BR112015018832A2 - staple cartridge comprising a releasable cover - Google Patents

Abstract

staple cartridge comprising a releasable cover. The present invention relates to a retainer for use with a staple cartridge that is secured to the staple cartridge until the staple cartridge is inserted into the staple cartridge groove of a surgical staple. the retainer may include one or more deflectable tabs that engage the staple cartridge. the one or more tabs can be detached when the staple cartridge is fully installed in the staple cartridge groove so that the tabs disengage from the staple cartridge, allowing the user to remove the retainer. in certain embodiments, the tabs may extend from a retainer body and may engage outer portions of a staple cartridge. the tabs can be moved out through the groove in the staple cartridge. in certain embodiments, the tabs may extend from one or more movable portions that engage a slot in the staple cartridge. the tabs can be shifted inward when the movable portions are deflected by the groove of the staple cartridge.

Description

Descriptive Report of the Patent of Invention for "STAPLE CARTRIDGE COMPRISING A RELEASE COVER".

BACKGROUND

[001] The present invention relates to surgical instruments and, in various embodiments, to surgical cutting and stapling instruments, and staple cartridges therefor, which are designed to cut and staple tissue.

BRIEF DESCRIPTION OF THE DRAWINGS

[002] The features and advantages of this invention, and the way to obtain them, will become more evident, and the invention itself will be better understood, by reference to the following description of embodiments of the invention, considered in conjunction with the attached drawings, as follows:

[003] Figure 1 is an anterior left perspective view of a surgical stapling and cutting instrument with a handle portion that includes an automatic retraction mechanism actuated by a latch and a manual retraction mechanism actuated by a ratchet;

[004] Figure 2 is a right perspective view of the surgical stapling and cutting instrument of Figure 1 with a portion of an elongated shank cut away and a right half of a cable housing housing removed to expose a retracting mechanism. end-of-shot automatic movement traction and a manual trigger retraction mechanism;

[005] Figure 3 is a disassembled right rear perspective view of the cable portion and an elongated shaft of the surgical stapling and cutting instrument of Figure 1;

[006] Figure 4 is a right side elevation view of the partially disassembled surgical stapling and cutting instrument of Figure 1;

[007] Figure 5 is a right perspective view of the surgical stapling and cutting instrument of Figure 1 with a closed and secured closing mechanism, and the lateral pawl firing mechanism completing a first stroke and with a retraction mechanism. manual removal to expose a distal engagement of the engaged rack that triggers automatic retraction of the trigger mechanism;

[008] Figure 6 is a left side elevation view of the partially disassembled surgical stapling and cutting instrument of figure 4 in an initial state of the open-end actuator and engaged anti-return mechanism;

[009] Figure 7 is a left side elevation view of the partially disassembled surgical stapling and cutting instrument of figure 1, immediately after the distal engagement has actuated and locked forward the anti-return release lever, which allows the engaged rack retracts;

[0010] Figure 8 is a disassembled right perspective view of the intermediate and rear gears and the manual retraction lever and the ratchet pawl of a manual retraction mechanism of the surgical stapling and cutting instrument of Figure 1;

[0011] Figure 9 is a partially disassembled left perspective view in elevation of a surgical stapling and cutting instrument of Figure 1, with the non-return mechanism engaged in a fully actuated engaged rack, which is disconnected from a combination traction/compression spring before actuation of the manual retraction lever in figure 8;

[0012] Figure 10 is a partially disassembled left side elevational view of the surgical stapling and cutting instrument of figure 9, with hidden portions of the anti-return release lever, rear gear and back release lever. manual trigger being shown in dashed line;

[0013] Figure 11 is a partially disassembled left side elevation view of the surgical stapling and cutting instrument of figure 10, after the actuation of the manual trigger release lever has manually retracted the coupling rack;

[0014] Figure 12 is a partially disassembled left side elevation view of the surgical stapling and cutting instrument of Figure 11, with the engaged rack omitted, illustrating the manual trigger release lever disengaging the anti-return mechanism;

[0015] Figure 13 is a right side elevational view of a mechanism of an alternative anti-return release mechanism with the rack engaged in a retracted position and the anti-return release lever located in a proximal position with the anti-return plate engaged to the firing rod;

[0016] Figure 14 is a detailed elevation right side view of the auto-retracting cam wheel, rear gear and most distal engagement of Figure 13;

[0017] Figure 15 is a right side elevational view of the auto release mechanism after an additional firing stroke causes the auto-retract cam wheel to slide distally and lock the anti-return release lever by disengaging the anti-return mechanism;

[0018] Figure 16 is a front left perspective view of an open staple application assembly with a right half portion of a replaceable staple cartridge included in a staple channel;

[0019] Figure 17 is an exploded perspective view of the staple application assembly of Figure 16, with a complete replaceable staple cartridge, and an unarticulated rod configuration;

[0020] Figure 18 is a perspective view of a plurality of staple drivers within the cartridge body of a staple cartridge;

[0021] Figure 19 is a perspective view of a trigger bar ("E-beam") and two-piece knife of the staple application assembly of Figure 16;

[0022] Figure 20 is a perspective view of a triangular body slider of a staple cartridge of a staple application assembly;

[0023] Figure 21 is a left side elevational view taken in longitudinal cross-section along a centerline 21-21 of the staple application assembly of Figure 16;

[0024] Figure 22 is a perspective view of the open staple application assembly of Figure 16 without the replaceable staple cartridge and without a distal portion of a staple channel;

[0025] Figure 23 is a front elevational view taken in cross-section along line 23-23 of the staple application assembly of Figure 16, illustrating the internal staple drivers of the staple cartridge and portions of the bar. shot and two-piece knife;

[0026] Figure 24 is a left side elevational view taken generally along the longitudinal axis of line 24-24 of a closed clamping assembly of Figure 16, to include stitching points. center contact between two-piece knife and triangular body slider, but also laterally offset to show staples and staple drivers inside staple cartridge;

[0027] Figure 25 is a left side elevational detail view of the staple application assembly of Figure 24, with the two-piece knife slightly retracted, more as is typical for staple cartridge replacement;

[0028] Figure 26 is a detail view of the left side in elevation of the clamp application assembly of Figure 25, with the two-piece knife at the start of firing, corresponding to the configuration shown in Figure 24;

[0029] Figure 27 is a left side elevational cross-sectional view of the closed staple application assembly of Figure 24, after the trigger bar and two-piece knife have been fired distally;

[0030] Figure 28 is a cross-sectional view of the left side in elevation of the closed staple application assembly of Figure 27, after the staple cartridge firing and the retraction of the two-piece knife;

[0031] Figure 29 is a detailed view in cross-section of the left side in elevation of the closed staple application assembly of Figure 28, the two-piece knife having been allowed to go into a locking position;

[0032] Figure 29A is a partial perspective view of a gripper of an end actuator assembly with various elements removed therefrom, in accordance with various embodiments of the present disclosure, and depicting a trigger assembly in one position not triggered and, additionally, a slider coupled to an actuator release stop;

[0033] Figure 29B is a partial perspective view of the claw of figure 29A, with several elements removed therefrom, illustrating the firing assembly in a partially fired position, and further illustrating the slider disengaged from the release stop of the actuator;

[0034] Figure 30 is a perspective view of a surgical stapling instrument that includes a rod and an ex-actuator.

detachable tremor;

[0035] Figure 31 is a partial perspective view of the rod and end actuator of the surgical stapling instrument of Figure 30;

[0036] Figure 32 is a partial perspective view of the end actuator being mounted on the stem of the surgical stapling instrument of Figure 30;

[0037] Figure 33 is another partial perspective view of the end actuator being mounted on the stem of the surgical stapling instrument of Figure 30;

[0038] Figure 34 is an elevation view in partial cross section illustrating the end actuator uncoupled from the stem of the surgical stapling instrument of Figure 30;

[0039] Figure 35 is an elevation view in partial cross section illustrating the end actuator coupled to the rod of the surgical stapling instrument of Figure 30 and further illustrating a sliding collar in an open, non-locked position;

[0040] Figure 36 is an elevation view in partial cross section illustrating the end actuator coupled to the rod of the surgical stapling instrument of Figure 30 and further illustrating the sliding collar in a locked closed position;

[0041] Figure 37 is an exploded view of the end actuator of figure 30, shown with the components removed;

[0042] Figure 38 is an exploded view of the rod of Figure 30;

[0043] Figure 39 is a longitudinal cross-sectional view of an anvil in a closed position and a staple cartridge comprising a rigid support portion and a compressible fabric thickness compensator illustrated with staples being moved from a non-constant position. triggered to a triggered position during a first sequence;

[0044] Figure 40 is another cross-sectional view of the anvil and staple cartridge of Figure 39 illustrating the anvil in an open position after the firing sequence has been completed;

[0045] Figure 41 is a partial detailed view of the staple cartridge of Figure 39 illustrating the staples in an unfired position;

[0046] Figure 42 is a cross-sectional elevation view of a staple cartridge comprising a rigid support portion and a compressible tissue thickness compensator illustrating the staples in an unfired position;

[0047] Fig. 43 is a detailed view of the staple cartridge of Fig. 42;

[0048] Figure 44 is an elevation view of an anvil in an open position and a staple cartridge comprising a rigid support portion and a compressible tissue thickness compensator illustrating the staples in an unfired position;

[0049] Figure 45 is an elevation view of an anvil in a closed position and a staple cartridge comprising a rigid support portion and a compressible tissue thickness compensator illustrating the staples in an unfired position and tissue captured between the anvil and fabric thickness compensator;

[0050] Fig. 46 is a detailed view of the anvil and staple cartridge of Fig. 45;

[0051] Figure 47 is an elevation view of the anvil and staple cartridge of Figure 45, illustrating the fabric, with different thicknesses, positioned between the anvil and the staple cartridge;

[0052] Figure 48 is a detailed view of the anvil and staple cartridge of Figure 45, as shown in Figure 47;

[0053] Fig. 49 is a diagram illustrating a tissue thickness compensator that is compensating for different thicknesses of tissue captured by different staples;

[0054] Fig. 50 is a diagram illustrating a tissue thickness compensator applying compressive pressure to one or more vessels that have undergone transection by a line of staples;

[0055] Figure 51 is a diagram illustrating tissue captured by a staple;

[0056] Fig. 52 is a diagram illustrating thick tissue and a tissue thickness compensator captured by a staple;

[0057] Figure 53 is a diagram illustrating thin tissue and a tissue thickness compensator captured within a staple;

[0058] Figure 54 is a diagram illustrating fabric having an intermediate thickness and a thickness compensator of fabric captured by a staple;

[0059] Figure 55 is a partial cross-sectional view of an end actuator of a surgical stapling instrument according to at least one modality;

[0060] Figure 56 is a partial cross-sectional view of an end actuator, according to at least one alternative embodiment;

[0061] Figure 57 is a partial cross-sectional view of an end actuator, according to another alternative embodiment;

[0062] Figure 58 is a partial cross-sectional view of the end actuator illustrated in a flexed condition;

[0063] Figure 59 is a partial cross-sectional view of the end actuator of Figure 58 in a released condition;

[0064] Fig. 60 is a cross-sectional perspective view of a staple cartridge comprising side retaining members configured to secure a tissue thickness compensator to a support portion;

[0065] Figure 61 is a cross-sectional view of the staple cartridge of Figure 60 being used to staple fabric;

[0066] Fig. 62 is a perspective view of a staple cartridge including a cartridge body and a tissue thickness compensator secured to the cartridge body by a plurality of triggerable securing members;

[0067] Fig. 63 is an exploded view of the staple cartridge of Fig. 62;

[0068] Fig. 64 is an elevation view of the staple cartridge of Fig. 62;

[0069] Fig. 65 is a cross-sectional view of the staple cartridge of Fig. 62 taken along a cross-sectional line in Fig. 64, illustrating the firing clamp members in an unfired position;

[0070] Fig. 66 is a cross-sectional view of the staple cartridge of Fig. 62 taken along a cross-sectional line in Fig. 64, illustrating the firing clamp members in a fired snapped position;

[0071] Figure 67 is a perspective view of a fabric thickness compensator;

[0072] Fig. 68 is a perspective view of the fabric thickness compensator of Fig. 167, mounted on a staple cartridge;

[0073] Fig. 69 is an exploded view of the fabric thickness compensator and staple cartridge of Fig. 68;

[0074] Fig. 70 is a detail view of a proximal end of a tissue thickness compensator;

[0075] Fig. 71 is a partial elevation view of the tissue thickness compensator of Fig. 70, mounted on a staple cartridge;

[0076] Fig. 72 is a plan view of the tissue thickness compensator and staple cartridge of Fig. 71;

[0077] Fig. 73 is a front view of a fitting for retaining a tissue thickness compensator in a staple cartridge;

[0078] Figure 74 is a side view of the fitting of Figure 73;

[0079] Figure 75 is a rear view of the fitting of Figure 73;

[0080] Figure 76 is a bottom view of the housing of Figure 73;

[0081] Fig. 77 is a partial cross-sectional view of a staple cartridge that includes a retaining pin configured to releasably secure a tissue thickness compensator to a staple cartridge cartridge body;

[0082] Figure 77A is a perspective view in partial cross-section of the staple cartridge of Figure 77, with portions removed for illustrative purposes;

[0083] Figure 78 is a partial cross-sectional view of the staple cartridge of Figure 77, illustrating the retaining pin in a disabled condition;

[0084] Figure 79 is a perspective view in partial cross-section of the staple cartridge of Figure 77, illustrating the retaining pin in a disabled condition;

[0085] Fig. 80 is a partial cross-sectional view of a staple cartridge that includes a fastener configured to releasably secure a tissue thickness compensator to a cartridge body, illustrating the fastener in a closed condition;

[0086] Figure 81 is a partial cross-sectional view of the staple cartridge of figure 80, illustrating the fastener in an open condition;

[0087] Figure 81A is a perspective view of a staple cartridge with a layer, such as a tissue thickness compensator and/or a reinforcing material disposed therein, the staple cartridge being disposed in relation to a blade end actuator cutout, and the remaining portions of the end actuator removed for illustrative purposes;

[0088] Figure 82 is a cross-sectional plan view of the staple cartridge of Figure 81A showing a cutting blade for cutting the distal end of the layer disposed in a distal cavity in the staple cartridge, where the cutting blade does not is installed and the staples are omitted for clarity;

[0089] Figure 83 is a cross-sectional plan view of the staple cartridge of Figure 81A, the cutting blade for cutting the distal end of the layer is installed, and the staples being omitted for clarity;

[0090] Figure 84 is a perspective view of a gripper of an end actuator assembly, in accordance with various embodiments of the present disclosure, illustrating a tissue thickness compensator secured to a cartridge body by a proximal connector and by a distal connector and further illustrating a trigger assembly in an unfired position;

[0091] Figure 85A is a partial plan view of the claw of figure 84, illustrating the actuator in a pre-actuated position;

[0092] Figure 85B is a partial plan view of the claw of figure 84, illustrating the actuator in an actuated position;

[0093] Figure 85C is a detailed view of the claw of figure 85B;

[0094] Figure 85D is an elevation view of the claw of figure 84 illustrating the actuator in the actuated position and also illustrating the ruptured proximal and distal connectors;

[0095] Figure 86 is a partial elevation view of the claw of figure 84 with several elements removed therefrom, illustrating a cartridge body slider engaged to an actuator flap of figure 85A;

[0096] Figure 87 is a partial elevation view of the claw of figure 84 with several elements removed therefrom, illustrating the cartridge body slider disengaged from the actuator flap;

[0097] Figure 87A is a partial plan view of a gripper of an end actuator assembly in accordance with various embodiments of the present disclosure, illustrating a trigger bar of a trigger assembly against a release stop of a actuator;

[0098] Figure 87B is a partial plan view of the gripper of figure 87A, illustrating the trigger bar of the trigger assembly extending through the actuator release stop;

[0099] Figure 88 is a perspective view of a gripper of an end actuator assembly, in accordance with various embodiments of the present disclosure, illustrating a tissue thickness compensator attached to a cartridge body and further illustrating , a trigger assembly in an untriggered position;

[00100] Figure 89 is a partial elevation view of the gripper of figure 88 with various elements shown in transparency, illustrating an actuator extending through the gripper and further illustrating the trigger assembly in a non-returned position. fired;

[00101] Fig. 90 is a partial cross-sectional view of a staple cartridge that includes a retaining pin configured to releasably secure a tissue thickness compensator to a cartridge body of the cartridge, illustrating the retaining pin at an activated condition;

[00102] Fig. 91 is a partial cross-sectional view of the staple cartridge of Fig. 90 illustrating the retaining pin in a disabled condition;

[00103] Fig. 92 is a perspective view of an actuator of the staple cartridge of Fig. 90, which is configured to disable the retaining pin;

[00104] Figure 93A is a perspective view of a cartridge assembly of fasteners of an end actuator assembly, in accordance with various embodiments of the present disclosure, illustrating a tissue thickness compensator released from a cartridge body of the fastener cartridge assembly;

[00105] Fig. 93B is a perspective view of the fastener cartridge assembly of Fig. 93A, illustrating the fabric thickness compensator attached to the cartridge body of the staple cartridge assembly;

[00106] Fig. 93C is an elevation view of the fastener cartridge assembly of Fig. 93A with several elements removed therefrom, illustrating a firing assembly in a pre-fired position;

[00107] Fig. 93D is an elevation view of the fastener cartridge assembly of Fig. 93A with several elements removed therefrom, illustrating the firing assembly in a partially fired position;

[00108] Fig. 94 is a partial perspective view of a cartridge assembly of fasteners of an end actuator assembly, in accordance with various embodiments of the present disclosure, illustrating a released tissue thickness compensator a cartridge body of the fastener cartridge assembly;

[00109] Fig. 95 is a partial perspective view of a cartridge assembly of fasteners of an end actuator assembly, in accordance with various embodiments of the present disclosure, illustrating a released tissue thickness compensator from a cartridge body of the fastener cartridge assembly;

[00110] Fig. 96 is a partial cross-sectional view of the cartridge fastener assembly of Fig. 95, illustrating a tissue thickness compensator fitting held in a bridge of the cartridge body;

[00111] Figure 97 is a perspective view of a cartridge assembly of fasteners of an end actuator assembly, according to various embodiments of the present disclosure, illustrating a tissue thickness compensator released from a cartridge body of the fastener cartridge assembly;

[00112] Fig. 98 is a perspective view of the fastener cartridge assembly of Fig. 97, illustrating the fabric thickness compensator attached to the cartridge body of the fastener cartridge assembly;

[00113] Figure 99 is a cross-sectional elevation view of the end actuator assembly of figure 97, illustrating the tissue thickness compensator attached to the cartridge body of the fastener cartridge assembly and further illustrating , the tip actuator in an unclosed position;

[00114] Figure 100 is a cross-sectional elevation view of the end actuator assembly of Figure 97, illustrating the fabric thickness compensator not attached to the cartridge body of the fastener cartridge assembly and further illustrating the end actuator assembly in a closed position;

[00115] Fig. 101 is a perspective view of a staple cartridge applicator assembly comprising an upper tissue thickness compensator that includes a plurality of retaining members extending therefrom and a staple cartridge comprising a lower fabric thickness compensator;

[00116] Fig. 102 is an elevation view of the staple cartridge applicator assembly of Fig. 101, positioned within a staple cartridge channel and an anvil being closed on the staple cartridge applicator assembly;

[00117] Figure 103 is an elevation view of the anvil of the figure

102 in a re-opened position and the staple cartridge applicator of Fig. 101 being removed from the end actuator;

[00118] Figure 104 is a cross-sectional view of fabric in an intermediate position to the upper fabric thickness compensator and the lower fabric thickness compensator of Figure 101;

[00119] Fig. 105 is a cross-sectional view illustrating the upper fabric thickness compensator and the lower fabric thickness compensator stapled to the fabric and cut by a cutting element;

[00120] Fig. 106 is a perspective view of the staple cartridge applicator assembly comprising an upper tissue thickness compensator configured to be attached to an anvil in accordance with at least one embodiment;

[00121] Figure 106A is an elevation view of the staple cartridge applicator assembly of figure 106, positioned within a staple cartridge channel and an anvil being moved toward the upper tissue thickness compensator;

[00122] Fig. 106B illustrates the staple cartridge applicator of Fig. 106 being removed from the end actuator after the upper tissue thickness trim tab has been engaged with the anvil;

[00123] Fig. 107 is an end cross-sectional view of the anvil being moved toward the upper fabric thickness compensator of Fig. 106;

[00124] Fig. 108 is an end cross-sectional view of the anvil engaged with the upper fabric thickness compensator;

[00125] Figure 109 is a perspective view of a staple cartridge having a piece of reinforcing material, releasably retained therein, according to a non-limiting embodiment of the present invention;

[00126] Figure 110 is an exploded perspective view of the staple cartridge and the piece of reinforcement material of Figure 109, the piece of reinforcement material including a plurality of members extending thereto. from there;

[00127] Figure 111 is a cross-sectional view, taken along line 111-111 in Figure 109, illustrating the members of Figure 110 engaged in clamp cavities according to a non-limiting embodiment of the present invention;

[00128] Fig. 112 is a cross-sectional view of a piece of reinforcing material that includes members engaged with staple cavities of a staple cartridge, according to a non-limiting embodiment of the present invention;

[00129] Fig. 113 is an exploded view of Fig. 112 illustrating the separate members of the staple cavities of the staple cartridge, of a non-limiting embodiment of the present invention;

[00130] Figure 114 is a partial perspective view of a support portion of a staple cartridge comprising removable and/or displaceable staple leg guides;

[00131] Figure 115 is a partial cross-sectional view of the staple cartridge of Figure 114 illustrating the staples being dispensed by the staple cartridge;

[00132] Fig. 116 is a detailed view of the cross-sectional view of Fig. 114 after the staple cartridge has been fired;

[00133] Figure 117 is a partial perspective view of a cartridge body, a housing and a tissue thickness compensator, according to various embodiments of the present disclosure, illustrating projections extending from from the cartridge body;

[00134] Figure 118 is a partial perspective view of a color.

cartridge, a carcass, and a tissue thickness compensator, in accordance with various embodiments of the present disclosure, illustrating projections extending from the carcass;

[00135] Figure 119 is a partial cross-sectional view of an end actuator assembly, in accordance with various embodiments of the present disclosure, illustrating a clip positioned in a clip cavity of a cartridge body of the actuator assembly end and further illustrating the clamp in an unformed configuration;

[00136] Figure 120 is a partial cross-sectional view of the end actuator assembly of Figure 119, illustrating the clip ejected from the clip cavity and further illustrating the clip in a formed configuration;

[00137] Figure 121 is a perspective view of a clip of a lock, according to various embodiments of the present disclosure, illustrating the lock in a locked configuration;

[00138] Figure 122 is a perspective view of the clamp and lock of Figure 121, illustrating the lock in the locked configuration;

[00139] Figure 123 is a perspective view of the clamp and the lock of Figure 121, illustrating the lock in a pre-fired position in a clamp cavity and further illustrating the lock in the locked configuration;

[00140] Figure 124 is a perspective view of the clamp and latch of Figure 121, illustrating the latch in a triggered position in the clamp cavity and further illustrating the latch in an unlocked configuration;

[00141] Figure 125 is a perspective view of a cartridge assembly of fasteners of an end actuator assembly, in accordance with various embodiments of the present disclosure, illustrating latches extending from the latch cavities in a cartridge body of the fastener cartridge assembly;

[00142] Figure 126 is a cross-sectional view of a latch of Figure 125, illustrating the latch in an unlocked configuration and a connector not secured to the latch;

[00143] Figure 126A is a partial cross-sectional view of the cartridge fastener assembly of Figure 125, illustrating the cartridge body, a connector, a tissue thickness compensator and a latch in a partially assembled position;

[00144] Figure 127 is a partial cross-sectional view of the fastener cartridge assembly of Figure 125, illustrating the latch in a latched configuration, illustrating an anvil in a closed position, and illustrating a actuation switch in a non-triggered position;

[00145] Fig. 128 is a partial cross-sectional view of the fastener cartridge assembly of Fig. 125, illustrating the latch in a latched configuration, illustrating the anvil in the closed position, and further illustrating the actuation switch in a partially fired position;

[00146] Figure 129 is a partial cross-sectional view of the fastener cartridge assembly of Figure 125, illustrating the latch in the unlatched configuration, illustrating the anvil in the closed position and additionally illustrating the actuation switch in the fired position ;

[00147] Fig. 130 is a cross-sectional view of the end actuator illustrating a firing member in a partially fired position;

[00148] Fig. 131 is a cross-sectional view of the end actuator of Fig. 130 illustrating the support portion being moved away from the partially deployed tissue thickness compensator;

[00149] Figure 132 is a partial cut-away view of a staple cartridge comprising staple drivers having different heights according to at least one embodiment;

[00150] Figure 133 is a diagram illustrating the clamp drivers of Figure 132 and clamps having different unfired heights supported therein;

[00151] Figure 134 is a cross-sectional view of a staple cartridge comprising a tissue thickness compensator and a support portion according to at least one modality;

[00152] Figure 135 is a partial cross-sectional view of a fabric thickness compensator, a staple guide layer and a staple in an unfired position;

[00153] Figure 136 is a partial cross-sectional view of a fabric thickness compensator, a staple guide layer and a staple in an unfired position, according to at least one alternative embodiment;

[00154] Figure 137 is a partial cross-sectional view of a fabric thickness compensator, a staple guide layer and a staple in an unfired position, in accordance with at least one alternative embodiment;

[00155] Figure 138 is a partial cross-sectional view of a fabric thickness compensator, a staple guide layer, and a staple in an unfired position, in accordance with at least one alternative embodiment;

[00156] Figure 139 is a partial cross-sectional view of a fabric thickness compensator, a staple guide layer and a staple in an unfired position, according to at least one alternative embodiment;

[00157] Fig. 140 is a partial cross-sectional view of a fabric thickness compensator, a staple guide layer and a staple in an unfired position, according to at least one alternative embodiment;

[00158] Figure 141 is a partial cross-sectional view of a fabric thickness compensator, a staple guide layer and a staple in an unfired position, according to at least one alternative embodiment;

[00159] Figure 142 is a detailed view of a region surrounding a clamp tip of Figure 141;

[00160] Figure 143 is a partial cross-sectional view of a fabric thickness compensator, a staple guide layer and a staple in an unfired position, according to at least one alternative embodiment;

[00161] Fig. 144 is a detailed view of a region surrounding a tip of the clamp of Fig. 143;

[00162] Fig. 145 is a partial cross-sectional view of a fabric thickness compensator, a staple guide layer and a staple in an unfired position, in accordance with at least one alternative embodiment;

[00163] Figure 146 is a perspective view of a layer of the staple guide and a plurality of staples in an unfired position, in accordance with at least one alternative embodiment;

[00164] Fig. 147 is an exploded view of the tissue thickness compensator and a staple cartridge body;

[00165] Figure 148 is an elevation view of a disposable loading unit that includes a pivoting claw configured to support a staple cartridge;

[00166] Figure 149 is a perspective view of a tissue thickness compensator applicator positioned within an actuator of a disposable loading unit;

[00167] Fig. 150 is a top perspective view of the fabric thickness compensator applicator of Fig. 149;

[00168] Fig. 151 is a bottom perspective view of the fabric thickness compensator applicator of Fig. 149;

[00169] Figure 152 is a cross-sectional view of an end actuator of a surgical stapling instrument comprising staple drivers having different heights and a contoured platform surface, according to at least one embodiment;

[00170] Figure 153 is a cross-sectional view of an end actuator of a surgical stapling instrument comprising staple drivers having different heights and a stepped platform surface, according to at least one embodiment;

[00171] Fig. 154 is a diagram illustrating a fabric thickness compensator comprising a variable thickness, staple drivers having different heights and staples having different unformed heights;

[00172] Fig. 155 is a diagram illustrating the staples and tissue thickness compensator of Fig. 154 implanted in tissue;

[00173] Figure 156 is a partial cross-sectional view of a tissue thickness compensator attached to a staple cartridge body;

[00174] Fig. 157 is a partial cross-sectional view of a tissue thickness compensator and staple cartridge body of Fig. 156;

[00175] Fig. 158 is a partial exploded view of the fabric thickness compensator of Fig. 156;

[00176] Figure 159 is a partial exploded view of a compensator.

tissue thickness gauge, a staple cartridge body and a firing member;

[00177] Figure 160 is a partial elevation view of the embodiment of Figure 159;

[00178] [0178] Figure 161 is a bottom view of a staple cartridge;

[00179] Figure 162 is a detailed bottom view of the staple cartridge of Figure 161;

[00180] Fig. 163 is an exploded view of a staple cartridge illustrating a staple driver arrangement;

[00181] Figure 164 is a perspective view of an arrangement of a retainer fixed to a staple cartridge and with a layer, as a tissue thickness compensator, disposed in an intermediate position to the retainer and to the staple cartridge, wherein the retainer, layer and staple cartridge are disposed relative to a surgical stapler, and wherein a staple cartridge channel is removed for illustrative purposes;

[00182] Figure 165 is a perspective view of the retainer of Figure 164;

[00183] Figure 166 is a plan view of the retainer, layer and staple cartridge of Figure 164;

[00184] Figure 167 is a cross-sectional view of the retainer, layer and staple cartridge of Figure 164, with the clip tips extending from the staple cavities in the staple cartridge to the interior of the layer ;

[00185] Figure 168 is a perspective view of an embodiment of a retainer, the retainer including movable cam portions and locking tabs;

[00186] Figure 169 is a perspective view of the retainer of Figure 168 attached to a staple cartridge, with the staple cartridge and retainer positioned for insertion into a staple cartridge channel of an end actuator. of a surgical stapler;

[00187] Figure 170 is a plan view of the retainer of Figure 168 positioned, but not fully inserted, in a cartridge groove of the surgical stapler end actuator;

[00188] Figure 171 is an end cross-sectional view of the retainer of Figure 168 positioned, but not fully inserted, in the staple cartridge channel of Figure 170;

[00189] Figure 172 is a plan view of the retainer of Figure 168 fully inserted into the staple cartridge channel of Figure 170;

[00190] Figure 173 is an end cross-sectional view of the retainer of Figure 168 fully inserted into the staple cartridge channel of Figure 170, the retainer being unlocked and being removed from the staple cartridge;

[00191] [0191] Figure 174 is a plan view of an end actuator insert, according to at least one embodiment;

[00192] Fig. 175 is an elevation view of the end actuator insert of Fig. 174;

[00193] Figure 176 is a perspective view of the end actuator insert of Figure 174;

[00194] Figure 177 is a partial perspective view of the end actuator insert of Figure 174 illustrating the end actuator insert engaging the anvil of the end actuator of a surgical instrument;

[00195] Figure 178 is a partial perspective view of the end actuator insert of Figure 174 illustrating the end actuator insert engaging the end actuator clip cartridge of a surgical instrument.

co;

[00196] Figure 179 is an elevation view of the end actuator insert of Figure 174 illustrating the end actuator insert engaging the end actuator of a surgical instrument;

[00197] Figure 180 is an elevation view of the end actuator insert of figure 174 positioned on the end actuator of a surgical instrument;

[00198] Figure 181 is a partial perspective view of one embodiment of a staple cartridge assembly including a staple cartridge layer and an anvil-attachable layer positioned relative to a staple cartridge;

[00199] Figure 182 is a partial perspective view of the staple cartridge assembly of Figure 181, the layer attachable to the anvil being attached to the staple cartridge;

[00200] Figure 183 is a partial perspective view of one embodiment of a staple cartridge assembly that includes a layer of staple cartridge and a layer attachable to the anvil positioned relative to a staple cartridge, wherein a the proximal end portion of the anvil attachable layer is secured to fasteners of the staple cartridge by an adhesive or solder, and a portion of the anvil attachable layer being shown as being transparent for purposes of illustration;

[00201] Figure 184 is a partial perspective view of the staple cartridge assembly of Figure 183, a corner of the proximal end portion of the anvil-attachable layer is shown separated and raised away from the anvil cartridge. Bobby pins;

[00202] Figure 185 is a partial perspective view of one embodiment of a staple cartridge assembly that includes a staple cartridge layer and an anvil-attachable layer.

sectioned with respect to a staple cartridge, the anvil attachable layer being attached to the staple cartridge layer;

[00203] Figure 186 is a detailed view of the staple cartridge of Figure 185 and the layer attachable to the anvil attached thereto;

[00204] Figure 187 is a partial plan view of one embodiment of a layer attachable to the anvil;

[00205] Figure 188 is a partial plan view of the layer attachable to the anvil of Figure 187 being cut by a cutting blade;

[00206] Figure 189 is a plan view of a fabric compensator of a sleeve, according to at least one embodiment;

[00207] Figure 190 is a perspective view of the fabric compensator of Figure 189;

[00208] Figure 191 is an elevation view of the fabric compensator of Figure 189;

[00209] Fig. 192 is a perspective view of a fabric thickness compensator;

[00210] Figure 193 is a perspective view of the fabric thickness compensator of Figure 192, attached to a staple cartridge;

Fig. 194 is a detail view of a fabric thickness compensator of Fig. 192 superimposed, at least partially, by another fabric thickness compensator of Fig. 192;

[00212] Fig. 195 is a perspective view of a staple cartridge including a tissue thickness compensator attached thereto;

[00213] Figure 196 is a detail view of a fabric thickness compensator of Figure 195 superimposed, at least partially, by another fabric thickness compensator of Figure 195;

[00214] Fig. 197 is an exploded view of a staple cartridge including a tissue thickness compensator including a plurality of layers;

[00215] Figure 198 is a cross-sectional diagram illustrating a tissue thickness compensator of Figure 197 implanted on one side of the patient's tissue and another tissue thickness compensator of Figure 197 implanted on the other side of the patient. tissue;

[00216] Figure 199 is an exploded perspective view of an end actuator of a stapling instrument comprising a staple cartridge and a tissue thickness compensator, according to various embodiments;

[00217] Fig. 200 is a cross-sectional view of the tissue thickness compensator in Fig. 199, according to several modalities;

[00218] Figure 201 is a top view of a fabric thickness compensator including a plurality of circular pieces according to various embodiments;

[00219] Figure 202 is a top view of a fabric thickness compensator that includes a plurality of circular pieces, according to various embodiments;

[00220] Figure 202A is a cross-sectional view of a fabric thickness compensator, according to various modalities;

[00221] Figure 203 is a top view of a fabric thickness compensator, according to various embodiments;

[00222] Figure 204 is a top view of a fabric thickness compensator that includes a plurality of hexagonal pieces, according to various embodiments;

[00223] Figure 205 is a top view of an attached fabric thickness compensator that includes a plurality of parts, according to various embodiments;

[00224] Figure 206 is a top view of a fabric thickness compensator including a plurality of slits, according to various embodiments;

[00225] Figure 207A is an exploded view of a staple cartridge and a layer, according to at least one embodiment;

[00226] Figure 207B is a cross-sectional view of a layer and T fabric captured between a staple cartridge and an anvil, according to at least one embodiment;

[00227] Figure 207C is a perspective view of a layer comprising pillar-shaped shims, according to at least one embodiment;

[00228] Figure 208 is a cross-sectional view of the layer of Figure 207C;

[00229] Figure 209 is a perspective view of a layer comprising linear protrusions, according to at least one embodiment;

[00230] Figure 210 is a cross-sectional view of the layer of Figure 209;

[00231] Figure 211 is a perspective view of a layer comprising dome-shaped protuberances, according to at least one embodiment;

[00232] Figure 212 is a cross-sectional view of the layer of Figure 211;

[00233] Figure 213 is a perspective view of a layer comprising linear depressions, according to at least one embodiment;

[00234] Figure 214 is a cross-sectional view of the layer of Figure 213;

[00235] Figure 215 is a perspective view of a layer comprising linear protuberances, according to at least one embodiment;

[00236] Figure 216 is a cross-sectional view of the layer of Figure 215;

[00237] Figure 217 is a perspective view of a layer comprising linear protrusions, according to at least one embodiment;

[00238] Figure 218 is a perspective view of a layer comprising cone-shaped protrusions, according to at least one embodiment;

[00239] Figure 219 is a perspective view of a layer comprising pyramid-shaped protrusions, according to at least one embodiment;

[00240] Figure 220 is a cross-sectional view of the layer in Figure 219, according to at least one embodiment;

[00241] Figure 221 is a perspective view of a layer, according to at least one embodiment;

[00242] Figure 222 is a cross-sectional view of the layer of Figure 221;

[00243] Figure 223 is a perspective view of a layer comprising depressions, according to at least one embodiment;

[00244] Figure 224 is a cross-sectional view of the layer of Figure 223;

[00245] Figure 224A is a cross-sectional view of a layer comprising portions of reduced thickness and T fabric captured between an anvil comprising a plurality of staple forming pockets and a staple cartridge, in accordance with at least a modality;

[00246] Figure 224B is a cross-sectional view of a layer comprising a plurality of protrusions and T tissue captured between an anvil comprising a plurality of staple forming pockets and a staple cartridge, according to at least one modality;

[00247] Figure 225 is a cross-sectional view in perspective of a layer, such as a tissue thickness compensator, attached to an anvil of an end actuator of a surgical instrument, according to at least one modality;

[00248] Figure 226 is a cross-sectional view of the layer of Figure 225 attached to the anvil;

[00249] Figure 227 is a cross-sectional view of the layer of Figure 225;

[00250] Figure 228 is a perspective view of an embodiment of a retainer for use with a staple cartridge;

[00251] Figure 229 is a perspective view of a staple cartridge assembly including the retainer of Figure 228 engaged with a staple cartridge and a layer attachable to the anvil;

[00252] Figure 230 is a plan view of the staple cartridge assembly of Figure 229;

[00253] Figure 231 is an end cross-sectional view of the staple cartridge assembly of figure 229, the staple cartridge assembly being inserted into a staple cartridge groove of an end actuator , and an anvil of the end actuator is positioned relative thereto;

[00254] Figure 232 is an end cross-sectional view of the staple cartridge assembly and an end actuator shown in Figure 231, the anvil being pressed against the layer attachable to the anvil and retainer ;

[00255] Figure 233 is a cross-sectional plan view of the staple cartridge and end actuator assembly shown in Figure 231, the anvil being raised relative to the retainer, removing the layer attachable to the anvil attached to the retainer;

[00256] Figure 234 is a cross-sectional plan view of the end actuator shown in Figure 231, the anvil attachable layer being attached to the anvil and the retainer removed;

[00257] Figure 235 is a perspective view of an embodiment of a layer attachable to the anvil, according to at least one embodiment;

[00258] Figure 236 is a perspective view of an embodiment of a layer attachable to the anvil, according to at least one embodiment;

[00259] Figure 237 is a perspective view of an embodiment of a layer attachable to the anvil, according to at least one embodiment;

[00260] Figure 238 is a perspective view of an arrangement of a layer attachable to the anvil, with installable fasteners being that the installable fasteners are in an uninstalled configuration;

[00261] Figure 239 is a perspective view of the layer attachable to the anvil of Figure 238, the installable fasteners being shown in an installed configuration;

[00262] Figure 240 is a cross-sectional plan view of the anvil attachable layer of Figure 238, positioned relative to an anvil of an end actuator, the installable fasteners being installed in an anvil slot;

[00263] Figure 241 is a perspective view of an arrangement of a layer attachable to the anvil with installable fasteners, with the installable fasteners being in an uninstalled configuration;

[00264] Figure 242 is a perspective view of the layer attachable to the anvil of Figure 241, the installable fasteners being shown in an installed configuration;

[00265] [0265] Figure 243 is a cross-sectional plan view of the layer attachable to the anvil of Figure 241, positioned relative to an anvil of an end actuator, with the fastening elements installables are installed in an anvil slot;

[00266] Figure 244 is an exploded perspective view of an anvil and a tissue thickness compensator according to at least one embodiment;

[00267] Figure 245 is a cross-sectional plan view of an anvil comprising a plurality of staple-forming pockets and a layer attachable to the anvil, such as a tissue thickness compensator, comprising a plurality of capsules aligned with the anvil. training pockets, according to at least one modality;

[00268] Fig. 246 is a detailed view of the caps of the layer attachable to the anvil of Fig. 245;

[00269] Fig. 247 is a diagram illustrating the anvil and anvil-attachable layer of Fig. 245 positioned relative to the fabric to be stapled by the staples of a staple cartridge positioned on the opposite side of the fabric;

[00270] Figure 248 is a diagram illustrating the anvil of Figure 245 moved towards the staple cartridge of Figure 247, and the staples partially fired from the staple cartridge;

[00271] Figure 249 is a cross-sectional view of a modality of an anvil-attachable layer disposed in relation to an anvil and the patient's tissue, with the staples of a staple cartridge being fired through the layer and tissue of the patient;

[00272] Figure 250 is a cross-sectional view of an anvil-securable layer arrangement positioned relative to an anvil and the patient's tissue, with the staples of a staple cartridge being fired through the layer and of the patient's tissue;

[00273] Figure 251 illustrates a retainer assembly being inserted into a surgical instrument, the surgical instrument comprising an anvil and a staple cartridge channel, and with a portion of the insertion tool being removed to illustration purposes;

[00274] Figure 252 illustrates the retainer assembly of Figure 251 being inserted into the surgical instrument, with a portion of the insertion tool being removed for illustrative purposes;

[00275] Figure 253 illustrates the insertion tool of Figure 251 being moved relative to the retainer to engage the staple cartridge in the staple cartridge channel and to engage a layer attachable to the anvil, such as a fabric thickness compensator. - from the anvil, with a portion of the insertion tool being removed for illustrative purposes;

[00276] Figure 254 illustrates the insertion tool of Figure 251 being moved relative to the retainer to disengage the retainer from the anvil attachable layer and staple cartridge, with a portion of the insertion tool being removed for illustrative purposes. traction;

[00277] Figure 255 is a perspective view of an embodiment of a retainer engaged to a staple cartridge, a layer attachable to the anvil having installable fasteners engaged to the retainer, and the retainer being positioned for insertion into an end actuator;

[00278] Figure 256 is a perspective view of the retainer of the figure.

ra 255;

[00279] Figure 257 is an elevation view of the retainer of Figure 255;

[00280] Figure 258 is an elevation view of the retainer, staple cartridge and anvil attachable layer of figure 255 inserted into an end actuator, with the installable fasteners of the anvil attachable layer being installed , and portions of the anvil and the anvil attachable layer being removed for illustration purposes;

[00281] Figure 259 is an elevation view of an embodiment of a retainer inserted into an end actuator, with a layer attachable to the anvil with installable fasteners being disposed on the retainer, and wherein retainer portions of the layer attachable to the anvil and the anvil are removed for illustration purposes;

[00282] Figure 260 is an elevation view of the retainer of Figure 259, the retainer having installed the installable fasteners of the anvil attachable layer, and with portions of the retainer, the anvil attachable layer and the anvil they are removed for illustration purposes;

[00283] Figure 261 is a detailed elevation view of the retainer, the anvil attachable layer and the anvil of Figure 259, the installable fasteners being not installed, and the retainer portions of the attachable layer being the anvil and the anvil are removed for illustration purposes;

[00284] Figure 262 is a detailed elevation view of the retainer, the anvil attachable layer and the anvil of Figure 259, with the installable fasteners being installed in a slot in the anvil, and portions of the retainer being , the anvil attachable layer and the anvil are removed for illustration purposes;

[00285] Figure 263 illustrates a fabric thickness compensator.

of which comprises a flowable attachment portion, in accordance with certain non-limiting embodiments;

[00286] Figure 264 illustrates a pressure sensitive adhesive laminate in an untensioned position, aligned with a slot in the staple cartridge, according to certain non-limiting embodiments;

[00287] Figure 265 illustrates the pressure-sensitive adhesive laminate in Figure 264 releasably attached to a staple cartridge in accordance with certain non-limiting embodiments;

[00288] Figure 266 illustrates a tissue thickness compensator comprising a flowable fastening portion, according to certain non-limiting embodiments;

[00289] Figure 267 illustrates a pressure-sensitive adhesive laminate in an untensioned position, aligned with staple cavities in the staple cartridge, in accordance with certain non-limiting embodiments;

[00290] Figure 268 illustrates the pressure-sensitive adhesive laminate in Figure 267, releasably attached to a staple cartridge, in accordance with certain non-limiting embodiments;

[00291] Figures 269 to 273 illustrate a pressure-sensitive adhesive laminate comprising an adhesive tab, according to certain non-limiting embodiments;

[00292] Figures 274 to 279 illustrate a pressure-sensitive adhesive laminate comprising an adhesive tab, according to certain non-limiting embodiments;

[00293] Figures 280 to 283 illustrate a pressure sensitive adhesive laminate comprising tabs for releasably attaching to an anvil, according to certain non-limiting embodiments;

[00294] Figures 284 to 288 illustrate a pressure sensitive adhesive laminate releasably attached to an anvil using an applicator, in accordance with certain non-limiting embodiments;

[00295] Figures 289 to 292 illustrate a pressure sensitive adhesive laminate releasably attached to an anvil, in accordance with certain non-limiting embodiments;

[00296] Figure 293 is a perspective view of an end actuator of a surgical stapling instrument that includes an implantable transition portion extending from the anvil and an implantable transition portion extending from the anvil. staple cartridge; and

[00297] Figure 294 is a diagram illustrating tissue positioned between the anvil and staple cartridge of the surgical stapling instrument of Figure 293.

[00298] Corresponding reference characters indicate corresponding parts across the various views. The exemplifications described in the present invention illustrate certain embodiments of the invention, in one form, and such exemplifications are not to be considered as limiting the scope of the invention in any way.

