clamping member 120 Likewise, the tissue-contacting portion 159 ′ can be placed adjacent to or in contact with the surface 132 and, in addition, the side portions 160 ′ can be abutted against the side walls 125 of the second clamping member 124. ary embodiments, each second end 154 of each elastic member 150 may be configured to come into contact with the side piece portions 160 and reinforcing material 136 annexes holding force. In at least one other embodiment, the elastic members 150, for example, may be configured to release the reinforcing material 136 after the brackets are pushed through the reinforcing material and / or when the reinforcing material is separated from the working member. In at least another embodiment, the elastic elements may comprise an elastic material, such as, for example, metal or plastic.

Referring to FIGS. 15-18, the holding element may be arranged to move within the working body between the first position and the second position in order to releasably hold a piece of reinforcing material on the working body. In at least one other embodiment, the implement member 214 may comprise a first clamping member including a brace cassette 222 and a second clamping member 226, the holding member 262 being movable relative to the brace cassette 222 and the anvil 226. In various embodiments, the holding element 262 can move between a first or extended position, where it is closer to the distal end 264, to a second or retracted position, where it is closer to the proximal end 263. B in the extended position, the holding member 262 can hold the reinforcing material 236 in place when the operating member 214 is inserted into the area being operated. Subsequently, the working body 214 can be closed on the fabric, for example, and the brackets can be pushed through the reinforcing material into the fabric. In various embodiments, the holding member 262 can be moved to the retracted position so that the holding member 262 can be detached from the reinforcing member 236. In at least one other embodiment, the holding member 262 can be retracted before the brackets are ejected. In any case, the working body 214 can be opened and pulled out of the operated area, leaving a reinforcing material and fabric that were braced together.

In various embodiments, the holding member may have proximal ends that can engage with a lever or other drive mechanism in the handle portion of the surgical stapling instrument, so that the surgeon can remotely move the holding member to the retracted position as described above. In at least one other embodiment, the holding member 262 may have distal ends that can be engaged or otherwise detachably held by the holding rod 264, so that force may be required to bias the holding elements 262 from the holding rod 264. Subsequently, the retaining elements 262 can be retracted in the proximal direction by a distance L to translate them into a second position. In at least one other embodiment, the retaining elements 262 can be pulled through channels or holes 266 in the reinforcing element 236, for example, until they are completely removed from the reinforcing material. In at least one such embodiment, the openings 266 may enclose and guide the holding elements 262 as they are drawn. In various embodiments, the holding elements may consist of flexible wires. In at least one embodiment, the working body may comprise two or more pieces of reinforcing material that are held onto the working body by retractable holding elements. In at least one such embodiment, referring to FIGS. 17 and 18, the operating member 214 may include retaining elements 262 ′ for holding the reinforcing material 236 ′ in place.

In various embodiments, the implementation of the node of the working body may contain a cutting element, which is arranged to cut one or more pieces of reinforcing material. In at least one other embodiment, the cutting element can be set in motion relative to the working body by means of a firing actuator for a surgical instrument, and it can be guided through the cuts of the cutting element inside the anvil and / or cassette of the working body brackets. Referring to FIG. 19, in at least one other embodiment, the upper portion 267 of the cutting element 268 may be slidable inside the slot in the anvil, and further, the lower portion 269 of the cutting element may be slidable inside the slot in the bracket cassette. In various embodiments, the cutting tool 268 may comprise a positive inclined blade 270, i.e., the lower end of the cutting edge is located distally relative to the upper part. In at least one other embodiment, such a configuration can cut the reinforcing material without significantly pressing the reinforcing material in the distal direction and, accordingly, without disturbing the alignment of the reinforcing material within the working body. Referring to FIG. 20, in at least another alternative embodiment, the blade 270 ′ of the cutting member 268 ′ may have a negative slope, that is, the lower end of the cutting edge may be proximal to the upper portion. Referring to FIG. 21, the “cutting element 268” blade 270 may comprise a first positive slope portion 270a ″ and a negative slope second portion 270b ″.

As described above, the assembly of the working unit may contain a cassette of brackets, an anvil and at least one piece of reinforcing material mounted between the cassette of brackets and the anvil. Referring to FIGS. 22-24, in at least one other embodiment, a piece of reinforcing material, such as reinforcing material 336, may be able to articulate with a cassette 322 of brackets and / or anvil (not illustrated) to releasably hold the piece reinforcing material inside the working body. Referring to FIGS. 23 and 24, the bracket cassette 322 may comprise a first side wall 302 and a second side wall 304, wherein at least one of the first and second side walls may comprise a lip protruding therefrom 306. In various embodiments, reinforcing material 336 may comprise a first edge or side 308, a second edge or side 310, and at least one lip 312 extending at least partially along the length of the edges 308 and 310. Referring to FIG. 24, in at least another embodiment, the lips 312 may be executed with possible Stu engagement with lips 306 on the basis of joint, to releasably hold the reinforcing material 336 on the cassette 322 brackets.

Moreover, the reinforcing material 336 may include a surface 316, which can be arranged to fit adjacent to or adjacent to the base 328 of the bracket cassette 322. In at least another embodiment, the side edges 308 and 310 may include side walls that extend in a perpendicular or transverse direction relative to surface 316. In such embodiments, lips 312 may extend from these side walls so that lips 312 can be engaged. with lips 306 cassettes 322 brackets. In various embodiments, the lips 312 of the reinforcing material 336 may be disconnected from the lips 306 of the bracket cassette 322 when the brackets are ejected from the bracket cassette 322. More specifically, when the brackets are ejected, they can come into contact with the reinforcing material 336, exert an upward force on the reinforcing material 336, and peel the reinforcing material 336 from the bracket cassette 322. As a result, the reinforcing material 336 can be automatically separated from the bracket cassette 322 when the brackets are ejected from it and / or when the working body is opened, as described above.

Referring to FIGS. 23 and 24, in various embodiments, a piece of reinforcing material may comprise at least one element protruding from it, which may be configured to releasably hold the reinforcing material on the bracket cassette and / or anvil. In at least another embodiment, element 318 may protrude from reinforcing material 336 in a direction that is perpendicular or transverse to surface 316. In various embodiments, element 318 may come into contact with bracket cavity 320 and / or anvil hole by friction or compression to detachably hold a piece of reinforcing material on the bracket cassette and / or anvil. Similarly, in various embodiments, the brackets pushed out of the bracket bracket 320 can exert an upward force on the reinforcing material 336 and separate the elements 318 from the brace cavities 320. In various embodiments, the brackets may pierce the protrusions 318 and / or the reinforcing material 336 to attach the reinforcing material to the fabric, as described above.