DETAILED DESCRIPTION

[00299] The Applicant of the present application also holds the rights to the US patent applications identified below which are incorporated herein, each by reference in their respective entireties:

[00300] US Patent Application Serial No. 12/894,311, entitled

SURGICAL INSTRUMENTS WITH RECONFIGURABLE SHAFT SEGMENTS, now US Patent Publication No. 2012/00 80496;

[00301] US Patent Application Serial No. 12/894,340, entitled SURGICAL STAPLE CARTRIDGES SUPPORTING NON-LINEARLY

ARRANGED STAPLES AND SURGICAL STAPLING INSTRUMENTS WITH COMMON STAPLE-FORMING POCKETS now US Patent Publication No. 2012/0080482;

[00302] US Patent Application Serial No. 12/894,327, entitled JAW CLOSURE ARRANGEMENTS FOR SURGICAL INSTRUMENTS,

now US Patent Publication No. 2012/0080499;

[00303] US patent application serial number 12/894,351, entitled SURGICAL CUTTING AND FASTENING INSTRUMENTS WITH SE-

PARATE AND DISTINCT FASTENER DEPLOYMENT AND TISSUE CUTTING SYSTEMS, now US Patent Publication No. 2012/0080502;

US Patent Application Serial No. 12/894,338 entitled IMPLANTABLE FASTENER HAVING A NON-UNIFORM ARRANGEMENT, now US Patent Publication No. 2012/0080481;

[00305] US Patent Application Serial No. 12/894,369, entitled

IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER, now US Patent Publication No. 2012/00 80344;

[00306] US Patent Application Serial No. 12/894,312, entitled

IMPLANTABLE FASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS, now US Patent Publication No. 2012/0080 479;

US Patent Application Serial No. 12/894,377 entitled SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE, now US Patent Publication No. 2012/0080 334;

[00308] US Patent Application Serial No. 12/894,339, entitled SURGICAL STAPLING INSTRUMENT WITH COMPACT ARTICULATION CONTROL ARRANGEMENT, now U.S. Patent Application Publication No. 2012/0080500;

[00309] US Patent Application Serial No. 12/894,360, entitled

SURGICAL STAPLING INSTRUMENT WITH A VARIABLE STAPLE FORMING SYSTEM, now US Patent Publication No. 2012/0080484;

[00310] US Patent Application Serial No. 12/894,322, entitled

SURGICAL STAPLING INSTRUMENT WITH A INTERCHANGEABLE STAPLE CARTRIDGE ARRANGEMENTS, now US Patent Publication No. 2012/0080501;

[00311] US Patent Application Serial No. 12/894,350, entitled

SURGICAL STAPLE CARTRIDGES WITH DETACHABLE SUPPORT STRUCTURES AND SURGICAL STAPLING INSTRUMENTS WITH

SYSTEMS FOR PREVENTING ACTUATION MOTIONS WHEN A CARTRIDGE IS NOT PRESENT, now U.A. No. 2012/0080478;

US Patent Application Serial No. 12/894,383 entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING BIOABSOR-BABLE LAYERS, now US Patent Publication No. 201 2/0080345;

[00313] US Patent Application Serial No. 12/894,389, entitled COMPRESSIBLE FASTENER CARTRIDGE, now US Patent Publication No. 2012/0080335;

[00314] US Patent Application Serial No. 12/894,345 entitled FASTENERS SUPPORTED BY A FASTENER CARTRIDGE SUPPORT, now US Patent Publication No. 2012/0080483;

[00315] US Patent Application Serial No. 12/894,306, entitled COLLAPSIBLE FASTENER CARTRIDGE, now US Patent Publication No. 2012/0080332;

[00316] US Patent Application Serial No. 12/894,318, entitled

FASTENER SYSTEM COMPRISING A PLURALITY OF CONNECTED RETENTION MATRIX ELEMENTS, now US Patent Publication No. 2012/0080480;

[00317] US Patent Application Serial No. 12/894,330, entitled

FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND AN ALIGNMENT MATRIX, now US Patent Publication No. 2012/0080503;

[00318] US Patent Application Serial No. 12/894,361 entitled FASTENER SYSTEM COMPRISING A RETENTION MATRIX, now US Patent Publication No. 2012/0080333;

[00319] US Patent Application Serial No. 12/894,367, entitled

FASTENING INSTRUMENT FOR DEPLOYING A FASTENER SYSTEM COMPRISING A RETENTION MATRIX, now US Patent Publication No. 2012/0080485;

[00320] US Patent Application Serial No. 12/894,388, entitled

FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND A COVER, now US Patent Publication No. 2012/00804 87;

[00321] US Patent Application Serial No. 12/894,376, entitled

FASTENER SYSTEM COMPRISING A PLURALITY OF FASTENER CARTRIDGES, now US Patent Publication No. 2012/0080486;

[00322] US Patent Application Serial No. 13/097,865, entitled SURGICAL STAPLER ANVIL COMPRISING A PLURALITY OF FORMING POCKETS, now US Patent Publication No. 201 2/0080488;

[00323] US Patent Application Serial No. 13/097,936 entitled TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER, now US Patent Publication No. 2012/0080339;

[00324] US patent application serial no. 13/097954, entitled

STAPLE CARTRIDGE COMPRISING A VARIABLE THICKNESS COMPRESSIBLE PORTION, now US Patent Publication No. 2012/0080340;

[00325] US patent application serial no. 13/097,856, entitled

STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF, now US Patent Publication No. 2012/0080336;

[00326] US Patent Application Serial No. 13/097,928, entitled

TISSUE THICKNESS COMPENSATOR COMPRISING DETACHABLE PORTIONS, now US Patent Publication No. 2012/00 80490;

[00327] US patent application serial no. 13/097,891, entitled

TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER COMPRISING AN ADJUSTABLE ANVIL, now US Patent Publication No. 2012/0080489;

[00328] US Patent Application Serial No. 13/097,948, entitled

STAPLE CARTRIDGE COMPRISING AN ADJUSTABLE DISTAL PORTION, now US Patent Publication No. 2012/008 3836;

[00329] US Patent Application Serial No. 13/097,907, entitled COMPRESSIBLE STAPLE CARTRIDGE ASSEMBLY, now US Patent Publication No. 2012/0080338;

[00330] US patent application serial no. 13/097,861, entitled

TISSUE THICKNESS COMPENSATOR COMPRISING PORTIONS HAVING DIFFERENT PROPERTIES, now US Patent Publication No. 2012/0080337;

[00331] US Patent Application Serial No. 13/097,869 entitled STAPLE CARTRIDGE LOADING ASSEMBLY, now US Patent Publication No. 2012/0160721;

[00332] US Patent Application Serial No. 13/097,917, entitled

COMPRESSIBLE STAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS, now US Patent Publication No. 2012/008 3834;

[00333] US Patent Application Serial No. 13/097,873 entitled STAPLE CARTRIDGE COMPRISING A RELEASABLE PORTION, now US Patent Publication No. 2012/0083833;

[00334] US Patent Application Serial No. 13/097,938, entitled

STAPLE CARTRIDGE COMPRISING COMPRESSIBLE DISTORTION RESISTANT COMPONENTS, now US Patent Publication No. 2012/0080491;

[00335] US Patent Application Serial No. 13/097,924 entitled STAPLE CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR, now US Patent Publication No. 2012/00 83835;

[00336] US Patent Application Serial No. 13/242,029 entitled SURGICAL STAPLER WITH FLOATING ANVIL, now US Patent Publication No. 2012/0080493;

[00337] US patent application serial no. 13/242,066, entitled

CURVED END EFFECTOR FOR A STAPLING INSTRUMENT, now US Patent Publication No. 2012/0080498;

[00338] US Patent Application Serial No. 13/242,086, entitled STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK;

[00339] US patent application serial no. 13/241,912, entitled STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK ARRANGEMENT;

[00340] US Patent Application Serial No. 13/241,922 entitled SURGICAL STAPLER WITH STATIONARY STAPLE DRIVERS;

[00341] US Patent Application Serial No. 13/241,637, entitled SURGICAL INSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATING MULTIPLE ACTUATION MOTIONS, now US Patent Publication No. 2012/0074201;

[00342] US patent application serial no. 13/241,629, entitled

SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR, now US Patent Publication No. 201 2/0074200;

[00343] US Patent Application Serial No. 13/433,096, entitled

TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF CAPSULES, now US Patent Publication No. 2012/0241496;

[00344] US patent application serial no. 13/433,103 entitled

TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF LAYERS, now US Patent Publication No. 2012/0 241498;

[00345] US Patent Application Serial No. 13/433,098 entitled EXPANDABLE TISSUE THICKNESS COMPENSATOR, now US Patent Publication No. 2012/0241491;

[00346] US Patent Application Serial No. 13/433,102 entitled TISSUE THICKNESS COMPENSATOR COMPRISING A RESERVOIR, now US Patent Publication No. 2012/0241497;

[00347] US Patent Application Serial No. 13/433,114 entitled RETAINER ASSEMBLY INCLUDING A TISSUE THICKNESS COM-

PENSATOR, now US Patent Publication No. 2012/02 41499;

[00348] US Patent Application Serial No. 12/433,136, entitled

TISSUE THICKNESS COMPENSATOR COMPRISING AT LEAST ONE MEDICAMENT, now US Patent Publication No. 2 012/0241492;

[00349] US Patent Application Serial No. 13/433,141, entitled

TISSUE THICKNESS COMPENSATOR COMPRISING CONTROLLED RELEASE AND EXPANSION, now US Patent Publication No. 2012/0241493;

[00350] US Patent Application Serial No. 13/433,144, entitled

TISSUE THICKNESS COMPENSATOR COMPRISING FIBERS TO PRODUCE A RESILIENT LOAD, now US Patent Publication No. 2012/0241500;

[00351] US Patent Application Serial No. 13/433,148, entitled

TISSUE THICKNESS COMPENSATOR COMPRISING STRUCTURE TO PRODUCE A RESILIENT LOAD, now US Patent Publication No. 2012/0241501;

[00352] US Patent Application Serial No. 13/433,155, entitled

TISSUE THICKNESS COMPENSATOR COMPRISING RESILIENT MEMBERS, now US Patent Publication No. 2012/024 1502;

[00353] US Patent Application Serial No. 13/433,163, entitled

METHODS FOR FORMING TISSUE THICKNESS COMPENSATOR ARRANGEMENTS FOR SURGICAL STAPLERS, now US Patent Publication No. 2012/0248169;

[00354] US Patent Application Serial No. 13/433167 entitled TISSUE THICKNESS COMPENSATORS, now US Patent Publication No. 2012/0241503;

[00355] US Patent Application Serial No. 13/433,175 entitled LAYERED TISSUE THICKNESS COMPENSATOR, now US Patent Publication No. 2012/0253298;

[00356] US Patent Application Serial No. 13/433,179, entitled

TISSUE THICKNESS COMPENSATORS FOR CIRCULAR SURGICAL STAPLERS, now US Patent Publication No. 2012/02 41505;

[00357] US Patent Application Serial No. 13/433,115, entitled

TISSUE THICKNESS COMPENSATOR COMPRISING CAPSULES DEFINING A LOW PRESSURE ENVIRONMENT;

[00358] US Patent Application Serial No. 13/433,118 entitled TISSUE THICKNESS COMPENSATOR COMPRISED OF A PLURALITY OF MATERIALS;

[00359] US Patent Application Serial No. 13/433,135 entitled MOVABLE MEMBER FOR USE WITH A TISSUE THICKNESS COMPENSATOR;

[00360] US Patent Application Serial No. 13/433140, entitled

TISSUE THICKNESS COMPENSATOR AND METHOD FOR MAKING THE SAME;

[00361] US Patent Application Serial No. 13/433,147 entitled TISSUE THICKNESS COMPENSATOR COMPRISING CHANNELS;

[00362] US Patent Application Serial No. 13/433,126 entitled TISSUE THICKNESS COMPENSATOR COMPRISING TISSUE INGROWTH FEATURES;

[00363] US Patent Application Serial No. 13/433,132, entitled

DEVICES AND METHODS FOR ATTACHING TISSUE THICKNESS COMPENSATING MATERIALS TO SURGICAL STAPLING INSTRUMENTS; and

[00364] US Patent Application Serial No. 13/433,129, entitled

TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF MEDICAMENTS.

[00365] The Applicant of the present application also holds the rights to the US patent applications identified below which are incorporated herein, each by reference in their respective entireties:

[00366] US Patent Application Serial No. 11/216,562, entitled

STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now US Patent Publication No. 7,669,746;

[00367] US Application Serial No. 11/714,049, entitled SURGICAL STAPLING DEVICE WITH ANVIL HAVING STAPLE FORMING POCKETS OF VARYING DEPTHS, now US Patent Publication No. 2007/0194082;

[00368] US Application Serial No. 11/711,979, entitled "SURGICAL

STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now US Patent No. 8,317,070;

[00369] US Application Serial No. 11/711,975, entitled SURGICAL

STAPLING DEVICE WITH STAPLE DRIVERS OF DIFFERENT HEIGHT, now US Patent Publication No. 2007/0194 079;

[00370] US Application Serial No. 11/711,977, entitled "SURGICAL

STAPLING DEVICE WITH STAPLE DRIVER THAT SUPPORTS MULTIPLE WIRE DIAMETER STAPLES, now US patent no.

7,673,781;

[00371] US application serial no. 11/712,315, entitled "SURGICAL STAPLING DEVICE WITH MULTIPLE STACKED ACTUATOR WEDGE CAMS FOR DRIVING STAPLE DRIVERS, now US patent no.

7,500,979;

[00372] US Request Serial No. 12/038,939, entitled STAPLE

CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now US Patent No. 7,934.63 0;

[00373] US Application Serial No. 13/020.263, entitled SURGICAL STAPLING SYSTEMS THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now US Patent Publication No. 2011/0147434;

[00374] US Request Serial No. 13/118278, entitled ROBOTI-CALLY-CONTROLLED SURGICAL STAPLING DEVICES THAT

PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now US Patent Publication No. 2011/0290851;

[00375] US Application Serial No. 13/369,629 entitled ROBOTIC-CALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS, now US Patent Publication No. 2012/013866 0;

[00376] US Application Serial No. 12/695,359, entitled SURGICAL

STAPLING DEVICES FOR FORMING STAPLES WITH DIFFERENT FORMED HEIGHTS, now US Patent Publication No. 2 010/0127042; and

[00377] US Patent Application Serial No. 13/072,923, entitled STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now US Patent Publication No. 2011/0174863.

[00378] [0301] The applicant of the present application also holds the US patent applications identified below which were filed on the same date as the present application and which are each incorporated herein by reference in their entirety, respectively:

[00379] US Order Serial No. _______________, entitled SURGICAL STAPLING CARTRIDGE WITH LAYER RETENTION FEATURES (attorney document no. END7104USCIP/110 606CIP1);

[00380] US Application Serial No. _______________, entitled AD-HESIVE FILM LAMINATE, (attorney document no. END6843USCIP19/100528CP19);

[00381] US Order Serial No. _______________, Entitled ACTU-

ACTOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM A FASTENER CARTRIDGE, (prosecutor's document no. END6848USCIP2/100533CIP2);

[00382] Order US Serial No. _______________, entitled RELE-

ASABLE TISSUE THICKNESS COMPENSATOR AND FASTENER CARTRIDGE HAVING THE SAME, (prosecutor's document no. END6848USCIP3/100533CIP3);

[00383] US Patent Application Serial No.___________ ____, entitled "FASTENER CARTRIDGE COMPRISING A RELEASABLE TIS-SUE THICKNESS COMPENSATOR", Attorney Document No. END6848USCIP4/100533CIP4);

[00384] US patent application serial no.___________ ____, entitled "FASTENER CARTRIDGE COMPRISING A CUTTING MEMBER FOR RELEASING A TISSUE THICKNESS COMPENSATOR", no. d attorney's document END6848USCIP5/100533CIP5);

[00385] US patent application serial no.___________ ____, entitled "FASTENER CARTRIDGE COMPRISING A RELEASABLY AT-TACHED TISSUE THICKNESS COMPENSATOR, (attorney document no. END6848USCIP6/100533CIP6);

[00386] US Request Serial No. _______________, entitled ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR, (attorney document no. END7102USCIP2/110604 CIP2);

[00387] US Request Serial No. _______________, entitled LAYER COMPRISING DEPLOYABLE ATTACHMENT MEMBERS, (attorney document no. END7102USCIP3/110604CIP3);

[00388] US Request Serial No. _______________, entitled END EFFECTOR COMPRISING A DISTAL TISSUE ABUTMENT MEMBER, (attorney document no. END7102USCIP4/110604 CIP4);

[00389] US Request Serial No. _______________, entitled LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES, (attorney document no. END6232USCIP1/070348CIP1);

[00390] US Request Serial No. _______________, entitled IM-PLANTABLE ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES, (attorney document no. END6232USCIP2/070348CIP2);

[00391] US Order Serial No. _______________, Entitled MUL- TIPLE THICKNESS IMPLANTABLE LAYERS FOR SURGICAL STA-

PLING DEVICES, (attorney document no. END6840USCIP2/100525CIP2);

[00392] Order US Serial No. _______________, entitled RELE-

ASABLE LAYER OF MATERIAL AND SURGICAL END EFFECTOR HAVING THE SAME, (attorney document number END6232USCIP3/070348CIP3);

[00393] US Request Serial No. _______________, entitled ACTU- ATOR FOR RELEASING A LAYER OF MATERIAL FROM A SURGICAL END EFFECTOR, (attorney document no. END6232USCIP4/070348CIP4); and

[00394] US Request Serial No. _______________, entitled STAPLE CARTRIDGE COMPRISING A COMPRESSIBLE PORTION, (attorney document no. END7200USNP/120302.

[00395] Certain exemplary embodiments will now be described to provide a general understanding of the principles of structure, function, fabrication and use of the devices and methods described here. One or more examples of such modalities are illustrated in the accompanying drawings. Those skilled in the art will understand that the devices and methods specifically described in the present invention and illustrated in the accompanying drawings are exemplary rather than limiting embodiments, and that the scope of the various embodiments of the present invention is defined solely by the claims. Features illustrated or described in relation to one exemplary modality can be combined with features from other modalities. Such modifications and variations are intended to be included within the scope of the present invention.

[00396] Throughout this descriptive report, reference to the terms "various modalities", "some modalities", "one (1) modality" or "a modality", or the like, means that a resource, a structure or a particular feature described accordingly.

together with the modality it is included in at least one modality. Therefore, the appearance of the phrases "in various modalities", "in some modalities", "in one (1) modality" or "in a modality", or similar, in places throughout the descriptive report, are not all necessarily referring to the same modality. In addition, particular features, structures or features can be combined in any suitable way in one or more modalities. Therefore, the particular features, structures or features illustrated or described in conjunction with an embodiment may be combined, in whole or in part, with the feature structures or features of one or more other embodiments, without limitation. Such modifications and variations are intended to be included within the scope of the present invention.

[00397] The terms "proximal" and "distal" are used in the present invention with reference to a physician manipulating the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the physician, and the term "distal" refers to the portion located furthest from the physician. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "upward" and "downward" may be used in the present invention in connection with the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.

[00398] Several exemplifying devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, those of ordinary skill in the art will readily understand that the various methods and devices described herein can be used in numerous surgical procedures and applications including, for example, those in conjunction with open surgical procedures. As this Description

Moving forward, those of ordinary skill in the art will further understand that the various instruments presented in the present invention can be inserted into a body in any way, such as through a natural orifice, through an incision or perforation. formed in the fabric, etc. Functional portions or end-actuator portions of instruments can be inserted directly into a patient's body or can be inserted through an access device that has a working channel through which the end-actuator and elongated shaft of a surgical instrument can be advanced.

[00399] In Figures 1 and 2, a surgical stapling and cutting instrument 8010 may comprise an anvil 8014 that can be opened and closed repeatedly around its pivotal attachment to an elongated staple channel 8016. A set of clamping assembly 8012 may comprise anvil 8014 and channel 8016, the assembly 8012 being affixed proximally to the elongated shaft 8018, forming an implementation portion 8022. When the clamping assembly 8012 is closed, or to the less substantially closed, the implementing portion 8022 may have a sufficiently small cross section suitable for inserting the clamping assembly 8012 through a trocar. In various embodiments, the 8012 assembly can be manipulated by an 8020 handle connected to the 8018 rod. The 8020 handle may comprise user controls such as an 8030 turn knob that rotates the 8018 elongated rod and the clamp application assembly. 8012 about a longitudinal axis of rod 8018. A closing trigger 8026, which can revolve in front of an 8036 pistol grip, around a closing trigger pin 8152 (Figure 3) engaged laterally through the handle housing 8154, can be pressed to close the staple application assembly 8012.

In various embodiments, a lock release button 8038 can be presented out of the cable 8020 when the lock trigger 8026 is secured so that the release button 8038 can be pressed to release the lock trigger 8026 and open the assembly. application of 8012 staples, as described in more detail below. A firing trigger 8034, which can revolve in front of the closing trigger 8026, can cause the staple application assembly 8012 to simultaneously cut and staple the tissue attached therein. In various circumstances, as described in more detail below, multiple firing strokes can be employed, using the 8034 firing trigger, to reduce the amount of force required to be applied by the surgeon's hand per stroke. In certain embodiments, the cable 8020 may comprise swiveling right and/or left indicator wheels 8040, 8041 (figure 3) which may indicate the progress of the shot. For example, full firing motion may require three full firing strokes of the 8034 firing trigger, so the 8040, 8041 indicator wheels can rotate up to one-third of a revolution each per stroke. 8034 firing trigger. As described in more detail below, an 8042 manual firing release lever can allow the release system to be retracted before the full firing motion has been completed, if desired, and, in addition, the 8042 trigger release lever may allow a surgeon, or other physician, to retract the triggering system in the event that the triggering system jams and/or fails.

[00400] With reference to Figures 1 and 3, the elongated rod 8018 may comprise an external structure that includes a longitudinally reciprocating closure tube 8024 that revolves the anvil 8014 towards its closed position in response to the proximal pressing of the closure trigger 8026 of the 8020 cable. The elongated channel 8018 can be connected to the 8020 cable by an 8028 frame (figure 3) that is inside the 8024 closure tube. The 8028 frame can be pivotally engaged with the 8020 cable of so that rotation of the knob 8030 (figure 1) may rotate the implementing portion 8022. With particular reference to figure 3, the knob 8030 may comprise two half-casings which may include one or more inward projections 8031 which can extend through one or more elongated side openings 8070 in the closure tube 8024 and engage the frame 8028. As a result of the above, the turn knob 8030 and the frame 8028 p They can be rotated together or synchronously so that the rotated position of the knob 8030 determines the rotated position of the implementing portion 8022. In various embodiments, the longitudinal length of the longer opening 8070 is long enough to allow movement of longitudinal closure, and an opening movement, of the closure tube 8024. With regard to the generation of the closing movement of the closure tube 8024, referring mainly to figures 3 and 5, an upper portion 8160 of the trigger closure 8026 can push forward a closure fork 8162 (figure 4) by means of a closure hitch

8164. The closure latch 8164 is pivotally secured at its distal end by a closure fork pin 8166 to the closure fork 8162 and is pivotally secured at its proximal end by a closure latch pin 8168. In various embodiments, the closing trigger 8026 can be biased to an open position by a spring closing trigger 8246 that is proximally connected to the upper portion 8160 of the closing trigger 8026 and a cable housing 8154 formed by the halves. right and left of housing 8156, 8158. The tension force applied by tension spring 8246 can be overcome by a closing force applied to the closing trigger 8026 to advance the fork 8162, the closing engagement 8164 and the closing tube. 8024 closure distally.

[00401] When the 8026 close trigger is actuated, or depressed, as described above, the 8038 close release button can be positioned so that the surgeon or other physician can push the 8038 close release button , if desired, and allow the 8026 closing trigger, and the rest of the surgical instrument, to return to an unactuated state. In various embodiments, the close release button 8038 can be connected to a pivotal locking arm 8172 by a center side pivot 8173 so that movement can be transferred between the release button 8038 and the release arm 8172 Referring again to Fig. 3, a compression spring 8174 can proximally force the close release button 8038, ie clockwise around the central side pivot 8173 as seen from the right, and the top portion. 8160 of the closing trigger 8026 may include a proximal ridge 8170 with a rear notch 8171. When the closing trigger 8026 is depressed, the pivot locking arm 8172 may slide over the proximal ridge 8170 and when the closing trigger 8026 reaches its fully depressed position, it is to be understood that the rear notch 8171 is presented below the pivoting locking arm 8172 which drops and locks into the rear notch 8171 under the thrust. the compression spring 8174. At this point, manually depressing the 8038 close release button rotates the 8172 pivot locking arm up and out of the 8171 rear notch, thus unlocking the 8026 close trigger and allowing it to close trigger 8026 is placed back in its unlocked position.

[00402] When the 8026 close trigger is held close to

Also, as discussed above, the trigger trigger 8034 may be pulled toward the handle of the pistol 8036 in order to advance a trigger rod 8032 distally from the handle 8020. In various embodiments, trigger trigger 8034 can rotate around a laterally movable firing trigger pin 8202 and is engaged with the right and left halves of the housing 8156, 8158 of the cable 8020. The firing trigger 8034, when actuated, can advance a transmission firing mechanism engaged 8150. The 8150 engaged transmission firing mechanism can be propelled to a retracted position and not triggered by a spring 8184 ie one fixed to the 8036 pistol grip of the 8020 handle, and two fixed to the one of the engagements, for example, of the 8150 engaged transmission firing mechanism as described in more detail below.

Spring 8184 may comprise a non-movable end 8186 connected to housing 8154 and a movable end 8188 connected to a proximal end 8190 of a steel band 8192. A distally disposed end 8194 of the steel band 8192 may be affixed to a fastener 8195 in a front engagement 8196a of a plurality of links 8196a to 8196d that form an engaged rack 8200. The engaged rack 8200 may be flexible so that it can easily retract into the pistol grip 8036 and minimize the length of the 8020 cable and still form a straight, rigid rack assembly that can transfer significant firing force to and/or through the 8032 firing rod. As described in more details below, firing trigger 8034 may be engaged with a first engagement 8196a during a first actuation of firing trigger 8034, engaged with a second engagement 8196b during a second actuation of firing trigger 80 34, engaged with a third engagement 8196c during a third actuation of firing trigger 8034, and engaged with a fourth engagement 8196d during a fourth actuation of firing trigger 8034, each actuation of firing trigger 8034 being able to advance engaged rack 8200 distally for an increasing distance. In various embodiments, in addition to the above, the multiple strokes of the firing trigger 8034 can rotate the right and left gauge wheels 8040, 8041 to indicate the distance that the engaged rack 8200 has been moved.

[00403] Now referring to figures 3 and 5, an 8250 anti-return mechanism can prevent the combination tension/compression spring 8184 from retracting the engaged rack 8200 between firing strokes. In various embodiments, a coupling slide tube 8131 abuts the first coupling 8196a and connects the trigger rod 8032 to transmit firing motion. Fire rod 8032 extends proximally outward from a proximal end of frame 8028 and through a through hole 8408 of a non-return plate 8266. Through hole 8408 is sized to slidingly receive fire rod 8032 when aligned perpendicularly, but to hold when tilted. A lower tab attachment 8271 extends proximally from a lower edge of the proximal end of the frame 8028, extending through an opening 8269 over a lower edge of the non-return plate 8266. This lower tab attachment 8271 pulls the portion bottom of check plate 8266 near frame 8028 so that check plate 8266 is perpendicular when trigger rod 8032 is displaced distally and is allowed to tilt the top back to a holding state when trigger rod 8032 attempts to retract. A non-return compression spring 8264 is constricted distally by the proximal end of the frame 8028 and abuts proximal to an upper portion of the non-return plate 8266, forcing the non-return plate 8266 into a locked state. In opposition to spring tension, a non-return cam tube 8268 slides over the coupling slide tube 8131 and abuts the non-return plate 8266. A proximally projecting non-return yoke 8256 is secured to the cam tube backstop 8268, extends over the closing fork 8162.

[00404] Referring to Fig. 3, an 8289 latch-actuated automatic retraction mechanism is incorporated in the 8010 surgical stapling and cutting instrument to cause knife retraction at the end of the full firing path. To do this, a distal coupling 8196d includes an 8290 tang that protrudes upward when the distal coupling 8196d is advanced into the 8291 rack groove (figure 3) formed in the closing yoke 8162. This 8290 tang is aligned to activate an 8292 lower proximal cam on an 8248 non-return release lever (figure 6). Referring in particular to Fig. 6, frames formed in the right and left halves of housing 8156, 8158 constrain movement of non-return release lever 8248. A pin receptacle 8296 and circular pin 8293 formed, respectively, between the right and left halves of the housing 8156, 8158 are received through a longitudinally elongated opening 8294 formed in the anti-return release lever 8248 distally to the lower proximal cam 8292, thus allowing longitudinal translation as well as rotation. around the circular pin 8293. In the right half of the housing 8156, a proximally open channel includes a proximal horizontal portion that communicates with an upwardly and distally angled portion that receives a proximal right rear pin 8297. to the proximal end of the anti-return release lever 8248, thereby providing an upward rotation as the anti-return release lever 82 48 reaches the most distal portion of its translation. A locking structure formed in the right half of housing 8156 proximally to the anti-return release lever 8248 prevents its proximal movement when mounted to hold the right rear pin 8297 in the proximally open channel discussed above.

[00405] In addition to the above, with reference now to Figures 3 and 7, a distal end 8254 of the anti-return release lever 8248 is thereby pushed distally and downwards, causing a right front pin 8298 to fall into the frame on a distally open step 8299 formed in the right half of the housing 8156, which is driven into this engagement by a compression spring 8300 (figure 3) coupled to a left hook 8301 on the anti-return release lever 8248 between the right front pin 8298 and the opening elongated longitudinally. The other end of the compression spring 8300 is attached to a hook 8302 (figure 6) formed in the right half of the housing 8156 in a more proximal and lower position, just above the closing fork 8266. The compression spring 8300 , then pulls the distal end 8254 of the 8248 Anti-Return Release Lever downward and backward, which results in the right front pin 8298 locking into the 8299 Distal Open Step Frame when advanced distally. Thus, once activated, with reference to figure 7, the 8248 non-return release lever remains forward holding the 8266 non-return plate perpendicularly, thus allowing the engaged rack 8200 to be retracted. When the lock fork 8266 is subsequently retracted by unlocking the end actuator 8012, an upwardly projecting reset shank 8303 on the lock fork 8266 contacts a lower distal cam 8305 of the anti-return release lever 8248, lifting the right front pin 8298 out of the distally open step frame 8299 so that the anti-return compression spring 8264 can proximally push the anti-return cam tube 8268 and the anti-return release lever 8248 to their retracted positions (figure 6) .

[00406] In various embodiments, with reference to figures 1 to 3, the firing trigger 8034 can be operatively engaged to the engaged rack 8200 in any suitable way. With particular reference to Figures 2 and 3, firing trigger 8034 revolves around a pin of firing trigger 8202 which is connected to housing 8154. An upper portion 8204 of firing trigger 8034 moves distally about of the trigger pin 8202 when the trigger trigger 8034 is pressed towards the handle of the pistol 8036, stretching a proximally placed trigger trigger tension spring 8206 (figure 3), connected proximally between the upper portion 8204 of the firing trigger 8034 and housing 8154. Upper portion 8204 of firing trigger 8034 engages engaged rack 8200 during each press of the firing trigger through a spring-tensioned side latch mechanism 8210. When firing trigger is released, the side latch mechanism is disengaged from the engaged rack 8200 and the firing trigger can be returned to an unpressed or non-firing position. In use, an inclined right side rail formed by a proximally right-facing chamfered surface 8284 on each of the latches 8196a to 8196d is engaged by a lateral latch structure 8285. In particular, a sliding latch piece 8270 (Figures 3 and 4) has right and left 8272 lower guides that slide respectively on a left rail 8274 (figure 3) formed in the closing fork 8266 below the 8291 rack channel and in a right rail 8275 in a rail of the closing fork 8276 which is parallel to a rack channel 8291 and is secured to a rack channel cover 8277 which closes an open portion to the right of rack channel 8291 in the closing fork 8266 which is distal to the displacement of the sliding piece of pawl 8270. In figures 3 to 5, a compression spring 8278 is secured between an 8279 hook over an upper proximal position on the 8276 closure fork rail and a hook 8280 on a distal right side of the sliding pawl piece 8270, which keeps the sliding pawl piece 8270 pulled proximally into contact with the upper portion 8204 of the firing trigger 8034.

[00407] With particular reference to Figure 3, a bolt block 8318 rests on the sliding bolt piece 8270 revolving around a rear vertical pin 8320 that passes through a proximal left corner of the bolt block 8318 and the piece tongue slider 8270. A recess of spacer block 8322 is formed in a distal portion of an upper surface of block 8318 to receive a spacer block 8324 pivotally secured therein by a vertical pin 8326 whose lower end extends to into a pawl spring recess 8328 in an upper surface of pawl slider 8270. A pawl spring 8330 in pawl spring recess 8328 extends to the right of vertical front pin 8326 driving pawl block 8318 to rotate counterclockwise when viewed from above to engage with the right-hand sloped track 8282. A small coil spring 8332 in the recess of the 8322 separation block drives the 8324 Separation Block to rotate clockwise when viewed from above, its proximal end is pushed to contact the 8334 curved lip formed in the 8266 closure fork above the 8291 rack groove. As shown in Figure 5, the stronger mechanical advantage of pawl spring 8330 over small coil spring 8332 means that pawl block 8318 tends toward engagement with separator block 8324 rotated clockwise. In Fig. 3, when the firing trigger 8034 is fully depressed and begins to release, the separator block 8324 encounters a ridge 8336 on the contoured bead 8334 as the sliding pawl piece 8270 retracts, forcing the separator block 8324 rotating clockwise when viewed from above and thus separating the pawl block 8318 from the engagement with the engaged rack 8200. The recess shape of the separator block 8322 interrupts the clockwise rotation of the separator block 8324 at an orientation perpendicular to the 8334 curved bead maintaining this disengagement during full retraction and thus eliminating ratchet noise.

[00408] In figures 3, 4, 8 and 12, the 8010 surgical stapling and cutting instrument can include a manual retraction mechanism 8500 that provides manual release of the trigger mechanism, manual retraction and, in one version (figures 13 to 15), it also performs automatic retraction at the end of the complete shooting path. Referring now to Figures 3 and 8, in particular, a front idler gear 8220 is engaged to a leftmost toothed surface 8222 of the engaged rack 8200, with the front idler gear 8220 also engaging an idler gear rear idler gear 8230 which has a smaller ratchet gear on the right side 8231. Both the front idler gear 8220 and the rear idler gear 8230 are swivelly connected to the cable housing 8154, respectively, to the front idler shaft 8232 and the rear idler shaft 8234 Each end of the rear axle 8232 extends through the respective right and left halves of the housing 8156, 8158 and is attached to the left and right gauge wheels 8040, 8041 and, provided the rear axle 8234 is freely rotating in the cable housing 8154 and has a hitch linked to the rear gear 8230, the gauge wheels 8040, 80 41 rotate with the rear gear 8230. The gear ratio between the engaged rack 8200, the idler gear 8220 and the rear gear 8230 can be advantageously selected so that the toothed upper surface 8222 has tooth dimensions that are suitably strong and that the rear gear 8230 does not make more than one revolution during the entire firing path of the 8150 in-train transmission firing mechanism. In addition to the 8502 gear mechanism visually indicating the firing travel or progress, the 8502 gear mechanism can also be used to manually retract the knife.

In various embodiments, the smaller right hand ratchet gear 8231 of the rear idler gear 8230 extends to a central portion 8506 of the manual retract lever 8042, specifically aligned with a longitudinally aligned vertical slot 8508 (figure 8) which divides the central portion 8506. A lateral through hole 8510 of the central portion 8506 communicates with an upper recess 8512. A front portion 8514 is shaped to receive a proximally directed locking tab 8516 that revolves around a pin right side 8518 formed at a distal end of the upper recess 8512. A rear portion 8520 is shaped to receive an L-shaped spring tab 8522 which urges the locking tab 8516 downwardly into engagement with the smaller ratchet gear of the right side 8231. A support structure 8524 (figure 6) protrudes from the right half of the frame 8156 into the upper recess 8512 sustain I walk the 8516 locking tab of the hitch with the smaller 8231 right-hand ratchet gear when the 8042 manual retract lever is down (figure 10). An 8525 spiral spring (figure 3) drives the manual retract lever

8042 down.

[00409] In use, as shown in figures 9 and 10, the combination tension/compression spring 8184 can disconnect from the engaged rack located in the distal position. In figures 11 and 12, as the manual retract lever 8042 is raised, the locking tab 8516 rotates clockwise and is no longer held up by the 8524 support frame and engages the smaller ratchet gear on the side. right 8231 by turning the rear idler 8230 clockwise when viewed from the left. In this way, the rear idler gear 8220 responds counterclockwise by retracting the engaged rack 8200. In addition, a curved ridge to the right 8510 protrudes outward from the center portion 8506, sized to contact and move the lever distally. 8248 non-return release to release the 8250 non-return mechanism when the 8042 manual retract lever is rotated.

[00410] In Figures 13 to 15, an automatic retraction mechanism 8600 for a surgical stapling and cutting instrument may incorporate automatic retraction at the end of the full firing path for a front idler gear 8220a that has a tooth 8602 that moves within an 8604 circular groove on an 8606 cam wheel until it encounters a lock after an almost complete rotation corresponding to three firing strokes. In these circumstances, the right ridge 8610 is rotated upward to contact a lower cam recess 8612 to distally move a non-return release lever 8248a. Referring in particular to Figure 13, the anti-return release lever 8248a includes a distal end 8254 that functions as described above. Round pin 8293 and pin receptacle 8296 formed between the right and left halves of housing 8156, 8158 are received through a generally rectangular opening 8294a formed in non-return release lever 8248a behind lower cam 8192, thus allowing the longitudinal translation as well as downward locking movement of the distal end 8254 of the anti-return release lever 8248a. In the right half of frame 8156, a proximally horizontal open channel receives the right rear pin near the proximal end of the anti-return release lever 8248a.

[00411] In operation, before firing in figures 13 and 14, the engaged rack 8200 and the anti-return cam tube 8268 are in a retracted position, locking the anti-return mechanism 8250 as the anti-return compression spring 8264 proximally tilts the plate 8266 backstop. The 8600 automatic retract mechanism is in an initial state with the 8248a backstop release lever retracted with the 8196a engagement in contact with the 8220a front idler gear. Tooth 8602 is in a position corresponding to 6 o'clock with complete displacement of the circular groove 8604 progressing counterclockwise with the crest on the right 8610 immediately proximal to tooth 8602. After a shooting stroke, the the engaged rack 8200 has moved up a distal engagement 8196b to contact the front idler gear 8220a. Tooth 8602 has progressed one-third of a turn through circular groove 8604 of immobile cam wheel 8606. After a second stroke of firing, the engaged rack moved up one more clutch 8196c to contact the front idler gear 8220a. Tooth 8602 has progressed two-thirds of a turn through circular groove 8604 of immobile cam wheel 8606. After a third firing stroke, engaged rack 8200 moved upward a distal engagement 8196b into contact with front idler gear 8220a. Tooth 8602 has progressed completely around circular groove 8604 to contact the above-mentioned block, which initiates directional rotation.

counterclockwise (when viewed from right) of cam wheel 8606 bringing crest on right into contact with anti-return release lever 8248a. In Figure 15, the 8248a anti-return release lever moved distally in response to this, locking the right front pin 8298 into the 8299 distally open step frame and releasing the 8250 anti-return mechanism. Similar surgical stapling instruments are disclosed in US patent no.

7,083,075, which issued on August 1, 2006, the full disclosure of which is incorporated herein by reference.

[00412] With reference to Figure 16, the staple application assembly 9012 of a surgical stapling instrument 9010 performs the functions of stapling the tissue, directing staples and cutting tissue by two distinct movements transferred longitudinally downwards on the rod 9016 in relation to a rod frame 9070. This rod frame 9070 is attached proximally to a handle of a surgical stapling instrument and is coupled thereto for rotation about a longitudinal axis. An illustrative multipath cable for the surgical stapling and cutting instrument is described in greater detail in the co-pending US patent application of the same holder entitled SURGICAL STAPLING INSTRUMENT IN-

CORPORATE A MULTISTROKE FIRING POSITION INDICATOR AND RETRACTION MECHANISM, Serial No. 10/374,026, whose report is incorporated into the present invention by reference in its entirety. Other applications compatible with the present invention may incorporate a single firing stroke as described in the co-pending US patent application SURGICAL STA-

PLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, Serial No. 10/441,632, the contents of which are incorporated herein by reference in their entirety.

[00413] With particular reference to Figure 17, the distal end of the shank frame 9070 is secured to the clamp channel 9018. The anvil 9022 has a proximal pivot end 9072 which is pivotally received in a proximal end 9074 of the casing. - clip nib 9018, in position immediately distal to its engagement with shank frame 9070. When anvil 9022 is pivoted down, anvil 9022 moves a tissue contact surface 9028 and forming pockets 9026 into towards an opposite staple cartridge, described in more detail below. The pivoting end 9072 of the anvil 9022 includes a closure member 9076 proximal to, but distal to, its pivotal attachment with the clip channel.

9018. Thus, a closing tube 9078, the distal end of which includes a 9080 horseshoe opening that engages this 9076 closing element, selectively imparts an opening movement to anvil 9022 during the proximal longitudinal movement and a movement of closure to anvil 9022 during distal longitudinal movement of closure tube 9078 sliding over stem frame 9070 in response to a closure trigger, similarly to the above. The rod frame 9070 encompasses and guides a firing movement of the cable through a firing bar and cutting into two longitudinally reciprocating pieces 9090. In particular, the rod frame 9070 includes a longitudinal firing bar slot 9092 that receives a proximal portion of the two-piece 9090 shot and cut bar, specifically, a 9094 tapered and laminated fire bar. It should be understood that the 9094 tapered and laminated fire bar can be replaced with a solid and/or fire bar or by any other suitable materials.

[00414] An E-beam 9102 is the distal portion of the trigger bar and cut into two pieces 9090, which facilitates separate closing and firing as well as spacing the anvil 9022 of the elongated staple channel 9018 during triggering. With particular reference to Figures 17 and 19, in addition to any fixation treatment such as brazing or an adhesive, the firing and shear bar 9090 is formed by a female vertical fixation opening 9104 formed proximally in the receiving E-beam 9102. a corresponding male fixation element 9106 presented in a distal position by the tapered and laminated firing bar 9094, allowing each portion to be formed from a selected material and by a process suitable for its different functions (eg strength, flexibility, friction ). The E-beam 9102 may advantageously be formed of a material having material properties suitable to form a pair of upper pins 9110, a pair of intermediate pins 9112 and a lower pin or foot 9114, as well as being able to acquire a sharp cutting edge 9116. In addition, the proximally projecting integrally formed upper guide 9118 and the intermediate guide 9120 including each vertical end of the cutting edge 9116 further define a tissue preparation area 9122 that helps guide fabric to sharp cutting edge 9116 before cutting. Intermediate guide 9120 also serves to engage and trigger clip application apparatus 9012 by adjoining a stepped center member 9124 of a triangular body slider 9126 (Figure 20) which performs the formation of the clip by the application assembly. 9012 clamps, as described in more detail below. Forming these elements (eg, top pins 9110, intermediate pins 9112, and bottom foot 9114) integrally with the E-beam 9102 facilitates fabrication to tighter tolerances relative to one another compared to mounting from a plurality of parts, ensuring the desired operation during firing and/or effective interaction with various locking elements of the 9012 staple application structure.

[00415] In figures 21 and 22, the staple application set

9012 is shown open with the E-beam 9102 fully retracted.

During assembly, the lower foot 9114 of the E-beam 9102 is released through an enlarged hole 9130 of the clamp channel 9018 and the E-beam 9102 is then advanced so that the E-beam 9102 slides distally along. a bottom rail 9132 formed in the clip channel 9018. In particular, the bottom rail 9132 includes a narrow slot 9133 which opens as an enlarged slot 9134 over a lower surface of the clip channel 9018 to form an inverted T-shape in the lateral cross-section, as shown particularly in Figures 22 and 23, which communicates with flared hole 9130. Once assembled, components proximally coupled to tapered and laminated fire bar 9094 do not allow lower foot 9114 to move proximally back to flared hole 9130 to allow disengagement.

Referring to figure 24, the tapered and laminated trigger bar 9094 facilitates insertion of the 9012 staple application set through a trocar.

In particular, a more distal downward projection 9136 raises the beam at E 9102 when fully retracted.

This is achieved by placing the downward projection 9136 at a point where it acts upward over a proximal edge of the flared hole 9130 in the 9018 staple channel. Referring now to Figure 25, the tapered and laminated fire bar 9094 also improves the operation of certain locking members that may be incorporated into the clamp channel 9018 by including a more proximal ascending projection 9138 that is driven downward by the rod structure 9070 during an initial portion of the firing path.

In particular, a sidebar 9140 is defined between a pair of square openings 9142 in the rod frame 9070 (figure 17). A clip spring 9144 that spans sidebar 9140 pushes down a portion of laminated and tapered trigger bar 9094 that protrudes distally out of the longitudinal slot of trigger bar 9092, which ensures that certain elements Advantageous locking devices are engaged where appropriate. This thrust is more pronounced or confined to only that portion of the trigger path when the upward projection 9138 contacts the clip spring 9144.

[00416] In Figures 21 and 22, the E-beam 9102 is retracted with its upper pins 9110 contained in an anvil pocket 9150 near the pivoting proximal end of anvil 9022. A downwardly open anvil vertical slit 9152 ( Figure 16) widens laterally on anvil 9022 into an inner rail of anvil 9154 that captures the upper pins 9110 of the E-beam 9102 as they advance distally during firing, as shown in figures 24 and 25, positively spacing anvil 9022 of staple channel 9018. In this way, with the E-beam 9102 retracted, the surgeon is able to repeatedly open and close staple application structure 9012 until satisfied with the placement and orientation of the captured tissue there for stapling and cutting, in addition, the E-beam 9102 assists in the proper positioning of the tissue even for a set of 9012 staple application with reduced diameter and correspondingly rigidity reduced. In Figures 16, 17, 20, 21, 23 and 29, the staple application assembly 9012 is shown with the replaceable staple cartridge 9020 which includes the triangular body slider 9126. A plurality of downwardly aligned open triangular body slots longitudinally and parallel 9202 (Figure 23) receive respective wedges 9204 integral with triangular body slider 9126. In Figures 23 to 25, triangular body slider 9126 then actuates upwardly a plurality of clamp drivers 9206 which are slidable vertically into the recesses of the 9208 staple driver.

In that illustrative version, each clamp driver 9206 includes two vertical extensions, each translating upwardly into a respective clamp hole 9210, or cavity 9024, to force upward and deform a clamp 9023 which then rests against a staple forming surface 9214 (figure 25) of anvil 9022. A central firing recess 9216 (figure 17) defined within staple cartridge 9020 near staple channel 9018 permits passage of the lower horizontal portion 9218 (figure 20 ) of the triangular body slider 9126 as well as the intermediate pins 9112 of the E-beam 9102. Specifically, a staple cartridge tray 9220 (figures 17, 23) attaches to and is under a polymeric staple cartridge body 9222 which it has the clamp driver recesses 9208, the clamp holes 9210 and the center firing recess 9216 formed therein. When staples 9023 are so formed for either side, sharp cutting edge 9116 enters a vertical through slot 9230 which passes through the longitudinal axis of staple cartridge 9020, except only for a more distal end thereof.

[00417] The firing of the clamp application set 9012 starts as shown in figure 25 with the firing bar and cut in two pieces 9090 pulled proximally until the descending projection 9136 actuate the intermediate guide 9120 in the beam at E 9102 up and back, allowing a new 9020 staple cartridge to be inserted into the 9018 staple channel when the 9022 anvil is open, as shown in figures 16 and 21. In figure 26, the trigger and cutter bar two-piece 9090 has been advanced distally a short distance, allowing downward projection 9136 to fall into flared hole 9130 of bottom rail 9132 under bias of clip spring 9144 against upward projection 9138 of tapered and laminated fire bar 9094. The middle guide

9120 prevents further downward rotation by resting on the stepped center element 9124 of the triangular body slider 9126, thus keeping the intermediate pin 9112 of the E-beam within the center firing recess 9216. firing and cutting in two pieces 9090 was fired distally, advancing triangular body slider 9126 to cause staples 9023 to form while cutting tissue 9242 trapped between anvil 9022 and staple cartridge 9020 with sharp cutting edge 9116. Subsequently, in Fig. 28, the two-piece firing and cutting bar 9090 is retracted, leaving the triangular body slider 9126 positioned distally. In figure 29, the intermediate pin 9112 is allowed to translate downwardly into a locking recess 9240 formed in the clamp channel 9018 (see also figures 22 and 25). In this way, the operator receives a tactile indication when intermediate pin 9112 meets the distal edge of locking recess 9240, when triangular body slider 9126 (not shown in figure 29) is not located proximally (ie, staple cartridge 20 missing or staple cartridge 20 spent). Similar surgical stapling instruments are disclosed in US Patent No. 7,380,696, which was issued June 3, 2008, the full disclosure of which is incorporated herein by reference.

[00418] In various embodiments, turning now to Figures 30 to 38, a surgical instrument 12000 may comprise a handle 12010, a rod 12020 extending from the handle 12010, and an end actuator 12040, removably attachable to the rod 12020 , as described in more detail below. The handle 12010 may comprise a trigger 12014 which can be actuated to one close the 12040 end actuator and two advance a trigger member 12043 distally through the 12040 end actuator. Although not shown in figures 30a 38, the 12010 cable can include any

want suitable drive train configured to transfer and convert rotary motion of trigger 12014 into linear motion of trigger member 12023 extending across rod

12010. In use, trigger 12014 may be actuated toward a pistol grip 12012 of handle 12010 so as to advance trigger member 12023 distally within rod 12020 along a longitudinal axis 12039 and when the trigger member of the rod 12023 is operatively coupled to the triggering member of the end actuator 12043, as discussed below in more detail, distal movement of the triggering member of the rod 12023 can be transferred to the triggering member of the end actuator 12043 When the end actuator trigger member 12043 is advanced distally, the end actuator trigger member 12043 may be configured to engage a first jaw 12040a that includes an anvil and/or a second jaw 12040b, including a cartridge channel of clamps, and moving at least one of the first jaw 12040a and the second jaw 12040b toward each other. In addition to the foregoing, and referring primarily to figures 30 to 32, end actuator 12040 can be mounted on stem 12010 in a direction that is transverse to the longitudinal axis.

12039. For example, end actuator 12040 can be mounted on stem 12010 in a direction that is perpendicular to longitudinal axis 12039, for example. In such circumstances, end actuator 12040 may be moved toward stem 2010 so that frame 12041 of end actuator 12040 engages and connects with frame 12021 and so that proximal end 12044 of end member trigger 12043 engages and engages with distal end 12024 of trigger member 12023. Stem frame 12021 may include a channel 12022, defined therein, which can be configured to slidably receive stem trigger member 12023 and define the longitudinal axis 12039. To align end actuator frame 12041 with stem frame 12021, in various modes, proximal end 12045 of end actuator frame 12041 and distal end 12025 of stem frame 12021 may include dovetail cooperating elements, for example, that can orient end actuator 12040 with respect to rod 12020. Rod frame 12021 may further include mounting openings 12026 defined therein which can be configured to receive mounting projections 12046 extending from the end actuator frame 12041. As a result of the cooperating dovetail elements of the ends 12025, 12045 and/or the mounting elements 12026, 12046, in various circumstances, it is possible to securely mount the end actuator 12040 to the rod 12020. In various embodiments, the surgical instrument 12000 can further comprise a locking collar 12030 that can be configured to lock the actuator to end 12040 to rod 12020. Referring now primarily to figures 34 to 36, locking collar 12030 can be moved between an unlocked position (figures 34 and 35) and a locked position (figure 36). When the 12030 locking collar is in its unlocked position, referring to Figure 34, the 12040 end actuator can be mounted on the 12020 stem. Once the 12040 end actuator has been engaged with the 12020 stem, the locking collar - 12030 rod can be slid over the 12040 end actuator and 12020 rod interconnection to lock the 12040 end actuator in place. More specifically, in at least one embodiment, locking collar 12030 can define an internal opening 12031 that can be configured to intimately receive the outer perimeters of the end actuator 12040 and the stem.

12020. In certain embodiments, surgical instrument 12000 may comprise a spring or tensioning member configured to bias locking collar 12030 into its locked position. In such embodiments, a physician may pull locking collar 12030 proximally against the biasing force of the spring and thereafter release locking collar 12030 and allow the spring to return collar 12030 to its locked position.

[00419] Now with reference again to Figures 30 to 38, and particularly Figures 32 and 33, the surgical instrument 12000 may comprise a 12050 articulated joint. The 12050 articulated joint, in various embodiments, can be configured to allow a distal portion of end actuator 12040 pivots around an axis defined by swivel joint 12050. In such an embodiment, end actuator 12040 may comprise a proximal portion securely mounted on stem 12020 and a distal portion which may rotate relative to the proximal portion about the hinge joint 12050. In certain embodiments, the surgical instrument 12000 may comprise a latch configured to engage and disengage the distal portion of the end actuator 12040. For example, the end actuator 12040 may include a 12047 end actuator lock that can be pushed distally to lock the distal portion of the 12040 end actuator in position and/or pulled proximally. to unlock the distal portion of the end actuator 12040. The surgical instrument 12000 may further comprise a locking actuator 12060 adjacent to the handle 12010, for example, which can be pulled proximally so as to pull the locking portion of the actuator from end 12047 proximally. In such an embodiment, the lock actuator 12060 may be operably coupled to a lock portion 12027 that extends through the rod 12020, which is operably coupled, or operably coupleable, to the lock portion of the end actuator. 12047. In at least one such embodiment, the proximal end 12048 of the locking portion of the end actuator 12047 may be mounted to the distal end 12028 of the locking portion 12027 when the end actuator 12040 is mounted on the stem 12020. In at least one such embodiment, the end actuator locking portion 12047 may be mounted to the locking portion 12027 at the same time that the end actuator triggering member 12043 is mounted to the rod triggering member 12023.

[00420] In various embodiments, as described above, a staple cartridge may comprise a cartridge body that includes a plurality of staple cavities defined therein. The cartridge body may comprise a platform and an upper platform surface, each clip cavity may define an opening in the platform surface. As also described above, a staple may be positioned within each staple cavity so that the staples are stored within the cartridge body until ejected therefrom. Before being ejected from the cartridge body, in various embodiments, the staples may be contained in the cartridge body so that the staples do not protrude above the platform surface. When the staples are positioned below the platform surface, in such embodiments, the possibility of the staples being damaged and/or prematurely coming into contact with the target tissue can be reduced. In various circumstances, the staples can be moved between an unfired position in which they do not protrude from the cartridge body and a fired position in which they have emerged from the cartridge body and may contact an anvil positioned opposite the cartridge. of staples. In various embodiments, the anvil, and/or the formation pockets defined within the anvil, can be positioned a predetermined distance above the platform surface so that,

when the staples are being dispensed from the cartridge body, they are deformed to a predetermined formed height. In some circumstances, the thickness of tissue captured between the anvil and staple cartridge may vary and, as a result, thicker tissue may be captured by certain staples while thinner tissue may be captured by certain other staples. In any case, the stapling pressure, or force, applied to the tissue by the staples may vary from staple to staple or it may vary between a staple at one end of a row of staples and a staple at the other end of the row of staples, for example. Under certain circumstances, the gap between the anvil and the staple cartridge platform can be controlled so that the staples apply a certain minimum stapling pressure to each staple. In some of these circumstances, however, there may still be significant variation in the clamping pressure in different clamps.

[00421] In use, in addition to the above and with reference primarily to Figure 39, an anvil, such as the anvil 10060, for example, can be moved to a closed position opposite the 10000 staple cartridge. in more detail below, anvil 10060 can position fabric against fabric thickness compensator 10020 and, in various embodiments, compress fabric thickness compensator 10020 against support surface 10011 of the support portion. 10010, for example. Once the anvil 10060 has been properly positioned, the clamps 10030 can be installed, as also illustrated in figure 39. In various embodiments, as mentioned above, the clamp trigger slider 10050 can be moved from the proximal end. 10001 of the 10000 staple cartridge toward the distal end 10002, as illustrated in figure 40. As the 10050 slider is advanced, the 10050 slider can contact the 10040 staple drivers and lift the 10040 staple drivers on the inside. of clip cavities 10012. In at least one embodiment, slider 10050 and clip drivers 10040 may each comprise one or more ramps, or sloping surfaces, that can cooperate to move clip drivers 10040 up from their unfired positions.

In at least one embodiment, each clip driver 10040 can comprise at least one sloped surface and slider 10050 can comprise one or more sloped surfaces, which can be configured so that the sloped surfaces of the slider can slide under the slanted surface of the driver as slider 10050 is advanced distally into the staple cartridge.

As clamp drivers 10040 are lifted into their respective clamp cavities 10012, clamp drivers 10040 can lift clamps 10030 so that clamps 10030 can emerge from their clamp cavities 10012 through openings in the platform of staples 10011 (figure 41). During an exemplary firing sequence, slider 10050 may contact a first clip 10030 and begin lifting the first clip 10030. As slider 10050 is further advanced distally, slider 10050 may begin to lift additional clips 10030, and any other subsequent clips in a sequential order.

Slider 10050 can drive clamps 10030 upward so that legs 10032 of the clamps contact the opposite anvil, are deformed to a desired shape, and are ejected from support portion 10010. In various circumstances, slider 10050 can move multiple clamps up at the same time as part of a firing sequence.

[00422] With reference to figures 49 to 54, each clamp 10030 can be deformed so that a compression zone 10039 is defined therein. For example, each clamp 10030 may comprise a base 10031 and one or more legs 10032 extending from base 10031 which, upon deformation, may cooperatively define an area with base 10031 within which to fabric T and fabric thickness compensator 10020 can be captured. Within compression zone 10039, fabric thickness compensator 10020 can apply pressure to fabric T and, in certain circumstances, assume different compressed heights depending on the thickness of fabric T. Fabric Thickness Compensator 10020 can resiliently fill gaps or free spaces within compression zones 10039 defined by clamps 10030.

[00423] As discussed above and with reference to Figure 41, the clamp legs 10032 of the clamps 10030 may extend above the platform surface 10011 of the support portion 10010 when the clamps 10030 are in their unfired positions. In various embodiments, the tips of clip legs 10032, or any other portion of clip legs 10032, may not protrude through an upper fabric contact surface 10021 of fabric thickness compensator 10020 when the 10030 clamps are in their unfired positions. As clips 10030 are moved from their unfired positions to their fired positions, the tips of the clip legs may protrude through the tissue contact surface. In various embodiments, the tips of clip legs 10032 may comprise sharp points that can cut and penetrate fabric thickness compensator 10020. In certain embodiments, fabric thickness compensator 10020 may comprise a plurality of apertures that may be configured to receive clip legs 10032 and allow clip legs 10032 to slide relative to fabric thickness compensator 10020. In certain embodiments, support portion 10010 may additionally comprise a plurality of guides 10013 ( Figure 41) extending from platform surface 10011. Guides 10013 may be positioned adjacent to the clamp cavity openings in platform surface 10011 so that clamp legs 10032 can be supported, at least partially, by the guides

10013. In certain embodiments, a guide 10013 may be positioned at a proximal end and/or a distal end of a staple cavity opening. In various embodiments, a first guide 10013 can be positioned at a first end of each clamp cavity opening, and a second guide 10013 can be positioned at a second end of each clamp cavity opening such that each first guide 10013 can support a first clip leg 10032 of a clip 10030 and each second guide 10013 can support a second clip leg 10032 of the clip. In at least one embodiment, with reference to Fig. 41, each guide 10013 may comprise a groove or slot, such as groove 10016, for example, into which a clamp leg 10032 can be slidably received within. In various embodiments, each guide 10013 may comprise a shim, protrusion, and/or stake which may extend from support surface 10011 and may extend into fabric thickness compensator 10020. In at least one embodiment, as discussed in more detail below, shims, bulges and/or pegs can reduce the relative movement between fabric thickness compensator 10020 and support portion 10010. In certain embodiments, the tips of clamp legs 10032 may be positioned within -

part of guides 10013 and may not extend above the upper surfaces of guides 10013 when clamps 10030 are in their unfired position. In at least such an embodiment, guides 10013 may define a guide height, and clips 10030 may not extend above that guide height when in their unfired positions.

[00424] In various embodiments, a fabric thickness compensator, such as fabric thickness compensator 10020, for example, can be composed of a single sheet of material. In at least one embodiment, a fabric thickness compensator can comprise a continuous sheet of material that can cover the entire upper platform surface 10011 of the support portion 10010, or alternatively, cover less than the entire platform surface.

10011. In certain embodiments, the sheet of material may cover the clip cavity openings in the support portion 10010 while, in other embodiments, the sheet of material may comprise openings that may be aligned, or at least partially aligned. , with the clamp cavity openings. In various modes, a fabric thickness compensator can be composed of multiple layers of material. In some embodiments, a tissue thickness compensator may comprise a compressible core and a wrap surrounding the compressible core.

[00425] In various embodiments, a tissue thickness compensator may comprise a wrapper to releasably retain a compressible core to the support portion 10010. In at least one such embodiment, a staple cartridge may additionally comprise retainer clips that can be configured to prevent the wrapper and compressible core from prematurely separating from support portion 10010. In certain embodiments, as described above, a fabric thickness compensator may be removably attached to support portion 10010 by clips 10030. More particularly, also as described above, the legs of clips 10030 may extend into the fabric thickness compensator 10020 when clips 10030 are in their unfired position and, as a result, securely releasable, fabric thickness compensator 10020 to support portion 10010. In at least one embodiment, legs of clamps 10030 may be in contact with the side walls of their respective clip cavities 10012 where, due to friction between the clip legs 10032 and the side walls, the clips 10030 and tissue thickness compensator 10020 may be retained in position until the 10030 staples are dispensed from the 10000 staple cartridge. When the 10030 staples are dispensed, the 10020 Fabric Thickness Compensator can be captured on the 10030 staples and held against the T stapled fabric.

When the anvil is further moved to an open position to release the fabric T, the support portion 10010 can be moved away from the fabric thickness compensator 10020 that has been secured to the fabric.

In certain embodiments, an adhesive may be used to releasably secure fabric thickness compensator 10020 to support portion 10010. In at least one embodiment, a two-part adhesive may be used, wherein, in at least one embodiment, a first portion of the adhesive may be positioned on the platform surface 10011, and a second portion of the adhesive may be positioned on the fabric thickness compensator 10020 such that when the fabric thickness compensator 10020 is positioned against the platform surface 10011, the first part can contact the second part to activate the adhesive and detachably glue the fabric thickness compensator 10020 to the support portion 10010.

or other suitable means could be used to releasably secure the tissue thickness compensator to the support portion of a staple cartridge.

[00426] In various embodiments, in addition to the above embodiment, slider 10050 may be advanced from a proximal end to a distal end to fully install all of the 10030 clips contained in the 10000 clip cartridge. In at least one embodiment, with reference now Figure 44, slider 10050 may be advanced distally into a longitudinal cavity within support portion 10010 by a trigger member, or cutter bar, 10052, of a surgical stapler. In use, the staple cartridge 10000 can be inserted into a staple cartridge groove in a surgical stapler jaw and the trigger member 10052 can be advanced to contact the slider 10050, as illustrated in Figure 44. As slider 10050 is advanced distally by firing member 10052, slider 10050 may contact the most proximal clamp trigger(s) 10040 and trigger, or eject, clamps 10030 from the 10010 cartridge body as described above. As illustrated in Fig. 44, firing member 10052 may further comprise a cutting edge 10053 which can be advanced distally through a knife slot in support portion 10010 as the clips are fired. In various embodiments, a corresponding knife slot may extend through the anvil positioned opposite the staple cartridge 10000 so that, in at least one embodiment, the cutting edge 10053 can extend between the anvil. and the support portion 10010 and cutting the fabric, and the fabric thickness compensator positioned therebetween. In various circumstances, the slider 10050 may be advanced distally by the firing member 10052 to the slider.

10050 reaches the distal end of staple cartridge 10000. At such a point, firing member 10052 can be retracted proximally. In some embodiments, slider 10050 can be retracted proximally with firing member 10052 but, in various embodiments, slider 10050 can be left behind at the distal end 10002 of staple cartridge 10000 when shooting member 10052 is retracted Once the firing member 10052 has been retracted sufficiently, the anvil can be opened again, the tissue thickness compensator 10020 can be separated from the support portion 10010 and the remaining non-implanted portion of the extended staple cartridge 10000, including support portion 10010, can be removed from the staple cartridge channel.

[00427] After the expended staple cartridge 10000 has been removed from the staple cartridge channel, in addition to the above, a new staple cartridge 10000, or any other suitable staple cartridge, can be inserted into the staple cartridge channel. Bobby pins. In various embodiments, in addition to the above, the staple cartridge channel, the firing member 10052 and/or the staple cartridge 10000 may comprise cooperating elements that may prevent the firing member 10052 from advancing distally a second time. , or a subsequent time, without a new staple cartridge, or unfired staple cartridge, 10000, positioned in staple cartridge channel 10070. More particularly, as firing member 10052 is advanced to contact the slider 10050, and, when slider 10050 is in its proximal unfired position, a firing member support tip 10052 may be positioned in and/or over a support protrusion on slider 10050 such that the member 10052 is maintained in a sufficient vertical position to prevent a latch, or beam, 10054, which extends from firing member 10052, from falling into a latch recess defined within the gas cartridge channel. ramps. If latch 10054 does not fall into the latch recess under such circumstances latch 10054 may not abut a distal side wall of the latch recess as firing member 10052 is advanced. As firing member 10052 pushes slider 10050 distally, firing member 10053 can be held in its vertical firing position due to the support tip resting on the support protrusion. When firing member 10052 is retracted relative to slider 10050, as discussed above, firing member 10052 may fall from its vertical position as the support tip is no longer resting on the support protrusion of slider 10050 In at least one such embodiment, the surgical stapler may comprise a spring and/or other suitable tensioning element which may be configured to tension the firing member 10052 to its downward position. Once firing member 10052 has been fully retracted, firing member 10052 cannot be advanced distally through the used staple cartridge 10000 again. More particularly, firing member 10052 cannot be held in its upper position by slider 10050 since slider 10050, at that point in the operating sequence, has been left behind at the distal end of the staple cartridge.

10000. Thus, as mentioned above, in the case where firing member 10052 is advanced again without replacement of the staple cartridge, locking beam 10054 will contact side wall 10057 of the locking recess that will prevent firing member 10052 from being advanced distally to staple cartridge 10000 again. In other words, once the used staple cartridge 10000 has been replaced with a new staple cartridge, the new staple cartridge will have a proximally positioned slider 10050, which can hold firing member 10052 in its upper position and allow it to firing member 10052 is advanced distally once more.

[00428] As described above, the slider 10050 can be configured to move the staple drivers 10040 between a first unfired position and a second fired position so as to eject the staples 10030 from the support portion 10010. embodiments, clamp drivers 10040 may be contained in clamp cavities 10012 after clamps 10030 have been ejected from support portion 10010. In certain embodiments, support portion 10010 may comprise one or more elements of retainers that can be configured to prevent clip drivers 10040 from ejecting or falling out of clip cavities 10012. In various other embodiments, slider 10050 can be configured to eject clip drivers 10040 from the support portion 10010 with the staples 10030. In at least one such embodiment, staple actuators 10040 may be composed of a bioabsorbable and/or biocompatible material, such as Ultem, by and example. In certain embodiments, staple drivers may be attached to staples 10030. In at least one such embodiment, a staple driver may be molded over and/or around the base of each staple 10030 such that the trigger is integrally formed with the clamp. US Patent Application Serial No. 11/541,123 entitled SU RGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SE-

CURING TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME, filed September 29, 2006, is incorporated herein by reference in its entirety.

[00429] In various circumstances, in addition to the above, a com-

The compressible tissue thickness thinker may move, twist and/or deflect relative to the underlying rigid support portion of a staple cartridge.

In various embodiments, the support portion, and/or any other suitable portion of the staple cartridge, can comprise one or more elements configured to limit relative movement between the fabric thickness compensator and the support portion.

As described above, at least a portion of the clips 10030 may extend above the platform surface 10011 of the support portion 10010 whereby, under certain circumstances, lateral forces applied to a tissue thickness compensator may suffer strength offered by clamps 10030 and/or shims 10013 extending from support portion 10010, for example.

In various circumstances, clips 10030 may skew and/or bend within clip pockets 10012, while resisting lateral movement of the tissue thickness compensator, with, in various embodiments, clip pockets 10012 and staples 10030 can be sized and configured to maintain relative alignment between legs 10032 of staples 10030 and the forming pockets on opposite anvil 10060 so that staples 10000 are properly formed during the staple forming process. .

In various embodiments, clips 10030 and/or shims 10013 can be configured to prevent, or at least limit, lateral distortion within fabric thickness compensator 10020. clamps 10030 and/or shims 10013, for example, may be configured to stiffen, or limit the lateral and/or longitudinal movement of a first fabric contact surface of the fabric thickness compensator relative to a section. second surface, or lower surface.

In various embodiments, a staple cartridge, and/or a staple cartridge channel in which the staple cartridge is positioned, may comprise at least one distortion-reducing element that can extend upwardly to limit lateral and/or movement. longitudinal, or distortion, of a fabric thickness compensator. A casing at least partially surrounding a fabric thickness compensator, as discussed above, may also prevent, or at least limit, lateral and/or longitudinal movement, or distortion, of the fabric thickness compensator.

[00430] In various embodiments, a staple cartridge may comprise a plurality of staple cavities, each containing a staple positioned therein, wherein the staple cavities may be arranged in a plurality of rows, and wherein an anvil positioned oppositely to the staple cartridge may comprise a plurality of forming pockets corresponding to the staple cavities in the staple cartridge. In other words, the anvil may comprise a plurality of rows of forming pockets, each forming pocket being positioned opposite a staple cavity in the staple cartridge. In various embodiments, each forming pocket may comprise two forming containers configured to receive clamp legs 10032 of a clamp 10030 wherein each forming container is configured to receive a clamp leg 10032 and form or bend a clamp. clamp leg 10032 towards another clamp leg 10032, for example. In various circumstances, legs 10032 may miss or not properly fit into forming containers and, as a result, clamp legs 10032 may become malformed during the firing sequence. In various embodiments described herein, an anvil can comprise an array, or grid, of forming pockets that are each configured to receive and form a clamp leg. In at least one modi-

As such, the forming pocket arrangement may comprise a number of forming pockets which exceeds the number of staples contained in the staple cartridge. In at least one embodiment, a staple cartridge may comprise six longitudinal rows of staple pockets, for example, wherein the anvil may comprise six rows of forming pockets aligned with the six rows of staple pockets and, in addition, pockets of formation pockets positioned between the rows of formation pockets. For example, on one side of the anvil, the anvil may comprise a first row of forming pockets which can be positioned over a first row of clamp pockets, a second row of forming pockets which may be positioned over a second row of staple pockets that is adjacent to the first row of staple pockets, and, in addition, a row of forming pockets positioned between the first row of forming pockets and the second row of forming pockets.

[00431] In various embodiments, as described above, an anvil can be moved from an open position to a closed position in order to compress tissue against the tissue thickness compensator of a staple cartridge such as the fabric thickness compensator 10020, for example. In various circumstances, the tissue thickness compensator may be positioned to the side of the staple cartridge support portion before the tissue thickness compensator is positioned relative to the tissue. In certain embodiments, tissue thickness compensator 10020 may be in a position in which it is contiguous with support portion 10018 before the anvil is moved to its closed position. In certain other embodiments, fabric thickness compensator 10020 may be in a position in which a gap is present between fabric thickness compensator 10020 and the support portion.

10018. In at least one such embodiment, the anvil can move the fabric and the fabric thickness compensator 10020 downward until the fabric thickness compensator 10020 is adjacent to the support portion 10018 where, at this point, the anvil can be moved to its closed position and generate compression within the tissue. In the event that a surgeon is not satisfied with the position of the tissue between the anvil and the staple cartridge, the surgeon can open the anvil, adjust the position of the anvil and staple cartridge, and close the anvil again. Due to such positioning and repositioning of the staple cartridge relative to tissue, in various circumstances, the distal end of tissue thickness compensator 10020 may be dislodged from support portion 10010, for example. In some such circumstances, the distal end of tissue thickness compensator 10020 may contact tissue and detach or curl relative to support portion 10010. In various embodiments, as described in more detail below, a cartridge A staple cartridge may comprise one or more elements configured to releasably retain a tissue thickness compensator to an underlying support portion of the staple cartridge.

[00432] In various embodiments, with reference now to Fig. 55, a staple cartridge 10300 may comprise a support portion 10310, a tissue thickness compensator 10320 supported by the support portion 10310, and a distal end 10302 that includes a tip 10303 configured to releasably retain a distal end 10325 of the tissue thickness compensator 10320 in position. In at least one embodiment, tip 10303 may comprise a slit 10305 configured to receive distal end 10325 of tissue thickness compensator 10320.

to be compacted, or embedded, in the slot 10305 so that the distal end 10325 can be held in place when the staple cartridge 10300 is positioned relative to the tissue.

In at least one such embodiment, slot 10305 may be oriented in a direction that is parallel, or at least substantially parallel, to platform surface 10311 of support portion 10310. In various embodiments, slot 10305 may be horizontal with with respect to platform surface 10311. In various other embodiments, now referring to Fig. 56, a staple cartridge 10400 may comprise a support portion, a tissue thickness compensator 10420 supported by the support portion, and a distal end. 10402 which includes a tip 10403 configured to releasably retain the distal end 10425 of the tissue thickness compensator 10420 in position.

In at least one embodiment, distal end 10425 may comprise a projection extending therefrom, and tip 10403 may comprise a vertical slot 10405 configured to receive the projection of distal end 10425. In various embodiments, the distal end 10425, and/or the projection extending therefrom, can be compressed, or wedged, into the slot 10405 so that the distal end 10425 can be held in place when the staple cartridge 10400 is positioned in relation to the fabric.

In certain embodiments, fabric thickness compensator 10420 may comprise a slit, such as slit 10429, for example, that can be configured to receive at least a portion of nib 10403. In at least one embodiment, slit 10405 may be oriented in a direction that is perpendicular, or at least substantially perpendicular, to the platform surface 10411 of the support portion.

In various embodiments, now referring to Fig. 57, a staple cartridge 10500 may comprise a support portion, an offset.

tissue thickness gauge 10520 supported by the support portion, and a distal end 10502 that includes a tip configured to releasably retain distal end 10525 of tissue thickness compensator 10520 in position. In at least one embodiment, the tip can comprise a vertical slit 10505 configured to receive distal end 10525 of tissue thickness compensator 10520. 10505 so that the distal end 10525 can be held in place when the staple cartridge 10500 is positioned relative to tissue.

[00433] In various embodiments, referring again to Figure 55, the fabric thickness compensator 10320 may comprise an upper surface 10324 which can be positioned above the upper surface 10304 of the tip 10303. Another exemplary embodiment in which the upper surface of a fabric thickness compensator is positioned above the tip of the staple cartridge, shown in Figure 44, the upper surface 10721 of the fabric thickness compensator 10720 being positioned above the upper surface 10004 of the tip. 10003, for example. In use, again referring to Fig. 55, the fabric may slide over the top surface 10304 of the tip 10303 and, under some circumstance, the tissue may contact the distal end 10325 of the 10320 Fabric Thickness Compensator and may apply a force to the tissue thickness compensator 10320 tending to detach the tissue thickness compensator 10320 from the support portion 10310. In the embodiments described herein, this detachment force may be opposed by the distal end portion 10325 en. crimped on the tip 10303. In any case, when the fabric has been properly positioned in relation to the staple cartridge 13000,

an anvil can be rotated to a closed position to compress the fabric and the fabric thickness compensator 10320 against the support portion 10310. In at least one such embodiment, the anvil can be rotated to a position in which the anvil is rotated. contacts the top surface 10304 of tip 10303 and, as a result, the anvil can be prevented from turning further. In various circumstances, because the upper surface 10324 of the fabric thickness compensator 10320 is positioned above the upper surface 10304 of the tip 10303, the upper surface 10324 may be pushed down towards the support portion 10310 when the anvil is being closed and, in some cases, the upper surface 10324 may be pushed below the upper surface 10304 of the tip 10303, for example. After the staples contained in the 10300 staple cartridge have been dispensed and the 10320 Fabric Thickness Compensator has been cut as described herein, the support portion 10310 and tip 10303 can be moved away from the fabric thickness compensator 10320 so that the distal end 10325 of the tissue thickness compensator 10320 can slide out of the slit 10305.

[00434] As described above, an anvil, such as anvil 10060, for example, can be rotated to a closed position in which the anvil 10060 contacts the upper nose surface 10004 of a staple cartridge such as the 10000 staple cartridge, for example. Once the anvil has reached its closed position, the amount by which a fabric thickness compensator, such as a 10020 fabric thickness compensator, for example, is compressed will depend, among other things, on the uncompressed thickness, or height , fabric thickness compensator and fabric thickness. Referring now to Figures 42 and 43, a fabric thickness compensator 10920 may comprise an upper surface that is aligned, or at least substantially aligned, with the upper surface 10004 of tip 10003. In such embodiments, the upper surface of the fabric thickness compensator 10920 can be pushed below the top surface 10004 of the tip 10003. Now with reference to figures 47 and 48, a fabric thickness compensator such as the fabric thickness compensator 10820, for example, can comprising an upper surface 10821 which is positioned below the upper surface of the tip 10004 before the fabric thickness compensator 10820 is compressed by the fabric T and anvil 10060. In circumstances where the fabric T is relatively thin, as illustrated in Figures 45 and 46 , the 10920 Fabric Thickness Compensator can be subjected to relatively little compression. Referring now to Figs. 47 and 48, the fabric thickness compensator 10820 can be subjected to greater compression when the fabric T is relatively thicker. In circumstances where the fabric T has both thin sections and thicker sections, as illustrated in Figures 47 and 48, the fabric thickness compensator 10820 can be compressed by a greater proportion when it is positioned under the thicker T fabric, and by a smaller proportion when it is positioned under the thinnest T fabric, for example. In this way, as described above, the fabric thickness compensator can compensate for different fabric thicknesses.

[00435] In various embodiments, now referring to Figures 58 and 59, a surgical stapling instrument may comprise, one, a 16670 cartridge channel configured to receive a 16600 staple cartridge, and two, a pivotally coupled 16660 anvil to the cartridge runner 16670. The staple cartridge 16600 may comprise a support portion 16610 and a tissue thickness compensator 16620, wherein a distal end 16625 of the tissue thickness compensator 16620 is releasably secured to the portion. of support 16610 by a tip 16603 at the distal end 16602 of the staple cartridge 16600. In at least one embodiment, the tip 16603 may comprise a slit 16605 and may be composed of a flexible material. In use, referring primarily to Fig. 58, tip 16603 may be flexed downwardly to expand the opening of slot 16605. In certain embodiments, tip 16603 may comprise notches or cutouts 16606 that can be configured to allow the 16603 tip flex down. In any case, in various circumstances, the expanded opening of the slit 16605 can facilitate the insertion of the distal end 16625 of the tissue thickness compensator 16620 into the slit 16605. Once the tissue thickness compensator 16620 has been properly positioned, tip 16603 can be released and, due to the resilience of tip 16603 material, tip 16603 can return, or at least substantially return, to its uninflected condition and grip distal end 16625 of tissue thickness compensator 16620 against the surface of platform 16611, as illustrated in Fig. 59. In use, similarly to the above, distal end 16625 can be pulled out of slot 16605 when support portion 16610 is pulled away from the stapled tissue. In various circumstances, the flexible tip 16603 may be configured to deflect when the fabric thickness compensator 16620 is detached from the support portion.

16610. In various embodiments, again referring to Fig. 59, fabric thickness compensator 16620 may comprise an upper surface 16621 which is aligned, or at least substantially aligned, with an upper surface 16604 of tip 16603.

[00436] In various embodiments, now referring to figures 60 and 61, a staple cartridge, such as the 11400 staple cartridge,

for example, it may comprise a 11420 fabric thickness compensator releasably secured to a support portion.

11410. In at least one embodiment, the staple cartridge 11400 may comprise one or more retainer bars 11413 which may be configured to retain the longitudinal sides of the fabric thickness compensator 11420 on the platform surface.

11411. In at least one such embodiment, each retainer bar 11413 may comprise opposing arms 11418 which may define a channel 11416 therebetween. In such embodiments, one of the arms 11418 may be configured to extend over the fabric thickness compensator 11420 and the other arm 11418 may be configured to extend under a bead 11419 that extends from the support portion 11410. Referring primarily to Fig. 60, channel 11416 of each retainer bar 11413 may be sized and configured to apply a compressive force to the longitudinal sides of fabric thickness compensator 11420 before staple cartridge 11400 is used. . During use, referring primarily to Fig. 61, the 11400 staple cartridge can be positioned within a staple cartridge groove and, once the 11400 staple cartridge has been properly positioned, a An anvil, such as anvil 11460, for example, can be moved to a position in which it can compress the fabric thickness compensator 11420. Similar to the above, the fabric thickness compensator 11420, when compressed, can expand laterally, or outward, and, as a result, separate from the retainer bars 11413 of the 11400 staple cartridge. Staple cartridge retainer bars 11413. In at least one such embodiment, advancing a trigger bar, described above, through the staple cartridge 11400 can dispense the staples 10030 from the support portion 11410 and simultaneously press the anvil 11460 and the cartridge. of staples 11400 closer together to apply a compression force to the 11420 Fabric Thickness Compensator that is sufficient to cause the 11420 Fabric Thickness Compensator to expand laterally and release the retaining bars 11413 of the staple cartridge 11400. Once the retainer bars 11413 have been separated from the staple cartridge 11400, the support portion 11410 can be moved away from the implanted tissue thickness compensator 11420 and removed from the surgical site.

[00437] In various embodiments, in addition to the above, a staple cartridge may comprise a plurality of fasteners configured to releasably secure a tissue thickness compensator to a support portion of the staple cartridge. In certain embodiments, the support portion may comprise a plurality of apertures defined in the platform surface, for example, the fasteners may extend through the fabric thickness trim and may be releasably retained, at the openings of the support portion. In use, the fasteners can be progressively released from the support portion when the clips are progressively ejected from the support portion. In at least one such embodiment, the fixatives can be implanted with the tissue thickness compensator and, in at least one embodiment, the fixatives can be composed of at least one bioabsorbable material, for example. In certain embodiments, the fasteners may disengage from the support portion after the tissue thickness compensator has been at least partially implanted and when the support portion is moved away from the implanted tissue thickness compensator. In several modalities, now with reference to

Referring to Figs. 130 and 131, a staple cartridge, such as staple cartridge 11600, for example, may comprise a tissue thickness compensator 11620 releasably mounted to a support portion 11610 by a plurality of fasteners. 11613. Each fastener 11613 may comprise a first end 11618 engaged and/or otherwise engaged with the fabric thickness compensator 11620, a second end 11618 engaged with the support portion 11610, and a connector 11616 connecting the first end 11618 to second end 11618. In various embodiments, fasteners 11613 can extend through a knife slot 11615 defined in support portion 11610. In use, a firing member 10052 can move a knife edge through the knife slot 11615 in the support portion 11610 and cut the fasteners 11613 so as to release the fabric thickness compensator 11620 from the support portion 11610. In at least one such embodiment, the bar trigger 10052 may be advanced from a proximal end of staples cartridge 11600 to a distal end of staples cartridge 11600 so as to, one, advance slider 10050 distally and progressively drive staples 10030, as discussed above, and, two, progressively cutting and/or breaking the fasteners 11613 to progressively release the fabric thickness compensator 11620 from the support portion.

11610. In certain embodiments, similarly to the above, the fabric thickness compensator 11620 may comprise a plurality of separable segments that can each be secured to the support portion 11610 by one or more fasteners 11613 , for example. In the case where the firing member 10052 is stopped intermediate the proximal end and the distal end of the clip cartridge 11600, as shown in Fig. 130, the fasteners 11613 can help maintain the non-implanted portion of the compensation.

The fabric thickness gauge 11620 on the support portion 1610 after the anvil 11660 is opened and the support portion 11610 is moved away from the fabric T, as illustrated in Fig. 131. In various embodiments, in addition to the above, the cutting edge 10053 of firing element 10052 may be configured to cut and/or break fasteners 11613.

[00438] In various embodiments, now referring to Fig. 132, a staple cartridge may comprise a tissue thickness compensator, such as the tissue thickness compensator 15120, for example, which may comprise a plurality of portions which have different thicknesses. In at least one embodiment, the fabric thickness compensator 15120 may comprise a first, or inner, portion 15122a that may have a first, second, or intermediate thickness 15122b that extends from the first portion 15122b, which may, each having a second thickness, and third or outer portions 15122c which extend from the second portions 15122b and which may each have a third thickness. In at least one such embodiment, the third thickness may be thicker than the second thickness, and the second thickness may be thicker than the first thickness, for example, although any suitable thicknesses can be used in various others. modalities. In various embodiments, portions 15122a to 15122c of fabric thickness compensator 15120 may comprise steps having different thicknesses. In at least one embodiment, similarly to the above, a staple cartridge may comprise several rows of staples 10030 and a plurality of staple drivers having different heights which may deform staples 10030 to different formed heights. Also similarly to the above, the staple cartridge may comprise the first triggers.

staple drivers 15140a that can drive clips 10030 supported thereon to a first formed height, second staple drivers 15140b that can drive clips 10030 supported thereon to a second formed height, and third staple drivers which can direct the clips 10030 supported thereon to a third formed height, whereby the first formed height may be shorter than the second formed height and the second formed height may be shorter than the third formed height, for example. In various embodiments, as illustrated in Figure 132, each clamp 10030 may comprise the same, or substantially the same, unformed, or unfired, height. In certain other embodiments, now referring to Fig. 133, the first actuators 15140a, the second actuators 15140b, and/or the third actuators 15140c can support clamps having different unformed heights. In at least one such embodiment, first staple drivers 15140a can sustain staples 15130a having an unformed first height, second staple drivers 15140b can sustain staples 15130b having an unformed second height, and third clamp drivers 15140c can hold clamps 15130c having an unformed third height, the unformed first height may be shorter than the unformed second height, and the unformed second height may be shorter than the unformed third height , for example. In various embodiments, again referring to Fig. 133, the tips of the clips 15130a, 15130b and/or 15130c may be located, or at least substantially located, in the same plane as, in other embodiments, the tips of the clips 15130a, 15130b and/or 15130c may not be situated on the same plane.

[00439] In certain embodiments, now with reference to Figure 154,

a staple cartridge may include a tissue thickness compensator 15220 which has a plurality of portions having different thicknesses which may be implanted against tissue T by staples 15130a, 15130b and 15130c as described above. In at least one embodiment, now referring to Fig. 155, the clips 15130a, 15130b and/or 15130c can be deformed to different formed heights, the first clips 15130a being able to be formed at a first formed height, the second clips 15130b can be formed to a second formed height, and the third clips 15130c can be formed to a third formed height, and wherein the first formed height may be smaller than the second formed height and the second formed height may be smaller than the third formed height, for example. Other embodiments are envisaged in which the clips 15130a, 15130b and 15130c can be formed at any suitable formed height and/or at any relative formed height.

[00440] As discussed above and with reference to Fig. 134, a staple cartridge such as staple cartridge 10000, for example, may comprise a support portion 10010 and a tissue thickness compensator 10020, a plurality of which of staples 10030 may be at least partially stored in support portion 10010 and may extend into tissue thickness compensator 10020 when staples 10030 are in their unfired position. In various embodiments, the tips of staples 10030 do not protrude from fabric thickness compensator 10020 when staples 10030 are in their unfired positions. When clamps 10030 are moved from their unfired positions to their triggered positions by clamp drivers 10040, as discussed above, the tips of clamps 10030 can penetrate through the thickness compensator.

fabric 10020 and/or penetrate through the topsheet, or overlay, 10022. In certain alternative embodiments, the tips of the staples 10030 may protrude through the upper surface of the fabric thickness compensator 10020 and/or the overlay 10022 when clamps 10030 are in their unfired position. In any case, the clips 10030, when extending upwards from the support portion 10010 before being dispensed, may tilt and/or deflect relative to the support portion, as also discussed above.

[00441] In various embodiments, now referring to Fig. 140, a staple cartridge may comprise a fabric thickness compensator 13620 and a cover, or top layer, 13621, for example. In at least one such embodiment, one or more pads, or retainers, 13622, for example, may be recessed into cover 13621. In certain embodiments, each retainer 13622 may comprise one or more apertures 13629 defined therein, which may be configured to receive clamp legs 13032 of clamps 13030 when clamps 13030 are in their unfired position, as illustrated in Figure 140. In use, in addition to the above, clamp legs 10032 may slide through openings 13629 when clamps 13030 are moved from their unfired position to their fired position until the bases 13031 of clamps 13030 contact the fabric thickness compensator 13620 and compress at least a portion of the fabric thickness compensator 13620 against the bottom surfaces of pads 13622, for example. In various embodiments, now referring to Fig. 135, a staple cartridge may comprise a fabric thickness compensator 13120 and a cover, or topsheet, 13122, for example. In at least one such embodiment, the fabric thickness compensator 13120 may comprise stops, projections and/or conical protrusions 13128, for example, which may extend upwards from the upper surface 13121 of the thickness compensator. - fabric ra 13120. The projections 13128 can be configured to receive and envelop the ends of the clip legs 13032 of the clips 13030 when the clips 13030 are in their unfired position, as illustrated in Figure 135. The topsheet 13122 can also comprise stops, projections, and/or conical protrusions 13129 that can be aligned, or at least substantially aligned, with projections 13128. In use, clamp legs 10032 may penetrate projections 13128 and 13129 and emerge from the thickness compensator of fabric 13120. In various embodiments, now referring to Fig. 139, a staple cartridge may comprise a fabric thickness compensator 13520 and a cover, or c. superior beloved, 13522, for example. In at least one such embodiment, the cover 13522 may comprise stops, projections and/or conical protrusions 13529, for example, which may extend upwardly from the upper surface 13521 of the fabric thickness compensator 13520. Similar to the above, the projections 13529 can be configured to receive and envelop the ends of the clamp legs 13032 of the clamps 13030 when the clamps 13030 are in their unfired position, as illustrated in Figure 139. In use , clamp legs 10032 can penetrate projections 13529 and emerge from cover 13522.

[00442] In various embodiments, now referring to Fig. 136, a staple cartridge may comprise a fabric thickness compensator 13220 and a cover, or top layer, 13222, for example. In at least one such embodiment, the fabric thickness compensator 13220 may comprise coarse cavities.

and/or recesses 13128, for example, which may extend downwardly to the upper surface 13221 of the fabric thickness compensator 13220. In various embodiments, the tips of the clamp legs 13032 may extend through the recesses 13128 when the clamps 13030 are in their unfired position, as illustrated in Figure 136. In at least one embodiment, the topsheet 13222 may also comprise conical cavities and/or recesses 13229 that can be aligned, or to the same. - us substantially aligned, with recesses 13228. In various embodiments, now referring to Fig. 137, a staple cartridge may comprise a fabric thickness compensator 13320 and a cover, or topsheet, 13322, for example. In at least one such embodiment, cover 13320 may comprise thick portions 13329 which may extend downwardly into upper surface 13321 of fabric thickness compensator 13320. In various circumstances, thick portions 13329 may be configured to receive at least a portion of the clamp legs 13032 of the clamps 13030 there when the clamps 13030 are in their unfired position, as illustrated in Figure 137. In such embodiments, the thickened portions 13329 can secure the legs of clamp 13032 in position such that legs 13032 are aligned, or at least substantially aligned, with the staple-forming pockets of an anvil positioned on the opposite side of the fabric thickness compensator

13320. In various embodiments, now referring to Fig. 138, a staple cartridge may comprise a fabric thickness compensator 13420 and a cover, or topsheet, 13422, for example. In at least one such embodiment, cover 13422 may comprise thick portions 13429 which may extend upward from upper surface 13421 of fabric thickness compensator 13420. In various circumstances, thick portions 13429 may be configured to receiving at least a portion of the clamp legs 13032 of the clamps 13030 there when the clamps 13030 are in their unfired position, as illustrated in Figure 138. In such embodiments, the thick portions 13429 can secure the clamp legs 13032 in position such that legs 13032 are aligned, or at least substantially aligned, with the staple-forming pockets of an anvil positioned opposite the fabric thickness tab 13420.

[00443] In various embodiments, now referring to figures 141 and 142, a staple cartridge may comprise a tissue thickness compensator 13720 and a cover, or top layer, 13721, for example. In at least one such embodiment, the fabric thickness compensator 13720 may comprise anvils, projections and/or pyramidal and/or stepped protrusions 13728, for example, which may extend upwards from the upper surface 13721 of the fabric thickness compensator 13720. The projections 13728 can be configured to receive and envelop the ends of the staple legs 13032 of the staples 13030 when the staples 13030 are in their unfired position, as illustrated in Figure 142. Similarly, the layer The top 13721 may also comprise stops, projections, and/or pyramidal and/or stepped protrusions 13729 which may be aligned, or at least substantially aligned, with the projections 13728. In various embodiments, the cover 13721 may further comprise one or more prongs 13727 extending upward from projections 13729 that may be configured to engage fabric positioned against topsheet 13 721 and prevent, or at least limit, relative lateral and/or longitudinal movement between the fabric, the topsheet 13721 and/or the tips of the clip legs 13032. In use, the clip legs 13032 can penetrate the projections 13728 and 13729 and emerges from the fabric thickness compensator 13720 when the staples 13030 are moved from their unfired positions to their fired positions. In various embodiments, now referring to Figs. 143 and 144, a staple cartridge may comprise a fabric thickness compensator 13820 and a cover, or topsheet, 13821, for example. In at least one such embodiment, the fabric thickness compensator 13820 may comprise stops, projections, and/or pyramidal and/or stepped protrusions 13828, for example, which may extend upwards from the upper surface 13821 of Fabric Thickness Compensator 13820. Projections 13828 can be configured to receive and envelop the ends of clip legs 13032 of clips 13030 when clips 13030 are in their unfired position, as illustrated in Figure 144. Similarly, topsheet 13821 may also comprise stops, projections, and/or pyramidal and/or stepped protrusions 13829 that may be aligned, or at least substantially aligned, with projections 13828. In various embodiments, the Topsheet 13821 may further comprise one or more prongs 13827 which extend downwardly into fabric thickness compensator 13820 which may be configured to avoid or at least. less limit the relative lateral and/or longitudinal movement between the topsheet 13821 and the fabric thickness compensator 13820, for example. In use, clamp legs 10032 can penetrate projections 13828 and 13829 and emerge from fabric thickness compensator 13820 when clamps 13030 are moved from their unfired positions and their fired positions.

[00444] In various embodiments, now with reference to figure 145,

a staple cartridge may comprise a fabric thickness compensator, such as fabric thickness compensator 13920, for example, which may include ridges 13923 and grooves 13924 defined therein, wherein in at least one embodiment, grooves 13924 may be defined between crests 13923. In various embodiments, each crest 13923 may comprise the same height, substantially the same height, or different heights.

Similarly, each groove 13924 may comprise the same depth, substantially the same depth, or different depths.

In various embodiments, a plurality of staples 13030 may be at least partially stored within fabric thickness compensator 13920 so that the tips of staples 13030 can be positioned within ridges 13923. In at least one such embodiment, , staple legs 13032 of staples 13030 may not protrude from fabric thickness compensator 13920 and/or from a cover, or top layer, 13921 attached to fabric thickness compensator 13920, for example, when staples 13030 are stored in its unfired position.

In various embodiments, ridges 13923 and/or grooves 13924 can extend laterally across the staple cartridge.

In at least one such embodiment, the staple cartridge may comprise a longitudinal knife slot in which the ridges 13923 and grooves 13924 may extend in a direction that is transverse and/or perpendicular to the knife slot.

In various circumstances, ridges 13923 can be configured to hold the tips of clamp legs 13032 in position until clamps 13030 are moved from their unfired position to their fired position.

In various embodiments, now referring to Fig. 146, a fabric thickness compensator, and/or a cover covering a fabric thickness compensator, may comprise ridges and/or longitudinal grooves.

dinals. In at least one such embodiment, a fabric thickness compensator may comprise an upper surface defined by ridges 14023 and ridges 14024, wherein ridges 14024 may be defined between ridges 14023, for example. In various embodiments, the fabric thickness compensator may comprise a cover 14021 which may include a plurality of apertures 14029 defined therein, which may each be configured to receive a clamp leg 13032. In certain embodiments, apertures 14029 may be defined in ridges 14023, wherein the tips of clamp legs 13032 may be positioned below peaks 14028 of ridges 14029, positioned flush with peaks 14028, and/or positioned above peaks 14028. In certain embodiments, in addition to or instead of the above, openings 14029 may be defined in grooves 14024, for example. In certain embodiments, each opening may be surrounded, or at least partially surrounded, by an embossment, for example, which can strengthen the cover and/or the fabric thickness compensator that surrounds the openings. In any case, in addition to the above, the cover 14021 can be attached to a fabric thickness compensator in any suitable way, including using at least one adhesive, for example.

[00445] In various embodiments, now referring to Fig. 148, a disposable loading unit 15900, for example, may comprise an anvil 15960 and a staple cartridge channel 15970 wherein the staple cartridge channel 15970 can rotate with respect to anvil 15960. In at least one such modality, anvil 15960 may not be able to rotate. In certain embodiments, the fabric can be positioned between the anvil 15960 and the staple cartridge channel 15970, and thereafter, the staple cartridge channel 15970 can be rotated toward the fabric to secure the fabric against the anvil. In at least one such embodiment, the disposable loading unit 15900 may further comprise a fabric thickness compensator 15920 which can be configured to contact the fabric.

[00446] In various embodiments, now referring to Figures 149 to 151, a disposable loading unit 12900 may comprise a loading assembly that includes a lower portion 12922, which can be removably attached to the support portion. 12610, an upper portion 12990, which is removably attachable to the anvil 12560, and a flexible hinge 12991, which connects the lower portion 12922 and the upper portion 12990. Similar to the above, a longitudinal retaining rail 12825 may extend downwardly from bottom portion 12922 and into knife slot 12615 defined in support portion 12610 so that bottom portion 12922 can be releasably retained to support portion 12610. Similarly, a longitudinal retaining rail 12995 may extend upwardly from upper portion 12990 into a knife slot defined in anvil 12560 so that upper portion 12990 can be retained from mode releasable to the anvil 12560. As illustrated in Figures 150 and 151, a fabric thickness compensator 12620 may be mounted to the lower portion 12922 of the loading assembly so as to position the fabric thickness compensator 12620 in relation to to the support portion 12610, a physician could flex the upper portion 12990 and the lower portion 12922 toward each other, position the loading assembly between the anvil 12560 and the support portion 12610, and release the flexural loading assembly. - swim so that it can resiliently expand and force the upper portion 12990 against the anvil 12560 and the lower portion 12922 against the support portion 12610.

[00447] In various embodiments, now referring to Fig. 152, a staple cartridge, such as staple cartridge 14900, for example, may comprise a support portion 14910 and, in addition, a tissue thickness compensator 14920 positioned against the support portion 14910. Similar to the above, the support portion 14910 may comprise staple drivers which can be lifted by a staple dispensing slider to lift staples, such as staples 10030, for example, positioned thereon. less partially within the support portion 14910 towards an anvil, such as anvil 10060, for example, positioned opposite the staple cartridge

14900. In certain embodiments, the support portion 14910 may comprise six rows of staple cavities, such as two outer rows of staple cavities, two inner rows of staple cavities, and two intermediate rows of staple cavities. positioned between the inner rows and the outer rows, for example, the anvil 10060 may comprise six rows of forming pockets 10062 in line with, or at least substantially in line with, the clamp pockets. In various embodiments, the inner rows of the staple cavities may include the 14940a staple drivers positioned therein, the middle rows of the staple cavities may include the 14940b staple drivers positioned therein, and the outer rows of the staple cavities. may include the staple drivers 14940c positioned therein, each of the staple drivers 14940a may include a cradle 14949a configured to support a staple 10030, each of the staple drivers 14940b may include a cradle 14949b configured to support a staple 10030, and wherein each of the staple drivers 14940c may include a cradle 14949c configured to support a staple 10030. actuators 14926 extending under support portion 14910, cradles 14949a of staple actuators 14940a may be positioned. are driven closer to the anvil 10060 than the 14949b cradles of the 14940b staple drivers and the 14949c cradles of the 14940c staple drivers.

In this position, a first forming distance can be defined between cradles 14949a and forming pockets 10062 positioned on cradles 14949a, a second forming distance can be defined between cradles 14949b and forming pockets 10062 positioned over cradles 14949b, and a third forming distance can be defined between cradles 14949c and forming pockets 10062 positioned over cradles 14949c, where, in various modalities, the first forming distance may be shorter than the second distance training distance, and the second training distance may be shorter than the third training distance, for example.