As illustrated in FIG. 23, a piece of reinforcing material may comprise more than one protruding element or protrusion from it to hold a piece of reinforcing material on the bracket cassette and / or anvil. Referring to Figs. 25-26, in various embodiments, more than one element 318 'may protrude from a piece of reinforcing material 336', for example. In at least one other embodiment, the elements 318 'can be pressed into the brackets cavity 320' of the brackets cassette 322 'and / or into the anvil holes (not illustrated) so that by means of friction these elements can hold a piece of reinforcing material on the bracket cassette and / or anvil as described above. As described in more detail below, in addition to the brackets cavities of the bracket cassette and the anvil holes, the bracket cassette and / or anvil may contain slots and / or holes for receiving protrusions or retaining elements protruding from a piece of reinforcing material.

Referring to Fig. 33, in various embodiments, the anvil and / or cassette brackets of the node of the working body may contain one or more slots and / or grooves made in such a way as to releasably hold a piece of reinforcing material on the site of the working body. In at least one other embodiment, the bracket cassette 722 may comprise at least one opening 704 that can be configured to accommodate a protrusion 706 extending from the reinforcing material 736. In at least one other such embodiment, the protrusion 706 may fit into the hole 704 according to the principle of press and / or friction connection in order to releasably hold the reinforcing material 736. Referring to FIG. 33, in at least one other embodiment, the reinforcing material 736 may comprise ate 708 with a surface 710 which can be configured to be mounted adjacent and / or abut against the base 728. In various embodiments, projection 706 can extend from body 708 in a direction which is perpendicular or transverse to the plane formed by surface 710.

In various embodiments, the protrusion 706, for example, may comprise a first part or leg 712 and a second part or tab 714, the first part 712 being able to extend through the hole 704 and the second part 714 may be sized and shaped to slightly larger than the hole 704. In at least one such embodiment, the protrusion 706 can be inserted into the hole 704 and pushed through it until the second part 714 at least partially passes through it. In various embodiments, the protrusion 706 may bend inwardly when it is inserted into the hole 704, then it may snap in the outward direction when it passes through the hole. In addition to or in place of the foregoing, the second part 714 may contract when it is inserted into the hole 704, and it may stretch after it passes through the hole. In any case, the second part 714 may come into contact with the surface of the back side of the base 728 near the hole 704 in order to detachably hold the reinforcing material 736 on the bracket cassette 702 according to the latch principle. In at least another embodiment, the protrusion 706 can be releasably held inside the hole 704 until the force of the brackets pushed out of the bracket cassette is applied to it and / or until the working member opens, as described above.

Referring to FIG. 27, in various embodiments, the cassette 322 "brackets and / or anvil 326", for example, may include grooves 334 "that can be configured to receive reinforcing material 336". In at least one other embodiment, the grooves 334 "may be removably able to hold the reinforcing material 336" on the bracket cassette 322 ". In at least one such embodiment, the reinforcing material 336" may be pressed between the holding elements 302 " and 304 ", so that force must be applied to them to overcome the friction between the reinforcing material 336" and the holding elements 302 "and 304". In various embodiments, the holding elements 302 "and 304" may contain jaws or protrusions that can prevent or at least prevent the lifting of reinforcing material 336 ". Referring to FIG. 28, in various embodiments, the working body assembly may comprise a bracket cassette 422 and an anvil 426, the bracket bracket and / or anvil may comprise a first holding member 402 and / or a second holding member 404 protruding therefrom. At least in yet another embodiment, the first and second retaining elements 402 and 404 can extend substantially perpendicularly and / or transversely with respect to the base 428 or front surface 432 to hold the reinforcing material 436 on the working body. In various embodiments, the first and second holding elements 402 and 404 may be configured to releasably hold the reinforcing material 436 between them in a frictional manner. In at least one other embodiment, the coefficient of friction between the side walls of the reinforcing material and the retaining elements may be sufficient so that the reinforcing material cannot be shifted when the working member is inserted and manipulated within the area being operated. After inserting the brackets into the soft tissue, the working member can be opened again and, in various embodiments, the frictional force between the reinforcing material 436 and the holding elements 402 and 404 can be overcome.

Referring to Fig. 32, in various embodiments, the working organ of the surgical stapling instrument may comprise an anvil and a cassette of brackets (not illustrated), wherein the anvil may come into contact with the cassette of the brackets so that the working organ can be configured to clamp the tissue located between them. . In at least one other embodiment, the anvil 626 may comprise a face 632 and, in addition, a slot 602 that can be adapted to receive a cutting element, such as, for example, a cutting element 668 that can slide along the slot 602. B various embodiments, although not shown, the cassette bracket may comprise a slot configured to accommodate the cutting element 668 so that it slides along the slot. In any case, the cutting element 668 may include a blade, such as, for example, a blade 670, which can be configured to cut soft tissue and / or reinforcing material 636 located in the working body.

Referring to FIG. 32, in at least another embodiment, the reinforcing material 636 may comprise a body part with a surface, such as, for example, surface 604, which may be configured to be adjacent to the anvil face 632. In various embodiments, the reinforcing material 636 may further comprise a protrusion 606 extending from the body part in the perpendicular and / or transverse direction relative to the surface 604. In at least one other embodiment, the protrusion 606 may be adapted to be inserted into the slot 602 of the cutting element, in order to releasably hold the reinforcing material 636 on the anvil 626. Although not illustrated, a piece of reinforcing material may contain similar elements that may Gut hold the reinforcing material on the cassette brackets.

In various embodiments, the cutout 602 of the cutting element may comprise a first side wall 608 and a second side wall 610, the protrusion 606 may be able to frictionally connect and / or be pressed between the first side wall and the second side wall and detachably hold the protrusion 606 in slot 602. In at least another embodiment, slot 602 may comprise a transverse portion 612 that may be configured to accommodate cam elements 631 extending from p cementitious member 668, wherein cam members 631 can be configured to hold anvil 626 in a closed position. In at least another embodiment, the protrusion 606 may include at least one extending tab 614 from it, which may be configured to extend at least partially to the transverse portion 612 and help to retain the protrusion 606 within the slot 602. In various embodiments the protrusion may contain elastic elements that can exert a biasing force on the side walls 602 when they are compressed into the slot 602.