When staple drivers 14940a through 14940c are moved from their unfired positions (figure 152) to their fired positions, each staple driver 14940a through 14940c can be moved upward an equal, or at least substantially equal, distance. towards the anvil 10060 by the staple-dispensing runner, so that the first drives 14940a direct their respective staples 10030 to a first formed height, the second drives 14940b drive their respective staples 10030 to a second formed height, and third actuators 14940c direct their respective clamps 10030 to a third formed height, the first formed height may be shorter than the second formed height, and the second formed height may be shorter than the third formed height, for example.

Various other embodiments are envisioned, in which the first staple drivers 14940a are moved up a first distance, the second staple drivers 14940b are moved up a second distance, and the third staple drivers 14940c are moved to up to a third distance, where one or more of the first distance, the second distance, and the third distance may be different.

[00448] In various embodiments, again with reference to Fig. 152, the platform surface 14911 of the support portion 14910 may vary in height with respect to the tissue contact surface 10061 of the anvil 10060. In certain embodiments, this variation height may occur laterally and, in at least one embodiment, the height of the support surface 14911 surrounding the inner rows of clip cavities may be greater than the support surface 14911 surrounding the outer rows of clip cavities, by example. In various embodiments, the bottom surface 14922 of the fabric thickness compensator 14920 can be configured to be parallel, or at least substantially parallel, to the platform surface 14911 of the support portion 14910. Fabric Thickness 14920 may also be of different thickness, wherein, in at least one embodiment, the upper, or fabric-contacting surface 14921 of the Fabric Thickness Compensator 14920 may slope inward from its side. outside or side edges. In at least one such embodiment, as a result of the above, the 14920 fabric thickness compensator may be thinner in a region positioned over the inner rows of staple wells and thicker in a region positioned over the outer rows of clamp cavities, for example. In various embodiments, now referring to Fig. 153, the platform surface of a support portion 15010 may comprise a stepped support surface, e.g.

the higher rungs of the stepped surface being able to surround the inner rows of clamp cavities and the lower rungs of the stepped surface may surround the outer rows of clamp cavities, for example. In at least one such embodiment, steps having an intermediate height may surround the intermediate rows of clamp cavities. In certain embodiments, a fabric thickness compensator, such as fabric thickness compensator 15020, for example, may comprise a bottom surface which may be parallel to and contiguous with the platform surface of the support portion 15010. in at least one embodiment, the upper, or fabric-contacting surface 15021 of the fabric thickness compensator may comprise an arcuate, parabolic, and/or curved surface, for example, which, in at least one such embodiment, may be extending from a first lateral side of fabric thickness compensator 15020 to a second lateral side of fabric thickness compensator 15020 with an apex aligned, or at least substantially aligned, with the center of staple cartridge 15000, for example.

[00449] In various embodiments, in addition to the above, a staple firing slider 10050 of a staple cartridge 10000 can be moved from a proximal end of the staple cartridge 10000 towards a distal end 10002 of the cartridge of clamps as illustrated in Figures 161 and 162 by a firing member illustrated elsewhere. As slider 10050 is advanced, slider 10050 may contact staple drivers 10040 and lift staple drivers 10040 into staple cavities 10012 defined in a cartridge body 10010 of staple cartridge 10000. at least one embodiment, the slider 10050 and the staple drivers 10040 may each comprise one or more ramps,

or angled surfaces, which can cooperate to move the clamp drivers 10040 and the clamps supported thereon upward from their unfired positions. The staple cartridge 10000 may further comprise a panel 10027, for example, which may at least partially surround the bottom of the cartridge body 10010 and at least partially contain the staple drivers 10040 within the cartridge body. 10010. Cartridge body 10010 may further comprise a longitudinal slot 10016 defined therein that may be configured to at least partially receive the firing member as it passes through the clip cartridge 10000.

[00450] Turning now to Fig. 163, staples contained in staple cartridge body 10010 can be fired sequentially between a proximal end 10001 and a distal end 10002 of staple cartridge 10000. In various embodiments, the staple cartridge clamps 10000 may comprise clamp drivers 10040a, 10040b and 10040c, for example, which can actuate the clamps in a predetermined manner. For example, staple cartridge 10000 may comprise a proximal driver 10040c positioned on a first side of longitudinal slit 10016 and a second proximal driver 10040c positioned on a second, or opposite side, of slit 10016. Each driver 10040c can be configured to fire two clamps, ie the two most proximal clamps, simultaneously. Such clamps are positioned in the clamp cavities designated 10012c. Indeed, among the clip cavities designated 10012c on each side of the slit 10016, such clip wells 10012c may comprise a distal clip cavity designated 10013c and a proximal clip cavity 10014c. The reader will understand that the staple cavity 10013c is positioned in a different staple row than the gram cavity.

po 10014c. In fact, clamp cavities 10013c and 10014c can be located in the two innermost rows of clamps, with the third outermost row not having a clamp that is triggered by a 10040c trigger. In addition, staple cartridge 10000 may comprise an intermediate driver 10040b positioned on a first side of longitudinal slot 10016 and a second intermediate driver 10040b positioned on a second, or opposite side, of slot 10016. Each driver 10040b may be set to trigger three clamps simultaneously. Such clamps are positioned in the clamp cavities designated 10012b. In fact, among the clip pockets designated 10012b on either side of slit 10016, such clip pockets 10012b may comprise a distal clip pocket designated 10013b, an intermediate clip pocket 10014b, and a distal clip pocket. 10015b. The reader will also appreciate that clamp pockets 10013b, 10014b and 10015b are all positioned in different rows of clamps. In addition, the staple cartridge 10000 may comprise a distal driver 10040a positioned on a first side of the longitudinal slit 10015, and a second distal driver 10040a positioned on a second, or opposite side, of the slit.

10015. Each 10040b trigger can be configured to trigger four clamps simultaneously. Such clamps are positioned in the clamp cavities designated 10012a. Indeed, of the four clip cavities designated 10012a on each side of slit 10016, such clip wells 10012a may comprise two distal clip cavities designated 10013a, an intermediate clip cavity 10014a and a distal clip cavity 10015a. The reader will also understand that the clip pockets 10013a, 10014a, and 10015a are all positioned in an arrangement that extends across all three rows of clips on one side of the longitudinal slot.

10016. In fact, the most distal staples positioned within the distal most cavities 10013a within the cartridge body 10010 are positioned in the inner and outer staple rows and extend distally with respect to the most distal staple cavity 10014a in the row intermediate positioned between the inner row and the outer row of staple cavities. Although only a few triggers 10040a, 10040b and 10040c are discussed above, the staple cartridge 10000 may comprise any suitable number of staple triggers for ejecting staples from the staple cavities. Such staple triggers can eject two, three, four and/or more staples simultaneously. With specific reference to Figure 18, a staple cartridge may comprise one or more staple drivers 41040a, for example, configured to hold two staples thereon, one or more triggers 41040b, for example, configured to hold three staples thereon, and/ or one or more 41040c staple drivers configured to hold four staples thereon. In various embodiments, the last or most distal drivers contained in a cartridge may comprise drivers 41040c which may include two distal support cradles 41041c which may hold the last staples in a row of staples. For example, 41040a-c triggers support staples on six rows of staples and 41040c triggers support the last staples on four of those rows. Such clips can be aligned, or at least substantially aligned, along an axis that is perpendicular to a cutting path that extends along a longitudinal axis. Such staples, due to their arrangement, can provide several hemostatic advantages. The last staples on the other two staple lines can be supported by cradles 41041b.

[00451] In various embodiments, a staple cartridge for a surgical stapler may include a layer, such as a tissue thickness compensator and/or a reinforcing material, for example, disposed on a staple platform of a surgical stapler. Bobby pins. In use, the patient's layer and tissue can be captured by staples when the staples are fired. Then, the layer can be separated from the surgical stapler and can remain on the patient when the staple is removed from the patient. In certain embodiments, a distal end of the layer may be attached to the staple cartridge to stabilize the layer relative to the staple cartridge while the staple cartridge and layer are being positioned relative to the patient's tissue.

[00452] In certain embodiments in which a distal end of the layer is attached to the staple cartridge, the staple cartridge may include a distally disposed cutting blade that cuts the free layer of the distal end that is attached to the gram cartridge. pos. Figures 81A through 83 illustrate a staple cartridge assembly 2300 that includes a staple cartridge 2330 and a distal cutting blade 2324 disposed in a distal cavity 2332 of staple cartridge 2330. As described in more detail below, the cutting blade Distal 2324 can be moved from an uninstalled position within distal cavity 2332 to a positioned installed position, in which cutting blade 2324 extends outward from distal cavity 2332 to cut a distal end portion 2316 of a layer 2306 , arranged in the staple cartridge.

[00453] Referring to Figures 82 and 83, in various embodiments, the distal portion 2316 of layer 2306 can be secured to staple cartridge 2300 by being captured between staple cartridge 2300 and a panel 2310 extending proximally from a tip 2308 of staple cartridge assembly 2300. In certain embodiments, layer 2306 can be captured by being compressed between staple cartridge 2330 and panel 2310. In other words, a gap between staple cartridge 2330 and panel 2310 may be less than a thickness of distal portion 2316 of layer 2306 positioned in the gap, such that distal portion 2316 is compressed between staple cartridge 2330 and panel 2310. In certain embodiments, with reference to Figures 82 and 83 , distal portion 2316 of layer 2306 may include one or more apertures 2320. One or more grippers 2318 may extend from panel 2308 and pass through apertures 2320 to capture distal portion 2316 of layer 2306. certain In embodiments, distal portion 2316 of layer 2306 can be secured to staple cartridge 2330 by adhesives, welding and/or heat mounting, for example.

The distal cutting blade 2324, which separates the distal portion 2316 of the layer 2306 from the remainder of the layer 2306, can be disposed in a distal cavity 2332 of the staple cartridge 2330. The distal cavity 2332 and the cutting blade Distal 2324 can be positioned so that distal cutting blade 2324 can cut distal portion 2316 of layer 2306 at a location proximal to a location where distal portion 2316 is secured to staple cartridge 2330. For example, with reference to to Figures 82 and 83, distal cutting blade 2324 can separate distal portion 2316 of layer 2306 at a location proximal to grippers 2318 and apertures 2320 that secure distal portion 2316 to staple cartridge 2330. distal cutting blade 2324 cuts distal portion 2316 of layer 2306, remainder of layer 2306 can be released from staple cartridge.

Distal cutting blade 2324 may include a cam 2322 that can push distal cutting blade 2324 out of distal cavity 2332. Cam 2322 may engage rails and/or channels 2334 in distal cavity 2332, which may constrict the movement of cam 2322 and distal cutting blade 2324 in a particular direction as blade 2324 extends out of distal cavity 2332. Rails and/or channels 2334 are illustrated in Figures 82 and 83 as being perpendicular to staple platform 2302 of staple cartridge 2330. In such an arrangement, when moved from an uninstalled position (shown in figure 82) to an installed position (shown in figure 83), the distal cutter blade 2324 may extend from the cavity. - distal point 2332 in a direction that is perpendicular to staple platform 2302 of staple cartridge 2330. In various embodiments, rails and/or channels 2334 may be disposed at any suitable angle relative to staple platform 2302 of staple cartridge 2330. For example, rails or channels 2334 may be disposed at a 30° angle to staple platform 2302 of staple cartridge 2330 such that distal cutting blade 2324 extends outwardly. of distal cavity 2322 partially in a distal direction that is 30° from perpendicular to staple platform 2302 of staple cartridge 2330.

[00456] To install the distal cutting blade, the cam 2322 can be pushed by a firing member 2326. The firing member 2326 can be disposed in a slot in the staple cartridge 2330, such as the knife slot 2304, for example . Trigger member 2326 may include cam surfaces 2328 and 2329 which may engage cam 2322 to move cam 2322 and distal cutting blade 2324 toward layer 2306. Trigger member 2326 may move distally in with respect to cam 2322 and distal cutting blade 2324 from an unactuated position to an actuated position to install cutting blade 2324 and cutting distal portion 2316 of the layer

2306. Figure 82 illustrates firing member 2326 in an unactuated position where cam surfaces 2328 and 2329 have not engaged cam 2322.

cies 2328 and 2329 of firing member 2326 may be in contact with the cam in an unactuated position, as long as the distal cutting blade 2324 is not pushed out of the distal cavity.

2332. As firing member 2326 moves distally to an actuated position shown in Fig. 83, cam surfaces 2328 of firing member 2326 engage cam 2322 to progressively push cam 2322 and distal cutting blade 2324 pa. - is in an installed position so that the distal cutting blade cuts the distal portion 2316 of the layer 2306.

[00457] As described above, the cam 2322 can engage the rails and/or channels 2334 in the distal cavity 2332. In addition, the rails and/or channels 2334 may be disposed at an angle to the staple platform 2302 of the cartridge. clips 2330. In various embodiments, rails and/or channels 2334 can be disposed at an angle such that cam 2322 and distal cutting blade 2324 move distally as blade 2324 is installed from the distal cavity. In various circumstances, arranging the rails at such an angle can reduce the amount of force required to actuate firing member 2326 by aligning a component of the movement of cam 2322 and blade 2324 along a longitudinal axis along which the firing member 2326 moves. Arranging the rails at such an angle may also reduce the likelihood of retention between cam 2322 and firing member 2326 and/or between cam 2322 and rails and/or channels 2324 in distal cavity 2332.

[00458] In various embodiments, firing member 2326 can be moved distally from an unactuated position to a position actuated by cutting blade 2312 and/or a staple driver 2340. In various embodiments, firing member 2326 can be integral with tissue cutting blade 2312 and/or staple driver 2340 such that firing member 2326 travels through staple cartridge 2330 and along a longitudinal axis of staple cartridge 2330 with tissue cutting blade 2312 and/or staple driver 2340. In various other embodiments, firing member 2326 may be detached from tissue cutting blade 2312 and/or staple driver 2340. , fabric cutting blade 2312 and/or staple driver 2340 can push firing member 2326 through staple cartridge.

2330. Alternatively, in embodiments in which firing member 2326 is separate from tissue cutting blade 2312 and/or clip driver 2340, firing member 2326 may be positioned at a distal end of the staple cartridge 2330 in an unactuated position, as illustrated in figure 82. Cutting blade 2312 and/or staple driver 2340 can travel through staple cartridge 2330 and then push firing member 2326 to the actuated position shown in Fig. 83, as cutter blade 2312 and/or staple driver 2340 strikes the distal end of staple cartridge 2330. In all of these modes, movement of tissue cutting blade 2312 and /or staple driver 2340 in one direction along a longitudinal axis of staple cartridge 2330, may cause distal cutter blade 2324 to position in a different direction than tissue cutter blade and/ or the 2340 staple driver.

[00459] In various embodiments, distal cutting blade 2324 is not positioned to cut distal portion 2316 of layer 2306 until the firing stroke of tissue cutting blade 2312 and/or staple driver 2340 has been completed or is nearing completion complete. In such embodiments, distal portion 2316 of layer 2306 may remain attached to staple cartridge 2330, thereby stabilizing layer 2306 with respect to staple cartridge 2330, until most or all of the staples have been fired by the trigger. clips 2340 and/or until the patient tissue and layer 2306 have been cut by cutting blade 2312. In various other embodiments, distal cutting blade 2324 can be positioned to cut distal portion 2316 of layer 2306. before fabric cutting blade 2312 and/or staple driver 2340 have started their firing stroke. For example, firing member 2326 can be moved from the unactuated position shown in Fig. 82 to the actuated position shown in Fig. 83 by a first actuation of a trigger trigger of a surgical stapler. A subsequent actuation of the firing trigger may move tissue cutting blade 2312 and/or staple driver 2340. As a result, distal portion 2316 of layer 2306 may be separated from staple cartridge 2330 before the cutting blade does. tissue 2312 cuts the patient's tissue and/or before the staples capture layer 2306 and the patient's tissue. As another example, firing member 2326 may be actuated by a first trigger of the surgical instrument and tissue cutting blade and/or staple driver 2340 may be actuated by a second trigger.

[00460] As described above, the tip 2308 of the staple cartridge assembly 2300 may include a panel 2310 that extends proximally from the tip 2308 and which at least partially covers the distal portion 2316 of the layer 2306. Panel 2310 may include an inwardly facing surface 2309 that may face distal portion 2316 of layer 2306. In certain embodiments, inwardly facing surface 2309 of panel 2310 may support distal portion 2316 of layer 2306. 2306 as distal cutting blade 2324 separates distal portion 2316. In various circumstances, when distal cutting blade 2324 is positioned, distal cutting blade 2324 may ultimately make contact with the inwardly facing surface 2309 , thereby completely separating the distal portion 2316 from the casing.

layer 2306 from the remainder of layer 2306.

[00461] Panel 2310 can also protect patient tissue from distal cutting blade 2324. In various circumstances, unaffected patient tissue, which is not cut by tissue cutting blade 2312 and/or stapled by cartridge staples of clips 2330, can pass over an outwardly facing surface 2311 of the panel

2310. In such circumstances, panel 2310 can protect unaffected tissue against distal cutting blade 2324. For example, as illustrated in Figure 83, panel 2310 can be positioned between distal cutting blade 2324 extending away from the distal cavity 2332 and the patient tissue near the outwardly facing surface 2311 of the panel 2310 so that the patient tissue is not exposed to the distal cutting blade 2324.

[00462] Referring now to Figs. 77 to 79, a staple cartridge 20000 may comprise a cartridge body 20010 and a fabric thickness compensator 20020 releasably secured thereto. The staple cartridge 20000 may comprise any suitable arrangement of staples, staple wells and/or staple drivers that are triggered by a slider, or trigger member, passing distally through the staple cartridge 20000 to capture at least a portion. of the 20020 Tissue Thickness Compensator and at least a portion of the patient's tissue within the clamps, as described herein. Such a discussion of staples, staple cavities, and staple drives will not be repeated here, for the sake of brevity to the reader. Now referring primarily to Figs. 77 and 77A, the staple cartridge 20000 may include a slider 20060, which is advanced distally by a trigger member 20050. 20060, slider 20060, for example, can be configured to release tissue thickness compensator 20020 from the cartridge body 20010, as illustrated in Figures 78 and 79. For example, the distal end 20022 of the tissue thickness compensator 20020 can be releasably retained at the distal end of the 20010 cartridge body by a flexible gripper 20013 and a 20072 retainer pin, and the 20060 slider can annul or withdraw the 20072 retainer pin. Flex holder 20013 can be configured to securely hold the Fabric Thickness Compensator 20020 against the 20015 platform of the cartridge body 20010. In such circumstances, the Flex Fastener 20013 may provide sufficient gripping force to the 20020 fabric thickness tab to hold the 20020 fabric thickness tab in place. The 20072 retaining pin can also securely retain the 20020 fabric thickness tab in the body of the cartridge 20010. For example, referring to Figs. 77 and 77A, the distal end 20022 of the tissue thickness compensator 20020 may comprise an aperture 20023 defined therein which may be configured to receive the retaining pin 20072 and, due to the interaction between retaining pin 20072 and the side walls of opening 20023, retaining pin 20072 can prevent fabric thickness compensator 20020 from sliding out between retainer 20013 and cartridge platform 20015. Detent Pin 20072 and Fastener 20013 can cooperatively confine the movement of the Fabric Thickness Compensator 20020 and, in various circumstances, the top of Detent Pin 20072 can f be contiguously or closely adjacent to fastener 20013.

[00463] In use, in addition to the above, retaining pin 20072 can be lowered by slider 20060 as illustrated in figures 78 and 79. More specifically, retaining pin 20072 can extend from a cam 20070, where the cam

20070 can rest or rest on a resilient member, or spring, 20012, which extends from a panel 20011 secured to the cartridge body 20010, and when slider 20060 engages cam 2070, slider 20060 can push cam 20070 and the retaining pin 20072 down, thereby compressing spring 20012. The body of the cartridge 20010 may include guides 20018 defined therein that confine the movement of the cam 20070 along a substantially vertical path, i.e. , a trajectory perpendicular to the platform of the cartridge 20015. In various embodiments, the slider 20060 can include a cam actuator 20062 that extends distally with respect to the elevator surfaces of the staple driver 20063. Since the pin 20072 has been lowered sufficiently, the fabric thickness compensator 20020 may slide relative to the 20015 cartridge platform and escape out of the catch 20013. In various circumstances, the 20072 pin may be lowered a q sufficient quantity, although it still protrudes, at least partially, from the 20015 cartridge platform. In other circumstances, the 20072 pin can be lowered to below the 20015 cartridge platform. In any case, the cam actuator 20062 e the elevator surfaces of the 20063 clamp driver of the 20060 slider can be configured so that the 20072 retaining pin is lowered far enough at the same time that the last clip, or the most distal clip, is triggered by the 20060 slider. In other circumstances, the cam actuator 20062 and the elevator surfaces of the slider 20063 clamp driver 20063 may be configured so that the 20072 retaining pin is lowered sufficiently before the last clamp, or most distal clamp, is triggered by the slider

20060. In other circumstances, cam actuator 20062 and slider 20060 clamp drive 20063 riser surfaces can be configured so that retaining pin 20072 is lowered sufficiently after the last clamp, or most distal clamp, is triggered by slider 20060. Although cam 20070 is described herein as having a detent 20072, a plurality of detent pins 20072 may extend from cam 20070, each of which may be configured to retain, In a releasable manner, the fabric thickness compensator 20020 in the cartridge body 20010. Accordingly, the fabric thickness compensator 20020 can include an appropriate number of apertures 20023, configured to receive the retaining pins 20072.

[00464] Now referring to Figs. 80 and 81, a cartridge 21000, for example, may comprise a cartridge body 21010, a fabric thickness compensator 21020 releasably attached to the cartridge body 21010, and a slider 21060 which can be configured to release tissue thickness compensator 21020 from cartridge body 21010. clamp actuators, and the clamps supported thereon, toward an anvil opposite the fabric thickness compensator 21020. Also similarly to the above, the slider 21060 may additionally comprise a cam actuator 21062 which may be configured to deactivate a fastener 21013 that secures a distal end 21022 of the tissue thickness trim 21020 to the platform surface 2105 of the cartridge body

21010. More specifically, fastener 21013 may include a cam 21072 extending downwardly into cartridge body 21010, cam 21072 may be engaged by cam actuator 21062 as slider 21060 is advanced dis. - namely through the staple cartridge 21000. When the cam actuator 21062 engages the cam 21072, the cam actuator 21062 can raise the cam 21072 and flex the catch 21013 away from the distal end 21022 of the tissue thickness trim 21020, as illustrated in Fig. 81. At such a point, the cartridge body 21010 can be moved in the opposite direction to the fabric thickness compensator 21020. In other words, at the moment when the fabric thickness compensator 21020 is released from the body of cartridge 21010, tissue thickness compensator 21020 will have been implanted into the patient's tissue by one or more staples, with tissue thickness compensator 21020 having been released, the body cartridge 21010 can be moved in the opposite direction to implanted tissue thickness compensator 21020 and removed from the surgical site.

[00465] In addition to the above, the cam actuator 21062 and the lifting surfaces of the clamp driver 21063 of the slider 21060 can be configured so that the cam 20072 is high enough to sufficiently reduce the applied gripping force. by clamp 21013 at the same time that the last clamp, or most distal clamp, is triggered by the slider

20060. In other circumstances, the cam actuator 21062 and the lifting surfaces of the clamp driver 21063 of the slider 21060 can be configured so that the cam 21072 is sufficiently raised to sufficiently reduce the grip force applied by the clamp 21013 before the last clip, or most distal clip, is triggered by slider 21060. In still other circumstances, cam actuator 21062 and the lifting surfaces of clip driver 21063 of slider 21060 can be configured so that the cam 20072 is sufficiently high to sufficiently reduce the gripping force applied by clamp 21013 after the last clamp, or more distal clamp, is triggered by slider 21060. Although clamp 21013 is described herein as having a cam 21072 extending into thereafter a plurality of cams 21072 may extend from clamp 21013, each of which can be configured to raise clamp 21 013 and release the fabric thickness compensator 20020 from the body of the cartridge 20010.

[00466] In addition to the above, a slider, or firing member, which passes through a staple cartridge, can release a tissue thickness compensator from a cartridge body at or near the end, distal movement of the slider and/or at the end of the firing stroke of the firing member. In other words, the tissue thickness compensator can be released from the cartridge body at the same time, or nearly the same time, as all staples are fired by the staple cartridge. In various other embodiments, the tissue thickness compensator may be released from the cartridge body at the same time as, or before, the first staples, or more proximal staples, have been fired by the staple cartridge. An exemplary embodiment of this type is illustrated in Figures 90 to 92 which illustrate a staple cartridge 22000. Similar to the above, staple cartridge 22000 may comprise a cartridge body 22010 and a fabric thickness compensator 22020 attached thereto. in a releasable way. Although the 22000 staple cartridge may additionally include a staple trigger slider, as described above, the slider may not release the 22020 fabric thickness compensator; instead, the 22000 staple cartridge can additionally comprise a 22011 actuator that can be advanced distally by the trigger member at the beginning of its trigger stroke. Several other modalities are described here that provide means for advancing an actuator distally and are not repeated with respect to this modality, for the sake of brevity to the reader.

In either case, the 22011 actuator may include a 22012 cam bracket extending therefrom that can be configured to support a 22070 cam when the 22011 actuator is in its unactuated position, as illustrated in figure 90. moreover, the staple cartridge 22000 may additionally comprise a tensioning member, or spring, 22074, which may be configured to retain or force cam 22070 against cam holder 22012 while again actuator 22011 is in its unactuated position. illustrated in Fig. 90. In such a position of cam 22070, a retaining pin 22072, extending from cam 22070, can be engaged and extends through an opening 22023 defined in a distal end 22022 of the compensator. fabric thickness 22020 so that, similar to the above, the retaining pin 22072 and/or the retaining pin 22072 together with a catch 22013, which extends from the cartridge body 22010, can hold the compensator in position. in 22020 fabric thickness.

[00467] When actuator 22011 is advanced distally by the trigger member, now with reference to figure 91, cam holder 22012 can be advanced distally so that cam holder 22012 can no longer support cam 22070. - under circumstances, spring 22074 can force cam 22070 downward so that retaining pin 22072 is forced out of engagement, or at least partially out of engagement, with fabric thickness compensator 22020. One less circumstance, spring 22074 may force cam 22070 downward so that retaining pin 22072 is positioned below platform 22015 of cartridge 22010. In either case, distal advance of actuator 22011 may release trim tab of fabric thickness 22020 from the cartridge body 22010. In other words, once the retaining pin 22072 has been lowered, the fastener 22013 can still provide a retaining force to the fabric thickness compensator 22020, so that the fabric thickness compensator 22020 has been lowered. fabric thickness tester 22020 remains attached to staple platform 22015; however, fabric thickness compensator 22020 can be slid out from under fastener 22013 by applying sufficient relative force between fabric thickness compensator 22020 and cartridge body 22010. In addition As stated above, release of the Fabric Thickness Compensator 22020 from the 22010 cartridge body may occur before, at the same time and/or immediately after the more proximal staples are fired from the 22000 staple cartridge. In such circumstances, release The early release of the 22020 Tissue Thickness Compensator may allow the 22020 Tissue Thickness Compensator to be released from the 22010 cartridge body even though the 22000 staple cartridge has only been partially fired, for example.

[00468] Now referring to Figures 84 to 87, an end actuator assembly 5000 may include a first jaw, illustrated elsewhere, and a second jaw 5002. In various embodiments, the second jaw 5002 may include a cartridge assembly which includes a fastener cartridge body 5050 and a fabric thickness compensator 5058 releasably secured to the fastener cartridge body 5050. Referring primarily to Fig. 84, the fastener cartridge body 5050 may have a cartridge platform 5052 and fastener cavities 5054 defined on cartridge platform 5052. Additionally, second jaw 5002 may include fasteners, such as surgical clips, for example, which can be removably positioned in fastener cavities 5054. For example, a holder may be ejectably positioned in each holder cavity 5054 of cartridge body 5050. In certain embodiments, cartridge body 5050 may include a slit 5056, which may extending from a proximal portion 5004 of second jaw 5002 to a distal portion 5006 of second jaw 5002. In various embodiments, a firing assembly 5030 may translate along slot 5056 of cartridge body 5050. Firing Assembly 5030 can translate into slot 5056 during a firing stroke and can eject the fasteners from the fastener pockets 5054 during the firing stroke.

[00469] [0376] Referring primarily to Figs. 84, 86 and 87, the firing assembly 5030 may include a firing bar (Fig. 84), a cutting edge 5036, a crossbar 5038 and a foot 5044 (Figs. 86). and 87). Cutting edge 5036 can cut fabric and/or cut fabric thickness compensator 5058, as firing assembly 5030 is fired through second jaw 5002 during a firing stroke. Crossbar 5038 can grip first claw with respect to cartridge body 5050, and foot 5044 can grip firing assembly 5030 with respect to cartridge body 5050, for example. In various embodiments, crossbar 5038 and foot 5044 can hold cutting member 5036 perpendicular to platform 5052 of fastener cartridge 5050, for example. Referring primarily to Figs. 29A and 29B, the firing assembly 5030 can engage a slider 5034 in the cartridge body 5050 during the firing stroke. Firing assembly 5030 may push slider 5034 distally during the firing stroke to eject the fasteners from the fastener cavities 5054, for example.

Referring primarily to Fig. 84, tissue thickness compensator 5058 can be releasably secured to cartridge body 5050 by at least one connector 5080a, 5080b. In certain embodiments, multiple 5080a, 5080b connectors can secure the 5058 Tissue Thickness Compensator to the cartridge body.

5050. For example, a 5080a proximal connector can secure the com-

tissue thickness thinker 5058 to cartridge body 5050 at proximal portion 5004 of second jaw 5002, and a distal connector 5080b can secure tissue thickness compensator 5058 to cartridge body 5050 at distal portion 5006 of second jaw 5002. embodiments, additional connectors may secure tissue thickness offset 5058 to cartridge body 5050. In such embodiments, additional connectors may be spaced along at least a portion of the length of cartridge body 5050 and may be positioned between proximal connector 5080a and distal connector 5080b, for example.

Referring primarily to Fig. 84, connectors 5080a, 5080b can secure tissue thickness compensator 5058 to cartridge body 5050. Fabric thickness compensator 5058 can be released from cartridge body 5050 when connectors 5080a , 508ab is broken, cut, dislodged, or otherwise overcome. In certain embodiments, firing assembly 5030 may bypass connectors 5080a, 5080b as firing assembly 5030 is translated along slot 5056 in fastener cartridge 5050 during a firing stroke. During such a course of firing, firing assembly 5030 can cut tissue trapped between the first claw and second claw 5002, and may also move fasteners from fastener pockets 5054 into the trapped tissue. In various embodiments, firing assembly 5030 can push slider 5034 (Figures 86 and 87) distally during the firing stroke. Slider 5034 may have a cam surface or ramp 5042 that can engage actuators in fastener cavities 5054. When ramp 5042 engages a driver, ramp 5042 may push the actuator toward platform 5052 to eject the fastener cavity fastener 5054. Additionally, firing assembly 5030 can cut tissue thickness compensator 5058 and connectors.

5080a, 5080b during the shooting course.

Referring primarily to Fig. 84, the cutting edge 5036 of the firing assembly 5030 may cut the proximal connector 5080a at or near the beginning of the firing stroke, for example, and may cut the distal connector 5080b at the end or near the end of the shooting course, for example. In certain embodiments, slider 5034 (Figures 86 and 87) can eject the fasteners from fastener pockets 5054 after cutting edge 5036 cuts proximal connector 5080a and before cutting edge 5036 cuts distal connector 5080b. In such embodiments, if firing assembly 5030 does not complete the firing stroke, cutting edge 5036 of firing assembly 5030 may stop before reaching distal connector 5080b and tissue thickness compensator 5058 may remain attached to the body. of cartridge 5050 in distal portion 5006 of second jaw 5002. In certain embodiments, tissue thickness compensator 5058 may remain attached to cartridge body 5050 until the operator cuts or otherwise bypasses distal connector 5080b. For example, the operator can introduce a surgical instrument and/or additional step into the surgical procedure to bypass the 5080b distal connector.

[00473] Still referring to figures 84 to 87, in various modes, the second claw 5002 can surpass the connectors 5080a, 5080b at the beginning or near the beginning of the firing stroke. In other words, an element of the second jaw 5002 can overcome the proximal connector 5080a, the distal connector 5080b, and any additional connectors in between, at or near the beginning of the firing stroke. For example, second jaw 5002 and/or cartridge assembly may include an actuator 5010, which can bypass distal connector 5080b before the fasteners are ejected from the fastener wells. The 5010 actuator can overcome the 5080b distal connector and the 5358 tissue thickness compensator can be released from the cartridge body.

cho 5050 even if the firing stroke ends prematurely, i.e., before firing assembly 5030 reaches distal portion 5006 of second jaw 5002, for example. In various embodiments, actuator 5010 can include a bottom side 5016 (figures 85A through 85C) and sidewalls 5018 (figures 84 and 85D). Sidewalls 5018 may extend from underside 5016 and around at least a portion of cartridge body 5050. Underside 5016 and/or sidewalls 5018 may extend beyond or around the fasteners positioned in fastener cavities 5054. Additionally, actuator 5010 can be movably fastened relative to the cartridge body.

5050. For example, the 5010 actuator can move from a pre-actuated position (figure 85A) to an actuated position (figures 85B and 85D). In certain embodiments, side walls 5018 of actuator 5010 may engage slots in cartridge body 5050 such that actuator 5010 moves in the slots to slide relative to cartridge body 5050. When actuator 5010 moves with respect to cartridge body 5050, actuator 5010 may slide relative to fasteners positioned in fastener cavities 5054 of cartridge body 5050. For example, actuator 5010 may slide past and/or around positioned fasteners in the 5054 fixer cavities.

Referring primarily to Figs. 85A to 85C, actuator 5010 may include a slot 5012 that may extend from proximal portion 5004 toward distal portion 5006 of the second jaw.

5002. Slot 5012 in actuator 5010 can match and/or be aligned with slot 5056 (figure 84) in cartridge 5050 body, for example. Additionally, firing assembly 5030 may translate along and/or within slot 5012 in actuator 5010 as firing assembly 5030 is translated along and/or within slot 5056 in cartridge body 5050 during the firing stroke. In various embodiments, trigger assembly 5030 can engage actuator 5010 to move actuator 5010 distally when trigger assembly 5030 is at or near the beginning of the trigger stroke. In such embodiments, trigger assembly 5030 may actuate actuator 5010 on proximal portion 5004 of second jaw 5002. When actuator 5010 is actuated and moves distally, a distal end of actuator 5010 may otherwise cut or overlap. , the distal connector 5080b, for example. In other words, the proximal actuation of the 5010 actuator can effect the distal release of the tissue thickness compensator 5058 from the 5050 cartridge body. . In at least one modality, the 5010 actuator can travel approximately 1 mm, for example, before overcoming the 5080b distal connector. In certain embodiments, the 5010 actuator can travel approx. 0.5 mm to approx. 5 mm, for example, before overcoming the 5080b distal connector.

[00475] Referring primarily to figures 85A and 85B, the actuator 5010 can move from the pre-actuated position (figure 85A) to the actuated position (figure 85B) when the trigger assembly 5030 moves between a non-triggered position and a partially triggered position during part of the trigger stroke. In various embodiments, actuator 5010 may include a release stop, such as detent tabs 5022, for example. The progression of the trigger element relative to the actuator 5010 can be stopped by the detent tabs 5022. In other words, the detent tabs 5022 can temporarily stop the progression of the trigger assembly 5030 relative to the actuator 5010. For example , although actuator 5010 moves from the pre-actuated position toward the actuated position, detent tabs 5022 may engage slider 5034 and/or trigger assembly 5030 to secure trigger assembly 5030 relative to actuator 5010 , so that the 5010 actuator moves with it.

For example, referring primarily to Figs. 86 and 87, underside 5016 of actuator 5010 may include a detent 5022, and slider 5034 may include a recess or groove 5040. In various embodiments, groove 5040 may receive a tab 5022 when slider 5034 is positioned on the proximal portion 5004 of the second claw

5002. For example, groove 5040 may be aligned with tab 5022 when trigger assembly 5030 moves from an untriggered position to a triggered position and thus when the actuator is pushed from a pre-actuated position. (figure 85A) to an actuated position (figure 85B). In various embodiments, at least one tab 5022 can be positioned on either side of slot 5012 (figures 85A to 85C) on actuator 5010, and each tab 5022 can engage slider 5034.

Referring primarily to Fig. 85A, slider 5034 may engage detent tabs 5022 as trigger assembly 5030 and slider 5034 translate along slot 5056 (figure 84) during the firing stroke . For example, detent tabs 5022 may engage slider 5034 at or near the beginning of the firing stroke. In certain embodiments, detent tabs 5022 may be near proximal end 5010 and slider 4034 can engage detent tabs 5022 upon initiation of the firing stroke. When trigger bar 5032 is moved distally and detent tabs 5022 are engaged with recesses 5040 in slider 5034 (figures 86 and 87), actuator 5010 can be actuated and/or displaced distally. In certain embodiments, referring primarily to Fig. 85B, the actuator 5010 can move distally until it reaches a hard stop 5060, defined in the cartridge body 5050, for example. Hard stop 5060 may be on distal portion 5006 of second jaw 5002 and may prevent further distal movement of actuator 5010, for example. In various embodiments, actuator 5010 may abut hard stop 5060 before firing assembly 5030 ejects fasteners from fastener cavities 5054 of cartridge body 5050 (Fig. 84). In some embodiments, actuator 5010 may abut hard stop 5060 as trigger assembly 5030 ejects at least one fastener from fastener cavity 5054 and/or after trigger assembly 5030 has ejected to the minus one fastener from a fastener cavity 5054.

[00477] Referring primarily to figure 85D, when actuator 5010 is pushed distally by slider 5034 and/or trigger assembly 5030, actuator 5010 may cut or otherwise bypass distal connector 5080b to release the tissue thickness compensator 5058 of cartridge body 5050 in distal portion 5006 of second jaw 5002. In certain embodiments, actuator 5010 may include a notch 5024 for receiving and retaining distal connector 5080b. Notch 5024 may retain distal connector 5080b as actuator 5010 travels distally toward hard stop 5060. In addition, actuator 5010 may include a cutting edge 5020, for example, along notch 5024. In certain embodiments, when actuator 5010 moves toward hard stop 5060, distal connector 5080b can be pushed between hard stop 5060 and cutting edge 5020 of actuator 5010. In various embodiments, cutting edge 5020 can cut distal connector 5080b when cutting edge 5020 is pushed to and/or toward hard stop 5060. In such embodiments, distal connector 5080b may be cut by cutting edge 5020 of actuator 5010 at or near the start of the trigger stroke and before that the fasteners are fired from the fastener cavities 5054 (figure 84). In some embodiments, cutting edge 5020 may cut distal connector 5080b as trigger assembly 5030 ejects at least one fastener from a fastener cavity 5054 and/or after firing assembly 5030 has ejected at least one fastener from a fastener. 5054 fastener cavity. In various embodiments, the 5010 actuator can bypass the 5080b distal connector without cutting it. For example, actuator 5010 may dislodge or stretch distal connector 5080b out of position so that distal connector 5080b no longer retains tissue thickness compensator 5058 with respect to cartridge body 5050.

[00478] In various embodiments, the proximal connector 5080a may be cut by a proximal cutting edge on actuator 5010. Similarly, additional connectors along the length of the cartridge body 5050 may be cut or otherwise bypassed by the actuator. 5010 at the beginning or near the beginning of the shooting stroke. Additionally or alternatively, cutting edge 5036 of firing assembly 5030 may cut or otherwise bypass proximal connector 5080a and/or additional connectors. For example, cutting edge 5036 of firing assembly 5030 may cut proximal connector 5080a, and cutting edge 5020 of actuator 5010 may cut distal connector 5080b before the fasteners are ejected from fastener cavities 5054 of cartridge body 5050 ( figure 84).

[00479] Referring primarily to Fig. 87, slider 5034 and/or trigger assembly 5030 may be configured to bypass detent tabs 5022 of actuator 5010. detent tabs 5022, trigger assembly 5030 and slider 5034 may move relative to actuator 5010. For example, trigger assembly 5030 may push slider 5034 distally to move actuator 5010 distally until further distal movement of the actuator is prevented by hard stop 5060 (figures 85A, 85C and 85D). Still referring to Fig. 87, when actuator 5010 is prevented from further distal movement, trigger assembly 5030 can push slider 5034 with sufficient force to deform, deflect and/or dislodge detent tabs 5022 from recesses. 5040 on slider 5034. For example, tabs 5022 may each comprise a cantilever that can flex downwardly out of engagement with groove 5040 after sufficient longitudinal force has been applied to the slider.

5034. When trigger assembly 5030 pushes slider 5034 out of engagement with detent tabs 5022, trigger assembly 5030 and slider 5034 may move relative to the actuator.

5010. In various embodiments, detent tabs 5022 can be rigid enough to withstand the force of trigger assembly 5030 as actuator 5010 travels distally toward hard stop 5060, and can be flexible enough to deflect when the 5010 actuator reaches the 5060 hard stop without requiring excessive force from a motor and/or operator. In various circumstances, detent tabs 5022 can be configured to allow trigger bar 5032 to pass through cartridge body 5050 after the force applied to detent tabs 5022 has exceeded a predetermined force.

[00480] Now with reference to Figures 29A and 29B, an end actuator assembly 5100 may include a first claw, shown elsewhere, and a second claw 5102. In various embodiments, the second claw 5102 and/or an assembly of fastener cartridge positionable therein, may include a 5110 actuator. The 5110 actuator may slide or displace relative to a fastener cartridge body, such as the fastener cartridge body 5050 (figure 84), for example, of the fastener cartridge assembly. Additionally, in certain embodiments, actuator 5110 may include a base wall 5116 and side walls 5118, which may be positioned at least partially around cartridge body 5050. Base wall 5116 and/or walls sides 5118 may extend beyond or around fasteners positioned in fastener cavities 5054 (figure 84)

when the actuator is secured relative to the cartridge body 5050. In various embodiments, the actuator 5110 may include a slot 5112 extending along at least a portion of the base wall.

5116. Additionally, the side walls 5118 may include lips 5122 and/or lips 5124 that can slidably engage cartridge body 5050. For example, lips 5122 may extend around the cartridge body. 5050 and into slots in platform 5052 (Fig. 84) of cartridge body 5050. Additionally, lips 5124 may extend into slots along the side of cartridge body 5050, for example. In various embodiments, the beads 5122, 5124 can slide into the slots as the actuator 5110 moves relative to the cartridge body 5050. In such embodiments, the beads can constrict and/or define the relative movement between the actuator 5110 and the 5050 cartridge body, for example. When actuator 5110 moves relative to cartridge body 5050, actuator 5110 may slide relative to fasteners positioned in fastener cavities 5054 of cartridge body 5050. For example, actuator 5110 may slide past or around the fasteners. fasteners in fastener cavities 5054.

[00481] Still referring to figures 29A and 29B, the actuator 5110 may include a release stop, such as the detent 5114, for example, on the proximal portion 5104 of the second jaw 5102, for example. Referring primarily to Fig. 29A, detent 5114 may include a detent arm 5120 which can operatively secure a slider 5134 of the cartridge body 5050 (Fig. 84). For example, slider 5134 may include a groove 5144 and detent arm 5120 may engage groove 5144 to retain slider 5134 relative to actuator 5110. In various embodiments, detent 5114 may have multiple detent arms 5120, which may be retained in grooves 5144 on slide 5134. Detent arms 5120 po-

They may extend from opposite sides of actuator 5110, for example, and slider 5134 may be positioned intermediate to detent arms 5120, for example. In certain embodiments, trigger assembly 5030 can force against slider 5134 and can displace actuator 5110 distally, while detent arms 5120 are held in grooves 5144 of slider 5134 (Fig. 29A). The 5120 detent arms can be rigid enough to retain the 5134 slider relative to the 5110 actuator as the 5110 actuator is pushed distally by the 5030 trigger assembly. hard, such as the 5060 hard stop (figures 84 to 85B and 85D), for example, which can prevent further distal movement of the 5110 actuator.

Referring primarily to figure 29B, when actuator 5010 is adjacent to hard stop 5060 (figures 84 to 85B and 85D), trigger assembly 5030 can push slider 5134 through detent 5114. In other words, firing assembly 5030 may force slider 5134 to overcome detent arms 5120. In such embodiments, detent arms 5120 may be flexible enough to flex out of engagement with slider grooves 5144 and allow passage of trigger assembly 5030 between detent arms 5120 and along slot 5112 in actuator 5110. Similar to actuator 5010, actuator 5110 may include an edge that may cut or otherwise overcome a distal connector, similar to distal connector 5080b (figure 84 and 85D), for example, when actuator 5110 is displaced distally by trigger assembly 5030. Thereafter, trigger assembly 5030 and slider 5134 can be moved along the slot 5112 and can eject the fasteners from the fastener cavities 5054 in the cartridge body, for example. In various embodiments, the 5110 actuator can bypass the distal connector and/or additional connector(s) before a fastener is fired from the 5050 fastener cartridge. /or additional connector(s), as a fastener is fired from a fastener cavity and/or after at least one fastener has been fired from a fastener cavity.

[00483] Now with reference to Figs. 87A and 87B, an end actuator assembly 5200 may include a first claw, shown elsewhere, and a second claw 5052. In various embodiments, the second claw 5202 and/or a set of Fasteners cartridge may include an actuator 5210 that is slidable relative to a fasteners cartridge body, such as fasteners cartridge body 5050 (FIG. 84), for example. Additionally, in certain embodiments, actuator 5210 may include a bottom wall 5216 and side walls. The side walls can be positioned at least partially around the cartridge body 5050, for example. Actuator 5210 may include a slot 5212 extending along at least a portion of bottom wall 5216. Additionally, actuator 5210 may be movably secured relative to cartridge body 5050. moves relative to cartridge body 5050, actuator 5210 may move relative to fasteners positioned in fastener cavities 5054 of cartridge body 5050. For example, actuator 5210 can slide past or around fasteners positioned in fixer cavities 5054.

[00484] In various embodiments, the firing assembly 5030 may translate along and/or within the slot 5212 during a firing stroke. Similar to actuators 5010, 5110, actuator 5210 can include a release stop 5214. In various embodiments, release stop 5214 can include a frangible portion 5220 which can be a bridge that spans slot 5212, for example. Referring primarily to Fig. 87A, trigger assembly 5030 may abut release stop 5214 to push actuator 5210 distally. Thereafter, the 5210 actuator can be adjacent to a hard stop, such as the 5060 hard stop (figures 84 to 85B and 85D), which can prevent further distal movement of the actuator.

5210. Referring primarily to Fig. 87B, upon reaching hard stop 5060, firing assembly 5030 may break frangible portion 5220 of release stop 5214 to continue to move distally along slot 5212 during the course of shooting. The frangible portion 5220 may be rigid enough to withstand the force of the 5030 firing assembly as the 5210 actuator travels distally toward the 5060 hard stop (figure 85D) and may be frangible enough to rupture when the 5210 actuator reaches 5060 hard stop without requiring excessive force from a motor and/or operator. In various embodiments, the 5210 actuator can bypass the 5080b distal connector and/or additional connector(s) before a fastener is fired from the 5050 fastener cartridge. In certain embodiments, the 5210 actuator can outrun the distal connector and/or additional connector(s), as a fastener is fired from a fastener cavity and/or after at least one fastener has been fired from a fastener cavity.

[00485] Now referring to Figures 88 and 89, an end actuator assembly 5300 may include a first jaw, illustrated elsewhere, and a second jaw 5302. In various embodiments, the second jaw 5302 may include a cartridge body 5350 and a tissue thickness compensator 5358 releasably secured to cartridge body 5350. Similar to second claw 5302, second claw 5302 may include fasteners such as surgical clips, for example, which can be positioned in a manner. removable in 5350 fastener pockets. For example, a fastener can be ejectedly positioned in each fastener cavity. In certain modalities

For example, the cartridge body 5350 may include a slit 5356 (Fig. 88), which may extend from a proximal portion 5304 toward a distal portion 5306 of the second jaw 5302. In various embodiments, a firing assembly 5030 may will translate along slot 5356 of cartridge body 5350. Firing assembly 5030 may translate along slot of cartridge of fasteners 5350 during a firing stroke and may eject fasteners from fastener cavities during firing stroke, for example . Firing assembly 5030 may engage slider 5334 (Fig. 89) on cartridge body 5350 during the firing stroke, for example, and may push slider 5334 distally during the firing stroke, for example. Furthermore, during the firing stroke, the firing assembly 5030 and/or an actuator 5310 may release the tissue thickness compensator 5358 from the cartridge body 5350.

[00486] Still referring to Figures 88 and 89, the tissue thickness compensator 5358 may include a body 5360, a proximal socket 5362, extending from the body 5360, and a distal socket 5364, extending from of body 5360. Referring primarily to Fig. 89, a pin 5366 may extend through proximal socket 5362 into an opening 5356a in cartridge body 5350 so that pin 5366 retains. releasable, tissue thickness compensator 5358 relative to cartridge body 5350 in the proximal portion of second jaw 5302, for example. Pin 5366 can be friction fit and/or press fit into opening 5356a, for example. In certain embodiments, pin 5366 can be held in opening 5456a using one or more stickers, for example. In some embodiments, at least a portion of the cartridge body 5350 and/or pin 5366 can be soldered, for example. In various embodiments, fabric thickness compensator 5358 can include multiple proximal grooves 5362, which can

must be releasably secured to the body of the 5350 cartridge on one side or the other or both sides of the slot 5356 (figure 88) in the body of the 5350 cartridge. In certain embodiments, the distal fitting 5364 can be secured to the cartridge body 5350 in distal portion 5306 of second jaw 5302, for example. Distal fitting 5364 may be secured to cartridge body 5350 at least by means of an adhesive between distal fitting 5364 and cartridge body 5350, for example. Additionally or alternatively, distal fitting 5364 may be secured to cartridge body 5350 by at least one pin and/or fastener, for example.

[00487] Referring primarily to Fig. 89, the actuator 5310 may make a loop around the distal fitting 5364 and may extend to the slider 5334 on the second jaw 5302. In various embodiments, the actuator 5310 may comprise a cable or wire, which may extend through the cartridge body 5350 and/or through a channel 5346 defined in the second claw 5302 and/or the slider 5334, for example. In various embodiments, distal movement of slider 5334 can cause actuator 5310 to break through distal socket 5364 of tissue thickness compensator 5358. For example, actuator 5310 can have a first end 5316 secured to slider 5334. a second end 5318 secured within the cartridge body 5350 and a loop 5320 between the first end 5316 and the second end 5318. The loop 5320 may loop around the distal fitting 5364, for example. In various embodiments, loop 5320 may surround distal fitting 5364 between portion of distal fitting 5364, which is secured to cartridge body 5350, and body 5360 of tissue thickness compensator 5358. end 5318 can be fixedly secured to cartridge body 5350 such that when first end 5316 moves, loop 5320 tightens around distal fitting 5364.

In other embodiments, the second claw 5302 and/or cartridge body 5350 may include buttons, pins and/or pulleys, such as a first button 5312 and a second button 5314, for example. The 5310 actuator can involve the first button 5312 and the second button 5314, for example. The position of knobs 5312, 5314 and the orientation of actuator 5310 around knobs 5312, 5314 may cause loop 5320 of actuator 5310 to tighten around distal fitting 5364 when slider 5334 and trigger assembly 5330 move distally during a firing stroke. Additionally, as loop 5320 tightens around distal socket 5364, loop 5320 may break distal socket 5364 to release body 5360 of tissue thickness compensator 5358 from cartridge body 5350 in distal portion 5306 of second claw 5302. Thus, in view of the above, the distal fitting 5364 can be disengaged during the start of the firing stroke.

[00488] In various embodiments, when the distal fitting 5384 of the tissue thickness compensator 5358 is released from the cartridge body 5350, the pin 5366 which secures the proximal fitting 5362 of the tissue thickness compensator 5358 to the body of the cartridge. cartridge 5350, can be released from opening 5356 in the cartridge body. For example, at or near the beginning of a stroke, pin 5366 can be released from opening 5356. Pin 5366 can be sheared and/or cut by cutting edge 5036 of firing assembly 5030, for example. , and/or can be pushed and/or actuated out of opening 5356 by an element of firing assembly 5030. In such embodiments, tissue thickness compensator 5358 can be released from cartridge body 5350 at the beginning or near the start of the trigger stroke when both the proximal fitting 5362 and the distal fitting 5364 are released from the cartridge body 5350. In other words, the actuator 5310 can release the tissue thickness compensator

5358 of cartridge body 5350 before firing assembly 5030 and/or slider 5334 ejects the fasteners from fastener cavities in cartridge body 5350. In some embodiments, firing assembly 5030 and/or slider 5334 may eject upon minus one fastener from a fastener cavity and/or while the actuator 5310 releases the tissue thickness compensator 5358 from the cartridge body

5350.

[00489] A cartridge fastener assembly may comprise a cartridge body comprising a plurality of fastener cavities and a slit. The fastener cartridge assembly may further comprise a plurality of fasteners, each fastener being removably positioned in a fastener cavity. The cartridge assembly of fasteners may further comprise a trigger member configured to move along the slit, a tissue thickness compensator releasably secured to the cartridge body, and a socket, the socket engaging the tissue thickness compensator to the cartridge body, and the insert is positioned distally to a fastener of the plurality of fasteners. The fastener cartridge assembly may additionally comprise a cable between the firing element and the socket, the cable being configured to break the socket when the firing element moves distally along the slot. The fabric thickness compensator can be released from the cartridge body when the handle breaks the snap. The cable may break the socket before removing the fasteners from the fastener pockets. The fastener cartridge assembly may additionally comprise a channel, the cable extending through the channel.

[00490] Now referring to Figs. 93A to 93D, an end actuator assembly 5600 may include a first jaw, shown elsewhere, and a second jaw 5602. In various embodiments, the second jaw 5602 can include a cartridge body of fasteners 5650 and a fabric thickness compensator 5658 releasably attached to the second jaw 5602 and/or the fastener cartridge body 5650. In certain embodiments, the fastener cartridge body 5650 and the thickness compensator of fabric 5658 releasably secured thereto, may comprise a fastener cartridge assembly.

Referring primarily to Fig. 93A, cartridge body 5650 may have cartridge platform 5652 and fastener cavities 5654 defined in cartridge platform 5652. e.g., which can be removably positioned in fastener cavities 5654. For example, a single fastener can be ejectably positioned in each fastener cavity 5654 of cartridge body 5650. Still referring primarily to Fig. 93A , cartridge body 5650 may include a ridge 5648 extending from cartridge platform 5652. Crest 5648 may extend around at least a portion of a fastener cavity 5654, for example.

In various embodiments, when a fastener is positioned in a fastener cavity 5654, the fastener tip may protrude from the fastener cavity 5654. In such embodiments, the ridge 5648 is positioned at least partially around the fastener cavity 5654, can support and/or guide the fastener tip when the fastener is ejected from the fastener cavity 5654. In certain embodiments, still referring to Fig. 93A, the cartridge body 5650 may include an extendable slot 5656. from a proximal portion 5604 of the second jaw 5602 to a distal portion 5606 of the second jaw 5602. In various embodiments, a trigger assembly 5630 can translate along slot 5656 of the cartridge body 5650. For example, firing assembly 5630 can translate within slot 5656 during a firing stroke and can eject fasteners from fastener cavities 5654 during the firing stroke.

Still referring to Figs. 93A to 93D, the firing assembly 5630 may include a firing bar 5632, a cutting edge 5636, a crossbar 5638 and a foot 5644. The cutting edge 5636 can cut fabric and/or or cut the fabric thickness compensator 5658, as the firing assembly 5630 is fired through the second jaw 5602 during a firing stroke. Crossbar 5638 can engage a slit in the anvil of the first claw to secure firing assembly 5630 relative to the first claw, and foot 5644 can engage a slit in second claw 5602 such that slit 5656 in the body of the cartridge 5650, for example, secure the first claw relative to the body of cartridge 5650. In various embodiments, crossbar 5638 and/or foot 5644 can hold cutting edge 5636 of firing assembly 5630 in a perpendicular position. to platform 5652 of fastener cartridge 5650, for example. Referring primarily to Figs. 93A and 93D, the firing assembly 5630 can engage a slider 5634 in the cartridge body 5650 during the firing stroke. Firing assembly 5630 may push slider 5634 distally during the firing stroke to eject the fasteners from the fastener cavities 5654, for example. In various embodiments, slider 5634 can have a cam surface or ramp 5642 that can engage drivers and/or fasteners in fastener cavities 5654, for example. When ramp 5642 engages a trigger, ramp 5642 can push the trigger toward platform 5652 to eject the corresponding fastener from the fastener cavity 5654. Additionally, in various embodiments, the trigger assembly 5630 can cut the thickness compensator of fabric 5658 during the shooting course.

Referring primarily to Figs. 93A and 93B, tissue thickness compensator 5658 may include a cartridge contacting surface 5662 (Fig. 93A) and a tissue contacting surface 5664 (Fig. 93B). The cartridge contact surface 5662 can be positioned against the cartridge platform 5652 when the tissue thickness compensator 5658 is secured to the cartridge body 5650 (Fig. 93B), for example.

Additionally, the tissue contact surface 5664 can be positioned against the tissue when the tissue is trapped between the first jaw and the second jaw 5602, for example.

Referring primarily to Fig. 93A, fabric thickness compensator 5658 may include a recess 5660. In various embodiments, the recess 5660 may be a rectangular or triangular tab, for example, which may extend from the trim. of fabric thickness 5658. Additionally, insert 5660 may be a cutaway portion of fabric thickness compensator 5658 so that a space 5666 is left in fabric thickness compensator 5658 that corresponds to the shape of insert 5660. socket 5660 can be aligned with slot 5656 of cartridge body 5650 when tissue thickness compensator 5658 is positioned relative to cartridge body 5650, for example.

Additionally, socket 5660 may extend into slot 5656 when cartridge contact surface 5662 of tissue thickness compensator 5658 is in position adjacent to platform 5652 of cartridge body 5650. In various embodiments, the fitting 5660 may be frictionally fit with the slot 5656 when the fabric thickness compensator 5658 is secured to the cartridge body 5650. The fitting 5660 may secure at least a portion of the fabric thickness compensator 5658 relative to the cartridge body 5650 For example, when the socket 5660 is frictionally engaged with the slot 5656, the cartridge contact surface 5662 can be positioned against the platform 5652 of the cartridge body 5650.

[00493] In various embodiments, tissue thickness compensator 5658 may include a plurality of grooves 5660 that can be aligned with slot 5656 of cartridge body 5650. For example, at least one groove 5660 may be positioned in proximal portion 5604 of the second jaw 5602, and at least one socket 5660 may be positioned on the distal portion 5606 of the second jaw 5602. In various embodiments, the sockets 5660 may be spaced apart along at least a portion of the length of the tissue thickness compensator 5658. For example, slot 5656 may be a longitudinal slot extending from proximal portion 5604 to distal portion 5606 of second jaw 5602. Slots 5660 may friction fit into longitudinal slot 5656, for example, and may secure the compensator fabric thickness 5658 to cartridge body 5650.

Referring primarily to Figs. 93A to 93D, slider 5634 may include a pawl 5640 which may protrude from slider 5634 toward the distal portion 5606 of jaw 5602. When firing assembly 5630 push slider 5634 during firing stroke, pawl 5640 can move along slot 5656 in body of cartridge 5650. Referring mainly to figure 93D, pawl 5640 can move along slot 5656 in body of cartridge 5650. slot 5656 adjacent to the cartridge contact surface 5664 of the fabric thickness compensator 5658. Additionally, tab 5640 may move against slots 5660 which are positioned in slot 5656. In various embodiments slots 5660 may be deflectable. When pawl 5640 forces against inserts 5660, pawl 5640 may deflect inserts 5660 into alignment, or at least substantial alignment, with the body of fabric thickness compensator 5658. For example, when pawl 5640 moves in the 5650 cartridge body, the 5660 notches can be deflected.

sequentially in corresponding spaces 5666 defined in tissue thickness trim 5658. When the notches 5660 are deflected out of slot 5656, tissue thickness trim 5658 may be released and/or released from the cartridge body 5650. In various embodiments , another element of slider 5634 and/or firing assembly 5630 may deflect recesses 5660 out of slot 5656 to release and/or release fabric thickness compensator 5658 from cartridge body 5650.

[00495] Now with reference to Fig. 94, a 5700 end actuator assembly, similar to the 5600 end actuator assembly may include a first jaw, shown elsewhere, and a second jaw 5702. In various embodiments, the second jaw 5702 may include a fasteners cartridge body 5750 and a fabric thickness compensator 5758 releasably secured to the fasteners cartridge body 5750 and/or the second jaw 5702. In certain embodiments, the fasteners cartridge body 5702. fasteners 5750 and fabric thickness compensator 5758 releasably secured thereto may comprise a fastener cartridge assembly, for example. Similar to cartridge body 5650, cartridge body 5750 may have cartridge platform 5752, fastener cavities 5754 defined in cartridge platform 5752, and to retain the fasteners, ridges 5748 at least partially around the fastener cavities. tors 5754 and/or a slit 5756 extending from a proximal portion 5704 of the second jaw 5702 toward a distal portion 5706 of the second jaw 5702. In various embodiments, the body of the cartridge 5750 may include a bridge 5780 which runs or extends through slit 5756. Bridge 5780 can be a frangible and/or splittable bridge, for example. In certain embodiments, the 5780 tip can be a thin, tearable portion and can be an absorbable material in solid form, such as PGA, PCL, PGA/PCL, PLA/PCL and/or TMC, for example. Bridge 5780 may have an opening 5782 that may extend, at least partially, through bridge 5780.

[00496] Still referring to Fig. 94, in various embodiments, firing assembly 5630 may translate along slot 5756 of cartridge body 5750. For example, firing assembly 5630 may translate along slot 5756 during a firing stroke and can eject the fasteners from the 5754 fastener cavities during the firing stroke. Firing assembly 5630 may include firing bar 5632, cutting edge 5636, crossbar 5638 and foot.

5644. Cutting edge 5636 can cut fabric and/or cut fabric thickness compensator 5758, as firing assembly 5630 is fired through second jaw 5702 during a firing stroke. Crossbar 5638 can engage a slit in the anvil of the first claw to secure the first claw relative to the body of the cartridge 5750, and the foot 5644 can engage a slit in the second claw 5702 so that the slit 5756 in the body of the cartridge 5750 , for example, secure firing assembly 5630 relative to second jaw 5702. In various embodiments, crossbar 5638 and/or foot 5644 can hold cutting member 5636 in position perpendicular to platform 5752 of the fastener cartridge. 5750, for example.

Referring primarily to Fig. 94, the fabric thickness compensator 5758 may include a cartridge contact surface 5762 and a fabric contact surface. Cartridge contact surface 5762 may be positioned against cartridge platform 5752 when tissue thickness compensator 5758 is secured to cartridge body 5750 and/or second jaw 5702, for example. Additionally, the fabric contact surface can be positioned against the fabric when the fabric is trapped between the first claw and the second claw 5702, for example. In various embodiments, the 5758 Fabric Thickness Compensator may include a recess 5760. The recess 5760 may be a protrusion, a pin, a flap and/or column, for example, which may extend from the contact surface. of cartridge 5762 of the fabric thickness compensator 5758. The insert 5760 may be aligned, or at least substantially aligned, with the opening 5782 of the bridge 5780 when the fabric thickness compensator 5758 is positioned relative to the 5750 cartridge body, for example. Additionally, socket 5760 may extend at least partially into opening 5782 when cartridge contact surface 5762 of tissue thickness compensator 5758 is in position adjacent platform 5752 of cartridge body 5750. In various embodiments, fitting 5760 can be friction fit with opening 5782 when tissue thickness compensator 5758 is secured to cartridge body 5750. Fitting 5760 can secure and/or hold tissue thickness compensator 5758 in position with respect to cartridge body 5750 and/or second jaw 5702. For example, when socket 5760 is frictionally engaged in opening 5782 of bridge 5780, cartridge contact surface 5762 can be positioned against platform 5752 of the 5750 cartridge body.

[00498] In various embodiments, the fastener cartridge 5750 may include a plurality of bridges 5780 extending through slot 5756 of the cartridge body 5750. The bridges 5780 may be spaced along at least a portion of the length of slot 5756, for example. For example, slit 5756 may be a longitudinal slit extending from proximal portion 5704 to distal portion 5706 of second jaw 5702. Additionally, in various embodiments, tissue thickness compensator 5758 may include a plurality of recesses 5760 which can be aligned with the bridges 5780 of the body of the cartridge 5750. For example, at least one socket 5760 can be positioned in the proximal portion 5704 of the second jaw 5702 and at least one socket 5760 can be positioned in the distal portion 5706 of the second jaw 5702 when the fabric thickness tab 5758 is positioned relative to the cartridge body 5750. In various embodiments, the recesses 5760 may be spaced along at least a portion of the length of the fabric thickness tab 5758. sockets 5760 may be friction fit into slot 5756, for example, and may secure tissue thickness compensator 5758 to cartridge body 5750 and/or second jaw 5702.

[00499] Still referring to Figure 94, the cutting edge 5636 of the firing assembly 5630 can cut the fabric thickness compensator 5758 and/or the fabric trapped between the first claw and the second claw 5702 of the end actuator assembly 5700, when firing assembly 5630 moves along slot 5756 during a firing stroke. Additionally, firing assembly 5630 may separate bridge 5780 when firing assembly 5630 moves through slot 5756. For example, cutting edge 5636 of firing assembly 5630 may break and/or cut bridge 5780 when the firing assembly moves through slot 5756. In various embodiments, cutting edge 5636 can successively cut each bridge 5780 as firing assembly 5630 moves in slot 5756 during the firing stroke. When bridges 5780 are cut or broken by cutting edge 5636, fabric thickness compensator 5758 may be released and/or released from the body of cartridge 5750. In certain embodiments, cutting edge 5636 may break or cut grooves 5760 in line with the same during a shooting course. In various embodiments, another element of the slider and/or firing assembly 5630 can break or cut the bridges 5780 to release the tissue thickness compensator 5758 from the cartridge body.

5750.

[00500] Now with reference to figures 95 and 96, a 5800 end actuator assembly, similar to the 5600 end actuator assembly, may include a first grip, shown elsewhere, and a second grip 5802. embodiments, second gripper 5802 may include a fastener cartridge body 5850 and a fabric thickness compensator 5858 releasably secured to the fastener cartridge body 5850 and/or second gripper 5802. In certain embodiments, the body of fastener cartridge 5850 and fabric thickness compensator 5858 releasably secured thereto may comprise a fastener cartridge assembly. Similar to cartridge body 5650, cartridge body 5850 may have a cartridge platform 5852, fastener cavities 5854 defined in cartridge platform 5852 and configured to receive the fasteners, a ridge 5848 positioned around at least a portion of a fastener cavity 5854, and a slit 5856, which may extend from a proximal portion 5804 of the second jaw 5802 toward a distal portion 5806 of the second jaw.

5802. In various embodiments, cartridge body 5850 can include a bridge 5880 that runs or extends at least partially through slit 5856. Bridge 5880 can be a frangible and/or divisible bridge, for example. In certain embodiments, bridge 5880 may include a first leg 5884 and a second leg 5886. Referring primarily to Fig. 96, first leg 5884 may extend from a first side of the cartridge body 5850. into slot 5856, for example, and second leg 5886 may extend from a second side of cartridge body 5850 into slot 5856, for example. First leg 5884 and second leg 5886 may be oriented angularly with respect to the axis of slot 5856 and first leg 5884 may be angularly oriented at approximately 90 degrees relative to second leg 5886, for example. In certain modalities, first leg 5884 and/or second leg 5886 may be deflectable. In various embodiments, bridge 5880 may include a span between first leg 5884 and second leg 5886, for example.

Referring further to Figs. 95 and 96, in various embodiments, firing assembly 5630 may translate along slot 5856 of cartridge body 5850. For example, firing assembly 5630 may translate along slot 5856 of cartridge body 5850. slit 5856 during a firing stroke and can eject the fasteners from the 5854 fastener cavities during the firing stroke. Firing assembly 5630 may include firing bar 5632, cutting edge 5636, crossbar 5638 and foot.

5644. Cutting edge 5636 can cut fabric and/or cut fabric thickness compensator 5858, as firing assembly 5630 is fired through second jaw 5802 during a firing stroke. Crossbar 5638 can engage a slit in the anvil of the first claw to secure the first claw relative to the body of the cartridge 5850, and the foot 5644 can engage a slit in the second claw 5802 such that the slit 5856 in the body of the cartridge 5850 , for example, secure firing assembly 5630 relative to second jaw 5802. In various embodiments, crossbar 5638 and/or foot 5644 can hold cutting member 5636 in position perpendicular to platform 5852 of the fastener cartridge. 5850, for example.

[00502] Still referring to Figs. 95 and 96, the fabric thickness compensator 5858 may include a cartridge contact surface 5862 and a fabric contact surface. Cartridge contact surface 5862 may be positioned against cartridge platform 5852 when tissue thickness compensator 5858 is secured to cartridge body 5850 and/or second jaw 5802, for example. Additionally, the fabric contact surface can be positioned against the fabric when the fabric is trapped between the first claw and the second claw 5802, for example. In various embodiments, fabric thickness compensator 5858 can include a socket 5860. Similar to socket 5760, socket 5860 can be a bulge, pin, tab, and/or column, for example, which can be extend from the 5862 cartridge contact surface of the 5858 fabric thickness compensator. The fitting 5860 may be aligned with the span 5884, 5886 of the 5880 bridge when the 5858 fabric thickness compensator is positioned in relation to the 5850 cartridge body, for example. Additionally, socket 5860 may be held by legs 5884, 5886 of bridge 5880 when cartridge contact surface 5862 of fabric thickness compensator 5858 is in position adjacent to platform 5852 of cartridge body 5850. embodiments, the fitting 5860 may be friction fit in the gap between the legs 5884, 5886 when the fabric thickness compensator 5858 is secured to the cartridge body 5850. of fabric thickness 5858 relative to cartridge body 5850. For example, when fitting 5860 is friction fit between legs 5884, 5886 of bridge 5880, cartridge contact surface 5862 can be positioned against the platform 5852 of the cartridge body

5850.

[00503] In various embodiments, referring primarily to Fig. 95, the fasteners cartridge 5850 may include a plurality of bridges 5880 extending through slot 5856 of the cartridge body 5850. The bridges 5880 may be spaced along. at least a portion of the length of slit 5856, for example. For example, slit 5856 may be a longitudinal slit extending from proximal portion 5804 to distal portion 5806 of second jaw 5802. Additionally, in various embodiments, tissue thickness compensator 5858 may include a plurality of recesses 5860 that can be aligned with the bridges 5880 of the cartridge body 5850. For example, at least one socket 5860 can be positioned in the proximal portion 5804 of the second jaw 5802 and at least one socket 5860 can be positioned in the distal portion 5806 of the second jaw 5802 when tissue thickness compensator 5858 is positioned relative to cartridge body 5850 and/or second jaw

5802. In various embodiments, inserts 5860 can be spaced along at least a portion of the length of fabric thickness compensator 5858. and can secure the fabric thickness compensator 5858 to the cartridge body

5850.

[00504] Still referring to Figures 95 and 96, the cutting edge 5636 of the firing assembly 5630 can cut the fabric thickness compensator 5858 and/or the fabric trapped between the first claw and the second claw 5802 of the actuator assembly end 5800 when firing assembly 5630 moves along slot 5856 during one firing stroke. Additionally, firing assembly 5630 may separate bridge 5880 when firing assembly 5630 moves through slot 5856. For example, cutting edge 5636 of firing assembly 5630 may deflect and/or separate legs 5884, 5886 of bridge 5880 when firing assembly 5630 moves through slot 5856. In various embodiments, cutting edge 5636 can successively deflect legs 5884, 5886 of each bridge 5880 to separate each bridge 5880 as firing assembly 5630 moves at slit 5856 during the shooting course. When the legs 5884, 5886 of a bridge 5880 are deflected by the cutting edge 5636, the bridge 5880 can release the mating insert 5860 from the fabric thickness tab 5858.

fabric thickness 5858 may not be secured to and/or released from the 5850 cartridge body when each 5860 socket is released from each 5880 bridge along the length of the 5850 cartridge body. In certain embodiments, the 5636 cutting edge may cut or break the 5860 sockets aligned with it during a shooting stroke. In various embodiments, another element of slider and/or firing assembly 5630 can separate bridges 5880 to release tissue thickness compensator 5858 from cartridge body 5850.

[00505] Now referring to figures 97 through 100, a 5900 end actuator assembly, similar to the 5600 end actuator assembly may include a 5910 first jaw or anvil (figures 99 and 100) and a second jaw 5902. In various embodiments, second jaw 5902 may include a fastener cartridge body 5950 and a fabric thickness compensator 5958 releasably secured to fastener cartridge body 5950 and/or second jaw 5902. In certain embodiments, fastener cartridge body 5950 and fabric thickness compensator 5958 releasably secured thereto may comprise a fastener cartridge assembly, for example. Now, referring to Fig. 98, the body of the fasteners cartridge 5950 may have a 5952 cartridge platform and wells defined in the 5962 cartridge platform. 5952 cartridge platform, for example. In various embodiments, the socket recesses 5948 and the fastener recesses 5954 may have the same structure and/or geometry. Second claw 5902 may include fasteners, such as surgical clips, however, which may be removably positioned in fastener cavities 5954. In certain embodiments, cartridge body 5950 may include a slit 5956, which may extend from a proximal portion. 5904 of the second claw 5902 toward a distal portion 5906 of the second claw 5902.

[00506] Still referring to Figs. 97 to 100, in various embodiments, firing assembly 5630 can be translated along slot 5956 of cartridge body 5950 during a course of cavities and may eject from fastener cavities 5954 during the shooting course. Cutting edge 5636 can cut fabric and/or cut fabric thickness compensator 5958, as firing assembly 5630 is fired through end actuator assembly 5900 during the firing stroke. Crossbar 5638 can engage a slit 5912 in anvil 5910 (FIGS. 99 and 100) to secure the first claw relative to the cartridge body 5950, and foot 5644 can engage a slit in the second claw 5902 so that the slit 5856 on cartridge body 5950, for example, secure firing assembly 5630 relative to second jaw 5902. In various embodiments, crossbar 5638 and/or foot 5644 can hold cutting edge 5636 in position perpendicular to platform 5952 of the 5950 fastener cartridge, for example.

[00507] Still referring to Figures 97 to 100, the fabric thickness compensator 5958 may include a cartridge contact surface 5962 (figure 97) and a fabric contact surface 5964 (figures 98 and 99). Cartridge contact surface 5962 may be positioned against cartridge platform 5952 when tissue thickness compensator 5958 is secured to cartridge body 5950 and/or second jaw 5902, for example. Additionally, the fabric contact surface 5964 can be positioned against the fabric when the fabric is trapped between the anvil 5910 and the second jaw 5902, for example. In various embodiments, fabric thickness compensator 5958 may include a socket 5960. Similar to socket 5760 and/or socket 5860, for example socket 5960 can be a bulge, pin, tab and/ or column, for example, that may extend from cartridge contact surface 5962 of tissue thickness compensator 5958. In certain embodiments, tissue thickness compensator 5958 may include a recess 5970 that may be adjacent the fitting 5960, for example. Recess 5970 may be vertically aligned with socket 5970, for example. Referring primarily to Fig. 99, recess 5970 may be defined in fabric contact surface 5964 of fabric thickness compensator 5958 and may extend toward housing 5960. In various embodiments, a thin piece of thickness compensator fabric 5958 may be positioned between recess 5970 and socket 5960, for example.

The socket 5960 may be aligned with a recess of the socket 5948 on the 5952 cartridge platform when the tissue thickness compensator 5958 is positioned relative to the cartridge body 5950, for example. Additionally, socket 5960 may be positioned in socket 5948 when cartridge contact surface 5962 of tissue thickness compensator 5958 is in position adjacent platform 5952 of cartridge body 5950. In various embodiments socket 5960 may be friction fit in socket 5948 when tissue thickness compensator 5958 is secured to cartridge body 5950. The friction fit engagement between socket 5960 and socket 5948 may retain at least a portion of the fabric thickness compensator 5958 relative to the cartridge body 5950. For example, when the socket 5960 is frictionally engaged with the socket cavity 5948, the cartridge contact surface 5962 can be secured against the platform 5952 of the body of cartridge 5950.

Referring primarily to Figs. 97 and 98, fastener cartridge 5950 may include a plurality of slotted cavities 5948 defined in cartridge platform 5952.

ties, mating slots 5948 can be defined in the 5952 cartridge platform, on either side of the slot.

5956. A first housing cavity 5948 may be defined on a first longitudinal side of cartridge body 5950, for example, and a second corresponding housing cavity 5948 may be defined on a second longitudinal side of cartridge body 5950, for example. A first pair of mating socket cavities 5948 may be positioned in the proximal portion 5904 of the second jaw 5902 and/or a second pair of mating socket recesses 5948 may be positioned in the distal portion 5906 of the second jaw 5902, for example . In various embodiments, fastener pockets 5954 may be positioned between corresponding pairs of socket pockets 5948, i.e., closer to slot 5956 and between pair of socket pockets 5948 in proximal portion 5904 of the second jaw. 5902 and the pair of socket cavities 5948 in distal portion 5906 of second jaw 5902, i.e., in an intermediate portion of cartridge body 5950. Additionally, in various embodiments, tissue thickness compensator 5958 may include a plurality of sockets 5960 that may be aligned with socket sockets 5948 of cartridge body 5950. For example, at least one socket 5960 may be positioned in proximal portion 5904 of second jaw 5902 and at least one socket 5960 may be positioned on distal portion 5906 of second jaw 5902. In various embodiments, a pair of sockets 5960 may be positioned on proximal portion 5904 of second jaw 5902, and a pair of sockets 5960 may be positioned on portion dia. stal 5906 of the second jaw 5902. The inserts 5960 may be frictionally engaged in the engagement cavities 5948, for example, and may secure at least a portion of the tissue thickness compensator 5958 to the cartridge body.

5950.

[00510] [0417] Referring primarily to Figs. 99 and 100, inserts 5960 can be removed from insert cavities 5948 during a firing stroke. In various embodiments, actuators 5920 movably positioned in sockets 5948 can eject sockets 5960 from sockets 5948 during the firing stroke. For example, a trigger 5920 may be positioned in each socket 5948. During a firing stroke, an element of the trigger assembly 5630 and/or a slider in the second jaw 5902 may engage the actuator 5920 to move the actuator 5920 towards the cartridge platform 5952 and/or towards the tissue thickness compensator 5958, for example. As actuator 5920 moves, actuator 5920 may push insert 5960, positioned in insert cavity 5948, toward platform 5952 and/or toward fabric thickness compensator 5958, for example. In various embodiments, the recess 5970 defined in the fabric thickness compensator 5958 which corresponds to the push fit 5960, can receive the push fit.

5960. For example, actuator 5920 can push insert 5960 into recess 5970. Insert 5960 can be crushed, deformed and/or compressed into recess 5970, for example. When the inserts 5960 are removed from the insert pockets 5960 during the firing stroke and pushed into the corresponding recesses 5970, the tissue thickness compensator 5958 can be released and/or released from the cartridge body.

5950.

[00511] [0418] In various embodiments, now referring to figures 62 to 66, a staple cartridge 13000 may comprise a cartridge body 13010, a tissue thickness compensator 13020 and a plurality of configurable connectors. to releasably retain cartridge thickness compensator 13020 in cartridge body 13010 as described in more detail below.

Cartridge body 13010 may comprise a proximal end 13011, a distal end 13012, and a platform 13015 configured to support tissue thickness compensator 13020. Cartridge body 13010 may include one or more proximal stops 13013 extending therefrom. therefrom, which can be configured to lock or resist proximal movement of the tissue thickness compensator 13020. Similarly, cartridge body 13010 can include one or more distal stops 13014 that can be configured to lock or resist distal movement of tissue thickness compensator 13020. Referring primarily to Fig. 63 , cartridge body 13010 may further comprise a plurality of clamp cavities 13016 defined therein.

In various embodiments, staple cartridge 13000 may comprise a plurality of connectors 13030 and 13040 configured to releasably secure tissue thickness compensator 13020 to cartridge body 13010. Each connector 13030 may comprise, for example, a plurality of cavity plugs 13031 which are positionable in the clamp cavities 13016 and a connecting bar 13032 extending between the cavity plugs 13031 and over the tissue thickness compensator 13020. The cavity plugs 13031, in at least one In one embodiment, it can fit snugly within clip cavities 13016. In certain embodiments, the well plugs 13031 can be press-fitted and/or tightly fitted into the clip wells 13016. Each connector 13040, for example, can comprising a cavity plug 13031 and a head 13042 extending therefrom, the head 13042 being able to extend, at least partially, over the compensator. tissue thickness 13020. Referring again to Fig. 63 , tissue thickness compensator 13020 may comprise an array of proximal notches 13023 defined at proximal end 13021 of tissue thickness compensator 13020 configured to receive plugs. cavity 13031 extending from a proximal connector 13030, intermediate notches 13024 each configured to receive a cavity plug 13031 extending from intermediate connectors 13040 and a set of distal notches 13025 defined at the distal end. 13022 of tissue thickness compensator 13020 configured to receive cavity plugs 13031 extending from a distal connector 13030, for example.

[00512] In use, a slider, or firing member, can be advanced distally through the 13000 staple cartridge to eject staples positioned within the staple wells

13016. In various embodiments, clamp cavities 13016 which comprise a clamp positioned therein may not be plugged by a cavity plug 13031. In certain embodiments, clamp cavities having a cavity plug 13031 positioned therein may not have a clip placed there. In some embodiments, although not shown, a clamp cavity may include a fastener and cavity plug 13031 positioned therein. Now referring again to Figs. 65 and 66, the staple cartridge 13000 may further comprise a plurality of staple drivers 13050, for example, which support the staples in their unfired position. As the firing member, for example, is advanced distally through the staple cartridge, the firing member can raise the staple drivers 13050 and the staples, i.e., towards the platform 13015 of the cartridge body 13010 and towards the an anvil positioned opposite the tissue thickness compensator 13020. Similarly, at least some of the clamp drivers 13050 may contact and lift cavity plugs 13031 positioned in some of the clamp cavities 13016 towards the anvil . When the staples are lifted by staple drivers 13050, the legs of the staples can pass through the fabric thickness trim 13020, through the fabric positioned between the fabric thickness trim 13020 and the anvil, and come into contact. with the anvil positioned on the opposite side of the fabric. Staple drivers 13050 can then drive the staples against the anvil so that the staples are deformed to capture tissue thickness compensator 13020 and tissue therein. When the socket plugs 13031 are lifted by the clamp drivers 13050, the anvil can resist the upward movement of the socket plugs 13031. In such circumstances, referring primarily to Figure 63, the socket plugs 13031 may deform , deflect and/or break. In certain embodiments, cavity plugs 13031 may include one or more notches, for example, that can induce deformation, deflection and/or rupture of cavity plugs 13031 at a specific location. In various circumstances, all, or at least substantially all, of the cavity plugs 13031 may be ejected from the clamp cavities 13016 by the clamp drivers 13050. At such a point, the connectors 13030 and/or 13040 do not can further connect the tissue thickness compensator 13020 to the cartridge body 13010, as such, the cartridge body 13010 can be moved in the opposite direction to the tissue thickness compensator 13020 that has been implanted against the tissue.

[00513] [0420] In use, in addition to the above, the trigger member may be advanced from the proximal end 13011 towards the distal end 13012 of the staple cartridge 13000. The cartridge body 13010 may include a longitudinal slot 13019 configured to slidingly receive at least a portion of the firing member therein.

As the firing member is advanced distally, the firing member can eject the clamps positioned on the proximal more clamps 13016 and then trigger the most proximal connector 13030. The firing of the most proximal connector 13030 can release the proximal end 13021 of the compensator from tissue thickness 13020 of cartridge body 13010. In other embodiments, the firing member may fire the most proximal connector before firing any clips.

In either case, the firing member can be further advanced distally to eject the clips from the clip cavities 13016 and then fire the intermediate connectors 13040. At such a point, only the most distal connector 13030 can remain, which secures tissue thickness compensator 13020 to cartridge body 13010. Once the trigger member has fired the most distal connector 13030, tissue thickness compensator 13020 can no longer be attached to cartridge body 13010. The sequence described above describes a staple cartridge that is fully or fully fired.

Other circumstances may arise in which less than all of the staples contained in the staple cartridge are fired.

In such circumstances, some of the connectors that hold the fabric thickness compensator 13020 to the cartridge body 13010 may not fire.

When partial use of the staple cartridge 13000 is complete, the anvil can be opened and the cartridge body 13010 can be pulled from the partially implanted tissue thickness compensator 13020. In such circumstances, the unfired connectors can be configured to slide out of clamp cavities 13016, even if they have not been fired.

In any case, connectors 13030 and 13040, for example, can comprise any suitable biocompatible material.

soluble and/or bioabsorbable.

[00514] In addition to the above, the firing member can include a cutting portion, such as a knife, for example, which can be configured to transect the fabric thickness compensator 13020 and the fabric, as the fabrication member firing is advanced distally through the staple cartridge 13000. In such circumstances, the cut-off portion may also be configured to transect connecting bars 13032 from connectors 13030.

[00515] In various embodiments, now referring to Figures 101 and 102, a staple cartridge 10800 comprising a support portion 10810 and a tissue thickness compensator 10820 can be loaded into a staple cartridge channel with a 10880 staple cartridge applicator, for example. Similar to the above, the staple cartridge applicator 10880 may also be configured to position an upper tissue thickness compensator 10890, for example, with respect to an anvil such as anvil 10060, by. example, so that when anvil 10060 is closed, anvil 10060 may contact and engage fabric thickness compensator 10890. In at least one embodiment, fabric thickness compensator 10890 may comprise a plurality of legs of retention 10895 extending from top surface 10891 of fabric thickness compensator 10890 which may be configured to engage anvil 10060 and releasably retain fabric thickness compensator 10890 to anvil 10060. in at least one such embodiment, legs 10895 may be arranged in a longitudinal row, each leg 10895 may comprise at least one foot configured to enter and engage knife slot 10065 defined on anvil 10060. In certain modalities, some of the feet of legs 10895 may extend in an inward direction.

how much other feet can extend in another direction. In at least one modality, some of the feet may extend in opposite directions.

[00516] In any case, once the anvil 10060 has been engaged with the tissue thickness compensator 10890, now referring to figures 102 and 103, the anvil 10060 can be opened again and the clinician can move the staple cartridge applicator 10880 in opposite direction to tissue thickness compensators 10820 and 10890. Thereafter, with reference to Fig. 104, upper tissue thickness compensator 10890 can be positioned on a first side of the target tissue and fabric thickness compensator 10820, which may comprise a lower fabric thickness compensator, may be positioned on a second side of the fabric. After fabric thickness compensators 10820 and 10890 have been properly positioned, now with reference to Fig. 105, a knife edge of a firing member, such as knife edge 10053, for example, can be advanced through the fabric. and fabric thickness compensators.

[00517] In various embodiments, now referring to Fig. 106, a staple cartridge applicator, such as applicator 12280, for example, may comprise a tissue thickness compensator 12290, detachably mounted thereon, which may be, similarly to the above, inserted into a staple cartridge channel as illustrated in Fig. 106A, and engaged by anvil 10060 when anvil 10060 is moved to a closed position. Applicator 12280 may include a handle 10084 for positioning compensator 12290 relative to a staple cartridge. In addition, applicator 10084 may comprise a plurality of legs 10081 that can secure compensator 12290 to the staple cartridge. In at least one such embodiment, the fabric thickness compensator 12290 may comprise a plurality of retaining elements 12295 extending upwardly from the top surface 12291 of the fabric thickness compensator 12290 with each retaining element. 12295 may comprise a plurality of flexible legs 12296 which can be configured to be inserted into knife slot 10065 on anvil 10060. Referring primarily to Figures 107 and 108, the flexible legs 12296 of each retaining member 12295 can be separated by a span 12298 so that when legs 12296 are inserted into knife slot 10065, legs 12296 can flex inward and then resiliently return outward when the flared feet of flexible legs 12296 have passed through the slot. knife 10065. In various embodiments, the flared feet of flexible legs 12296 can flex behind opposing retaining lips 12297 defined. those on anvil 10060 and, as a result of the interaction of legs 12296 and lips 12297, fabric thickness compensator 12290 can be retained on anvil 10060. Thereafter, staple cartridge applicator 12280 can be moved away from thickness compensator - sura of fabric 12290, as shown in figure 106B. In use, when the fabric thickness compensator 12290 has been implanted against the fabric by staples dispensed by the staple cartridge 10000, for example, the anvil 10060 can be reopened, and when the anvil 10060 is moved away from the thickness compensator implanted tissue 12290, legs 12296 of retaining members 12995 can flex inwardly so that they can be pulled from knife slot 10065.

[00518] As outlined above, an end actuator assembly may include a staple cartridge, an anvil, and at least one piece of backing material intermediate the staple cartridge and anvil. In at least one modality,

now referring to Figures 109 to 111, a piece of reinforcing material, such as reinforcing material 336, may be configured to be press-fit into at least one of the staple cartridge 322 and/or an anvil (not illustrated) to releasably retain the piece of backing material within the tip actuator. Referring to Figures 110 and 111, the staple cartridge 322 may include first side wall 302 and second side wall 304, at least one of the first and second wall may include a bead 306 extending outwardly therefrom. . In various embodiments, the reinforcing material 336 may include a first edge, or side, 308, second edge, or side 310, and at least one edge 312 extending at least partially along the length of the edges 308 and 310. In at least one embodiment, with reference to Fig. 111, lips 312 may be configured to engage lips 306 by snap fit to releasably retain the reinforcing material 336 in the staple cartridge.

322.

[00519] In addition to the above with reference to figure 111, the reinforcing material 336 may include surface 316, which may be configured to be positioned adjacent to or against the platform 328 of the cartridge. of clips 322. In at least one embodiment, side edges 308 and 310 may comprise side walls that may extend in a perpendicular or transverse direction relative to surface 316. In such embodiments, flanges 312 may extend from these side walls so that lips 312 can be interlocked behind lips 306 of staple cartridge 322. In various embodiments, lips 312 of backing material 336 can be disengaged from lips 306 of staple cartridge. 322 when the staples are dispensed from the staple cartridge 322. More particularly, when the staples are dispensed, the staples may come into contact with the reinforcing material 336, applying an upward force to the reinforcing material. prying 336 and dislodging the backing material 336 from the staple cartridge 322. Advantageously, as a result, the backing material 336 can be automatically disengaged from the staple cartridge 322 when the staples are dispensed therefrom and/or when the end actuator is opened as described above.

[00520] In various embodiments, with reference to figures 110 and 111, a piece of reinforcing material may include at least one member extending therefrom, which may be configured to releasably retain the material. of reinforcement to one of a staple cartridge and/or an anvil. In at least one embodiment, member 318 may extend from reinforcing material 336 in a direction that is perpendicular or transverse to surface 316. the staple port 320 and/or the anvil pocket, by friction fit or pressure, to releasably retain the piece of backing material to one of the staple cartridge and anvil. Similar to the above, in various embodiments, the clamps dispensed by the clamp cavities 320 can apply an upward force to the reinforcing material 336 and disengage the members 318 from the clamp cavities 320. In various embodiments, the clamps can pierce the members 318 and/or the reinforcement material 336 to secure the reinforcement material to the fabric, as outlined above.

[00521] As illustrated in Figure 110, a piece of reinforcement material may include more than one member, or projection, extending therefrom, to hold a piece of reinforcement material and one of a staple cartridge and an anvil . In various embodiments, now referring to Figs. 112 and 133, more than one member 318' may extend from piece of reinforcing material 336', for example.

In at least one embodiment, the members 318' may be press-fitted into the clip cavities 320' of the staple cartridge 322' and/or the anvil pockets of an anvil (not shown) so that the members can frictionally retain the piece of backing material in the staple cartridge and/or anvil as outlined above. As described in more detail in this document, a staple cartridge and/or anvil may include slots or openings in addition to the staple cartridge staple cavities and the anvil anvil pockets for receiving projections, or retaining members. , which extend from a piece of reinforcing material.

[00522] In certain embodiments, as described in more detail below, a support portion may comprise retaining elements that can be configured to progressively release a tissue thickness compensator from the support portion when the clips are progressively fired from the staple cartridge. Referring now to Fig. 114, a staple cartridge, such as staple cartridge 11200, for example, may comprise a support portion 11210 that includes retaining members 11213 that may be configured to releasably secure a compensator. of fabric thickness 11220 (Fig. 115) to the support portion 11210. In various embodiments, the retaining elements 11213 may be positioned at the ends of each clamp cavity 11212, for example, wherein each retaining element 11213 may comprise a groove guide 11216 defined therein, which is configured to slidingly receive a clamp leg 10032 of a clamp 10030. In such embodiments, both clamp legs 10032 and the retaining elements 11213 can be configured to securely retain removable fabric thickness compensator 11220 to support portion 11210.

[00523] In use, now with reference to Figure 115, the staple drivers 10040 contained in the support portion 11210 can be directed upwards by a slider 10050, as described above, in which the staple drivers 10040 can be configured to contact the retaining elements 11213, at least partially detach the retaining elements 11213 from the support portion 11210, and displace the retaining elements 11213 outwardly and away from the clips 10030 and the clip cavities 11212 When the retaining elements 11213 are detached from the support portion 11210 and/or displaced outwardly, the retaining elements 11213 may no longer be able to retain the fabric thickness compensator 11220 to the support portion 11210 and, as As a result, the 11220 fabric thickness compensator can be released from the support portion 11210. Similarly to the above, the 11220 fabric thickness compensator can be released prog. negatively from support portion 11210 when staples 10030 are progressively ejected from the staple cartridge towards an anvil, such as anvil 11260, for example. In various embodiments, staple drivers 10040 may contact retaining elements 11213 when the upper surfaces of staple drivers 10040 are coplanar, or at least substantially coplanar, with the platform surface 11211 of the portion. support 11210, for example. In such embodiments, fabric thickness compensator 11220 may be released from support portion 11210 simultaneously and/or immediately before staples 10030 are formed to their fully formed, or fully fired, configuration.

[00524] In at least one such modality, with respect mainly to figure 116, actuators 10040 may be excessive.

They are directed so that they are pushed above the platform surface 11211 to fully form the clamps 10030 and, in the process of being excessively directed, disengage the retaining elements 11213 from the support portion 11210. In various embodiments. , again referring to Fig. 115, retaining members 11213 may extend over, or protrude, into clamp cavities 11212 before being released or displaced outwardly so that actuators 10040 can enter into contact with the retaining elements 11213 as the actuators 10040 reach the platform surface 11211. In any case, once the fabric thickness compensator 11220 has been released from the support portion 11210, now with reference to the Fig. 116, support portion 11210 may be moved away from implanted tissue thickness compensator 11220.

[00525] Referring now to Fig. 117, a cartridge assembly of fasteners 6002 for use with an end actuator assembly may include a cartridge body 6050 and a fabric thickness compensator 6058, releasably attached to the same. Similar to cartridge body 5650, for example, cartridge body 6050 may include a slot 6056 configured to guide a firing assembly and/or fastener cavities 6054 configured to releasably retain fasteners in the body. of cartridge 6050. In various embodiments, cartridge body 6050 can include a projection 6048, such as a column, socket, flap, and/or ridge, for example. Projection 6048 may extend from the cartridge platform of the 6050 cartridge body into tissue thickness trim 6058 when tissue thickness trim 6058 is positioned relative to the cartridge platform. In various embodiments, cartridge body 6050 can include a plurality of projections 6048 extending from the cartridge platform. Projections 6048 may be positioned along the length of cartridge body 6050, for example, and may be positioned between adjacent fastener cavities 6054, for example.

[00526] Still referring to Fig. 117, in various embodiments, the fabric thickness compensator 6058 may be thermoformed around the projections 6048 of the fabric thickness compensator

6058. For example, fabric thickness compensator 6058 can be positioned relative to the cartridge platform of cartridge body 6050. Once positioned, fabric thickness compensator 6058 can be heated to a sufficient temperature such that the 6058 fabric thickness compensator deforms to accommodate the shape of the cartridge deck, including the shape of the 6048 projections extending therefrom. Fabric thickness compensator 6058 may be locally heated, for example, and may reach a temperature close to and/or approaching the glass transition temperature of the material comprising fabric thickness compensator 6058, for example. The fabric thickness compensator can be heated to approximately 90 degrees C, up to approximately 120 degrees C, for example. In certain embodiments, the fabric thickness compensator can be heated to approximately 75 degrees C, up to approximately 150 degrees C, for example. Once the 6058 Fabric Thickness Compensator has deformed to fit around the 6048 projections, the heat source can be removed or reduced and the 6058 Fabric Thickness Compensator can cool. The 6058 Fabric Thickness Compensator can be subjected to increased temperatures for approximately 2 seconds to approximately 5 seconds, for example, to achieve sufficient deformation around the projections.

6048. In other circumstances, the fabric thickness compensator

The 6058 can be subjected to increased temperatures for approximately 1 second to approximately 10 seconds, for example, to achieve sufficient deformation around the 6048 projections. to get closer towards and/or tighter around the 6048 projections, for example. In various embodiments, the thermoformed fabric thickness compensator 6058 can prevent and/or limit lateral displacement and/or bulging of the fabric thickness compensator 6058 between the fastener cavities 6054 and along the length of the body. cartridge 6050.