In various other embodiments, the cutting element 668 may be configured to cut the protrusion 606 as the cutting element advances in the anvil 626 and to separate the first part 618 from the second part 620. In at least one other embodiment, the grooves 616 may reduce the thickness of the cross section reinforcing material 636 to reduce the force required to dissect the reinforcing material. In various embodiments, one or more of the grooves 616 may be sized and shaped such that at least a portion of the protrusion 606 is thinner than the first part 618 and / or the second part 620. As described above, at least one of the grooves 616 may be V-shaped shape, for example, so that the cutting edge 670 can come into contact with the protrusion 606 at or near the base of the V-shaped base 634. In various embodiments, although not illustrated, the protrusion 606, for example, may include at least one perforation that can reduce the force required to cut the protrusion.

In various embodiments, in addition to or in place of the above-described attachment devices of the reinforcing material, a piece of the reinforcing material may be attached to the working body of the surgical instrument by adhesive. Referring to FIGS. 29 and 30, in at least one other embodiment, the working body assembly 514 may comprise an anvil 526 with a face 532 and, in addition, a channel 522 of the bracket cassette with a base surface 528. In at least another embodiment, a piece of reinforcing material, such as, for example, reinforcing material 536 may be placed on the front surface 532 or base surface 528, the reinforcing material 536 may comprise a body portion 502 and at least one handle portion 506. In at least one such embodiment, the handle portion 506 can extend from the body 502 so that the surgeon can use the handle portion 506 to position and center the reinforcing material 536 within the working body assembly. In at least another embodiment, the handle portion 506 may extend in a direction that is parallel and / or transverse to the plane of the surface 504.

Referring to FIGS. 29 and 30, an inactive or inert adhesive may be present on the surface of the reinforcing material, such as, for example, adhesive 512, which can be applied to the surface before the surface is placed against the base of the bracket cassette and / or the anvil face. In at least one other embodiment, the adhesive 512 may be removably bonded to the surface 504, for example, to the front surface 532 and / or the base 528 when the adhesive is activated by the reagent. Similarly, such an activated adhesive can be used to releasably hold the surface 504 in contact with the front surface 532 and / or the base 528. In various embodiments, the activated adhesive can be configured to separate the reinforcing material from the base and / or front surface under the action of the attached forces on it when the brackets are pushed out of the bracket cassette and / or when the working body opens, for example. In various embodiments, an inactive adhesive may be applied to the reinforcing material along the outer perimeter of the body portion 502 so that the reagent, for example, can be easily applied to the inactive adhesive.

In various embodiments, the non-activated adhesive on the reinforcing material may contain one component of a two-component adhesive, and the reagent may contain another component of a two-component adhesive, so that when the two components are combined, the adhesive is activated. In other words, a non-activated adhesive may contain a material that remains inert until a reagent is introduced into it, as described below. In at least one other embodiment, the non-activated adhesive and reagent may contain, for example, an epoxy resin that can be used from a surgical point of view. In various embodiments, the non-activated adhesive may contain, for example, a waterproof material, so that the adhesive can be substantially insoluble and / or substantially non-reactive when it is introduced into water. In at least one other embodiment, the adhesive may comprise material such as, for example, hot-melt adhesive, silicone, urethane, cyanoacrylate, hydrogel and / or isocyanate, or any other suitable monomer and / or polymer. In various embodiments, suitable adhesives and attachment devices may include the objects disclosed in US Pat. No. 5,263,629, "Method and Device for Achieving Hemostasis Along the Bracket Installation Line", issued November 23, 1993; US patent No. 6,656,193 "Device for attaching a reinforcing material to a surgical stapling device", issued December 2, 2003; US patent No. 6,592,597 "Adhesive for attaching a reinforcing material to a surgical stapler", issued July 15, 2003; US patent No. 6,273,897 "Surgical strengthening material and surgical stapling device", issued August 14, 2001; and US Patent Application No. 10 / 674.303, "Device and Method for Attaching Surgical Reinforcing Material to a Stapler," filed September 30, 2003, the contents of which are incorporated herein by reference in their entirety. In various embodiments, the reagent may comprise a material comprising at least one aerobic initiator, an anaerobic initiator, a four-component ammonium salt or ammonium compound and / or any other suitable radical initiator, such as, for example, anionic polymerization initiators, including materials disclosed in US Patent Application No. 11 / 479,424 "Resorbable cyanoacrylate formulations," filed June 30, 2006, the contents of which are incorporated herein by reference in their entirety. For example, in various embodiments, commercially available adhesives and / or reagents manufactured by Closure Medical Corporation may be used. In at least one other embodiment, the adhesive may be configured to be activated by ultraviolet light and / or any other photochemical process. For example, similar adhesives manufactured by Henkel Loctite Corporation are currently commercially available.

In addition, in various embodiments, the use of an inactive or inert adhesive on a piece of reinforcing material may allow the surgeon to install and reinstall a piece of reinforcing material on the front surface of the anvil and / or the base of the bracket cassette, and the adhesive does not immediately connect to them. In at least one other embodiment, the non-activated adhesive may not adhere to the front surface and / or to the base until the reagent is applied to the non-activated adhesive. This feature provides a significant advantage in that the surgeon does not need to properly install a piece of reinforcing material on the first try, but instead, he can install and reinstall a piece of reinforcing material on the base and / or face to ensure proper fit and alignment with front surface and / or base. In various embodiments, at least one holding or centering member, such as, for example, holding member 318 (FIG. 23) can be used in conjunction with an adhesive / reagent to hold a piece of reinforcing material on the face and / or base of the working body to reagent overlay, for example.