[00527] Additionally or alternatively, the 6058 Fabric Thickness Compensator may be thermoformed around at least a portion of a fastener releasably positioned in a 6054 fastener cavity. 6058 fabric can be thermoformed around the legs of staples that extend above the cartridge platform. Still referring to Fig. 117, in various embodiments, cartridge fastener assembly 6002 may include a cover or housing 6060 around at least a portion of cartridge body 6050. Housing 6060 may extend around the bottom, sides and/or cartridge platform of the 6050 cartridge body, for example. Housing 6060 can be secured to cartridge body 6050 by pins 6062, for example. Additionally, in various embodiments, the 6060 housing can include a metallic material, such as 300 series stainless steel, 400 series stainless steel, titanium and/or aluminum for medical use, for example. The 6060 metal housing can facilitate heat transfer in the 6050 cartridge body and/or 6048 projections to improve the thermoforming effect, for example.

[00528] Now referring to figure 118, a 6102 fastener cartridge assembly for use with an end actuator assembly.

ity, may include a cartridge body 6150 and a fabric thickness compensator 6158 releasably secured thereto. Similar to cartridge body 5650, cartridge body 6150 may include a slot 6156 configured to guide a firing assembly, for example, and fastener cavities 6154 configured to releasably retain fasteners in cartridge body 6150 , for example. The body of cartridge 6150 may also include a ridge 6146 similar to ridge 5648 that extends from cartridge platform 6152. Crest 6146 may extend around at least a portion of a fastener cavity 6154, by example. In various embodiments, when a fastener is positioned in a fastener cavity 6154, the tip of the fastener may protrude from the fastener cavity 6148. In such embodiments, the ridge 6146 is positioned at least partially around of the fastener cavity 6154, can support and/or guide the fastener tip as the fastener is ejected from the fastener cavity 6154. In various embodiments, the cartridge body 6150 may include a plurality of ridges 6146 at least partially surrounding the fastener pockets 6154. For example, a ridge 6146 may extend around at least the proximal and/or distal ends of each fastener pocket 6154.

[00529] Still referring to Figure 118, in various embodiments, the cartridge holder assembly 6102 may include a cover or housing 6160, similar to housing 6060, for example, positioned around at least a portion of the cartridge body 6150 The housing 6160 may extend around the bottom and/or sides of the cartridge body 6150, for example, and may be secured to the cartridge body 6150 by pins 6162, for example. In various embodiments, housing 6160 can include a projection 6148, such as a column, socket, flap and/or ridge, for example. Projection 6148 may extend beyond cartridge platform 6152 of cartridge body 6150. In various embodiments, projection 6148 may extend into tissue thickness compensator 6158 when tissue thickness compensator 6158 is positioned relative to to the cartridge platform. In various embodiments, housing 6160 can include a plurality of projections 6148 extending therefrom. Projections 6148 may be positioned along the length of housing 6160, for example, and around cartridge body 6150, for example.

[00530] Similar to the 6058 Fabric Thickness Compensator, the 6158 Fabric Thickness Compensator may be thermoformed around the projections 6148 of the housing 6160. In various embodiments, the 6158 Fabric Thickness Compensator may be wider than the housing 6160, so that a portion of the fabric thickness compensator 6158 extends beyond the perimeter of the cartridge body 6150. In such embodiments, the fabric thickness compensator 6158 may be thermoformed into the 6148 projections around the perimeter of the 6150 cartridge body, for example. Additionally or alternatively, tissue thickness compensator 6158 may be thermoformed on ridges 6146 and/or clamp legs extending from fastener cavities 6154, for example. In various embodiments, the housing 6160 can include a metallic material, such as 300 series stainless steel, 400 series stainless steel, titanium and/or aluminum for medical use, for example, to facilitate heat transfer and improve the effect. of thermoforming.

[00531] Now referring to Figures 119 and 120, an end actuator assembly 6200 may include a first claw or anvil 6210 and a second claw 6202. The second claw 6202 may include a cartridge body 6250 and a compensator. 6258 thickness of fabric releasably attached there. Similar to cartridge body 5650, cartridge body 6250 may include fastener cavities 6254 and fasteners, such as surgical clips, for example, which can be removably positioned therein. In various embodiments, a 6290 surgical clip can be positioned on a 6220 driver in a 6254 fastener cavity. Referring primarily to Fig. 119, when the 6220 driver is in a pre-firing position, a portion of the 6290 clip may be positioned in fastener cavity 6254. In various embodiments, clamp 6290 may include a base 6292 and deformable legs 6294a, 6294b extending from base 6292. First leg 6294a may extend from a first end of base 6292, for example, and a second leg 6294b may extend from a second end of base 6292, for example. In various embodiments, when driver 6220 is in a pre-firing position and clamp 6290 is in a pre-formed configuration, base 6292 of clamp 6290 can be positioned in fastener cavity 6254 and legs 6294a, 6294b of clamp 6290 can extend from fastener cavity 6254 to fabric thickness compensator 6258

[00532] [0439] In various embodiments, still referring to Figures 119 and 120, the legs of the clamp 6294a, 6294b may include a flash between the base 6292 and the tips 6299a, 6299b of each leg of the clamp 6294a, 6294b. The burr can be a sharp or pointed lump, like a thorn, for example. In various modes, the wire diameter of the staples can be approximately 0.18 m (0.0069"), approximately 0.20 mm (0.0079") and/or approximately 0.23 mm (0 .0089"), for example. The burr may be approximately 0.03 mm (0.001"), for example. In certain circumstances, the burr can be between approximately 0.0127 mm (0.0005") and approximately 0.0076 mm (0.003"), for example. In certain embodiments, a first lower burr 6296a may be positioned on the first leg clamp 6294a and a second lower burr 6296b may be positioned on the second clamp leg 6294b. The lower burrs 6296a, 6296b can be positioned between the base 6292 and the tips 6299a, 6299b of the clamp legs 6294a, 6294b. Additionally, a first lower barb 6298a can be positioned on the first clip leg 6294a and a second upper barb 6298b can be positioned on the second clip leg 6294b. The upper burrs 6298a, 6296b may be positioned between the lower burrs 6296a, 6296b and the tips 6299a, 6299b on the respective legs of the clamp 6294a, 6294b. When trigger 6220 is in a pre-firing position and clamp 6290 is in a pre-formed configuration, at least one burr 6296a, 6296b, 6298a, 6298b of clamp 6290 can be positioned on fabric thickness compensator 6258. In such embodiments, the burr 6296a, 6296b, 6298a, 6298b can catch and/or retain the fabric thickness compensator 6258 relative to the body of the cartridge 6250, for example. The burr 6296a, 6296b, 6298a, 6298b embedded in the fabric thickness tab 6258 can prevent and/or limit lateral movement of the fabric thickness tab 6258 relative to the cartridge platform, for example, and/or can prevent lifting of the fabric thickness compensator 6258 in the direction opposite the cartridge platform, for example. Additionally or alternatively, in various embodiments, a burr may be positioned on the tips 6299a, 6299b of the clip legs 6294a, 6294b.

Referring primarily to Fig. 120, when the actuator moves to a fired position, the clip 6290 can be removed and/or ejected from the fastener cavity 6254. Additionally, the tissue thickness compensator 6258 and the T fabric can be clamped between the 6210 anvil and the 6250 cartridge body of the 6200 end actuator assembly.

6214 on anvil 6210 can form clamp 6290 in a B-shape, for example. Additionally, at least one burr 6296a, 6296b, 6298a, 6298b of clip 6290 can engage fabric secured within clip 6290, for example. Burr 6296a, 6296b, 6298a, 6298b can catch and/or retain tissue T captured within clip 6290.

[00534] Now with reference to figures 121 through 124, a 6390 fastener may be releasably held by a 6320 latch actuator on a 6350 fastener cartridge (figures 123 and 124), for use with an end actuator assembly. In various embodiments, fastener 6390 may include a base 6392 and legs 6394a, 6294b extending from base 6392. First leg 6394a may extend from a first end of base 6392, for example, and a second leg 6394b may extend from a second end of base 6392, for example. In certain embodiments, the latch actuator 6320 may releasably retain the base 6392 of the fastener 6390. In various embodiments, the latch actuator 6320 may include a tab 6340, which can be hooked and/or secured in a manner. releasable, base 6392. Clamp 6340 can be flexible, for example, and can flex to release base 6392 from fastener 6390, for example. In various embodiments, the latch actuator 6320 and/or the tab 6340 may comprise plastic, such as Ultem, for example, with a glass charge or without a glass charge, such that the tab 6340 is sufficiently deformed, elastically and/or plastically. you.

[00535] Referring primarily to Figs. 123 and 124, the lock actuator 6320 can be movably positioned in a fastener cavity 6354 defined in the cartridge platform 6352 of the cartridge body 6350. The lock actuator 6320 can moving from a locked position (figure 123) to an unlocked position (figure

124) in the fastener cavity. A slider and/or actuator on the 6350 cartridge body may engage the latch actuator 6320 during a firing stroke to move the latch actuator 6320 from the locked position to the unlatched position. In various embodiments, the fastener 6390 can be secured to the latch actuator 6320 when the latch actuator 6320 is in the locked position, and can be released from the latch actuator 6320 when the latch actuator 6320 is moved to the unlatched position. . When the latch driver 6320 moves from the locked position to the unlatched position, the fastener 6390 can be ejected from the fastener cavity 6354. A key 6353 adjacent to the fastener cavity 6354 can release the fastener 6390 from the latch driver 6320 , for example. Key 6353 may be a bead that extends inwardly from at least a portion of the collar of fastener cavity 6354, for example. In various embodiments, key 6353 may have a cam surface 6355. When latch actuator 6320 moves from the locked position to the unlatched position, a protrusion 6340 of tab 6340 may abut the cam surface 6355 of the key 6353. In such embodiments, as tab 6340 moves against cam surface 6355, cam surface 6355 can flex tab 6340 so that hook 6342 releases base 6392 from fastener 6390. In various embodiments, hook 6342 may pivot upward to release base 6392. For example, hook 6342 may pivot upward so that the opening of hook 6342 is directed upward toward fabric thickness compensator 6358, and so that the base 6392 can move up through the opening and away from the lock actuator 6320.

[00536] Still referring to Figures 123 and 124, a fabric thickness compensator 6358 can be releasably secured to the cartridge platform 6352 of the cartridge body 6350. When the lock actuator 6320 is in the locked position (figure 123), the legs of the clamp 6394a, 6394b may extend from the fastener cavity 6354 into the tissue thickness compensator

6358. Clamp legs 6394a, 6394b can secure fabric thickness compensator 6358 relative to cartridge platform 6352, for example, and may prevent and/or limit lateral movement of the thickness compensator. fabric 6358 relative to cartridge platform 6352, for example. Additionally, when the latch driver 6320 moves to the unlatched position and the fastener 6390 is ejected from the fastener cavity 6354 (figure 124), the clip 6340 can release the base 6392 from the fastener 6390, so that the fastener 6390 is 6390 can disengage the latch actuators 6320 and the 6350 cartridge body. When the 6390 fasteners are removably positioned in the 6354 fastener cavities they eject from their respective 6354 fastener cavities and disengage the 6350 cartridge body, the compensator fabric thickness 6858 can be loosened and/or released from the 6350 cartridge body.

[00537] Now referring to figures 125 and 129, an end actuator assembly 6400 may include a first jaw and/or anvil 6410 (figures 127 to 129) and a second jaw 6402. The second jaw 6402 may include a fasteners cartridge body 6450 and a fabric thickness compensator 6458 releasably secured to second jaw 6402 and/or fasteners cartridge body 6458. Fabric Thickness Thinker 5958 releasably secured thereto may comprise a cartridge assembly of fasteners, for example. In various embodiments, cartridge body 6450 may include a cartridge platform 6452 and a slot 6456 extending through at least a portion of cartridge body 6450. Cavities may be defined in cartridge platform 6452 and in the body. of cartridge 6450. For example, fastener cavities 6454 may be defined on cartridge platform 6452 and may receive fasteners 6490 (Figures 126A through 129). Fasteners 6490 may be removably positioned in fastener cavity 6454. For example, a single fastener 6490 may be removably positioned in each fastener cavity 6454 and can be ejected from fastener cavity 6454 during one firing stroke. Additionally, lock pockets 6448 can be defined on cartridge deck 6452 and can receive locks 6440. For example, a single lock 6440 can be movably positioned in each lock pocket 6448 and can be moved from a locked position. (figures 127 and 128) to an unlocked position (figure 129) during the firing stroke.

Referring primarily to Fig. 126, latch 6440 may include a base 6444 and a hook 6442 movably positioned relative to base 6444. For example, hook 6442 may move within an opening formed through at least a portion of base 6444. Hook 6442 may receive and/or retain a connector 6480, for example. Hook 6442 may comprise liquid crystal polymer (LCP), nylon, Ultem, polycarbonate and/or ABS, for example. Connector 6480 can be a suture, for example. In certain embodiments, the connector may comprise PDS, PGA/PCL, PLLA/PCL, TMC/PCL, PGA and/or PCL, for example. In various embodiments, when hook 6442 is recessed or partially recessed into base 6444, hook 6442 can constrict connector 6480. Connector 6480 may be retained between hook 6442 and base 6444, for example. When hook 6442 is raised or partially raised out of base 6444, connector 6480 may no longer be constrained by hook 6442, for example, and may move out of engagement with latch 6440, for example. In various modes, the connector

6480 can slide out of engagement with latch 6440 when hook 6442 is raised at least partially out of base

6444.

[00539] Now, with reference to Figure 126A, connector 6480 can extend from fabric thickness compensator 6458. Fabric thickness compensator 6458 can be friction-fitted and/or thermoformed with connector 6480, for example . In various embodiments, connector 6480 can be threaded through hook 6442 of latch 6440 when latch 6440 is in the unlatched position. As connector 6480 is threaded onto hook 6442, fabric thickness compensator 6458 can move into a position relative to the body of cartridge 6450. For example, fabric thickness compensator 6458 can be positioned on the shelf cartridge 6452 from cartridge body 6450. Referring primarily to Fig. 127, once tissue thickness compensator 6458 is positioned relative to cartridge body 6450, latch 6440 can be moved from the unlatched position to a locked position. For example, hook 6442 of latch 6440 can be recessed or partially recessed into base 6444 such that latch 6440 encloses and/or constrains connector 6480. In various embodiments, latch 6440 and/or trigger 6420 can include a spring, which can force latch 6440 to the unlatched position, for example. When in the locked position, fabric thickness compensator 6458 can be secured to cartridge body 6450 by connector locking latch, for example.

Referring primarily to Figs. 128 and 129, a key may move along at least a portion of the cartridge body 6450 during a firing stroke. The key can be a slide 6434 and/or a trigger assembly element, for example. In various embodiments, slide 6434 can engage the drives.

in the cavities in the 6450 cartridge body during the firing stroke. Slider 6434 can push triggers toward cartridge platform 6452 and/or toward tissue thickness trim 6458 to eject the fasteners from the fastener wells 6453 and/or move the latches 6440 from the locked position into position. not locked. Referring primarily to Fig. 128, slider 6434 can engage a driver 6420 in latch cavity 6448 during the firing stroke. Slider 6434 can move driver 6420 toward cartridge platform 6452 and/or toward fabric thickness compensator 6458. Additionally, referring primarily to Fig. 129, driver 6420 can move latch 6440 from the locked position to the non-locked position. For example, the driver 6420 can push the hook 6442 out of the base.

6444. When hook 6442 is lifted from base 6444, the connector may be released from latch 6440. In such embodiments, fabric thickness compensator 6458 may be released and/or released from cartridge body 6450, for example.

[00541] Referring now to Fig. 67, a fabric thickness compensator 17050 may comprise, for example, a first portion 17052 and a second portion 17054 extending with respect to the first portion 17052. fabric thickness 17050 may comprise part of a staple cartridge assembly. In some circumstances, the 17050 Fabric Thickness Compensator may be attached to a cartridge body of the staple cartridge assembly. In certain circumstances, the tissue thickness compensator can be mounted on an anvil of a surgical stapling instrument. In either case, the first portion 17052 of the fabric thickness compensator 17050 may be compressible. In use, first portion 17052 can be captured by the staples ejected by the staple cartridge and may apply a compressive force to tissue also captured within the staples. Second portion 17054 of tissue thickness compensator 17050 may extend through first portion 17052, second portion 17054 may comprise a proximal end 17053 and a distal end 17055 extending from first portion 17052. As per discussed in more detail below, second portion 17054 may be less flexible and/or more rigid than first portion 17052. Referring now to Fig. 68, a staple cartridge assembly 17000 may comprise a cartridge body 17010 that includes a plurality of clip wells defined therein, and a plurality of clips stored, at least partially, within the clip wells. As shown in Fig. 68, fabric thickness compensator 17050 can be mounted to cartridge body 17010.

The staple cartridge assembly 17000 may comprise a proximal fitting 17060 configured to releasably retain the proximal end 17053 of the second portion 17054 in the cartridge body 17010 and a distal fitting 17070 configured to retain, releasably, distal end 17055 in second portion 17054. Proximal socket 17060 may comprise a single component or more than one component. As shown in Fig. 68, the proximal fitting 17060 may comprise a first fitting portion 17060a and a second fitting portion 17060b configured to at least partially capture and retain the second fitting portion 17054 against the cartridge body 17010 Turning now to Figure 69, each engaging portion 17060a, 17060b may comprise a key 17062 releasably lockable within a key slot 17012 defined in the cartridge body 17010. Each key 17062 and slot key slot 17012 can be sized and configured so that the side walls of the key slot

17012 can apply a holding force to the 17062 key that resists removal of the 17062 key from the 17012 key slot. In various circumstances, the 17062 key can be press-fit, releasably and/or tightly fitted, within of key slot 17012. In at least one circumstance, key 17062 may comprise an enlarged end 17063 releasably clampable between the side walls of key slot 17012, for example. As illustrated in Figures 68 and 69, each recess portion 17060a, 17060b may comprise a window 17064 configured to at least partially receive the proximal end 17053 of the second portion 17054. In such circumstances, the walls The sides of window 17064 may be configured to engage and compress fabric thickness compensator 17030 against the platform 17014 of cartridge body 17010. In addition, at least a portion of second portion 17054 may be contained in engagement portion 17060a. 17060b.

[00543] Now referring again to Figures 68 and 69, similarly to the above, the distal fitting 17070 may comprise a window 17074 that can be sized and configured to receive at least a portion of the distal end 17055 of the second portion 17054. Also similar to the above, the sidewalls of window 17074 can be configured to engage and compress fabric thickness compensator 17030 against platform 17014 of cartridge body 17010. Furthermore, at least a portion of the second portion 17054 may be contained in the engagement portion 17070. The distal engagement portion 17070 may comprise one or more pins 17072 extending therefrom which are releasably secured within one or more pin apertures. 17011 defined in cartridge body 17010 Each pin 17070 and pin opening 17011 can be sized and configured so that the side walls of pin opening 17011 can apply a force of retaining pin 17072 that resists removal of pin 17072 from pin opening 17011. In various circumstances, each pin 17072 may be press-fit or firmly fit, releasably within a pin opening 17011.

[00544] [0451] To mount the 17000 staple cartridge in at least one circumstance, the fabric thickness compensator 17030 may be positioned against the platform 17014 of the cartridge body 17010 and the proximal fittings 17060 and the distal fitting 17070 may then be mounted on cartridge body 17010. Snaps 17060, 17070 can be mounted on cartridge body 17010 to capture or lock tissue thickness compensator 17050 against cartridge body 17010, as discussed above. Also as discussed above, sockets 17060, 17070 may be configured to releasably capture and retain the ends of second portion 17074 in cartridge body 17010. In certain circumstances, proximal sockets 17060 and/or distal socket 17070 may be configured to capture at least a portion of the first portion 17052 therein. Although the fabric thickness compensator 17050 illustrated in Figures 67 to 69 comprises two portions, several alternatives are provided in which a fabric thickness compensator may comprise more than two servings. For example, a fabric thickness compensator may comprise a first compressible portion 17052 and two or more second stiff portions 17054 extending therethrough. Furthermore, for example, a fabric thickness compensator may comprise two or more compressible portions arranged in any suitable arrangement, as in two or more layers, for example.

[00545] Once assembled, the 17000 staple cartridge can be mounted to a surgical stapler. In at least one circumstance, the 17000 staple cartridge may be detachably retained with a groove defined in a surgical stapler end actuator and then inserted into a surgical site within a patient. Proximal fittings 17060 and/or distal fitting 17070 may be configured to retain tissue thickness compensator 17050 in cartridge body 17010, while staple cartridge 17000 is inserted into and/or manipulated within the surgical site. The second portion 17054 of the fabric thickness compensator 17050 can provide sufficient rigidity to the fabric thickness compensator 17050 so that the fabric thickness compensator 17050 does not separate from the cartridge body 17010 to one or more of the proximal grooves 17060 and/ or distal fitting 17070 is cut and/or detached from cartridge body 17010, as discussed in more detail below. Due to the stiffness of the second portion 17054, in various circumstances, the attributes of the first portion 17052 of the fabric thickness compensator 17050 may be selected primarily or exclusively so as to provide the desired fabric compensation properties of the fabric thickness compensator

17050. In use, the second portion 17054 of the tissue thickness compensator 17050 can resist relative movement between the proximal end 17053 and the distal end 17055 and, in various circumstances, resist movement of the proximal end 17053 and the distal end 17055 towards each other.

[00546] Once the staple cartridge 17000 has been properly positioned, in various circumstances, a firing member 17030 can be advanced through the staple cartridge 17000 to dispense the detachably positioned staples therein. The staple cartridge 17000 may include a movable member 17034 which is advanced from a proximal end of the staple cartridge 17000 toward a distal end of the staple cartridge 17000 by firing member 17030. The movable member 17034, in addition to the foregoing, it can be configured to lift the clips removably stored within cartridge body 17010 between an unfired position and a fired position. Firing member 17030 may additionally comprise a cutting portion, such as a knife 17032, for example, which may be configured to transect tissue being stapled as firing member 17030 is advanced distally through the cartridge. number of staples 17000. Knife 17032 can also be configured to transect 17050 tissue thickness offset as firing member 17030 is advanced distally through the staple cartridge.

17000. Referring primarily to Figures 67 and 68, the proximal end 17053 of the second portion 17054 can be cut by the knife.

17032. In at least one such embodiment, fabric thickness compensator 17050 may be at least partially cut, or fully cut, along a longitudinal axis partially defined by notch 17057 defined therein. As shown in Fig. 68, notch 17057 may be aligned, or at least substantially aligned, with a longitudinal knife slot 17015 that extends through cartridge body 17010. Since the proximal end 17053 of the second portion 17054 has been at least partially transected by knife 17032, second portion 17054 may be at least partially released from, or may be releasable from, proximal slots 17060a, 17060b. In such circumstances, tissue thickness compensator 17050 may be separated from cartridge body 17010. For example, firing member 17030 may be at least partially advanced, or fully advanced, through staple cartridge 17000 until implanted at least pair-

partially or completely, the fabric thickness compensator 17050 against the fabric and, due to the at least partial transection of the fabric thickness compensator 17050, especially of the second portion 17054, the fabric thickness compensator 17050 may be flexible or flexible. sufficient so as to slide out of the proximal fitting portions 17060a, 17060b and the distal fitting 17070. In use, in various circumstances, the firing member 17030 may be retracted to its proximal, or initial, position after the disarming member. stop 17030 has been triggered, at least partially, and tissue thickness compensator 17050 has been implanted, at least partially, whereby cartridge body 17010 can then be pulled from implanted tissue thickness compensator 17050. For example , if the cartridge body 17010 is pulled from the fabric thickness compensator 17050 along the longitudinal axis, the fabric thickness compensator is at least partially transectioned. 050 may be able to bulge longitudinally and the proximal and distal ends of the fabric thickness compensator 17050 may move towards each other, for example.

[00547] Now with reference to Figures 70 to 72, a fabric thickness compensator 17150 may comprise a compressible portion 17152 and an engaging portion 17154 extending through and/or extending from the compressible portion 17152. Compressible portion 17152 may comprise a proximal end 17153 which may include a thickness that is less than the thickness of body portion 17156 of tissue thickness compensator 17150. In at least one such embodiment , the proximal end 17153 may comprise a tapered portion, for example. Now with reference again to Figs. 70 to 72, a staple cartridge assembly, such as the 17100 staple cartridge, for example, may include a proximal 17160 fitting configured to

is releasably securing the fitting portion 17154 of the tissue thickness compensator 17150 to a cartridge body 17010. The proximal fitting 17160 may comprise one or more latches 17162 extending therefrom which can be received within. one or more lock-shaped holes 10112 defined in the cartridge body 17110. In at least one such embodiment, each of the latches 17162 may comprise a leg and a foot extending from the leg, wherein the leg may be configured to flex laterally as latch 17162 is inserted into a lock-shaped hole 17112 and then resiliently return, or at least substantially return, to its unflexed configuration so that the foot can engage, releasably, or moving past a side wall of the keyhole hole

17112. Similar to the above, the proximal socket 17160 may further comprise a cavity 17164 configured to receive the proximal socket portion 17154 of the tissue thickness compensator 17150. The cavity 17164 may be configured to compress the portion engaging proximal end 17154 against cartridge body platform 17110 and holding the proximal end of tissue thickness compensator 17150 in position. In various circumstances, a firing member such as firing member 17030, for example, may be configured to perform incision in proximal socket 17160 as trigger member 17030 is being advanced to incision of tissue thickness compensator

17150. In at least one such circumstance, incision of the proximal socket 17160 may release the tissue thickness compensator 17150 from the cartridge body 17110. Again with reference to the embodiment illustrated in Fig. 68, for example, the firing member 17030 it can be configured to pass through a slit defined between the proximal fitting portions 17060a, 17060b and, in at least some circumstances, pass through the proximal fitting portions 17060a, 17060b without incising the same.

[00548] Now referring to Figures 73 to 76, in addition to the above, a proximal fitting for releasably retaining a tissue thickness compensator to a cartridge body may comprise first and second portions 17260a, 17260b which, when mounted in the cartridge body, may define a longitudinal gap or slit 17267 which may be sized and configured to allow firing member 17030 to pass therebetween. Similar to the above, each of the first and second portions 17260a, 17260b may comprise a cavity 17264 configured to receive and hold in place, at least partially, a tissue thickness compensator. Also similarly to the above, each of the first and second portions 17260a, 17260b may comprise latches 17262 extending therefrom, which can be configured to engage the cartridge body.

[00549] As discussed above, a staple cartridge assembly may include a proximal socket or attachment portion configured to hold the proximal end of a tissue thickness compensator at the proximal end of a cartridge body and a distal socket or clamping portion configured to hold the distal end of the tissue thickness compensator at the distal end of the cartridge body. In certain other embodiments, a staple cartridge assembly may comprise at least one proximal socket or at least one distal socket to hold the tissue thickness compensator in the cartridge body. Turning now to Fig. 147, a cartridge assembly 17300 may comprise a cartridge body 17310 and a tissue thickness compensator 17350, the distal end of the tissue thickness compensator 17350 may comprise a distal end 17355 configured to be releasably mounted to cartridge body 17310. In at least this embodiment, the distal end of cartridge body 17310 may include latch apertures 17011 configured to receive and secure at least one fitting distal to the cartridge body 17310. The reader will understand, at least in connection with this embodiment, that cartridge assembly 17300 does not additionally include a proximal fitting for mounting the proximal end of tissue thickness trim 17350 to cartridge body 17310. In various circumstances, the distal end 17355 may be integrally formed with the body portion 17356 of the tissue thickness compensator 17350 or, alternatively, fixed. to the body portion 17356.

[00550] In various embodiments, now referring to Figures 156 and 157, a staple cartridge assembly, such as the staple cartridge 10400, for example, may comprise a support body 10410 that includes a distal end, or tip, 10419 , which can be configured to releasably hold in position a 10450 fabric thickness compensator. Similar to the above, the 10450 fabric thickness compensator may comprise a first portion 10452 mounted on a second portion 10454, wherein second portion 10454 may include a distal end 10455 configured to be releasably secured by tip 10419. In various circumstances, tip 10419 and a platform 10414 of cartridge body 10410 may defining a slot 10418 therebetween configured to receive the distal end 10455. The tip 10419 may comprise a resilient material that can be sized and configured so that the tip 10419 is forced into engagement with and distal end 10455. In use, with reference to Figure 157, tip 10419 may be flexible enough to allow tissue thickness compensator 10450 to slide outward from the underside of tip 10419 when cartridge body 10410 is moved in the opposite direction to the 10450 fabric thickness tab after the 10450 fabric thickness tab has been deployed, at least partially. Turning now to Fig. 158, in addition to the above, the first layer 10452 may comprise a compressible foam that can be fitted to the second layer 10454. In various circumstances, one or more adhesives may be used to mount the first layer 10452 to the second layer 10454. The first layer 10452 may be mounted to the second layer 10454 so that the distal end 10455 and a notch 10457 defined in the distal end 10455 remain exposed. First layer 10452 may be mounted on second layer 10454 such that first layer 10452 is laterally centered with respect to a central longitudinal axis 10459, defined by second layer 10454.

[00551] As discussed above, a staple cartridge assembly may include a movable firing member stored, at least partially therein, which may be configured to elevate staples stored within the staple cartridge assembly between the non-firing positions and the triggered positions. Turning now to Figures 159 and 160, a staple cartridge assembly 10500 may include a cartridge body 10510, a tissue thickness compensator 10550, and a movable firing member, or slider, 10034, stored therein. sliding mode. Slider 10034 may include one or more ramps 10035 defined therein that can be configured to elevate the clamps from their unfired positions to their fired positions in use. Prior to use, slider 10034 can be releasably locked into position. In at least one such embodiment, tissue thickness compensator 10550 may be configured to releasably hold slider 10034 in a proximal position before slider 10034 is advanced distally to eject the staples from the staple cartridge assembly. 10500 and incising the fabric thickness compensator 10550. The fabric thickness compensator 10550 may comprise one or more tabs, or detents, 10557, extending therefrom, which can releasably engage the slider.

10034. For example, slider 10034 may include one or more recesses 10037, into which detents 10557 can be positioned until a sufficient force is applied to slider 10034 which can cause slider 10034 to overcome the force of hold applied to slider 10034 by detents 10557. In use, detents 10557 may be configured to hold slider 10034 in position until a longitudinal firing force applied to slider 10034 in the distal direction exceeds a threshold force, where, when the firing force exceeds the threshold force, slider 10034 can slide distally, and detents 10557 can sufficiently flex or otherwise deform to allow slider 10034 to slide thereby. In at least one embodiment, detents 10557 may be positioned close to clip cavities defined in cartridge body 10510 and/or close to clips stored within cartridge body 10510 so that slider 10034 can be held. releasably in an unfired position that is proximal to the clamps. Once slider 10034 has been advanced distally, slider 10034 can be advanced towards the clamps.

[00552] In addition to the above, referring again to Figures 159 and 160, the cartridge body 10510 may include one or more retention slots 10517, which may be configured to receive at least a portion of the holders 10557. particularly, at least in the illustrated embodiment, a retaining slit 10517 defined on one side of the cartridge body 10510 may be aligned with a recess 10037 defined on a corresponding side of the slider 10034 when the slider 10034 is in its unfired proximal position, so that a detent 10557 can be positioned simultaneously within the aligned retaining slot 10517 and recess 10037. In at least one such embodiment, the side walls of retaining slot 10517 defined in the cartridge body. cho 10510, can support detent 10557 and at least prevent detent 10557 from being prematurely dislodged from recess 10037. As discussed above, slider 10034 can be advanced and dislodged. such that recess 10037 is no longer aligned with detent 10557; however, at least in the illustrated embodiment, detent 10557 may remain aligned with and/or positioned within detent 10517 after slider 10034 has been at least partially advanced. Referring primarily to Figure 159, a first arrangement comprising a detent 10557, a slider recess 10037 and a cartridge retaining slot 10517, may be disposed with respect to a first side of the slider 10034 and a second arrangement. comprising a second detent 10557, a second slider recess 10037 and a second cartridge retaining slot 10517 may be disposed with respect to a second or opposite side of the slider.

10034.

[00553] Certain embodiments of staple cartridges may include a pliable layer, such as a tissue thickness compensator and/or a reinforcing material, for example, on a staple platform, with the staples being arranged so that the tips of the unfired clamps extend into the layer. In certain other embodiments, the pliable layer may comprise a compressible and/or crushable staple cartridge that is deployable into a patient and deforms and/or compresses when captured in the staples. The malleable layer and/or the implantable staple cartridge may also deform and/or compress if a surgeon, nurse, technician or other user ("user" or "users") inadvertently presses a thumb or other finger against the malleable layer or implantable staple cartridge, for example. Such deformation and/or compression can make the staple cartridge unusable.

[00554] Often staple cartridge holders are provided with holders, which can assist the user in loading the staple cartridge into a surgical stapler. The retainer can also cover the staple platform and any malleable layer, thus preventing users from inadvertently pinching, crushing and/or deforming the malleable layer. However, users sometimes prematurely remove the staple cartridge retainer before fully installing the staple cartridge into an end actuator of a surgical stapler. By prematurely removing the retainer, users risk causing damage to the soft layer.

[00555] Figures 164 to 167 illustrate an embodiment of a retainer 10000 that can be secured to a staple cartridge 10010. Referring to Figures 166 and 167, the staple cartridge 10010 may include a malleable layer 10020, as a fabric thickness compensator and/or reinforcement material, disposed on a staple platform 10011 of staple cartridge 10010. As shown in figure 167, staples 10030 may extend from the cartridge. 10010 to exposed pliable layer 10020. If retainer 10000 is prematurely removed, a user may inadvertently press on pliable layer 10020 while pushing staple cartridge 10010 into a cartridge groove.

clamp floor of an end actuator, thereby compressing and/or deforming layer 10020.

[00556] Figures 168 to 173 illustrate an embodiment of a retainer 2600 that can be locked into a 2650 staple cartridge and that cannot be unlocked and removed from the 2650 staple cartridge until the 2650 staple cartridge is fully inserted into a 2670 staple cartridge channel of an end actuator. As best illustrated in Fig. 168, a proximal end portion 2604 of retainer 2600 may include movable cam portions 2616, with locking tabs 2626 extending from movable cam portions 2616. Locking tabs 2626 extend into and engages a slot 2652, such as a knife slot, in the staple cartridge 2650. The engagement of the locking tabs 2626 within the slot 2652 releasably retains the retainer 2600 and the staple cartridge 2650 one after the other. other. As explained in more detail below, the locking tabs only disengage from the slot 2652 so that the retainer 2600 can be released and removed from the staple cartridge 2650 after the cam portions 2616 of the retainer 2616 engage a key in the staple cartridge groove 2670, which causes the cam portions 2616 to flex inward toward each other. Furthermore, in various embodiments, the cam portions 2616 can only engage the key if the staple cartridge 2650 is properly seated in the staple cartridge groove 2670.

[00557] As described above, in certain embodiments, the proximal end portion 2604 of retainer 2600 may include cam portions 2616, each of which is secured to body 2606 of retainer 2600 by a neck 2624. 2616 can be separated from each other by a span 2622. Cam portions 2616 can flex inward in the direction of arrow I (shown in figure 172) when an inward compressive force is applied, and can flex resiliently out in the direction of arrow O (shown in figure 170) around necks 2624. A locking tab 2626 can extend from each cam portion

2618. As described in more detail below, when disposed on a 2650 staple cartridge, the locking tabs 2626 can extend inwardly and releasably engage a slot 2652, such as a knife slot, in the staple cartridge 2650. Referring primarily to Figs. 170 and 171, the cam portions may be forced into an outwardly flexed position such that lips 2628 extending from locking tabs 2626 can engage ridges 2654 in the slot 2652 in the staple cartridge

2650. Forcing cam portions 2616 into the flexed outward position may push lips 2628 of locking tabs 2626 into engagement with ridges 2654 in slot 2652 such that retainer 2600 is locked onto staple cartridge 2650, if absent a compressive inward force from the staple cartridge channel key 2670.

Referring primarily to Figs. 170 to 173, in various embodiments, the staple cartridge channel 2670 key may include inner walls of the staple cartridge channel 2670 that provide a progressively inward compressive force. increasing to the cam portions 2616 so that the cam portions 2616 can flex inward in the direction of arrow I (shown in figure 172) as the retainer 2600 and staple cartridge 2650 are inserted into the staple cartridge channel

2670. For example, the staple cartridge channel 2670 may include first inner walls 2672 that define a first width that can accommodate the cam portions 2616 in their flexed-out tensioned position. The staple cartridge channel 2670 may include second inner walls 2676 that define a second width that can accommodate the cam portions 2616 in an inwardly flexed position, as shown in Figure 172. clamps 2670 may include intermediate inner walls 2674 positioned intermediately to first inner walls 2672 and second inner walls 2676 and can transition from first width to second width. In use, staple cartridge 2650 and retainer 2600 are moved in a proximal direction relative to and toward staple cartridge runner 2670 to be inserted into staple cartridge runner 2670 indicated by arrow P in figures 170 and 172. Referring primarily to figures 170 and 171, as staple cartridge 2650 and retainer 2600 are moved toward staple cartridge channel 2670, rounded ends 2620 and outwardly facing surfaces 2618 of the portions of cam 2616 can engage first walls 2672 of staple cartridge channel 2670. As described above, in certain embodiments, first walls 2672 can define a width that accommodates cam portions 2616 in their flexed-out tensioned position. . In various other embodiments, the first walls 2672 may define a width that accommodates the cam portions 2616 in a partially inwardly flexed position, the partial amount of inward bending being sufficient for the cam portions 2616. lips 2628 of locking tabs 2626 do not disengage from edges 2654 of staple cartridge 2650 and retainer 2600 unlocks staple cartridge

2650. Now with reference to figures 172 and 173, as the 2650 staple cartridge and 2600 retainer continue to move proximally toward the 2670 staple cartridge channel in the direction of arrow P, rounded ends 2620, and surfaces outward facing 2618 engage intermediate walls 2674 and then

second walls 2676. Intermediate walls 2674 and second walls 2676 can provide progressively increasing force that can cause cam portions 2616 to flex progressively inward. Ultimately, the cam portions 2616 will flex inward by such a rate that the lips 2628 of the locking tabs 2626 can be disengaged from the ridges 2654 in the slot 2652 of the staple cartridge 2650. When the locking tabs 2626 are disengaged from the ridges 2654 , retainer 2600 is unlocked from staple cartridge 2650 so that retainer 2600 can be removed from staple cartridge 2650. In various embodiments, cam portions 2616 flex inwardly so that tabs 2626 disengage from 2654 edges only when the 2650 staple cartridge is fully inserted into the 2670 staple cartridge groove.

[00559] In certain embodiments, a lockable retainer, such as the 2600 retainer described above with reference to figures 168 to 173, may also prevent a staple cartridge of a specific size from being inserted into an end actuator which is intended to be used with a staple cartridge of a different specific size. For example, staple cartridge 2650 may comprise a reference surface 2632 that can engage a reference surface 2674 of staple cartridge channel 2670. A first predetermined distance from surface 2632 of staple cartridge 2650 to the portions The cam 2616 may correspond to a second predetermined distance between the reference surface 2674 of the staple cartridge channel 2670 and the walls 2672, 2674 and 2676, which comprise the key of the staple cartridge channel 2670. and the second predetermined distances for a particularly sized retainer and staple cartridge and for a intended staple cartridge channel.

To be used with the particularly sized staple cartridge, pre-determined distances for other holders, staple cartridges, and differently sized staple cartridge channels may differ from the first and second.

In other words, each size of staple cartridge, retainer, and staple cartridge channel can have a predetermined first distance and a second predetermined distance that is different from other sizes of staple cartridge, retainer, and cartridge channel. floor of staples.

As a result, attempting to insert a staple cartridge and retainer into an incorrectly sized staple cartridge channel may result in the cam portions of the retainer not engaging the walls of the staple cartridge channel and/or the reference surfaces of the retainer. staple cartridge and staple cartridge channel do not engage.

For example, the staple cartridge 2650 and retainer 2600 can be arranged so that when they are inserted into a correctly sized staple cartridge channel, the cam portions 2616 can only engage the second walls 2676 of the channel. of staple cartridge 2670 such that locking tabs 2626 disengage from slot 2652 in staple cartridge 2650 when reference surfaces 2632 and 2674 engage with each other.

If staple cartridge 2650 and retainer 2600 are too short for staple cartridge channel 2670, for example, then cam portions 2616 may not reach second walls 2676 such that locking tabs 2626 may be disengaged from slot 2552 in staple cartridge 2659 when reference surfaces 2632 and 2674 are engaged.

As a result, retainer 2600 would not be unlocked and removed from staple cartridge 260. On the other hand, if staple cartridge 2650 and retainer 2600 are too long for staple cartridge groove 2670, for example, then portions of ca-

me 2616 which engage second walls 2676 of staple cartridge channel 2670 can prevent reference surfaces 2632 and 2674 of staple cartridge 2650 and staple cartridge channel 2670, respectively, from engaging. As a result, the 2650 staple cartridge is not fully seated in the 2670 staple cartridge channel.

[00560] In addition to locking tabs 2626 extending from cam portions 2616, retainer 2600 may also include a pair of proximal tabs 2612 disposed near a proximal end 2602 of retainer 2600 and a pair of distal tabs 2610 disposed near a distal end 2604 of retainer 2600. Proximal tabs 2608 and distal tabs 2610 can extend from body 2606 and can releasably engage and secure staple cartridge 2650. In certain embodiments. , the proximal tabs 2612 and the distal tabs 2610 can engage and retain the staple cartridge 2650 until the staple cartridge 2650 is fully seated in the staple cartridge channel 2670. In other words, the proximal tabs 2612 and/or the distal tabs 2610 can serve as another lock that prevents the 2600 retainer from being removed from the 2650 staple cartridge before the 2650 staple cartridge is fully seated in the 2670 staple cartridge channel.

Referring primarily to Fig. 168, each proximal flange 2612 may include a proximal flange 2614 and each distal flange 2610 may include a distal flange 2610. Each proximal flange 2614 may include an inwardly angled surface 2615 and each Distal flange 2610 may include an inwardly angled surface 2611. Proximal flanges 2614 and distal flanges 2610 may releasably engage and secure the sides of staple cartridge 2650. When staple cartridge 2650 and retainer 2600 are inserted into staple cartridge channel 2670, inwardly angled surfaces 2611 and 2615 can engage edges 2672 and 2678 of staple cartridge channel 2670. must flex outwardly from the proximal tabs 2612 and/or the distal tabs 2610 so that the proximal tabs 2614 and the distal tabs 2610 disengage from the sides of the staple cartridge 2650. When the proximal lips 2614 and the distal lips 2610 are disengaged, the 2600 retainer can be released and removed from the 2650 staple cartridge.

[00562] With reference to figures 174 to 180, the end actuator 12 of a surgical instrument, for example, can be configured to receive an end actuator insert 28010. In various embodiments, the end actuator 28010 may comprise a trim body 28012 and at least one tab 28014a, 28014b. In various embodiments, end actuator insert 28010 may comprise a proximal tab 28014b at the proximal end of trim body 28012 and a distal tab 28014a at the distal end of trim body 28012, for example. Referring particularly to Fig. 177, the distal clamp 28014a may be secured to the anvil 25060 of the end actuator 12 on or near the distal end of the anvil 25060. For example, the distal clamp 28014a may be substantially aligned and /or partially positioned within longitudinal slit 25062 of anvil 25060. Referring first to Fig. 178, proximal tab 28014b may be secured to a staple cartridge 25000 in lower jaw 25070 of end actuator 12 (Fig. 179). Proximal tab 28014b may be secured to staple cartridge 25000 over or near the proximal end of staple cartridge 25000. For example, proximal tab 28014b may be substantially aligned and/or po.

located within a longitudinal slot 25004 in staple cartridge 25000.

[00563] Now referring to figures 179 and 180, the end actuator insert 28010 can be inserted into the end actuator 12 of a surgical instrument. In various embodiments, at least a portion of the end actuator insert 28010, such as trim body 28012, distal cleats 28014a, and/or proximal cleat 28014b, may be deformable and/or resilient, for example. When end actuator insert 28010 is inserted into end actuator 12, the distal and/or proximal tabs 28014a, 28014b may bend or flex. When cleats 28014a, 28014b are flexed, for example, cleats 28014a, 28014b may seek to return to their initial undeformed configuration and may generate a corresponding restorative or elastic recovery force, for example. In various embodiments, when end actuator insert 28010 is positioned within end actuator 12, end actuator insert 28010 can apply a bending load to the end actuator.

12. In some embodiments, the end actuator insert 28010 may be solid or substantially solid so that an operator can squeeze the insert 28010 when the operator is inserting the end actuator insert. 28010 and the 25000 staple cartridge in end actuator 12.

[00564] In some embodiments, the 28010 end actuator insert may be removed from the end actuator 12 prior to cutting and/or clamping operations of the end actuator 12. In other embodiments, the 28010 end actuator insert can remain positioned on end actuator 12 during cutting and/or tripping operations. For example, end actuator insert 28010 may be transected by cutting member 25052 as staples are fired from their staple pockets 25002 (figure 178) in staple cartridge 25000. In various embodiments, the end actuator insert 28010 may comprise a fabric build-up material, similar to at least one of the fabric build-up compensators described herein. For example, end actuator insert 28010 can comprise a polymeric composition, such as a bioabsorbable, biocompatible, elastomeric polymer, for example. The end actuator insert 28010 may additionally comprise a bioabsorbable polymer such as, for example, lyophilized polysaccharide, glycoprotein, elastin, proteoglycan, gelatin, collagen and/or oxidized regenerated cellulose (ORC), for example. In some embodiments, tip actuator insert 28010 can comprise at least one therapeutic agent such as a drug or pharmaceutically active agent.

[00565] Still referring to Figures 174 to 180, the insert of the end actuator 28010 may be releasably secured to the end actuator 12 and/or the anvil 25060, and/or the staple cartridge 25000 of the actuator. end 12. Proximal tab 28014b is releasably fastened to staple cartridge 25000 (FIG. 178), for example, and distal tab 28014a is releasably fastened to anvil 25060 (FIG. 177) for example. In various embodiments, the proximal tab 28014b may be aligned with and/or retained within the slot 25004 of the staple cartridge 25000. Additionally, the distal tab 28014a may be aligned and/or retained within the longitudinal slot 25062 of the anvil.

25060. Referring first to figure 179, in certain fashions

The proximal tab 28014b may be releasably secured to the staple cartridge 25000 before the staple cartridge 25000 is positioned in the lower jaw 25070 (Fig. 179). As the 25000 clamp cartridge and the 28010 fixed end actuator insert are moved towards and/or into the end actuator 12 and/or lower jaw 25070, the distal clamp 28014a can be moved into alignment with slot 25062 in anvil 25060, for example. In various embodiments, when the staple cartridge 25000 and end actuator insert 28010 are positioned on end actuator 12 (Fig. 180), distal tab 28014a can releasably engage anvil 25060. Distal tab 28014a can slide into slot 25062 on anvil 25060, for example. In various embodiments, distal tab 28014a may be positioned relative to anvil 25060 before or while proximal tab 28014b is positioned relative to staple cartridge 25000.

[00566] When the end actuator insert 28010 is releasably secured within the end actuator 12, for example, by the proximal clamp 28014b and distal clamp 28014a, as described herein, the end actuator insert 28010 can be held in tension on end actuator 12. In other words, the proximal tab 28014b, secured relative to the staple cartridge 25000 in the lower jaw 25070, can exert a pulling force along the actuator insert. end cap 28010 and distal clamp 28014a, secured relative to anvil 25060, for example. In various embodiments, tension between the proximal clip 28015b and the distal clip 28014a can help to retain the end actuator insert 28010 in the end actuator 12.

[00567] In various arrangements, when the staple cartridge

25000 and end actuator insert 28010 are positioned on end actuator 12, proximal clip 28014b can be in-between unfired slider 25056 (figure 178) and staple cartridge 25000. non-triggered slider 25056 may be proximal to proximal loop 28013b. In certain embodiments, during a firing stroke, slider 25056 can move distally beyond proximal tab 28014b and can deflect proximal tab 28014b, for example. In various embodiments, when slider 25056 deflects proximal tab 28014b during the firing stroke, proximal tab 28014b can be released from slot 25004 in staple cartridge 25000. In certain embodiments, slider 25056 and/or an element of the trigger bar 25050 (illustrated elsewhere) can release the proximal clip 28014b from the 25000 staple cartridge. Additionally, when the proximal clip 28014b is released from the 25000 staple cartridge, the tension on the insert of the end actuator 28010 it can be alleviated, at least partially. In the absence of a pulling force exerted on the distal clamp 28014a, the distal clamp 28014a may release from the anvil 25060. Consequently, the end actuator insert 28010 may be released from the end actuator 12 and may remain, by for example, on the patient's tissue after the end actuator 12 has been removed from the patient.

[00568] In certain embodiments, a proximal end of a layer attachable to the anvil, such as a tissue thickness compensator and/or a reinforcing material, for example, may be releasably attached to a proximal end of a cartridge. of staples for alignment with and fastening to an anvil of an end actuator, into which the staple cartridge can be inserted. In general, the anvil-attachable layer can be arranged relative to the anvil.

one side that faces the anvil of a staple cartridge. For example, the anvil attachable layer may be disposed on a staple platform of the staple cartridge and/or may be disposed on a staple platform layer. A proximal end of the anvil attachable layer may be attached to a proximal end of the staple cartridge or a proximal end of the staple platform layer. After the staple cartridge is inserted into the surgical stapler end actuator, the surgical stapler anvil can be closed against the anvil-attachable layer such that the layer is secured to the anvil. When the anvil is opened again, the anvil attachable layer, now attached to the anvil, can move with the anvil and away from the staple cartridge. In various circumstances, as the anchor layer moves with the anvil, the anchor layer may pivot about its proximal end which is secured to the staple cartridge and/or staple cartridge layer. In various other circumstances, as the fixed layer moves with the anvil, the proximal end of the layer may separate from the staple cartridge. The surgical stapler, with the anvil-attachable layer attached to the anvil, can now cut and staple the patient's tissue. The anvil-attachable layer can also be cut by the surgical stapler and captured by the staples. After the incus-attachable layer and the patient's tissue are captured by the staples, the surgical stapler can be removed from the patient. In various embodiments in which the anvil attachable layer is still attached to the staple cartridge, the surgical stapler can be pulled free of the layer, breaking the attachment between the layer and the staple cartridge.

[00569] Figures 181 and 182 illustrate an embodiment of a staple cartridge assembly 2400 comprising a layer attachable to anvil 2414.

ender a fabric thickness compensator and/or a reinforcing material, for example. A proximal end 2416 of anvil-attachable layer 2414 may be secured to a proximal end 2418 of a staple cartridge body 2402. In various embodiments, the staple cartridge assembly 2400 may include a cartridge layer. of staples 2412, such as a fabric thickness compensator and/or a reinforcing material, for example, disposed in a staple platform of a staple cartridge body

2402. A cartridge protector 2404 may at least partially surround the body of the staple cartridge 2402 and may comprise a metallic material, for example. The staple cartridge body 2402 may include a surface 2406 and grooves 2408 defined in surface 2406 at a proximal end 2418 of the cartridge body 2402. Referring to Fig. 181, to secure the anvil attachable layer 2414 to the body. of staple cartridge 2402, a proximal end portion 2416 of the anvil-attachable layer 2414 may be positioned over grooves 2408. Then, as shown in Figure 182, tabs 2410 extending from cartridge guard 2404 may be deformed such that they extend into grooves 2408, capturing the proximal end portion 2416 of the anvil-attachable layer 2414 in grooves 2408 between the sidewalls of grooves 2408 and tabs 2410, for example . The flaps 2410 may also capture the anvil-attachable layer 2414 between the undersides of the grooves 2408 and the flaps 2410, for example.

[00570] In use, the staple cartridge assembly 2400 shown in Fig. 182, can be inserted into a staple cartridge groove of a surgical stapler end actuator. Then, an anvil of the end actuator may be closed against the anvil attachable layer 2414. The anvil attachable layer 2414 may be disposed on the staple cartridge body 2402 such that the layer 2414 is properly aligned with the anvil when the 2400 staple cartridge assembly is inserted into the 2400 staple cartridge groove and the anvil is then closed. In various embodiments, an anvil facing surface 2415 of the attachable layer to the anvil 2414 may include an adhesive that can adhere to a surface of the anvil and/or one or more features that engage the anvil to secure the attachable layer. to the anvil 2414 to the anvil. For example, the anvil facing surface 2415 may include one or more protrusions extending therefrom that can engage an anvil knife slot. After the anvil attachable layer 2414 has been attached to the anvil, the anvil can be returned to an open position with the anvil attachable layer 2414 attached thereto. The portion of the anvil attachable layer 2414 attached to the anvil may pivot about the proximal end 2416 of the layer 2414 which is attached to the staple cartridge body 2402 to allow the layer 2414 to move with the anvil. Now, the surgical stapler may comprise a staple cartridge layer 2412 aligned with the staple cartridge body 2402 and an anvil-attachable layer 2414 affixed to and aligned with the anvil.

[00571] When the staple cartridge layer 2412 is aligned with the staple cartridge body 2402 and the anvil attachable layer 2414 is attached to and aligned with the anvil, the surgical stapler is prepared for use to cut and staple tissue. of the patient. The staple cartridge body 2402 and staple cartridge layer 2412 can be positioned on one side of the patient's tissue, and the anvil and anvil-attachable layer 2414 can be positioned on an opposite side of the patient's tissue. . The attachment of the anvil attachable layer 2414 to the anvil and to the staple cartridge body 2402 can stabilize the anvil attachable layer 2414 in relation to the anvil 2414.

the anvil while the stapler is being positioned against the patient's tissue. When the surgical stapler is properly positioned relative to the patient's tissue, the anvil can be closed, capturing tissue between the 2402 staple cartridge body and the 2412 staple cartridge layer on one side of the tissue and the anvil and the anvil-attachable layer 2414 on a second opposite side of the tissue.

[00572] After the anvil is closed, with the patient tissue captured between the staple cartridge body 2402 and the staple cartridge layer 2412 on one side, and the anvil and the anvil-attachable layer 2414 on the on the other hand, the surgical stapler can be fired. For example, a staple driver can be advanced in a distal direction through staple drive slots 2422 in staple cartridge body 2402 to fire and form staples that are stored in the staple cartridge. The fired and formed staples can capture the staple cartridge layer 2412, the anvil-attachable layer 2414, and the patient tissue therebetween. In addition, a cutter blade can be advanced in the distal direction through a knife slot 2420 in the cartridge body 2402 and a knife slot in the anvil. The cutting blade can cut through the staple cartridge layer 2412, the anvil-attachable layer 2414, and the patient tissue therebetween, as the cutting blade is advanced. In various modalities, the staple driver and cutter blade can be advanced simultaneously. In various circumstances, the staple driver can drive the cutting blade so that the staples the staples are fired and formed before the cutting blade cuts the patient tissue, staple cartridge layer 2412, and the layer attachable to the anvil 2414.

[00573] After the staple cartridge layer, the anvil-attachable layer 2414 and the patient tissue therebetween have been captured by the staples and cut by the cutting blade, the anvil can be reopened.

When the anvil is reopened, the anvil attachable layer 2414, which is now attached to the staple cartridge layer 2412 and to the patient tissue by the staples, can be separated from the anvil.

For example, as the anvil is opened and/or the surgical stapler is removed from the patient, the anvil-attachable layer 2414 can be held in place by the patient's staples and tissue, such that the layer 2414 can be pulled from a adhesive and/or fastener, for example, that is securing layer 2414 to the anvil.

In addition, the proximal end 2416 of the anvil attachable layer 2414 may be pulled away from the staple cartridge body 2402 so as to be separated from the proximal end 2416 of the staple cartridge body 2402. For example, in various circumstances, the proximal end portions 2416 of the anvil attachable layer 2414, captured between the grooves 2408 in the cartridge body 2402 and the tabs 2410 of the cartridge shield 2404, can be pulled outwardly from the position between the tabs 2410 and the tabs. 2408. In various other circumstances, the anvil attachable layer 2414 may be spaced away from portions of the anvil attachable layer 2414 that are captured between the grooves 2408 and the flaps 2410 of the cartridge protector 2404. For example, the layer portion securable to the anvil 2414 captured between the grooves 2408 and the flaps 2410 may be deformed by the flaps 2410 pressing on the portion of the layer 2414 so as to reduce the force required to push the remaining portion apart. between layer 2414 and/or defining locations where layer 2414 will tear.

For example, tabs 2410, which extend into adjustable anvil layer 2414, may mark, cut, and/or partially perforate layer 2414, for example.

After the staple cartridge layer 2412 is separated from the staple cartridge body 2402, and the anvil-attachable layer 2414 is separated from the staple cartridge body 2402 and the anvil, the surgical stapler can be removed from the patient, leaving layers 2412 and 2414 implanted in the patient. Layers 2412 and 2414 can support the staple lines and/or can compress to different thicknesses in different staples so as to provide at least a minimal amount of compression to the patient's tissue captured by the staples, for example.

[00574] Still referring to figures 181 and 182, in various embodiments, the anvil-attachable layer 2414 may be separated from the staple cartridge body 2402 after the layer 2414 is attached to the anvil and the anvil is opened again . As described above, after the staple cartridge assembly 2400 is inserted into a staple cartridge channel and an anvil is closed on the anvil-attachable layer 2414, the layer 2414 can be secured to an anvil by an adhesive and/or fastener on an anvil-facing surface 2415 of layer 2414. When the anvil is opened again, the anvil-attachable layer 2414 can move with the anvil and away from the staple cartridge body

2402. In various circumstances, movement of the anvil and the anvil-attachable layer 2414 away from the staple cartridge body 2402 can pull the portions of the layer 2414 captured between the flaps 2410 of the cartridge protector 2404 and the ribs 2408 in the cartridge body 2402 out of position between tabs 2410 and grooves 2408 so that proximal end 2416 of layer 2414 can also move with the anvil.

[00575] Figures 183 and 184 illustrate another embodiment comprising a staple cartridge assembly 2450, which includes a layer attachable to anvil 2464, which can be attached to a staple cartridge body 2452. In this embodiment, a proximal end 2466 of the anvil attachable layer 2464 is attached to the surfaces.

cies 2472 in attachment portions 2470 which may extend from a surface 2456 of cartridge body 2452. The proximal end 2466 of the anvil attachable layer 2464 may be secured to surfaces 2472 by adhesives, ultrasonic welding, thermal welding, and /or hot mounting, for example. In various embodiments, staple cartridge assembly 2450 may include a staple cartridge layer 2462 disposed in the staple cartridge body.

2462. In such embodiments, securing portions 2470 may extend from surface 2456 of cartridge body 2452 so that surfaces 2472 are approximately flush with a surface facing anvil 2467 of staple cartridge layer 2462. As a result, the anvil-attachable layer 2464 may be substantially flat by the anvil-facing surface 2467 of the staple cartridge layer 2462 and surfaces 2472. 182, after the 2450 staple cartridge assembly is inserted into a staple cartridge channel of an end actuator, an anvil of the end actuator can be closed so as to make contact with a side facing the anvil. 2465 of the anvil attachable layer 2464. An adhesive and/or fasteners on the anvil-facing side 2465 of the anvil attachable layer 2464 can attach the attachable layer to the anvil 2 464 to the anvil. Then, when the anvil is reopened, the anvil-attachable layer 2464 can articulate around the proximal end 2466 secured to surfaces 2472. Similar to the embodiments described above with respect to Figs. 181 and 182, the cartridge layer of staples 2462, the anvil-attachable layer 2464, and the patient tissue therebetween, can be cut and stapled together. Then, the surgical stapler anvil is opened again and/or the surgical stapler is removed from the patient, the anvil-attachable layer 2464 can be detached from the anvil, and the staple cartridge layer 2462 can be detached from the cartridge body. of staples 2452. In addition, the proximal end 2466 of the anvil attachable layer 2464 may separate from the adhesive and/or other attachment to surfaces 2472 such that the anvil attachable layer 2464 can be implanted in the patient.

[00576] Still referring to Figures 183 and 184, in various embodiments, when the anvil is opened again after the anvil-attachable layer 2464 is attached thereto, the proximal end 2466 of the anvil-attachable layer 2464 may become separate from surfaces

2472. For example, the proximal end 2466 of the anvil attachable layer 2464 may also be attached to the anvil. When the anvil and the anvil attachable layer 2464 move in an opposite direction to the staple cartridge body 2452 and/or the staple cartridge layer 2462, the proximal end 2466 of the layer 2464 can be pulled apart from the surfaces 2472 In such embodiments, the anvil attachable layer 2464 may be separated from the staple cartridge before the staple cartridge layer 2464, the anvil attachable layer 2464, and the patient tissue therebetween, are cut and stapled.

[00577] Figures 185 and 186 illustrate another embodiment comprising a staple cartridge assembly 2500, which includes a staple cartridge layer 2506 and a layer attachable to the anvil 2510. In the embodiment shown in Figures 185 and 186, the ca. anvil attachable layer 2510 is attached to staple cartridge layer 2506 rather than staple cartridge body 2502. staple cartridge layer 2506 and anvil attachable layer 2510 may each comprise a fabric thickness compensator and/or a reinforcing material, for example. The anvil attachable layer 2510 may include a first proximal flap portion.

2512, which extends from a proximal end 2508 of layer 2510. Proximal flap first portion 2512 may be secured to a proximal end surface 2516 of staple cartridge layer 2506. Proximal tab 2512 may be glued, welded, and/or overmolded to a proximal end surface 2516 of staple cartridge layer 2506. In certain embodiments, anvil-attachable layer 2510 may include a second proximal tab portion 2514 extending the from the first proximal tab portion 2512. The second proximal tab portion 2514 can be secured to a lower surface 2518 of the staple cartridge layer 2506 by glueing, welding and/or overmolding, for example.

[00578] Similar to the embodiments described above with reference to figures 181 to 184, after the staple cartridge assembly 2500 is inserted into a staple cartridge groove of an end actuator of a surgical stapler and when an anvil of the end actuator is closed on the anvil attachable layer 2510, an anvil facing surface 2511 of the anvil attachable layer 2510 can be attached to the anvil by an adhesive and/or fasteners. When the anvil is opened again, the anvil attachable layer 2510 can move in the opposite direction to the staple cartridge layer 2506 and the staple cartridge body 2502 with the anvil. In various circumstances, the anvil attachable layer 2510 may revolve around the first flap portion 2512 as the anvil is opened again. After the anvil attachable layer 2510 is attached to the anvil, the end actuator can be closed on the patient tissue such that the staple cartridge body 2502 and the staple cartridge layer 2506 are positioned on a first side of the tissue. of the patient, and the anvil and anvil-attachable layer 2510 are positioned on a second opposite side of the patient's tissue.

As described above with reference to Figures 181 and 182, a cutting blade can be advanced through a knife slot 2520 in the cartridge body 2502 and a staple driver can be advanced through a staple drive slot 2422 in the cartridge body. cartridge 2502. Referring primarily to Fig. 185, in certain embodiments, the first flap portion 2512 and the second flap portion 2514 of the anvil attachable layer may be aligned with the knife slot 2512. As the cutting blade is advanced through knife slit 2520, the cutting blade can separate the first flap portion 2512 and the second flap portion 2514. In various circumstances, the separation of the first flap portion 2512 and the second flap portion 2514 by the cutter blade, it can separate the first flap portion 2512 and the second flap portion 2514 from the staple cartridge layer 2506. After the cutting blade and staple driver have been advanced and the cartridge layer of staples 2506, the cam Once securely attached to the anvil 2510 and the patient tissue therebetween have been cut and stapled, the anvil can be opened again such that the anvil attachable layer 2510 separates from the anvil, and the staple cartridge layer 2506 severs. separates from the staple cartridge body 2502. As noted above, the layer attachable to the anvil 2510 in the embodiment of Figures 185 and 186 is attached to the staple cartridge layer 2506 and not to the staple cartridge body 2502. , no action is required to separate the anvil attachable layer 2510 from the staple cartridge body 2502. In addition, the first flap portion 2512 and/or the second flap portion 2514 from the anvil attachable layer 2510, can - must remain attached to the layer of staple cartridge 2506, as both layers are captured by staples and are implantable in the patient.

For example, if the cutting blade does not separate the first flap portion 2512 and the second flap portion 2514 from the cap.

staple cartridge layer 2506, then staple cartridge layer 2506 and anvil attachable layer 2510 will be secured together within the patient by the formed staples and first and second flap portions 2512 and 2514.

[00579] Still referring to figures 185 and 186, in various modes, after the staple cartridge assembly 2500 has been inserted into the staple cartridge channel and the anvil-attachable layer 2510 has been attached to the anvil, the first flap portion 2512 and the second flap portion 2514 may separate from the staple cartridge layer 2506 when the anvil is reopened and the anvil attachable layer 2510 moves away from the staple cartridge layer 2506. For example, the anvil and the anvil attachable layer 2510 attached thereto can pull the first flap portion 2512 and the second flap portion 2514 away from the staple cartridge layer 2506 so that the first flap portion 2512 and second flap portion 2514 separate from staple cartridge layer 2506.

[00580] Figures 187 and 188 illustrate another embodiment comprising a layer attachable to the anvil 2550 for use with a surgical stapler. As explained below, the proximal end portion 2554 of the anvil attachable layer 2550 can be attached to a proximal end portion of a staple cartridge for insertion into a surgical stapler end actuator and for alignment and fastening to an anvil of the tip actuator. A body 2552 of the anvil attachable layer 2550 may be separated from the staple cartridge by a cutting blade of the surgical stapler at the beginning of the stroke of the cutting blade. For example, the cutting blade 2570 shown in Fig. 188 may separate from the anvil attachable layer 2550 of the staple cartridge before any tissue from the patient is cut and before any portion of the body 2552 of the anvil attachable layer 2550 has been captured by the staples.

Referring primarily to Fig. 187, the anvil-attachable layer 2550 may include a body 2552 and a proximal end portion 2554. The proximal end portion 2554 includes fasteners 2556 which may attach to a portion. of the proximal end of a staple cartridge. For example, fasteners 2556 may include adhesives, solders and/or heat-mounting. Fastener 2556 may also comprise a captured portion between a slot in a staple cartridge and a tab of a cartridge panel, as described above with respect to Figures 181 and 182, for example. The anvil attachable layer 2550 can be attached to and aligned with the staple cartridge so that the staple cavities of the staple cartridge are aligned with the body 2552 of layer 2550. In other words, when the staple cartridge staples have been fired, the clamps will capture the body 2552 of the anvil-attachable layer

2550. Similar to the embodiments described above with reference to figures 181 to 186, a staple cartridge assembly including an anvil-securable layer 2550, secured to a staple cartridge, may be inserted into a staple cartridge channel. staple cartridge staples of a surgical stapler end actuator. An end actuator anvil may close on a surface that faces anvil 2553 of the anvil-attachable layer.

2550. The anvil facing surface 2553 may include an adhesive and/or fasteners that releasably secure the anvil attachable layer 2550 to the anvil when the anvil is closed over the anvil facing surface. 2553. When the anvil is reopened, the layer attachable to the anvil 2550 can articulate around the fasteners 2556 to move with the anvil. Similar to the modalities described above with reference to the figures.

181 to 186, the staple cartridge may include a staple cartridge layer, such as a fabric thickness compensator and/or a reinforcing material, for example.

The anvil-attachable layer 2550 may comprise a first lateral side 2566 and a second lateral side 2568. The first lateral side 2566 and the second lateral side 2568 may define therebetween a midline 2564. In certain embodiments, the layer attachable to anvil 2550 can be attached to and aligned with the anvil of the end actuator so that the midline 2564 is aligned with a knife slot on the anvil and a knife slot on the staple cartridge. The body 2552 of the anvil attachable layer 2550 may include a first lateral slit 2558 positioned near a proximal end and extending from the first lateral side 2566 and extending beyond the midline 2564. The anvil 2550 may also include a second lateral slit 2560 positioned proximally to the first lateral slit 2558, extending from the second lateral slit 2568 and extending beyond the midline 2564. The first lateral slit 2558 and the second lateral slit 2558 2560 may define a connector portion 2562 therebetween which may connect the body 2552 of the attachable layer to the anvil 2550 to the proximal end portion 2554 of the layer 2550.

[00583] Referring primarily to Fig. 188, after the anvil attachable layer 2550 is releasably attached to the anvil of the end actuator, the end actuator can be closed in the patient's tissue so that the anvil and the anvil-securable layer 2550 are on one side of the fabric and the staple cartridge and/or staple cartridge layer are on an opposite side of the fabric. Then, a cutting blade 2570 can be advanced through a knife slot in the cartridge, such as the knife slot 2418 shown in Figures 181 to 185, for example, and a knife slot in the anvil. There-

Middle line 2564 of the anvil attachable layer 2550 may be aligned with the knife slots such that the cutting blade 2570 progressively cuts the anvil attachable layer 2550 along the midline. As the cutting blade advances through the anvil attachable layer 2550 in a distal direction indicated by arrow D, a cutting edge 2572 of the cutting blade 2570 first cuts the proximal end portion 2554 of the layer 2550 before, then cutting through connector portion 2562, separating body 2552 of layer 2550 from proximal end portion 2554 of layer 2550. Finally, cutting blade 2570 cuts through body 2552 of layer attachable to anvil 2550. cutting blade 2570 having advanced through the layer attachable to the 2550 anvil, the layer is divided into four pieces. The body 2552 of the anvil attachable layer 2550 is separated from the proximal portion 2554 of the layer 2550. In addition, the body 2552 of the anvil attachable layer 2550 is divided into two pieces 2580 and 2582 and the proximal portion 2554 of the layer 2550 is divided into two pieces 2586 and 2588.

[00584] In various circumstances, a surgeon using a surgical stapler may not fully trigger the stapler. For example, with reference to Fig. 188, the surgeon can only advance the cutting blade 2570 and the staple driver halfway through the body 2552 of the anvil-attachable layer.

2550. Continuing the example, the body 2552 of the anvil attachable layer 2550 is released from the staple cartridge at the beginning of the cutting stroke of the cutter blade 2570 when the blade 2570 separates the connector portion 2560 from the layer 2550. cut 2570 will then be advanced to cut along midline 2564, along approximately half the length of the body 2552 of the anvil-attachable layer 2550. Similarly, a staple driver may advance to fire and form staples in tissue of the patient and in the half of the body 2552 of the layer 2550 which is cut by the cutting blade 2570. The remaining half of the body 2552 of the layer attachable to the anvil 2550 is not cut and is not captured by the clamps. The 2570 cutter blade and staple driver can then be retracted and the anvil reopened. When the anvil is reopened, the portion of the body 2552 of the incus-attachable layer 2550 that is captured by the staples and secured to the patient's tissue may detach from the anvil. As described above, the connector portion 2560 which connects the body 2552 of the attachable layer to the anvil 2550 to the proximal end portion 2554, may be detached before any clip is fired and before the cutting blade 2570 separates any tissue from the patient or any portion of body 2552 of layer 2550. Consequently, body 2552 of layer 2550 is already free of the staple cartridge. When the surgical stapler is removed from the patient, the portion of the body 2552 of the anvil attachable layer 2550 that is captured by the patient's tissue can pull the remainder of the body 2552 away from the anvil. As this example describes, the anvil attachable layer 2550 can accommodate an incomplete firing of the surgical stapler because the connector portion 2560 of the anvil attachable layer 2550 can be cut by the cutting blade 2570 before any staple of a cartridge. staples be fed and formed into body 2552 of layer 2550.

[00585] The modalities described with reference to figures 181 to 186 can also accommodate an incomplete firing of a surgical stapler. In each case, a surgical stapler cutting blade is not required to separate the anvil-attachable layer from the staple cartridge. In the embodiments described with reference to Figures 181 to 184, the layers attachable to the anvil may be pulled free of their attachment to the staple cartridge body after a partial firing of the surgical instrument. In the embodiments described with reference to Figures 185 and 186, the anvil attachable layer is attached to a staple cartridge layer, rather than being attached to the staple cartridge. As described above, the staple cartridge layer and the anvil-attachable layer are both implantable in the patient. Thus, if the surgical instrument is fully triggered, there is no support in separating the layers attachable to the anvil in the modalities described with reference to Figures 181 to 186 of a staple cartridge in a surgical stapler.

[00586] In various circumstances, a surgeon may use a second surgical instrument to separate the incus-securable layers described above with reference to Figs. 181 to 184 of a staple cartridge. For example, in various circumstances, the surgical stapler is used on delicate tissue, such as lung tissue, and the surgeon may want to avoid pulling hard, which may result from pulling the surgical stapler free of the layer attachable to the anvil. In such circumstances, the surgeon may introduce another surgical instrument, such as a grip tool, to hold the stapled tissue of the patient and the anvil-attachable layer stationary while the surgical stapler is removed from the patient. In the various anvil-attachable layer modalities described above with reference to Figures 185 to 188, it may not be necessary for a surgeon to use a second surgical tool to separate the anvil-attachable layer from the surgical stapler. Again with reference to the modalities described with reference to Figures 185 and 186, the anvil attachable layer 2510 is attached to a staple cartridge layer 2506, which is also implanted in the patient. There is no attachment of the attachable layer to the anvil to the staple cartridge in the surgical stapler. Therefore, the patient's tissue does not need to be pulled out or pulled to separate the anvil-attachable layer of the staple cartridge when the stapler is removed from the patient. Again with regard to

Referring to the embodiments described with reference to Figures 187 and 188, the body 2552 of the anvil-attachable layer 2550 is mechanically separated from the surgical stapler by a cutting blade 2570 at the beginning of the cutting blade stroke. Again, there is no attachment of the body 2552 of the attachable layer to the anvil 2550 to the staple cartridge in the surgical stapler when the surgical stapler is ready for removal from the patient, after cutting and stapling the patient's tissue. Therefore, the patient's tissue does not need to be torn off or pulled to separate the body 2552 from the anvil-attachable layer 2550 of the staple cartridge when the stapler is removed from the patient.

[00587] First, with reference to Figures 189 and 190, a compensator 27120 for a sleeve 27110 may comprise a body 27122 having a longitudinal protrusion 27124 extending along at least a portion of the body 27122. longitudinal tuberace 27124 can define a longitudinal trajectory along the midline of the body 27122, for example. In various embodiments, the longitudinal bulge 27124 can be received by a longitudinal slit in an anvil when the sleeve 27110 is positioned on the anvil. Referring primarily to Fig. 191, the longitudinal protuberance 27124 may comprise a rounded projection. For example, the cross section of the longitudinal protuberance 27124 can form an arch and/or partial ring. In other embodiments, the longitudinal protuberance 27124 may comprise an angular and/or stepped projection. The compensator 27120 can additionally comprise an edge 27126, which can be straight, slanted, grooved, wavy and/or have a zigzag pattern, for example. In various embodiments, edge 27126 can comprise spans 27128 that can be configured to receive fastener extensions extending from the anvil when the assembled sleeve 27110 is positioned on the anvil.

[00588] As outlined here, a layer, such as a tissue thickness compensator, for example, can be implanted against tissue by one or more fasteners ejected by a staple cartridge.

Also as outlined herein, in various circumstances, an entire row of staples can capture at least a portion of the layer against tissue.

For example, the staples most proximal in a staple line can capture at least a portion of the layer there, while the staples more distal in the staple line can also capture at least a portion of the layer there.

In certain circumstances, a proximal portion of the layer may extend proximally with respect to the most proximal staples in the staple line and/or a distal portion of the layer may extend distally with respect to the most distal staples in the staple line .

In use, a series of layers can be deployed.

In at least one such circumstance, layers can be deployed consecutively along a cut line.

In some circumstances, layers can be deployed so that one layer partially overlaps another layer.

For example, the distal end of a first implanted layer may overlap the proximal end of a second implanted layer.

Similarly, the distal end of the implanted second layer may overlap a proximal end of a third layer, and so on.

As a result, certain fasteners can capture a portion of two or more layers there.

The presence of two or more layers trapped within a staple can increase the pressure applied to tissue trapped within the staple and/or increase tissue stiffness, specifically when multiple adjacent staples have trapped more than one layer.

Now with reference to figures 192 to 194, as described in more detail below, a 11050 fabric thickness compensator can be purchased.

extending a proximal end 11053 and a distal end 11055, wherein the proximal end 11053 and/or the distal end 11055 may comprise one or more strain relief portions that can reduce the stiffness of the tissue thickness compensator 11050 and the stiffness of the fabric being stapled.

[00589] Now referring again to Figs. 192 to 194, the distal end 11055 of the tissue thickness compensator 11050 may comprise one or more slits 11058 defined therein. Slots 11058 may comprise cutouts and/or notches, for example, defined in fabric thickness compensator 11050. Slots 11058 may define projections, or tabs, 11056, which may be configured to move and/or flex, upon less partially, relative to each other, and/or to the body portion of the fabric thickness compensator 11050. In other words, the slits 11058 can provide localized strain relief to the fabric thickness compensator 11050 and to the underlying tissue. In certain circumstances, tabs 11056 of a first tissue thickness compensator 11050 may be overlapped by a proximal end 11053 of a second tissue thickness compensator 11050. In various circumstances, slits 11058 may allow for the first. fabric thickness compensator 11050 and the second fabric thickness compensator pivot relative to each other. In certain circumstances, referring primarily to Fig. 194, tabs 11056 of a first fabric thickness compensator 11050 may be overlapped by tabs 11056 of a second fabric thickness tab 11050. overlapping distal ends 11055 can further reduce stiffness within the underlying tissue. While the illustrated fabric thickness compensator embodiment 11050 comprises only an arrangement of tabs 11057 and slits 11058 at one end thereof, a fabric thickness compensator may comprise an array of tabs 11057 and slits 11058 at both ends thereof, by example.

[00590] In certain embodiments, in addition to the above, each tab 11056 may comprise a tapered profile. For example, each flap 11056 may comprise a base attached to the body of the fabric thickness compensator 11050 having a base width and a free end at its opposite end with an edge width, wherein the width of the base may be larger than the width of the edge. In certain embodiments, the edge width may be greater than the base width. Referring primarily to Fig. 194, an end 11055 may comprise a plurality of tabs 11056 having different configurations. For example, tabs 11056 can be different lengths. As illustrated in Fig. 194, a more extreme tab 11056a can have a first length, a second tab 11056b can have a second length that is greater than the first length, a third tab 10056c can have a third length that is longer than the second length, a fourth tab 10056d can have a fourth length that is longer than the third length, a fifth tab 10056e can have a fifth length that is longer than the fourth length, and a sixth tab 10056f can have a sixth length that is longer than the fifth length, for example. In such an embodiment, tabs 10056 may be made progressively shorter toward the distal end of tissue thickness compensator 10050. In other embodiments, the lengths of tabs 10056 may be arranged in any other suitable arrangement.

[00591] In various circumstances, in addition to the above, a layer may comprise edges that define the perimeter of the layer. These edges can be straight, substantially straight, linear and/or substantially linear under certain circumstances. In some such circumstances, the edges of the layer may impact and/or otherwise affect the surrounding tissue. Also, in some of these circumstances, the edges can be rigid and can rigidly support the fabric. Indeed, certain portions of the fabric may not be supported by the layer adjacent to other portions of the fabric which are rigidly supported by the layer without transition from each other. Referring to Figs. 192 to 194 again, the perimeter of the fabric thickness compensator 11050 can include a contoured configuration that can provide a region of transitional stiffness to the underlying fabric. The perimeter of the fabric thickness compensator 11050 may comprise a plurality of notches or recesses 11059 defined therein, which may define the tabs.

11057. Similar to the above, tabs 11057 may extend from the body of fabric thickness compensator 11050 and may move relative thereto. Also similar to the above, each flap 11057 may comprise a base end secured to the body of the fabric thickness compensator 11050 and a free end which is movable relative to the base end. In certain circumstances, the free end of a tab 11057 may have a width that is less than the width of the base end of tab 11057, while, in other circumstances, the free end of a tab 11057 may have a width that is greater than the width of the base end of tab 11057. Tabs 11057 may comprise any suitable configuration such as a semi-circular configuration, or an at least partially arcuate configuration, for example. As a result of the above, the tissue underlying and/or attached to the body portion of the tissue thickness compensator 11050 may be rigidly supported by the body portion, the tissue underlying and/or attached to the tabs 11057 may be less than rigidly supported by tabs 11057, and fabric adjacent to tabs 11057, but not underlying tabs 11057, may not be supported by fabric thickness compensator 11050.

[00592] Now referring to Figs. 195 and 196, a staple cartridge assembly 11100 may comprise a cartridge body 11110 and a tissue thickness compensator 11150 secured to the cartridge body 11110. Cartridge assembly 11100 may comprise additionally one or more fasteners 11160 configured to releasably retain tissue thickness compensator 11150 in cartridge body 11110. In at least one circumstance, each fastener may comprise an extending strip around cartridge body 11110 and fabric thickness compensator 11150. In use, in addition to the above, a firing member 10030 may be advanced through staple cartridge 11100 to cut fabric thickness compensator 11150 , firing the staples at least partially stored in the cartridge body 11110 and separating the fasteners 11160. The tissue thickness compensator 11150 may comprise a first end. the proximal end or end 11157 and a second end or distal end 11155. The distal end 11155 may comprise an elongated projection 11156 extending from a body portion 11153 of the tissue thickness compensator 11150. As shown in Figure 195, the elongated projection 11156 may extend distally with respect to the more distal fixture 11160. In at least the illustrated embodiment, the cartridge body 11110 may comprise a platform 11113 within which the body clamp cavities of cartridge 11110 can be set. Under various circumstances, the body 11153 of the com-

Fabric Thickness Thinker 11150 can be configured and arranged so that it covers the platform 11113 and the clip cavities defined in the cartridge body 11110. elongated section 11156 may extend distally from platform 11113 and extend distally with respect to clamp cavities defined in platform 11113.

[00593] In use, in addition to the above, fabric thickness compensator 11150 can be attached to fabric and can provide fabric thickness compensation properties as described here. Similar to the above, the fabric underlying the tissue thickness compensator 11150 can be rigidly supported by the tissue thickness compensator 11150 and the clamps that secure the same, while the surrounding tissue fabric thickness compensator 11150 may not be supported by fabric thickness compensator 11150 and may be flexible. In such circumstances, the fabric between the unsupported flexible fabric and the rigidly supported fabric underlying the fabric thickness compensator 11150, i.e., the transition fabric, may be subjected to an undesirable amount of deformation. Such deformation can negatively impact the transition fabric. For example, when a tissue thickness compensator is attached to lung tissue, or to the lung, for example, tissue that immediately surrounds the perimeter of the tissue thickness compensator, i.e. the perimeter tissue, may tear under certain circumstances. , especially perimeter tissue adjacent to and/or surrounding the distal end of the tissue thickness compensator, i.e., edge perimeter tissue. The 11156 distal projection of the 11150 Tissue Thickness Compensator, however, can support the edge perimeter tissue. In other words, the distal projection 11156 can provide transitional support for the extremity perimeter tissue. Such transitional support may be less than the support provided by the fabric thickness compensator body 11150 and may mitigate the shift in deformation between the unsupported fabric and the fully supported fabric underlying the fabric thickness compensator 11150 In various circumstances, the 11156 distal projection can provide an enlarged area in which force can be transmitted between the unstapled tissue and the stapled tissue. Distal projection 11156 may be configured to flex and move with unsupported tissue and tissue thickness compensator 11150. In various circumstances, distal projection 11156 may move relative to the body portion of the thickness compensator. 11150 fabric and/or non-supported fabric.

The tissue thickness compensator 11150, again with reference to figures 195 and 196, may further comprise a notch 11157 defined at its proximal end 11153. The notch 11157 may be defined between two distally extending projections 11158. Notch 11157 may comprise any suitable shape, such as a parabolic shape, for example. Similar to the above, the distally extending projections 11158 can provide transitional support to the proximal end perimeter tissue. Such transitional support may be less than the support provided by the body of fabric thickness compensator 11150 and may mitigate the change in deformation between the unsupported fabric and the fully supported fabric underlying the fabric thickness compensator 11150. In various circumstances, the proximal projections 11158 can provide an enlarged area in which force can be transmitted between the unstapled fabric and the stapled fabric. The 11158 distal projections can be configured to flex and move with unsupported tissue and offset.

fabric thickness compensator 11150. In various circumstances, the proximal projections 11158 may move relative to the body portion of the fabric thickness compensator 11150, relative to one another and/or to the unsupported fabric. Several alternative modalities are devised in which more than two projections extend from the proximal end and/or the distal end of a tissue thickness compensator.

[00595] As illustrated in Fig. 196, two or more tissue thickness compensators 11150 can be deployed, in an end-to-end fashion, along a trajectory. In such circumstances, the distal end 11155 of a first tissue thickness tab 11150 may overlap the proximal end 11153 of a second tissue thickness tab 11150. Similarly, the distal end 11155 of the second tissue thickness tab 11150. tissue thickness 11150 may overlap the proximal end 11153 of a third tissue thickness compensator 11150. In various circumstances, the distal projection 11156 of the first tissue thickness compensator 11150 may be aligned, or at least substantially aligned, with the 11157 recess of the second fabric thickness compensator

11150. In addition, in various embodiments, distal projection 11156 and proximal recess 11558 may be sized and configured so that they are substantially the same size and/or shape. In various circumstances, a distal projection 11156 may be configured to be positioned within a proximal recess 11157 of an adjacent tissue thickness compensator 11150.

[00596] Turning now to figures 293 and 294, an end actuator of a surgical stapling instrument may comprise a first gripper that includes a cartridge channel

11390, configured to receive therein a staple cartridge 11300, and a second claw including an anvil 11391. Similar to the above, staple cartridge 11300 may comprise a cartridge body 11310 and a tissue thickness compensator

11350. The staple cartridge 11300 may further comprise a fabric adjoining member 11355 affixed thereto. The fabric adjoining member 13555, in various circumstances, may be removably affixed to the cartridge body 11310. In addition to or in lieu of being removably affixed to the cartridge body 11310, the fabric adjoining member 11355 may be attached to fabric thickness compensator 11350. In at least one such embodiment, fabric adjoining member 11355 may be releasably secured to fabric thickness compensator 11350. In use, similar to that set forth above, may be Fasteners are dispensed by the cartridge body 11310 to secure the 11350 fabric thickness compensator to the T fabric captured between the 11350 fabric thickness compensator and the 11391 anvil. In various circumstances, the fasteners may not penetrate the adjoining member to fabric 11355. In certain other circumstances, the fasteners may penetrate and capture at least a portion of the adjoining member to fabric 11355 and secure the adjoining member to the fabric. 11355 to the T fabric. In one case or another, similar to the above, at least a portion of the tissue adjoining member 11355 may be configured to provide transitional support between the unsupported fabric and the fabric underlying the slack compensator. 11350 fabric thickness, which is rigidly supported by the fasteners. Fabric adjoining member 11355 may comprise any suitable shape, such as a tongue shape, for example. In at least one embodiment, the fabric adjoining member 11355 may comprise one or more notches 11358 that can comprise one or more notches 11358.

set tabs 11356 between them. Once fabric thickness compensator 11350 has been positioned against and secured to fabric T, fabric adjoining member 11355 can be configured to flex relative to fabric thickness compensator 11350 and provide fabric support. adjacent to the distal end of tissue thinner 11350. In various circumstances, tissue adjoining member 11355 may flex relative to tissue thinner 11350 and tabs 11356 may flex relative to one another, to the body of the fabric adjoining member 11355 and/or the fabric thickness compensator 11350, for example.

[00597] Referring again to Figures 293 and 294, at least a portion of the fabric adjoining member 11355 may overlap the fabric thickness compensator 11350. In various circumstances, such a portion of the fabric adjoining member 11355 it can be attached to the fabric thickness compensator 11350 by one or more adhesives, for example. Under certain circumstances, at least a portion of tissue-contiguous member 11355 may overlap one or more clip cavities defined in cartridge body 11310, so that clips ejected from such clip cavities can capture at least one. portion of the fabric adjoining member 11355, and securing the fabric adjoining member 11355 to the fabric. At least a portion of tissue adjoining member 11355 may overlap a tip 11311 of cartridge body 11310. In various circumstances, such a portion of tissue adjoining member 11355 may be secured to tip 11311 by an or more stickers, for example. In other circumstances, such a portion of the tissue adjoining member 11355 may not be attached to the tip 11311. Referring primarily to Fig. 294, at least a portion of the tissue adjoining member 11355 may overlap a distal portion 11312. of tip 1311. In various circumstances, such portion of tissue adjoining member 11355 may not be secured to distal portion 11312 of tip 11311. In at least some circumstances, a gap may be defined between tissue adjoining member 11355. At least a portion of tissue adjoining member 11355 may extend freely from tip 11311 of cartridge body 11310. In such embodiments, tissue adjoining member 11355 may comprise a cantilever.

[00598] In use, in addition to the above, the staple cartridge 11300 can be positioned on a first side of the fabric T and the anvil 11391 can be positioned on the second side. Anvil 11391 may then be pivoted toward staple cartridge 11300 about a pivot 11392 defined on a shank 11393 of a surgical stapling instrument. Once the anvil 11391 and staple cartridge 11300 have been properly positioned, the staples contained in the cartridge body 11310 can be ejected therefrom, penetrate the tissue thickness compensator 11350 and secure the tissue thickness compensator 11350 in the fabric T. Thereafter, the anvil 11391 can be opened and the end actuator can be moved in the opposite direction to the fabric T. In such circumstances, the cartridge body 11310 can be pulled from the fabric thickness compensator 11350 , thereby leaving the 11350 fabric thickness compensator behind. Simultaneously, the fabric adjoining member 11355 may separate from the staple cartridge 11300 with the fabric thickness compensator 11350. To the point where the fabric adjoining member 11355 is secured to the fabric thickness compensator 11350, fabric thickness compensator 11350 can secure fabric adjoining member 11355 against fabric. In various circumstances, the fabric adjoining member 11355 may be forced against the fabric T by the fabric thickness compensator 11350. When the fabric moves, it expands and/or flexes, for example, the fabric adjoining member 11355 it can flexibly support the underlying tissue T and distribute forces, stresses and/or deformations over a large area.

[00599] Now with reference again to figures 293 and 294, the end actuator of a surgical instrument may comprise a tissue adjoining member, such as tissue adjoining member 11395, for example, attached to anvil 11391 In various circumstances, fabric adjoining member 11395 may be the same, or at least substantially the same, as fabric adjoining member 11355. In at least one circumstance, fabric adjoining member 11395 may comprise notches 11398 defined between tabs 11396. In use, fabric adjoining member 11395 may be secured to anvil 11391 using one or more adhesives, for example, fabric adjoining member 11395 may be positioned against the tissue T when anvil 11391 is positioned relative to tissue T and then closed. When the anvil 11391 is reopened after the staples have been fired from the staple cartridge, the tissue adjoining member 11395 may separate from the anvil 11391 and remain attached to the tissue T. In various circumstances, at least a portion of the tissue adjoining member 11395. tissue contiguity 11395 can be captured within the clips ejected by the cartridge body 11310, for example. At least in such circumstances, tissue adjoining member 11395 may overlap, at least partially, or extend over the staple cavities defined in anvil 11391. In some circumstances, one or more adhesives, such as activatable adhesives , for example, may be situated on the tissue contact surfaces of the tissue adjoining member 11395, so that the member.

Fabric adjoining member 11395 can adhere to fabric T. In any case, referring primarily to Fig. 294, one of or both fabric adjoining member 11355 and fabric adjoining member 11395 may be used to support, of flexibly, the fabric T. In embodiments where both the fabric adjoining member 11355 and the fabric adjoining member 11395 are used, the fabric adjoining members 11355 and 11395 may comprise the same material, or different materials. Fabric adjoining members 11355 and 11395 may comprise the same shape and configuration, or different shapes and configurations. Fabric adjoining members 11355 and 11395 may also comprise the same or different thicknesses. Such properties of the fabric adjoining members 11355 and 11395 can be selected so as to provide a desired support profile for the fabric positioned therebetween. For example, such properties can be selected so that one of the 11355 and 11395 fabric thickness compensators is stiffer than the other. Simultaneously, such properties can be selected so that one of the fabric thickness compensators 11355 and 11395 is more flexible than the other.

[00600] In various circumstances, a fabric thickness compensator may comprise a plurality of layers. For example, a fabric thickness compensator can comprise a first layer and a second layer. Such layers can comprise the same materials or different materials. Some layers can be configured to provide different fabric thickness compensator properties. For example, a fabric thickness compensator can comprise a compressible first layer that provides thickness compensating properties and a stiffer second layer that can support the first layer. Referring primarily to Figs. 197 and 198, fabric thickness compensator 11250 may comprise a first layer 11251 and a second layer 11252. Second layer 11252 may be compressible and may provide fabric thickness compensating properties . First layer 11251 may be rigid and may support second layer 11252. Second layer 11252 may be positioned against and/or secured to a cartridge body 11210, for example. Under certain circumstances, first layer 11251 may comprise a longitudinal channel 11253 extending along its length, which may be sized and configured to be releasably retained in a longitudinal knife slot 11215 defined in cartridge body 11210. In various circumstances, second layer 11252 may be secured to first layer 11251 and held in place by first layer 11251.

[00601] Again with reference to figures 197 and 198, the compensator 11250 may comprise a plurality of layers. In addition, an outer periphery 11218 of the second layer 11252 may be extended, at least partially, beyond an outer periphery 11220 of the first layer 11251. In addition, the first layer 11251 and the second layer 11252 may comprise different degrees of stiffness. For example, second layer 11252 can be configured to be more flexible than first layer 11251; Such an arrangement can provide fabric thickness compensator 11250 with a sufficiently rigid inner region comprising the first layer 11251 and the second layer 11252, which may be suitable to provide adequate support for the 11260 staples, and a sufficiently flexible outer region, which comprises the second layer 11252, which may be suitable to provide sufficient flexibility to cushion the impact on the fabric T and the fabric thickness compensator 11250 by the clamps 11260. The layers 11251 and 11252 can be joined, for example, by a sticker. Other securing means for securing first layer 11251 to second layer 11252 are contemplated within the scope of the present disclosure.

[00602] In addition to the above, the first layer 11251 may include an inner portion 11254 and an outer portion 11256 that at least partially surround the inner portion 11254, the outer portion 11256 may be configured to be more flexible than than the inner portion 11254. For example, the outer portion 11254 may comprise a plurality of slots 11210, which may increase the flexibility of the outer portion 11254. Furthermore, as described above, the second layer 11252 may be configured to be more flexible than the 11251 first layer. This arrangement can provide the 11250 fabric thickness compensator with three regions of different stiffness, including a first inner region that has the greatest stiffness, with the inner region comprising the inner portion 11254 of first layer 11251 and second layer 11252, a middle region having intermediate stiffness, the middle region comprising outer portion 11256 of first layer 1125 1 and the second layer 11252, and a third outer region which has the minimum stiffness, the third region comprising only the second layer 11252.

The second layer 11252 of the 11250 fabric thickness compensator may comprise a woven structure which may include a plurality of fibers which can be woven into the woven structure. The woven structure can provide the second layer 11252 with sufficient flexibility to cushion the impact on the fabric T, for example, during and/or after the capture of the fabric T and the fabric thickness compensator 11250 by the clamps 11260. In addition, the periphery External 11218 may comprise fibers that can provide an atraumatic tissue contact surface to minimize impact on tissue T, as described above. The woven structure and fibers can comprise biocompatible materials. Furthermore, the woven structure and/or the fibers can comprise from a biocompatible material, such as PLLA, PGA, PCL and/or combinations thereof, for example.

[00604] Referring to Figures 199 to 201, a staple cartridge channel may be configured to receive a staple cartridge 1060 which may comprise a cartridge body 1062, a cartridge platform 1064 and a holder 1065. , tissue thickness compensator such as tissue thickness compensator 1100 may be removably positioned against or adjacent to cartridge platform 1064 as illustrated in Fig. 199.

[00605] Again with reference to figures 199 to 201, a tissue thickness compensator can be configured to be absorbed after implantation into a patient. the absorption process may initially reduce the tissue thickness compensator to smaller pieces that may include rough edges that may have undesirable effects on the surrounding tissue T. To mitigate these effects, the tissue thickness compensator 1100 it can be at least partially assembled from a plurality of pieces 1140, which can each have atraumatic outer peripheries and can be joined together to form a single structure, as illustrated in Figure 201. 1140 can be joined to form fabric thickness compensator 1100 in such a way that the absorption process can first reduce fabric thickness compensator 1100 to pieces 1140, thus minimizing the presence of rough edges. For example, parts 1140 may comprise circular profiles and may be heat welded together to form fabric thickness compensator 1100. Other profiles and other means for joining parts 1140 are contemplated within the scope of the present disclosure. In one example, parts 1140 can be joined by an adhesive 1143 (See Figure 200) configured to absorb faster than parts 1140, to allow for separation of parts 1140 at an early stage of the absorption process. As shown in Fig. 200, the pieces 1140 can be arranged in an overlapping matrix, with an end portion of one piece 1140 being able to overlap an end portion of another piece 1140, so that the two end portions of the pieces 1140 are releasably secured together by an adhesive, for example. Under certain circumstances, parts 1140 may be arranged in another overlapping arrangement, with one of parts 1140 being releasably positioned and secured to a plurality of parts 1140, as illustrated in Fig. 201.

[00606] With reference to Figures 202 to 204, as described above, a tissue thickness compensator can be configured to be absorbed after implantation into a patient and the absorption process may initially reduce the tissue thickness compensator to random smaller pieces . Guiding the absorption process to produce parts with atraumatic outer edges can be achieved as described above, starting with small parts that have atraumatic outer edges. Another approach might include modifying the tissue thickness compensator in such a way as to allow its separation into smaller pieces having atraumatic peripheries at an early stage of the absorption process. For example, as illustrated in Fig. 202, a fabric thickness compensator 1200 may comprise a pattern such as pattern 1212, for example, which may be molded or notched into fabric thickness compensator 1200 to produce, for example. , a plurality of circular shaped portions 1210. Portions 1210 can be defined by reducing the thickness of the fabric thickness compensator 1200 along the circumferences 1214 of the circular shaped portions 1210, as illustrated in the cross-sectional view. in figure 202A. As a result, faster absorption may occur along the circumferences 1214 of circular shaped portions 1210, which can lead to a separation of the circular shaped portions 1210 from one another at an early stage of the absorption process. Patterns comprising other geometrically shaped portions with atraumatic outer peripheries are contemplated within the scope of the present disclosure. For example, as illustrated in Fig. 203, fabric thickness compensator 1200' may comprise a pattern 1216 comprising portions 1218 which may include longitudinally extending profiles in a wave-like profile along a length of the compensator. of fabric thickness 1200'. In another example, as illustrated in Fig. 204, fabric thickness compensator 1200" may comprise a pattern 1220 which may include hexagonal shaped portions 1222.