In various embodiments, the implementation of the piece of reinforcing material may contain at least one groove or channel, which may be configured to accommodate the reagent. Referring to FIG. 29, in at least another embodiment, the reinforcing material 536 may include recesses 508 that may be located between the body portion 502 and the handle portion 506. More specifically, a first recess 508 may be provided between the first side of the body 502 and the first part 506 of the handle, and, in addition, a second recess 508 may be provided between the second side of the body 502 and the second part 506 of the handle. In various embodiments, at least a portion of the non-activated adhesive 512 on the reinforcing material 536 can extend along the recess 508, so that an applicator, such as, for example, the applicator 514, can be inserted into the recesses 508 to apply a reagent to the adhesive 512 and activate the adhesive. As a result, in at least one other embodiment, the recesses 508 can facilitate the application of the reagent. In various embodiments, the reagent applicator 514 may include an absorbent tip 516, which may be configured to store a certain amount of reagent.

Referring to FIGS. 30 and 31, in various embodiments, at least one perforation may be provided in the piece of reinforcing material 536 to enable separation of at least one handle portion 506 from the body portion 502, for example. In at least another embodiment, perforations 510 may be located between the body part 502 and the handle part 506, so that when sufficient force is applied to the handle part 506, a piece of reinforcing material may come off along a line or channel formed by the perforations 510. In various embodiments perforations 510 may be located adjacent to and / or inside the recesses 508, so that the handle portion 506 can be easily separated from the body 502 due to the reduced thickness of the reinforcing material in and / or adjacent to the recesses 508. Ka to the result, in at least one other embodiment, a piece of the reinforcing material can be installed in the working body, the reagent can be applied to the inactive adhesive on the reinforcing material, and at least one part of the handle can be separated from the central part of the body of the reinforcing material.

In various embodiments, a piece of reinforcing material, an inactive adhesive, and a reagent may be included in a surgical kit, for example. In at least one other embodiment, the non-activated adhesive may be pre-applied to the reinforcing material. In other embodiments, the surgeon may use a kit to apply the targeted adhesive to the surface of the reinforcing material and allow the adhesive to “settle”, that is, to harden or dry so that a piece of the reinforcing material can be installed on the surface without substantially adhering to the surface. In at least one other embodiment, subsequently, a piece of reinforcing material can be mounted on a cassette of brackets or on the anvil of the working body. In at least one such embodiment, as mentioned above, the reinforcing material may comprise at least one handle that the surgeon can hold to manipulate the reinforcing material relative to the working body. Subsequently, the anvil of the working body can be closed on a reinforcing material to hold it in place until a reagent is applied to it. Referring to FIG. 31, in such a position that the anvil is closed, part of the handle can be removed. Alternatively, before removing the handle, the surgeon can wait until the activated adhesive cures at least partially. In any case, after that, the working body can be inserted into the operated area and the reinforcing material can be attached to the fabric through brackets, as described above. In various other embodiments, the handle portion (s) may be torn away from the body portion of the reinforcing material after the brackets come in contact with the fabric.

In various embodiments, the packaging assembly for at least one piece of reinforcing material may comprise means for activating an inactive adhesive on the reinforcing material. In at least one other embodiment, the packaging unit may contain a certain amount of reagent, the reagent may be isolated so that it comes into contact with an inactive adhesive and activates the adhesive. In various other embodiments, the implementation of the packaging unit may contain an initiator, which can be configured to cause a reaction between the inactive adhesive and other chemical substance inside the packaging unit. In various additional embodiments, the non-activated adhesive may be configured to activate when sufficient pressure is applied to it. Such pressure can be generated when the anvil of the working body is closed on the reinforcing material and pressed against the cassette brackets. Such materials may contain one or more pressure sensitive adhesives, such as, for example, silicone adhesives and acrylic adhesives. In various embodiments, the implementation of the package may contain a piece of reinforcing material coated with a biocompatible hot-melt adhesive, and this adhesive can be made with the ability to melt when heated, generated by an exothermic chemical reaction. In at least one other embodiment, the initiator may be mixed with a chemical to create an exothermic reaction and thereby generate heat in a localized area of the adhesive. In various embodiments, the initiator can be separated from the chemical by means of a removable sheet or other suitable separation device, so that when the sheet is removed, the initiator and the chemical can be mixed with each other. In at least one such embodiment, the initiator may contain an oxidizing agent or any suitable chemical composition that easily transfers oxygen atoms, for example, and the chemical substance may contain iron or an iron compound, for example, which may be oxidized by an oxidizing agent to create an exothermic reaction.

In various embodiments, the package may comprise a piece of reinforcing material coated with a biocompatible hot-melt adhesive, the adhesive being able to melt when heated by a source of electrical energy. In at least one other embodiment, the package may comprise a source of electrical energy. In various additional embodiments, the implementation of the energy source can be provided on the part of the working body, part of the reinforcing material, the sleeve of the working body and / or the applicator of the reinforcing material, for example. In various embodiments, the package assembly may comprise first and second contacts and / or any other suitable conductors and resistors that may be configured to close an electrical circuit to a battery. In at least one embodiment, the source of electrical energy can be activated by, for example, a switch on the package, and electricity can be supplied to the contacts.

In various embodiments, the implementation of the anvil of the node of the working body may contain a removable part or sleeve, which can be made with the ability to slide on the second part of the anvil and attached to the node of the working body. In at least another embodiment, as described in more detail below, a piece of reinforcing material can be attached to the sleeve prior to installing the sleeve on the assembly of the working body. Referring to FIG. 34, in at least one other embodiment, the sleeve 802 may be configured to slide along the anvil portion 826, such that the sleeve 802 is held in place by a latch or press connection configuration. In at least one such embodiment, the sleeve 802 may be configured to at least partially surround the external perimeter 804 of the anvil portion 826, the sleeve 802 may be configured to engage with the external perimeter 804. In various embodiments, the sleeve 802 may comprise the anvil holes 806 formed on the working surface 808, and the holes 806 may be configured to deform the brackets ejected from the bracket cassette, as described above. In various embodiments, the sleeve 802 may be cast or fabricated by machining a piece of metal in any suitable configuration, and it may consist of any suitable material, such as, for example, aluminum.

Referring to FIG. 34, a reinforcing material 836 may be installed on the sleeve 802, wherein at least a portion of the reinforcing material 836 may be releasably attached to the sleeve 802 by, for example, adhesive. Referring to FIG. 35, in at least another embodiment, the reinforcing material 836 ′ may comprise a body portion 812 ′ and at least one side portion 814 ′, the side portions 814 ′ may be detachably attached to the sleeve 802 ′ by adhesive 810 '. In various embodiments, the side portions 814 'may be disconnected from the sleeve 802' when a force is applied to them. In at least one other embodiment, a similar force can be created when the brackets are pushed out of the bracket cassette and come into contact with the reinforcing material. Referring to Fig. 36, in various embodiments, a piece of reinforcing material may further comprise at least one perforation and / or recess, which may allow separation of the part of the reinforcing material in contact with the tissue from the part of the reinforcing material that is attached to the working body. In at least one other embodiment, the reinforcing material 836 ″ may comprise a body part 812 ″ that is configured to come into contact with a tissue mounted inside the body and, in addition, side portions 814 ″ that can be attached to the sleeve 802 "anvils, for example by adhesive 810". In various embodiments, the reinforcing material 836 "may further comprise one or more perforations 816" that may be located between the body portion 812 and the side portions 814 ". In addition to or Amen side portions 814 "separating from sleeve 802", the part 812 "of the body can be configured to detach from side portions 814" along a line formed by perforations 816 "when a force is applied thereto. In at least one such embodiment, the side portions 814 "may remain intact on the sleeve 802" after the body portion 812 "is detached from it. Referring to FIG. 37, in various other embodiments, the sleeve 802" "may comprise a piece of reinforcing material, such as, for example, reinforcing material 836 ″ ″, which may contain one or more recesses 818 ″ ″ located between the body part 812 ″ ″ and the side portions 814 ″ ″, which may allow the part to be separated 812 '' 'of the body from the side portions of 814' ''.

In addition, in various embodiments, after the body of the body is separated from the side portions, the working member is removed from the fabric and the reinforcing material braced on the fabric. In at least one other embodiment, the used sleeve 802, for example, can be removed from the anvil portion 826, removed and replaced with another sleeve. In at least one such embodiment, the replacement sleeve may comprise a piece of reinforcing material, such as, for example, reinforcing material 836, so that the working member can be reused. In various embodiments, the removed sleeve may be sterilized as described below, and another piece of reinforcing material may be attached to this sleeve so that it can be used again.

In various embodiments, a package including a piece of reinforcing material can be configured to lay a piece of reinforcing material on the anvil or cassette of the brackets of the working body. Referring to FIGS. 38-40, in at least one other embodiment, the package 902 may comprise a first portion 904 with a surface 905 that can be configured to hold a piece of reinforcing material 936 so that it can be detached. In various embodiments, the surface 908 of the reinforcing material 936 may comprise an adhesive 910, and the adhesive 910 may be removably attached to the reinforcing material 936 to the anvil 926. In addition to the first part 904, the package 902 may include a second part 906 attached to the first part 904, and on the second part 906, a second piece of reinforcing material, such as, for example, reinforcing material 937 can be attached. In various embodiments, similarly to reinforcing material 936, reinforcing the material 937 may comprise an adhesive that can be used to releasably attach the reinforcing material 937 to the bracket cassette 922. In order to remove parts 904 and 906 from the pieces of reinforcing material, the surgeon can grasp at least one of the parts 904 and 906 and pull away from the pieces of reinforcing material, as illustrated in FIG. As such, the package 902 may be moved from the first / attached position to the second / detached position.

Referring to Figs. 41-46, in various embodiments, the packaging assembly for at least one piece of reinforcing material may comprise an outer packaging 901 ', which may be configured to enclose an inner packaging 902' in a sterile environment. In use, the surgeon opens the outer packaging 901 ', takes out the inner packaging 902' and manipulates the inner packaging 902 'to reveal the reinforcing material 936'. In at least one other embodiment, the inner packaging 902 'may comprise a cover sheet comprising a first part 904' and a second part 906 ', the first and second parts being able to at least partially cover the reinforcing material 936' when they are are in a first position, as illustrated in FIG. In various embodiments, the surgeon can rotate the second part 906 'relative to the first part 904' by gripping and pulling the tongue 938 'located on the second end 940' of the second part 906 ', as illustrated in Fig. 42, and moving the second part 906' to the second 43 and 44. In at least one such embodiment, the surgeon can rotate the second part 906 'relative to the first part 904' until the second part 906 'is set at least partially against the first part of 904 '.

Further, in various embodiments, the reinforcing material 936 'can be aligned with the anvil and / or cassette of the brackets of the working body, as described above. Referring to Figs. 45 and 46, in at least one other embodiment, the inner packaging 902 'can be inserted into the working member 914' between the anvil 926 'and the bracket cassette 922', so that the reinforcing material 936 'can be aligned with the cartridge 922 'brackets, for example. Similarly, in various embodiments, the anvil 926 'can be rotated to the brace cassette 922' and gripped over the package 902 'and the reinforcing material 936', so that the reinforcing material 936 'can be pressed against the brace cassette 922' and the adhesive 910 can be fixed thereto reinforcing material 936 '. Subsequently, the anvil 926 'can be re-opened and the sheet 918' can be peeled off or otherwise removed from the reinforcing material 936 '.

In various alternative embodiments, the implementation of the packaging unit may contain one or more tension threads, configured to separate the cover sheet from the reinforcing material contained in the packaging unit. In at least one such embodiment, the cover sheet can be manipulated to reveal a reinforcing material that can be attached to the working body, and the tension threads can be stretched in the proximal or distal direction to separate the cover sheet from the reinforcing material. Referring to Figs. 47 and 48, in various other embodiments, the tension threads can be attached to a part of the reinforcing material such that a part of the handle, for example, the reinforcing material, can be separated from the part of the reinforcing material in contact with the fabric. In at least one such embodiment, the reinforcing material 1002 may be sandwiched between the anvil and the cassette of the working body brackets, and a force is applied to tension the tension threads 1006 that are attached to the handle portion 1004 of the reinforcing material 1002. As a result, in various embodiments, the distal end 1003 of the reinforcing material 1002 can be pulled toward the proximal end 1005 by the tension threads 1006, so that the handle part 1004 can separate from the tissue-contacting part 1036 along the perforation line 1008. In at least one other In an embodiment, the reinforcing material 1002 may further comprise an opening 1010, which may be at the distal end of the tissue-contacting part 1036, wherein the opening 1010 may preform lenny area between the handle and part of 1004 in contact with the cloth part of 1036, to reduce the force required to separate parts of the handle 1004. Referring to FIG. 49, in at least one embodiment, at least one tension thread 1006 ′ may be attached to a handle portion 1004 ′ of a reinforcing material 1002 ′ such that the proximal end 1005 can be tensioned toward the distal end 1003 so that remove part 1004 of the handle.

In various embodiments, an applicator may be used to apply a piece of reinforcing material to the anvil and / or cassette of the brackets of the working body. Referring to Figures 50-53, in at least one other embodiment, the applicator assembly 1102 may comprise an applicator 1104 and at least one piece of reinforcing material 1136, wherein the applicator 1104 may comprise at least one surface to support the reinforcing material 1136. By in at least one such embodiment, the applicator 1104 may comprise an upper surface 1106 and a lower surface 1108, each of which may be configured to receive at least one piece of reinforcing material 1136 c the possibility of disconnecting it. In various embodiments, each piece of reinforcing material 1136 can be detachably attached to the upper and lower surfaces of the applicator 1104 using an adhesive and / or mechanical element, for example. Referring to Figs. 50 and 51, each piece of reinforcing material 1136 may comprise a face surface 1110 that may be at least partially coated with adhesive to hold the face surface 1110 on a working body. In at least one such embodiment, the adhesive may be applied to the reinforcing material 1136 at several points 1112.

In order to lay a piece of reinforcing material on the bracket cassette and / or the anvil of the working body assembly using an applicator, such as, for example, applicator 1104, the applicator can be at least partially positioned between the bracket cassette and the anvil so that the anvil can be closed onto the reinforcing material. Referring to FIGS. 52 and 53, in various embodiments, the applicator assembly 1102 can be at least partially installed between the anvil 1126 and the cassette 1122 of the brackets of the operating member 1114, so that the anvil 1126 can be combined with the reinforcing material 1136 and closed. In at least one other embodiment, the applicator 1104 may further comprise a centering slot 1116 at the first end and a tongue 1117 at the second end, the surgeon may use the centering slot 1116 to center and install the applicator assembly 1102 into the operating member 1114. At least in yet another such embodiment, the centering slot 1116 can be adapted to fit the working member 1114 tightly between the side walls of the centering slot 1116. Thanks to the adhesive 1112, pieces of the reinforcing mat The rial 1136 can be glued to the anvil 1126 and the bracket cassette 1122, so that when the anvil 1126 opens again, the applicator 1104 can be removed from the working body assembly 1114, leaving pieces of reinforcing material inside the working body.

In various embodiments, at least one protective sheet (not illustrated), similar, for example, to sheet 918, can be mounted on the front surface 1110, so that the applicator 1104 can be installed and reinstalled on the anvil or cassette of the brackets of the working body 1114 without adhesive 1112 to the anvil and / or cassette brackets. In at least one such embodiment, the sheets may be removed by the surgeon after the applicator is properly positioned and centered within the body to allow the adhesive to come into contact with the cassette bracket and / or anvil of the body. In various embodiments, in addition to or in place of tongue 1117, the applicator may comprise at least one handle 1134, for example, which may be configured to allow a surgeon to easily manipulate the applicator within a working body. In at least one other embodiment, the first handle 1134 may be provided on the first side of the applicator 1104, and, in addition, the second handle 1134 may be provided on the second side of the applicator. In various embodiments, the handle may comprise ribs 1138, which may be configured to allow the surgeon to more conveniently hold the applicator 1104. For this purpose, at least a portion of the arms 1134 may comprise soft or elastic material, such as, for example, rubber.

In other embodiments, although not illustrated, the packaging for at least one piece of reinforcing material may comprise a tubular sleeve that can be configured to be installed around the anvil and / or cassette brackets. In at least one embodiment, the reinforcing material may comprise an adhesive that can be adapted to releasably attach a piece of reinforcing material to the anvil and / or cassette brackets. In at least one such embodiment, the tubular sleeve may be configured to accommodate the anvil and / or cassette brackets, so that the anvil and / or cassette brackets align with a piece of reinforcing material inside the tubular sleeve. In various embodiments, the tubular sleeve may comprise a middle wall extending between the first side and the second side of the inner perimeter of the sleeve. In various embodiments, the middle wall may comprise an upper surface and a lower surface, the upper and lower surfaces being able to hold a piece of reinforcing material so that it can be detached. In at least one such embodiment, the working body can be centered relative to the middle wall, and it can clamp the middle wall to attach the reinforcing material to the anvil and / or cassette brackets.

In various embodiments, a reinforcing material dispenser may be used to distribute the reinforcing material. Referring to FIGS. 54 and 55, in at least one other embodiment, the distributor 1200 may be configured to distribute reinforcing material 1236 from a housing assembly comprising housing parts 1210 and 1212. As described in more detail below, the dispenser 1200 may include a roller or reel 1224 of reinforcing material, the reinforcing material can be distributed from the coil 1224 to the working body of the surgical instrument, as shown in Fig. 57. In various embodiments, the reinforcing material 1236 can be glued or otherwise supported on the carrier tape 1202, so that during the distribution of the reinforcing material 1236, the reinforcing material 1236 can be separated from the carrier tape 1202. Referring to FIGS. 54-57, in various embodiments the carrier tape 1202 may comprise a surface 1204, which may be configured to contain a reinforcing material 1236. In various embodiments, the reinforcing material 1236 may be divided into two pieces before and / or after it is placed on the surface 1204. In at least another embodiment, each piece of reinforcing material 1236 may have a width that is equal to or less than the width of surface 1204, and in various embodiments, these pieces of reinforcing material may be detachably attached to the surface 1204 of the carrier 1202 by, for example, an adhesive with a low fixing force.

Referring to FIGS. 54-57, in various embodiments, the inner wall 1214 of the first housing part 1210 may comprise a plurality of protruding connectors 1216. In at least one other embodiment, the connectors 1216 can connect to other connectors or holes on the inner wall of the second part 1212 to hold the first and second body parts together. Referring to FIG. 56, in various embodiments, the distributor 1200 may further comprise a coil shaft 1242, which may be configured to support the coil 1224 to rotate. In at least one such embodiment, the coil shaft 1242 may be coupled to a bore 1241 in the housing portion 1210 and an aperture (not illustrated) in the second portion 1212. In various embodiments, the coil shaft 1242 may be mounted on the coil 1242 so that they could spin together. As mentioned above, the reinforcing material 1236 and the carrier tape 1202 can be unwound from the reel 1224 as the reinforcing material 1236 is distributed. At least in another embodiment, a force can be applied to the reinforcing material 1236 so that it can be manually pulled from the distributor 1200. B various other embodiments, as described in more detail below, the reinforcing material dispenser 1200 may further comprise a thumb-driven roller 1234, wherein the roller 1234 may have in-person contact with the reinforcing material 1236 so that the surgeon or other clinical physician can rotate the roller 1234 and push the reinforcing material 1236 out of the dispenser 1200. Referring to FIG. 55, in at least one other embodiment, the dispenser 1200 may further comprise a roller shaft 1235, which can be configured to support the roller 1234 in the housing of the distributor with the possibility of rotation. In at least one other embodiment, the roller 1234 can be mounted on the shaft 1235 so that they can rotate together about an axis defined by the hole 1249 in the first housing part 1210 and the hole (not illustrated) in the second housing part 1212.

Referring to Fig. 55, in various embodiments, the roller 1234 can be configured to extend at least partially through an opening 1239 in the dispenser housing so that the surgeon can rotate the roller 1234. In at least one other embodiment, the roller 1234 can be made with the possibility of contact or by frictional force to engage with the reinforcing material 1236 and / or the carrier 1202, so that the rotation of the roller 1234 can move the reinforcing material 1236 in the distal direction in the direction of the drive roller 1232. In to or instead of the foregoing, the drive roller 1232 may be able to contact or frictionally engage with the reinforcing material 1236 and / or the carrier 1202. In at least one other embodiment, the drive roller 1232 may engage with the roller 1234 via a drive belt 1243 , for example, so that the rotation of the roller 1234 can be transmitted to the drive roller 1232. Although the drive belt is illustrated in this example, any suitable device can be used, such as, for example, single chain or tape. In various embodiments, at least one of the housing parts 1210 and 1212 may include guides 1262 that can be configured to center the drive belt 1243 with roller 1234 and drive roller 1232.

As described above, the carrier tape 1202 can be separated from the reinforcing material 1236 during the distribution of the reinforcing material 1236 from the distributor 1200. In various embodiments, the distributor 1200 may further comprise a carrier tape collector 1228 that can be adapted to wind the carrier tape 1202 after it has been removed from the reinforcing material 1236. In at least one other embodiment, the carrier tape collector 1238 may be mounted on the coil 1224 and / or the shaft 1242 of the coil, so that the coil 1224 carrier tape collector 1228 can be rotated synchronously. In at least one such embodiment, the carrier tape 1202 can be wound onto the tape collector 1228 in a direction that is opposite to the direction in which the reinforcing material 1234 is distributed from the coil 1224. As a result, the distribution of the reinforcing material 1234 and the winding of the carrier tape 1202 can be performed simultaneously. In various embodiments, the dispenser 1200 may further comprise a separating plate 1230 that can be used to peel or separate the reinforcing material 1234 from the carrier 1202. In at least another embodiment, the separating plate 1230 may have an edge 1258 along which the carrier 1202 can be redirected so so that it is peeled off in the proximal direction through the carrier tape collector 1202, as described above.

In various circumstances, after separation of the carrier tape 1202 from the reinforcing material 1236, sagging may occur therein. In at least one other embodiment, the distributor 1200 may include one or more tensioners to reduce a similar sag of the carrier tape 1202. In various embodiments similar to those described above, the distributor may further comprise a shaft 1218 that can be supported in the hole 1251 in the first part The housing 1210 and the hole (not illustrated) in the second housing part 1212, the shaft 1218 may be configured to support the pressure roller 1222 to rotate. Referring to Figs. 56 and 57, in various embodiments, the distributor 1200 may further comprise a second drive roller 1253, which may be configured to cooperate with the pinch roller 1222. In at least one other embodiment, the second drive roller 1253 may engage with a roller 1236, so that the rotation of the roller 1234 can be transmitted to the drive roller 1253. In various embodiments, the distributor 1200 may further comprise a gear train comprising a cylindrical gear wheel a wheel 1244 mounted on a roller 1234 and / or a shaft 1235, an intermediate gear 1246 supported by a shaft 1247, and a driven gear 1252 that can engage with a drive roller 1253. In at least one such embodiment, the carrier tape 1202 may be mounted between the drive roller 1253 and the pressure roller 1222, so that when the drive roller 1253 is driven by the roller 1234, the drive roller 1253 can drive the carrier tape 1202 in the proximal direction. In at least one other embodiment, the pinch roller 1222 and / or the drive roller 1253 may consist of at least partially compressible material, so that the pinch roller 1222 can press the carrier tape against the drive roller 1253.

Referring to Figs. 54-57, the applicator 1200 may include a housing 1201 comprising a first part 1210 and a second part 1212, the first and second parts being able to be attached to each other. In at least one other embodiment, the first and second parts of the housing 1201 may be screwed to each other, secured to each other by a latch, or otherwise. In various embodiments, the first and second parts of the housing can be detachably connected to each other, so that the first and second parts of the housing can be separated from each other to remove and replace the expended coil of reinforcing material. In at least another embodiment, the body may comprise ergonomic elements so that it is convenient for the surgeon to hold the body.

Referring to FIGS. 58-61, in various other embodiments, the dispenser or applicator 1266 may comprise a coil 1267 with which reinforcing material 1236 can be distributed, and, in addition, a collecting coil 1270 that can be configured to collect the accumulating tape 1202 after its separation from the reinforcing material 1236. Similarly to the above, the reinforcing material 1236 can be distributed from the applicator 1266 by adhesion between the reinforcing material 1236, the roller 1234 and / or the drive roller 1232. At least still in one embodiment, the collecting coil 1270 can also engage with the roller 1234, so that the rotation of the roller 1234 can rotate the coil 1270 and the accumulating coil 1202. In various embodiments, the applicator 1266 may include a gear comprising a spur gear 1244 mounted on the roller 1234 and / or shaft 1235, an intermediate gear 1246 supported by a shaft 1247, and a driven gear 1272, which may be mounted on a coil 1270 and / or shaft 1271. In at least one other embodiment, an axle estvleniya rotation roller 1234 may result in the rotation of the collecting coil 1270 directly apply a force to the carrier tape 1202 and 1202 to collect the carrier tape on the reel 1270.

Referring to Figs. 57 and 61, in various embodiments, the reinforcing material applicators 1200 and / or 1266 can be used to lay a piece of reinforcing material on the base “D” of the “SC” cassette of the brackets and / or the front surface “F” of the anvil “A” . As illustrated in FIG. 61, in at least one embodiment, the surgeon can first install the applicator 1266, for example, on the first end 1276 of the base D. Next, the surgeon can pull the applicator toward the second end 1278 of the base D by rotating the roller 1234 so that distribute the reinforcing material 1236. As described above, the reinforcing material 1236 can be divided into pieces, and in at least one other embodiment, the length of the pieces can be selected so that the pieces of the reinforcing material are properly set on the base of the cassette bracket and / or the front surface of the anvil. In various other embodiments, the implementation of the piece of reinforcing material may consist of one continuous tape, and the applicator may contain a cutting element (not shown), which can be made with the ability to cut the reinforcing material into pieces of any suitable length. In various embodiments, the pieces of reinforcing material may contain adhesive, or adhesive may be applied to the reinforcing material, which may be configured to hold the reinforcing material on the base and / or front surface so that it can be detached.

In various embodiments, a piece of reinforcing material may be made using an injection molding process. In at least one embodiment, the injection mold (not illustrated) may contain one or more mold cavities that can be configured to allow molten material to be filled in. In various embodiments, the molten material may comprise plastic and / or any other suitable material. In various embodiments, the mold may further comprise at least one casting cavity and / or a gate, through which connection to the injection molding machine can be provided. In at least another embodiment, the mold may comprise first and second parts that can be separated after the molten material has solidified or solidified in the mold cavities.

Referring to FIGS. 62 and 63, in various embodiments, a piece of reinforcing material 1336 may comprise a first surface 1302 and a second surface 1304, each of which may comprise a plurality of openings or recesses 130 formed therein. At least in another embodiment, the recesses 1306 can be formed from molten material inside the mold during the injection molding process. More specifically, the mold may contain one or more cavities with a plurality of protrusions, which can be molten with the possibility of molten material being poured around them, and when the piece of reinforcing material 1336 hardens and is taken out of the mold, in the places of the reinforcing material 1336 where the protrusions were previously located, recesses 1306 will be formed.

In various embodiments, the reinforcing material 1336 may further comprise a plurality of walls, such as, for example, walls 1305 formed between the first and second surfaces 1302 and 1304, wherein walls 1305 may form recesses 1306. In at least one other embodiment, walls 1305 may be perpendicular and / or transverse to the first and second planes, so that the walls 1305 may have such a structure and device to form a pattern or network of recesses 1306 in the reinforcing material 1336. In various embodiments, The reinforcing material 1336 can be resilient, so that the first surface 1302 and / or the second surface 1304 can be compressed toward each other. In at least one such embodiment, the reinforcing material 1336 may be configured in such a way that it can be compressed or latched between two or more holding members of the working member, as described above. In various embodiments, a piece of reinforcing material may be compressed when it is applied to a working body of a surgical instrument, and it may expand when it is removed from a working body. In at least one embodiment, the reinforcing material 1336 can be configured to contract so that the first surface 1310 can move toward the surface 1312. In any case, the walls 1305 can be configured so that they can bend or contract, allowing parts of the reinforcing material 1336 elastically move towards each other.

The devices disclosed herein may be designed for single use, or they may be designed for multiple use. However, in any case, the present device can be restored for reuse after at least one application. Recovery may include any combination of the steps of disassembling the device, cleaning or replacing certain elements and subsequent assembly. In particular, the device can be disassembled and any number of certain elements or parts of the device can be selectively replaced or removed in any combination. When cleaning and / or replacing certain parts, the device can be disassembled for subsequent use either in the recovery center or by the operating team immediately before the surgical procedure. It will be apparent to those skilled in the art that many different disassembling, cleaning / replacing and reassembling methods can be used in rebuilding a device. The use of such methods, as well as the resulting reconditioned device are included in the scope of this application.

Preferably, the process of the invention described herein occurs before surgery. First, a new or used tool is taken and, if necessary, it is cleaned. Further, the instrument can be sterilized. In another sterilization method, the instrument is placed in a closed and sealed container, such as a plastic bag or a TYVEK bag. Further, the container and instrument are placed in a radiation field that can penetrate into the container, such as gamma radiation, X-ray radiation, or high-energy electron radiation. Radiation kills bacteria on the instrument and in the container. Then the sterilized instrument can be stored in a sterile container. A sealed container keeps the instrument in a sterile condition until it is opened in a medical facility.

Along with the fact that the present invention has been described with reference to specific examples of implementation, it can be modified within the essence and scope of the present disclosure. Accordingly, the purpose of this application is to encompass any variations, applications, or adaptations of the present invention that may be realized through its general principles. Moreover, the present application is also intended to cover deviations from the present disclosure, which are within the scope of well-known or ordinary practices in the technical field to which the present invention relates.

Claims (6)

1. A surgical unit, comprising: a working body of a surgical instrument, made with the possibility of introducing brackets into the tissue and containing a clamping element having a proximal end and a distal end; a removable sleeve configured to move along the distal end of the clamping member for positioning around at least a portion of the clamping element and further configured to backwardly move along the distal end of the clamping member to separate from the clamping member; and an integral piece of reinforcing material, comprising: a first part and a second part attached to the sleeve so that when the sleeve is arranged around at least part of the clamping member, the working member is able to insert brackets into the first part of the integral piece of reinforcing material and into the fabric; characterized in that it has a disconnecting means formed between the first part and the second part, and the disconnecting means is configured to separate the first part from the second part so that the first part remains attached to the fabric by means of brackets. 2. The surgical unit according to claim 1, characterized in that the clamping element contains a part of the anvil, and the removable sleeve contains at least one hole of the anvil, made with the possibility of deformation of the bracket. 3. The surgical node according to claim 2, characterized in that the removable sleeve is made with the possibility of installation on the clamping element for press fit. 4. The surgical node according to claim 1, characterized in that the first part of a single piece of reinforcing material is made with the possibility of separation from the second part after the introduction of brackets into the tissue. 5. The surgical node according to claim 1, in which the first part of a solid piece of reinforcing material is made with the possibility of separation from the second part during the introduction of brackets into the tissue. 6. The surgical node according to claim 1, in which the decoupling means contains at least one perforation.

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