[00607] With reference to Figure 205, as described above, a fabric thickness compensator, such as a 1250 fabric thickness compensator, can be captured along with T fabric by the staples, such as the 1002 staples, for example, and it can be configured to be reduced to atraumatic parts, such as 1226 parts for example, at an early stage of the absorption process after implantation in a patient. Upon separation, pieces 1226 can move and/or slide relative to one another, which can affect surrounding tissue T. To minimize relative movement between pieces 1226, triggered clips 1002 can be spaced apart. cially in the 1250 Fabric Thickness Compensator so that a clamp 1002 can capture multiple 1226 pieces, as illustrated in Figure 205. This can also help to keep the 1250 Fabric Thickness Compensator in a substantially unique structure after the pieces 1226 are separated from one another at the initial stage of the absorption process. As such, the fabric thickness compensator 1250 can continue to provide support to the fabric T captured by the clips 1002 after the pieces 1226 are separated from one another at the initial stage of the absorption process.

[00608] In addition to the above, now with reference to figure 206, yet another approach can be taken to guide the process of absorbing a tissue thickness compensator to produce small pieces with atraumatic outer edges. For example, as illustrated in Fig. 206, a fabric thickness compensator such as fabric thickness compensator 1300 may comprise a plurality of slots 1310, which can be strategically positioned to improve the flexibility of the fabric thickness compensator. 1300, as described above. In addition, slits 1310 can partially divide fabric thickness compensator 1300 into a plurality of portions 1312 that can separate from one another during an early stage of the absorption process. Slits 1312 can reduce the width of the fabric thickness compensator 1300 along the outer peripheries 1314 of portions 1312, as illustrated in Figure 206. This reduction in width can lead to faster absorption along the peripheries 1314 of portions 1312, which can result in the reduction of the fabric thickness compensator 1300 to separate portions 1312 during the early stage of the absorption process.

[00609] Referring to figure 207A and 207B, an end actuator of a surgical stapling instrument can comprise a first claw and a second claw, at least one of the first claw and the second claw can be configured to be moved relative to one another. In certain embodiments, the end actuator may comprise a first jaw including a staple cartridge channel 1010 and a second jaw including an anvil 1012 (Fig. 207B), the anvil 1012 being pivotable toward and/or in the opposite direction. to the staple cartridge channel 1010, for example. Staple cartridge channel 1010 may be configured to receive a staple cartridge 1020, for example, which may be removably retained within staple cartridge channel 1010. Other embodiments may include staple cartridges that are not readily removable of the cartridge runner 1010. The staple cartridge 1020 may comprise a cartridge body 1022, a cartridge platform 1024, and a layer 1000, wherein, as shown in Figure 207A, layer 1000 may be removably positioned against or adjacent to cartridge platform 1024.

[00610] Similar to other embodiments described herein, now referring again to Figures 207A and 207B, cartridge body 1022 may comprise a plurality of clamp cavities 1026 and a clamp 1002 positioned within each clamp cavity.

1026. Also similar to other embodiments described herein, clips 1002 may be supported by clip drivers 1028 positioned within cartridge body 1022, a slider and/or firing member, for example, being advanced through staple cartridge 1020 to lift staple drivers 1028 into staple cavities 1026, and eject staples 1002 from staple cavities 1026, as illustrated in figure 207B. Tissue T and/or layer 1000 can be captured by staples 1002 as illustrated in Figure 207B as staples 1002 are ejected from staple wells 1026.

[00611] Layer 1000 may comprise a biocompatible material. Furthermore, layer 1000 may comprise a bioabsorbable material such as PLLA, PGA, PCL and/or combinations thereof, for example. In at least one embodiment, layer 1000 may comprise a tissue thickness compensator that may include internal compression features designed to compensate for tissue thickness T when layer 1000 and tissue T are captured by the staples. 1002 as described above.

[00612] Again with reference to Fig. 207B, layer 1000 may include a fabric contact surface 1003 which may be configured to reduce slippage between layer 1000 and the fabric T positioned against it. The pressure exerted against the tissue T in contact with the tissue contact surface 1003 may depend, in part, on the area of contact between the tissue T and the tissue contact surface 1003. How the pressure is inversely proportional to area, reducing the contact area can produce higher pressure against tissue T and, in turn, can produce better slip protection. Fabric contact surface 1003 may include a plurality of shims 1030 which comprise small contact areas, which shims 1030 can reduce slippage between layer 1000 and fabric T positioned against it. Layer 1000 can be fabricated with shims 1030, for example, by compression molding techniques. Alternatively, shims 1030 can be formed on the fabric contact surface 1003 after layer 1000 is fabricated, for example, by laser and/or chemical etching techniques, which can produce a plurality of projection structures. In addition, shims 1030 may comprise micrometer and/or nanometer scale structures formed on the surface for contact with tissue 1003 using, for example, photolithography techniques, which may generally use a photomask prefabricated as a matrix from which a final micrometer and/or nanometer scale shim pattern can be derived. Other techniques for forming 1030 shims at the micrometer and/or nanometer scale may be used and are contemplated within the scope of the present disclosure. In one example, electron beam lithography can be used to create the 1030 shims.

[00613] Now referring to figures 207C to 224, shims 1030 may comprise a plurality of shapes. For example, as illustrated in Fig. 207C, tissue contact surface 1003 may include pillar-shaped shims 1038 that may include square and/or rectangular bases and substantially perpendicular sides extending generally in the direction away from the fabric contact surface 1003. In addition, the pillar-shaped shims 1038 may terminate in generally narrow top portions, or tips 1040, as illustrated in the cross-sectional view in Figure 208. In addition, fabric contact surface 1003 may include cone-shaped shims 1032, as shown in Figure 218, pyramid-shaped shims 1034, as shown in Figure 219, and/or dome shaped shims 1042, as shown in Figure 218. illustrated in Figure 211. Pyramid-shaped shims 1034 may include square and/or triangular bases and sloping sides that may generally extend away from the surface for contact with the fabric. 003 and end in upper portions 1036, as illustrated in the cross-sectional view in figure 220.

The shims 1030 may be spatially arranged on the surface for contact with the fabric 1003 in a predetermined pattern or arrangement. For example, shims 1030 may be spatially disposed on the fabric contact surface 1003 in multiple rows that may extend longitudinally along a length of surface 1003 parallel to each other. The 1030 shims can also be arranged spatially in circles. For example, shims 1030 can be arranged in concentric circles. Alternatively, shims 1030 can be randomly positioned on the tissue contact surface 1003.

[00615] In addition to the above, fabric contact surface 1003 may include shims 1030, comprising multiple shapes, multiple heights, and/or multiple spatial arrangements to provide varying degrees of protection against slipping along various regions. tissue contact surface ions 1003. For example, increased slip protection may be needed in and/or around tissue contact surface regions 1003 where the clips 1002 are configured to penetrate and capture the tissue T .

[00616] Referring to Figures 209, 210 and 215 to 217, layer 1000 may comprise linear protrusions 1044 that may be disposed on the surface for contact with tissue 1003. Linear protuberances 1044 may extend longitudinally. For example, the linear protrusions 1044 may extend parallel to each other along a length of the layer 1000, as illustrated in Figure 209. Alternatively, the linear protrusions 1044 may extend along a width of the layer. layer 1000, as illustrated in Figure 215. In addition, linear longitudinal and transverse protrusions 1044 can cross the paths. For example, as illustrated in Figure 217, a first pattern 1046 of linear protrusions 1044 may extend in parallel in a first direction on the surface for contacting fabric 1003, and a second pattern 1048 of linear protrusions 1044 may extend in parallel in a second direction on the surface for tissue contact 1003, the first direction may be perpendicular, or substantially perpendicular, to the second direction. In addition, linear protrusions 1044 may comprise substantially uniform cross-sectional areas, as illustrated in Figure 210. Alternatively, linear protrusions 1044 may comprise different cross-sectional areas (not shown). Under certain circumstances, the first 1046 pattern and the second 1048 pattern may be continuous or intermittent.

[00617] In addition to the above, layer 1000 may include non-linear protrusions that can be arranged on the surface for tissue contact 1003 alone or in combination with linear protrusions 1044. In addition, linear protrusions 1044 and/ or non-linear protrusions may be disposed on the surface for tissue contact 1003 in combination with shims 1030 to produce a desired degree of slip protection.

[00618] With reference to Figures 213 and 214, layer 1000 may comprise a plurality of depressions 1050 that can be carved into the surface for contact with fabric 1003 as illustrated in Figure 223. The depressions 1050 may comprise shape - substantially uniform socket sections as illustrated in figure 224. Alternatively, the depressions 1050 can comprise different depths which can provide varying degrees of protection against slipping along various regions of the surface for contact with the fabric 1003. generally, a greater depth of a particular depression can produce greater flexibility of the region where the depression is and a greater ability to dismantle that region. In addition, as discussed above in connection with shims 1030, depressions 1050 may comprise a plurality of shapes and/or spatial arrangements. In addition, layer 1000 may comprise combinations of depressions 1050 and shims 1030 spatially disposed on the surface for contact with fabric 1003. In certain circumstances, shims 1030 and depressions 1050 may be arranged in alternating patterns.

[00619] Again with reference to Figures 223 and 224, layer 1000 may comprise linear depressions 1052 which, similar to linear protuberances 1044 (described above), may extend longitudinally, for example, in parallel with each other, along a length of layer 1000, as illustrated in Figure 223. In addition, layer 1000 may comprise combinations of linear depressions 1052 and linear protuberances 1044 spatially disposed on the surface for contact with fabric 1003, e.g., in a pattern alternated. In addition, now referring to Figures 221 and 222, the combinations of linear depressions 1052 and linear protuberances 1044 can be arranged in a corrugated pattern 1054, as illustrated in Figure 221.

[00620] Now with reference to Figures 244 to 246, a tissue thickness compensator such as compensator 22320, for example, may comprise a plurality of first cavities 22322a and a plurality of second cavities 22322b, which may be aligned with the staple forming pockets 22062a and 22062b, respectively. Referring primarily to Fig. 245, staple forming pockets 22062a and 22062b may be defined on separate stepped surfaces on anvil 22060. More particularly, forming pockets 22062a may be defined on first surfaces 22069a of anvil 22060 and the forming pockets 22062b may be defined on second surfaces 22069b, wherein first surfaces 22069a may be positioned offset, or higher, relative to second surfaces 22069b, for example. The first cavities 22322a of the tissue thickness compensator 22320 may be larger than the sec- tions.

two cavities 22322b whereby, in at least one such arrangement, the first cavities 22322a may extend higher than the second cavities 22322b. As a result of the above, the first cavities 22322a may extend upwardly into the first staple forming pockets 22062a while at the same time the second cavities 22322b may extend upwardly and into the second forming pockets of staples 22062b. First wells 22322a and/or second wells 22322b can be configured to contain a drug.

[00621] In addition to the above, the first cavities 22322a can be arranged in certain rows, while the second cavities 22322b can be arranged in different rows. Cavities 22322a and/or cavities 22322b may be configured so as to fit snugly into clip forming pockets 22062a and/or 22062b, respectively. In addition, tab 22320 can be mounted on anvil 22060 so that the second layer 22327 of tab 22320 is positioned against second surfaces 22069b of anvil 22060. Now with reference to Figures 247 and 248, tab 22320 can be positioned adjacent to anvil 22060 such that compensator 22320 can be adjacent to anvil 22060 when anvil 22060 is moved toward staple cartridge 22000 to compress tissue T therebetween.

[00622] Now with reference to Figures 224A and 224B, similarly to the above, layer 1000 can also be positioned adjacent to anvil 1012 so that layer 1000 can be contiguous with anvil 1012 when anvil 1012 is shifted towards the staple cartridge 1020 to compress the tissue T between them. Also similarly to the above, layer 1000 may be captured by clamps 1002 as clamps 1002 are ejected from clamp cavities 1026 by clamp drivers 1028. In particular, as illustrated in Figures 224A and 224B, clamps 1002 may comprise each a base 1060, a first deformable member 1062 comprising a first prong 1063 and a second deformable member 1064 comprising a second prong 1065 which, together with the first prong 1063, can penetrate through the layer 1000 to achieve their respective respects. - active forming pockets 1066 and 1068, as clamps 1002 are ejected from clamp cavities 1026 by clamp drivers 1028. In addition, tips 1063 and 1065 can each penetrate through layer 1000 a second time. as tips 1063 and 1065 are guided in a return path out of forming pockets 1066 and 1068, respectively.

[00623] Again with reference to Fig. 224A, layer 1000 may include portions 1070 that may comprise a reduced thickness relative to the remainder of layer 1000. For example, as illustrated in Fig. 224A, layer 1000 may comprise substantially a thickness uniform "A" and portions 1070 may comprise a thickness less than the thickness "A". In addition, layer 1000 can be aligned with staple cartridge 1020 so that when actuating staples 1002, tips 1063 and 1065 of staples 1002 can penetrate through fabric T and total thickness "A" of layer 1000, as the tips 1063 and 1065 of the deformable members 1062 and 1064 move towards the respective pockets 1066 and 1068 and can penetrate through the reduced thickness of portions 1070 as they are guided out of the pockets 1066 and 1068, respectively . The reduced thickness of portions 1070 can improve re-punching of tips 1063 and 1065 into fabric T on the return paths of tips 1063 and 1065 from pockets 1066 and 1068, respectively.

[00624] Now with reference to Fig. 224B, layer 1000 may comprise protrusions 1080 which may comprise an increased thickness relative to the remainder of layer 1000. For example, as illustrated in Fig. 224B, layer 1000 may comprise a substantially thickness uniform "A" and the 1080 protuberances may comprise a thickness "A+B" greater than the thickness "A". Layer 1000 can be aligned with staple cartridge 1020 so that by firing staples 1002, tips 1063 and 1065 of staples 1002 can penetrate through fabric T and thickness "A" of layer 1000 , as the tips 1063 and 1065 of the deformable members 1062 and 1064 move towards the respective pockets 1066 and 1068. In addition, the tips 1063 and 1065 of clamps 1002 can penetrate through the thickness "A" of the layer 1000 as they are guided out of pockets 1066 and 1068, respectively, thereby surrounding, or substantially surrounding, deformable members 1062 and 1064 at least partially around the protrusions

1080. In other words, the T fabric and the 1080 protrusions can be captured between each of the deformable members 1062 and 1064 and bases 1060 of the clamps 1002. In addition to the above, the 1080 protrusions can be arranged in rows and can be arranged in rows. - figured to fit snugly within the staple forming pockets of anvil 1020. For example, as illustrated in figure 224B, protrusions 1080 may comprise curved profiles that can be configured to match engagement with forming pockets 1066 and 1068.

[00625] As described above, certain embodiments of surgical staplers may include a layer, such as a backing material and/or a tissue thickness compensator, disposed on a surface of an anvil of the end actuator. The layer may be susceptible to movement and/or misalignment. For example, the layer can be moved relative to the anvil if the layer is dragged through the patient's tissue while a surgeon positions the surgical stapler before stapling the tissue. In certain embodiments, the layer may include releasable retention features to secure the layer to the anvil so that the layer remains aligned with the anvil until the surgical stapler is fired. In certain modalities, releasable retention resources may be implantable in the patient.

[00626] In certain embodiments, now referring to Figures 225 to 227, a layer attachable to the anvil 33420, as a reinforcing material and/or fabric thickness compensator, may comprise a carcass 33426, a cavity 33424 defined in the carcass 33426 , and a core 33425 positioned within cavity 33424. In at least one such embodiment, housing 33426 can comprise a film body formed from a continuous extruded shape and core 33425 can comprise a drug core. fibrous, such as ORC, for example. In at least one embodiment, housing 33426 can comprise one or more flexible legs 33423 that can be configured to extend into a knife slot 22063 defined on anvil 22060 and releasably retain fabric thickness trim 33420 to anvil 22060.

[00627] In certain embodiments, with reference to Figures 244 to 248, a layer attachable to the anvil 22320, such as a reinforcing material and/or a fabric thickness compensator, may be attached to an anvil 22060. In at least In one embodiment, the anvil attachable layer 22320 may include cavities 22322a and/or cavities 22322b which may be configured to fit snugly within clip forming pockets 22062a and/or 22062b, respectively.

actively. The snug fit can releasably retain the anvil attachable layer 22320 with respect to the anvil. In certain embodiments, the anvil attachable layer 22320 may be mounted on the anvil 22060 such that the second layer 22327 of the anvil attachable layer 22320 is positioned against the second surfaces 22069b of the anvil 22060. In certain other embodiments, now with reference to to Figures 247 and 248, the anvil attachable layer 22320 may be positioned adjacent the anvil 22060 so that the anvil attachable layer 22320 may abut an anvil 22060 when the anvil 22060 is moved towards the anvil 22060. 22000 staples to compress the T fabric together.

[00628] Referring to Figures 228 to 234, a retainer may be used to align and secure an anvil attachable layer to an anvil of an end actuator. Referring now to Figures 229 and 230, a layer attachable to the anvil 2030 may include a body 2034 and a protrusion 2036 extending from the body 2034. Referring to Figures 231 to 234, the protrusion 2036 may engage a slot 2048, like a knife slit, in a 2042 anvil of an end actuator. In certain embodiments, protrusion 2036 may be wider than slit 2048 such that bulge 2036 is compressed when inserted into slit 2048. In certain embodiments, protrusion 2036 may be deformed so that it bulges out to out and press against the crack surfaces

2048. A compressive force between the protrusion 2036 and the slit 2048 can provide a holding force that secures the attachable layer to the anvil 2030 relative to the anvil 2042.

The anvil attachable layer 2030 is releasably affixed to a retainer 2000. The retainer 2000 can align the anvil attachable layer 2030 with the anvil 2042 and affix the anvil attachable layer 2030 to the anvil 2042. retainer 2000 may include a 2006 cover and 2008, 2010 flaps (the 2010 flap illustrated in figures 228 to 230) extending from there. As illustrated in Figures 229 and 230, the tabs can releasably engage and retain a 2020 staple cartridge in retainer 2000. The retainer also includes a handle portion 2002 extending from the cover 2006 that a user can hold to insert the retainer 2000, the staple cartridge 2020, and the 2030 anvil attachable layer into a 2040 staple cartridge channel of an end actuator.

Retainer 2000 may also include 2014 tabs that extend from cover 2006. In certain embodiments, retainer 2000 may include two tabs 2014, one tab extending from each side of cover 2006. How can best be seen in figure 228, each tab 2014 may include an inwardly facing groove 2016 and an inwardly facing angled surface 2018. With reference to figures 229 and 230, side edges of the layer attachable to the anvil 2030 can engage the 2016 grooves on the 2014 flaps. When the layer attachable to the 2030 anvil is engaged in the 2016 slots of the retainer 2000, in various ways the layer attachable to the 2030 anvil and the 2006 cover of the 2000 retainer can define a gap between the same. The anvil-attachable layer 2030 may be disposed on retainer 2000 such that protrusion 2036 of layer 2030 extends from retainer 2000. As best seen in Figures 228 and 231, retainer 2000 may also include an elevated ridge 2022 extending from cap 2006. As best shown in Figure 231, raised ridge 2022 of retainer 2000 can be aligned with protrusion 2036 of layer attachable to anvil 2030.

[00631] In use, a surgeon, nurse, physician, or other user may insert the 2020 staple cartridge into the 2040 staple cartridge channel of the end actuator, close the anvil on the retainer to release the layer attachable to the retainer anvil, and secure layer to anvil and then remove retainer from end actuator. Now referring to figures 231 to 234, the user can hold retainer 2000 by the grip portion 2002 and insert staple cartridge 2020 into a staple cartridge 2040 groove of the end actuator. As Staple Cartridge 2020 is being inserted into Staple Cartridge Slot 2040, tabs 2008 of Retainer 2000 may engage Staple Cartridge Slot 2040 of the end actuator. Figure 231 illustrates staple cartridge 2020 loaded in staple cartridge channel 2040 with retainer 2000 and layer attachable to anvil 2030 on top of staple cartridge

2020. Also as illustrated in figure 231, the anvil 2042 of the end actuator is positioned above the layer attachable to the anvil 2030 and retainer 2000. Now with reference to figure 232, the anvil 2042 can be moved towards the retainer 2000 and the layer attachable to the anvil 2030. As the anvil 2042 is moved, a surface 2044 of the anvil 2042 may contact the body 2034 of the layer attachable to the anvil 2030. Also, a slot 2046, such as a knife slot of the anvil 2042 may engage the ridge 2036 of the attachable layer to the anvil 2030. In addition, as the anvil 2042 is moved toward the staple cartridge 2020, the side edges 2050 of the anvil 2042 may engage the inwardly facing angled surfaces 2018 of the tabs that hold the 2014 film, pushing the 2014 tabs outward so that the 2016 inward facing grooves move away from the side edges of the layer attachable to the 2030 anvil.

[00632] Continued movement of the anvil 2042 towards the layer attachable to the anvil 2030 may push the layer attachable to the anvil 2030 towards the cap 2006 of the retainer 2000. Also, as the anvil 2042 continues to move in toward the staple cartridge 2020, the raised ridge 2022 of the retainer 2000 can support the protrusion 2036 of the attachable layer to the anvil 2034 as it engages the slot 2046 of the anvil 2042. As described above, the raised ridge 2022 of retainer 2000 can deform protrusion 2036 of anvil attachable layer 2030 so that the outer dimensions of protrusion 2036 of anvil attachable layer 2030 extend outwardly. In other words, as the ridge 2036 of the anvil attachable layer 2030 enters the slot 2046 of the anvil 2042, the raised ridge 2022 of the retainer 2000 can press into the anvil attachable layer 2030 under the bulge 2036, causing the protrusion 2036 bulges outward and/or expands into the slit 2046 of the anvil 2042. The resulting contact between the expanded protrusion 2036 and the slit 2046 can hold the ridge 2036 of the layer attachable to the anvil 2030 within the slit

2046. Slit 2046 may include lips 2048 that can capture at least a portion of protrusion 2036, further retaining protrusion 2036 within slit 2046 of anvil 2042.

[00633] Now with reference to figure 233, when the anvil 2042 is moved in the opposite direction to the retainer 2000, the layer attachable to the anvil 2030 is removed from the retainer 2000 with the anvil 2042. As illustrated in figure 234, after the anvil 2042 and the anvil attachable layer 2030 have moved away from the retainer 2000, the retainer 2000 can be removed from the end actuator, leaving the anvil attachable layer 2030 and staple cartridge 2020 in the end actuator.

[00634] Again with reference to Figures 229 and 230, in certain embodiments, a proximal end 2032 of the anvil attachable layer 2030 may be secured to the staple cartridge 2020. For example, the anvil attachable layer 2030 may be secured to the 2020 staple cartridge by adhesive, adhesion soldering and/or heat mounting. In various embodiments, the anvil attachable layer 2030 can be detached from the staple cartridge 2020 after the anvil attachable layer 2030 is attached to the anvil 2042 and the anvil is opened again. In various other embodiments, the anvil attachable layer 2030 may remain attached to the staple cartridge 2020 until after the staples in the staple cartridge have been fired and the anvil attachable layer 2030 is captured within the fired staples.

[00635] Figure 235 illustrates the layer attachable to the anvil 2030 separated from the retainer 2000. Figures 236 and 237 illustrate other modalities of layers attachable to the anvil. Figure 236 illustrates an embodiment of a layer attachable to the anvil 2060 that includes a body 2064 and discrete protrusions 2062 extending therefrom. Figure 237 illustrates another embodiment of a layer attachable to the anvil 2070 that includes a body 2074 with discrete protrusions 2072 extending therefrom. For example, each discrete protrusion 2072 may include a peg 2073 extending from the body of the layer attachable to the anvil 2070 and a cap 2075 extending from the peg 2073. In certain embodiments, the cap 2075 may have dimensions larger than peg 2073 so that the cap extends over the side edges 2048, heading toward the slot 2046 in the anvil 2042 when the protrusions 2072 are inserted into the slot

2046.

[00636] Referring now to Figs. 238 to 243, various anvil-securable layer embodiments may include one or more installable fasteners that may be formed in the body of the anvil attachable layer. Figures 238 to 240 illustrate one embodiment of an anvil 2080 attachable layer that includes a body 2082 and an array of positionable fasteners 2084 formed in the body 2082. Each positionable fastener 2084 may be formed therein. body 2082 by forming apertures 2085 in body 2082. Each positionable fastener 2084 may include a longitudinal portion 2086 secured to body 2082 and a side portion 2088 secured to longitudinal portion 2086. In various embodiments, longitudinal portion 2086 can be secured to body 2082 by a hinge 2087. Aperture 2085 surrounding each positionable fastener 2084 and hinge 2087 can allow movement of the positionable fasteners 2084 between an unpositioned configuration and a configuration positioned, described in more detail below. In several other modalities, the 2087 joint may be absent. In such embodiments, the positionable fasteners 2084 may be flexed around the longitudinal portions 2086, for example, to move between the unpositioned configuration and the positioned configuration.

[00637] Figure 238 illustrates the positionable fasteners 2084 in an unpositioned configuration, each of the positionable fasteners 2084 being substantially in a plane defined by the body 2082 of the layer attachable to the anvil 2084. Figure 239 illustrates the positionable fasteners 2084 in a positioned configuration, each of the positionable fasteners 2084 extending outside the plane defined by the body 2082 of the layer attachable to the anvil 2080. For example, the positionable fasteners 2084 may rotate around the hinges 2087 so that they extend outwardly from the plane defined by the body 2082. As illustrated in Figure 240, the positionable fasteners 2084 can be positioned in a slot 2046 of an anvil 2042. When positioned, the longitudinal portion 2086 of the fastener is amenable to position 2084 may extend into slot 2046 of anvil 2042 and side portion 2088 may further extend into slot 2046. In various circumstances, side portion 2088 of positionable fastener 2084 may engage a bead 2048 in slot 2046 to provide stronger retention between the layer attachable to the anvil 2080 and the anvil 2042. In addition, engagement between the side portion 2088 of the locatable fastener 2084 and the bead 2048 in the slot 2046 may prevent that the positionable fastener 2084 returns to the uninstalled position. In certain embodiments, longitudinal portion 2086 of each positionable fastener 2084 may be shorter than a narrow portion 2047 of slot 2046. In such embodiments, longitudinal portion 2086 may be under tension when lateral portion 2088 engages bead 2048 with slit 2046. Tension on side portion 2088 can hold body 2082 of layer attachable to anvil 2080 firmly against anvil 2042.

[00638] The body 2082 and the positionable fasteners 2084 can be formed from a unitary body. Then, openings 2085 can be formed in body 2082 by, for example, cutting out openings 2085 in body 2082. Apertures 2085 can be cut by an embossing tool, a cutting blade, a laser, or any other suitable means. In various other embodiments, the anvil attachable layer 2080 and apertures 2085 may be formed in a mold. In certain embodiments, the openings 2085 may include a gap between the body 2082 and a positionable fastener 2084. In certain embodiments, the openings 2085 do not provide a gap between the body 2082 and the positionable fasteners. 2084. In various embodiments, hinge 2087 may be formed by tapering or marking the layer attachable to anvil 2080 between body 2082 and longitudinal portion 2086, for example. In various other embodiments, the hinges provide no change in thickness between the body 2082 and the longitudinal portions 2086 of the positionable fasteners 2084.

[00639] Figures 238 to 240 described above, illustrate one embodiment of a layer attachable to the anvil 2080 wherein the positionable fasteners 2084 each include a side portion 2088 that includes a circular portion. The side portion can include other suitable shapes, including, but not limited to, triangles, ovals, and polygons. For example, Figures 241 to 243 illustrate one embodiment of a layer attachable to the anvil 2090 wherein the positionable fasteners 2094 each include a side portion 2098 having a rectangular cross section. Each positionable fastener 2094 can be secured to the body 2092 by a hinge 2097.

[00640] In certain embodiments, the body and positionable fasteners of a layer attachable to the anvil may comprise a flexible and/or resilient material. For example, again referring to Figures 238 to 240, the body 2082 and the positionable fasteners 2084 of the anvil-attachable layer 2080 may comprise a flexible and/or resilient material. As another example, with reference to Figures 241 to 243, the body 2092 and the positionable fasteners 2094 of the layer attachable to the anvil 2090 may comprise a flexible and/or resilient material. With reference to the anvil attachable layer 2080 of Figures 238 to 240, when each positionable fastener 2084 is positioned in a slot 2046, such as a knife slot, of an anvil 2042, the side portion 2088 may flex and /or deform to pass through a narrow portion 2047 of slit 2046. Then, as side portion 2088 extends beyond edges 2048 of slit 2046 and into a wide portion 2049 of slit 2046, side portion 2088 may return to an uninflected and/or undeformed shape. As the side portion 2088 returns to an uninflected and/or undeformed shape, the side portion 2088 may extend laterally into the wide portion 2049 of the slit 2046. After the side portion 2088 extends laterally into the wide portion 2049 of slit 2046, narrow portion 2047 of slit 2046 can provide an interference fit that prevents side portion 2088 from being readily pulled out of slit 2046. In other words, to be pulled out of slit 2046. slit 2046, lateral portion 2088 must flex and/or deform again to fit through narrow portion 2047 of slit 2046. In various embodiments, lateral portion 2088 and/or narrow portion 2047 of slit 2046, may be sized so that a pulling force required to pull the positionable fastener 2084 out of the slot can be large enough so that the layer attachable to the anvil 2080 is not dislodged from the anvil 204 2 while the anvil 2042 is positioned relative to a patient's tissue. However, the pulling force may be small enough that the 2080 anvil attachable layer can pull from the anvil after the 2080 anvil attachable layer is captured by staples.

[00641] In various embodiments, a cutting blade of a surgical stapler can separate the positionable fasteners from a layer attachable to the anvil. Referring to Fig. 240, a cutter blade can move through slot 2046 of anvil 2042. The cutter blade can cut each positionable fastener 2084 substantially in half. The halves of each positionable fastener 2084 can be easily pulled out of the slot 2046 when the layer attachable to the anvil 2080 is removed from the anvil 2042 after the clamps are fired.

[00642] For anvil attachable layers that include positionable fasteners, such as the anvil attachable layers described in Figures 238 to 243, a retainer can be used to align the anvil attachable layer with an anvil and to position the positionable fasteners in a slot in the anvil. Figures 251 through 254 illustrate a 19700 retainer that first installs a 19690 staple cartridge into a 19740 staple cartridge channel and then presses a layer attachable to anvil 2056 against a 19720 anvil. The 19700 retainer includes a first portion 2052 and a second portion 2054, the first portion 2052 being movable relative to the second portion 2054 in the directions indicated by the arrows Q and S (shown in Figures 253 and 254, respectively). First portion 2052 may include a cam that includes cams 19646 and 19647 and shoulders 19642 and 19643. Second portion may include cam protrusions 19614 and 19616 that engage the cam of first portion 2052. As shown in Figures 251 and 252, when the 19700 retainer is being inserted into end actuator, cam protrusions 19614 and 19616 engage cam de-shims 16646 and 16647 of first portion cam

2052. Now with reference to Figures 253 and 254, after the staple cartridge has been seated in a staple cartridge groove 19740 of the end actuator, the first portion 2052 may move in the direction of arrow Q relative to the second portion 2054 Moving the first portion 2052 in the direction of arrow Q causes cam bosses 19614 and 19616 to engage cam bosses 19642 and 19643 of first portion 2052 cam. 19616 to separate, thus pushing the attachable layer to the 2056 anvil so that it comes into contact with the 19720 anvil.

[00643] Now referring to figures 255 to 258, in certain embodiments, a retainer can install a staple cartridge into a staple cartridge channel, arrange an anvil-attachable layer on an anvil, and position fasteners capable of positioning the layer attachable to the anvil in engagement with the anvil. Referring to Figures 256 and 257, embodiments of a retainer 2110 may include a handle portion 2112, a portion facing the staple cartridge 2114, and a portion facing the anvil 2118. The portion facing the cartridge of clamps 2214 and the portion facing the anvil 2118 can be spaced apart and arranged at an angle relative to each other by a bracket 2116. As can be better seen in Fig. 258, the portion facing toward the staple cartridge 2114 and the portion facing the anvil 2118 may be disposed at an angle similar to the angle between the staple cartridge channel 2160 and the anvil 2150 when the anvil 2150 is in a fully open position. The portion facing the staple cartridge 2114 may include first tabs 2124 and second tabs 2126 extending therefrom. The first tabs 2114 can releasably engage and retain a staple cartridge 2140 in the retainer 2110, as illustrated in Figure 255. The second tabs 2126 can releasably engage a staple cartridge 2160 channel of the end actuator, so that retainer 2110 is releasably held in staple cartridge channel 2160. The anvil-facing portion 2118 may include a tab 2120 that retains an anvil-attachable layer, such as the anvil-attachable layer 2080. , illustrated in Figures 238 through 240, with respect to anvil surface 2118. The portion facing anvil 2118 may also include discrete protrusions 2122 that are positioned relative to the locations of the fasteners capable of being supported.

2084 location of the anvil attachable layer 2080. As illustrated in Figure 255, when the anvil attachable layer 2080 is loaded onto the anvil 2118 portion of retainer 2110, the anvil attachable layer 2080 may rest on top of the protrusions discreet 2122.

[00644] Referring to Fig. 258, in certain embodiments, as the retainer 2110 is being inserted into the end actuator and the staple cartridge 2140 is being seated in the staple cartridge channel 2160, the layer attachable to the anvil 2080 may make contact with the anvil 2150. Once the layer attachable to the anvil 2080 is in contact with the anvil 2150, the retainer 2110 and staple cartridge 2140 may continue to move relative to the anvil 2150 to the cartridge of staples 2140 is fully inserted. In such embodiments, the anvil-facing portion 2118 of retainer 2110 can be moved toward and pushed against the layer attachable to the anvil 2080 such that the discrete protrusions 2122, which extend from the anvil-facing portion 2118 of retainer 2110 can push positionable fasteners 2084 into layer 2080 into a positioned configuration, described above in conjunction with Figures 238 to 243. In various embodiments, each discrete protrusion 2122 of the facing portion for the anvil 2118 of the retainer 2110 may include an angled face 2123 which can engage the positionable fasteners 2084. As the retainer 2110 continues to be moved relative to the anvil 2150, and the layer attachable to the anvil 2080, - angled profiles 2123 can be progressively engaged with the positionable fasteners 2084 until the positionable fasteners 2084 have rotated. o around hinges 2087 and be positioned in slot 2152 of anvil 2150. As illustrated in Figure 258, angled surface 2123 of discrete protrusions 2122 can support both longitudinal portion 2086 and lateral portion 2088 of each scalable feature. positioning such that both the longitudinal portion 2086 and the lateral portion 2088 are positioned in the slot 2152 of the anvil.

[00645] In certain other embodiments, retainer 2110 can fully seat staple cartridge 2140 in staple cartridge channel 2160 without the layer attachable to anvil 2080 contacting anvil 2150. In such embodiments, after the staple cartridge 2140 is fully seated in the staple cartridge channel 2160, the anvil 2150 can be moved from a fully open position to a closed position such that the anvil 2150 contacts the anvil 2080 attachable layer and protrudes. - discrete races 2122 position the positionable fasteners 2084 in the slot 2052 of the anvil.

[00646] Figures 259 to 262 show one embodiment of a retainer 2170. The retainer 2170 may include a portion facing the staple cartridge 2174 and a portion facing the anvil 2178, spaced apart and disposed at an angle to one another. another by a holder 2190. The portion facing the staple cartridge 2174 may releasably engage and retain the staple cartridge 2140. The portion facing the staple cartridge 2174 may also engage and retain, releasably, a 2160 staple cartridge channel of an end actuator. An anvil attachable layer, such as the anvil attachable layer 2080, described above with reference to Figures 238 to 240, may be disposed in the portion facing the anvil 2178. As illustrated in more detail in Figures 261 and 262, the portion facing the anvil 2178 may include apertures 2182 which may be aligned with the positionable fasteners 2084 of the layer attachable to the anvil 2080 disposed in the portion.

facing anvil 2178. Each opening 2182 may include a cam 2202 disposed therein. Each cam 2202 can be secured to the portion facing anvil 2178 by flexible member 2204 such that cam 2202 can pivot about flexible member 2204, out of aperture 2182 and in contact with positionable feature 2084. Each cam 2202 can include a curved surface 2203 that can progressively position the positionable feature 2084 in a slot 2152 in the anvil 2150. Referring to Fig. 261, as the cam begins to move out of the opening 2182 and into contact with the Positionable feature 2084, curved surface 2203 of cam 2202 will first make contact with side portion 2088 of positionable feature 2084 such that side portion 2088 is positioned in slot 2152 of the anvil

2150. Referring to Fig. 262, as cam 2202 continues to be moved out of opening 2182, curved surface 2203 of cam 2202 will make contact with longitudinal portion 2086 of positionable feature 2086 such that the side portion 2086 is also positioned in slot 2152 of anvil 2150.

[00647] The holder 2190 between the portion facing the staple cartridge 2174 and the portion facing the anvil 2178 may include a stationary portion 2194 and a movable portion 2196. The movable portion 2196 can be operatively coupled to a button 2192 which a user may push to move movable portion 2196 relative to stationary portion 2194. Movable portion 2196 of bracket 2190 may include a series of cam surfaces 2206 that can engage cam portions 2202 to push cam portions 2202 to outside apertures 2182. When movable portion 2196 is moved proximally relative to stationary portion 2194, cam surfaces 2206 can move cams 2202 out of apertures 2182 and into contact with positionable fasteners 2084 of the 2080 film as described above.

[00648] In certain embodiments, the movable portion 2196 of the bracket 2190 may be forced distally to the stationary portion 2194, as illustrated in Figure 259. For example, a spring or the like may be disposed between the portion. the stationary portion 2194 and the movable portion 2196. The spring can force the movable portion 2196 of the bracket 2190 into a distal position relative to the stationary portion.

2194. In various embodiments, the biasing force can be high enough that the forces necessary to seat the staple cartridge 2140 in the staple cartridge groove 2160 will not exceed the biasing force. As a result, the positionable fasteners 2084 are less likely to be positioned by the cams 2202 if forces necessary to fully seat the staple cartridge 2140 in the staple cartridge channel 2160 to the button 2192 are inadvertently applied.

[00649] In various embodiments in which an anvil attachable layer is releasably retained on an anvil of a surgical stapler, the anvil attachable layer may include additional features to stabilize the patient's tissue with respect to the layer and the anvil . Referring now to Figures 249 and 250, the anvil-attachable layers 22320a and 22320b are illustrated in a position between an anvil 22060 and the patient's T tissue. Anvil-attachable layer modalities 22320a and 22320b may include protrusions 2078 extending from the body on one side facing the patient's T tissue. Protrusions 2078 can push or pierce tissue T, providing grip between tissue T and anvil-attachable layers 22320a and 22320b. The handle can prevent fabric from slipping relative to the anvil-attachable layers 22320a and 22320b.

[00650] In various embodiments, the retention features can be separated from the anvil attachable layer after a surgical stapler,

in which the layer is installed, have been fired. In such arrangements, the retaining features can be attached to one or more cables. The cables can be attached to the surgical stapler or to another object outside the patient, such that the retention features can be removed from the patient by pulling the cables after the stapler has been activated.

[00651] In various embodiments, the fabric thickness compensator may comprise a polymeric composition. The polymer composition can comprise one or more synthetic polymers and/or one or more non-synthetic polymers. The synthetic polymer can comprise an absorbable synthetic polymer and/or a non-absorbable synthetic polymer. In various embodiments, the polymer composition can comprise a biocompatible foam, for example. The biocompatible foam may comprise a porous open cell foam and/or a porous closed cell foam, for example. The biocompatible foam can have a uniform pore morphology or it can have a pore gradient morphology (ie, small pores that gradually increase in size to large pores along the foam thickness in one direction). In various embodiments, the polymer composition can comprise one or more of a porous scaffold, a porous matrix, a gel matrix, a hydrogel matrix, a solution matrix, a filamentary matrix, a tubular matrix, a composite matrix, a membranous matrix, a biostable polymer, and a biodegradable polymer, and combinations thereof. For example, the fabric thickness compensator can comprise a foam reinforced by a filamentous matrix or it can comprise a foam that has an additional hydrogel layer that expands in the presence of bodily fluids to provide even more compression on the fabric. . In various embodiments, a tissue thickness compensator can also comprise a coating on a material and/or a second or third layer that expands in the presence of bodily fluids to provide further compression on the tissue. Such a layer could be a hydrogel which could be a synthetic and/or naturally derived material and could be biodurable and/or biodegradable, for example. In certain embodiments, a fabric thickness compensator could be reinforced with fibrous non-woven materials or fibrous mesh-like elements, for example, which can provide additional flexibility, stiffness and/or strength. In various embodiments, a tissue thickness compensator that has a porous morphology that exhibits a gradient structure such as small pores on one surface and larger pores on the other surface. Such morphology could be better for tissue ingrowth or hemostatic behavior. Additionally, the gradient could also be compositional with a different bioabsorption profile. A short-term absorption profile may be preferred to handle hemostasis while a long-term absorption profile may better handle tissue healing without leaks.

[00652] Examples of non-synthetic polymers include, but are not limited to, lyophilized polysaccharide, glycoprotein, elastin, proteoglycan, gelatin, collagen, and oxidized regenerated cellulose (ORC). Examples of synthetic absorbable polymers include, but are not limited to, poly(lactic acid) (PLA), poly(L-lactic acid) (PLLA), polycaprolactone (PCL), polyglycolic acid (PGA), poly(carbonate). trimethylene) (TMC), polyethylene terephthalate (PET), polyhydroxyalkanoate (PHA), a copolymer of glycolide and ε-caprolactone (PGCL), a copolymer of glycolide and trimethylene carbonate, poly(glycerol sebacate) (PGS) , polydioxanone, poly(orthoesters), polyanhydrides, polysaccharides, poly(ester-amides), tyrosine-based polyarylates, tyrosine-based polyiminocarbonates, tyrosine-based polycarbonates, poly(D,L-lactide-

urethane), poly(B-hydroxybutyrate), poly(E-caprolactone), polyethylene glycol (PEG), poly[bis(carboxylatophenoxy)phosphazene], poly(amino acids), pseudopoly(amino acids), absorbable polyurethanes, and combinations of the same.

In various embodiments, the polymer composition may comprise from approximately 50% to approximately 90%, by weight, of the polymeric composition of PLLA and approximately 50% to approximately 10%, by weight, of the polymeric composition of PCL, for example. In at least one embodiment, the polymer composition can comprise approximately 70% by weight PLLA and approximately 30% by weight PCL, for example. In various embodiments, the polymeric composition can comprise from approximately 55% to approximately 85%, by weight, of the PGA polymeric composition and 15% to 45%, by weight, of the PCL polymeric composition, for example. In at least one embodiment, the polymer composition can comprise approximately 65% by weight of PGA and approximately 35% by weight of PCL, for example. In various embodiments, the polymeric composition can comprise from approximately 90% to approximately 95%, by weight, of the polymeric composition of PGA and approximately 5% to approximately 10%, by weight, of the polymeric composition of PLA, for example.

[00654] In various embodiments, the synthetic absorbable polymer may comprise a biocompatible bioabsorbable elastomeric copolymer. Suitable bioabsorbable biocompatible elastomeric copolymers include, but are not limited to, copolymers of ε-caprolactone and glycolide (preferably having an ε-caprolactone to glycolide molar ratio of from about 30:70 to about 70:30, preferably. - range 35:65 to about 65:35, and more preferably 45:55 to 35:65); elastomeric copolymers of ε-caprolactone and lactide, including L-lactide, D-lactide and mixtures thereof, or lactic acid copolymers (preferably having a molar ratio of ε-caprolactone to lactide of about 35:65 to about 65:35 and more preferably 45:55 to 30:70), elastomeric copolymers of p-dioxanone (1,4-dioxan-2-one) and lactide including L-lactide, D-lactide and lactic acid (having preferably a molar ratio of p-dioxanone to lactide from about 40:60 to about 60:40); elastomeric copolymers of ε-caprolactone and p-dioxanone (preferably having an ε-caprolactone to p-dioxanone molar ratio of about 30:70 to about 70:30); elastomeric copolymers of p-dioxanone and trimethylene carbonate (preferably having a molar ratio of p-dioxanone to trimethylene carbonate from about 30:70 to about 70:30); elastomeric copolymers of trimethylene carbonate and glycolide (preferably having a molar ratio of trimethylene carbonate and glycolide from about 30:70 to about 70:30); elastomeric copolymer of trimethylene carbonate and lactide including L-lactide, D-lactide, mixtures thereof or lactic acid copolymers (preferably having a molar ratio of trimethylene carbonate to lactide of about 30:70 at about 70:30) and mixtures thereof. In one embodiment, the elastomeric copolymer is a copolymer of glycolide and ε-caprolactone. In another embodiment, the elastomeric copolymer is a copolymer of lactide and ε-caprolactone.

[00655] The disclosures of US patent No. 5,468,253, entitled ELASTOMERIC MEDICAL DEVICE, which was granted on November 21, 1995, and US patent No. 6,325,810, entitled FOAM BUT-TRESS FOR STAPLING APPARATUS, which was granted December 4, 2001, are hereby incorporated by reference in their respective entireties.

[00656] In various embodiments, the synthetic absorbable polymer may comprise one or more of a 90/10 poly(glycolide-L-lactide) copolymer, commercially available from Ethicon, Inc. under the tradename VICRYL (polyglactic 910) ), polyglycolide, commercially available from American Cyanamid Co. under the tradename DEXON, polydioxanone, commercially available from Ethicon, Inc. under the tradename PDS, poly random block copolymer (glycolide-trimethylene carbonate), commercially available from American Cyanamid Co. under the trade name MAXON, poly(glycolide-ε-caprolactone-polyglecaprolactone 25) 75/25 copolymer, commercially available from Ethicon under the trade name MONOCRYL, for example.

[00657] Examples of non-absorbable synthetic polymers include, but are not limited to, foamed polyurethane, polypropylene (PP), polyethylene (PE), polycarbonate, polyamides such as nylon, polyvinyl chloride (PVC), polymethyl methacrylate (PMMA) , polystyrene (PS), polyester, polyether ether ketone (PEEK), polytetrafluoro ethylene (PTFE), polytrifluoro- chloroethylene (PTFCE), polyvinyl fluoride (PVF), fluorinated ethylene-propylene (FEP), polyacetal, polysulfone, and combinations thereof. Synthetic non-absorbable polymers can include, but are not limited to, foamed elastomers and porous elastomers, for example silicone, polyisoprene and rubber. In various embodiments, the synthetic polymers can comprise expanded polytetrafluoroethylene (ePTFE), commercially available from WL Gore & Associates, Inc. under the tradename GORE-TEX Soft Fabric Patch, and co-polyetherester urethane foam, commercially available from to Polyganics under the trade name NASOPORE.

[00658] The polymer composition of a fabric thickness compensator can be characterized by porosity percentage, pore size and/or hardness, for example. In various embodiments, the polymeric composition can have a percentage porosity of approximately 30% by volume to approximately 99% by volume, for example. In certain embodiments, poly-composition

meric may have a percentage porosity of approximately 60% by volume to approximately 98% by volume, for example.

In various embodiments, the polymer composition can have a porosity percentage of approximately 85% by volume to approximately 97% by volume, for example.

In at least one embodiment, the polymer composition may comprise approximately 70% by weight PLLA and approximately 30% by weight PCL, for example, and may comprise approximately 90% porosity by volume, for example. .

In at least one such embodiment, as a result, the polymer composition would comprise approximately 10% copolymer by volume.

In at least one embodiment, the polymer composition may comprise approximately 65% by weight PGA and approximately 35% by weight PCL, for example, and may have a percentage porosity of approximately 93%. by volume, to approximately 95%, by volume, for example.

In various embodiments, the polymer composition can comprise a porosity greater than 85% by volume.

The polymer composition can have a pore size of approximately 5 micrometers to approximately 2000 micrometers, for example.

In various embodiments, the polymer composition can have a pore size between approximately 10 micrometers to approximately 100 micrometers, for example.

In at least one such embodiment, the polymer composition can comprise a copolymer of PGA and PCL, for example.

In certain embodiments, the polymer composition can have a pore size between approximately 100 micrometers to approximately 1000 micrometers, for example.

In at least one such embodiment, the polymeric composition can comprise a copolymer of PLLA and PCL, for example.

According to certain aspects, the hardness of a polymeric composition can be expressed in terms of the Sho- hardness.

re, which can be defined as the permanent indentation resistance of a material as determined with a durometer such as a Shore durometer.

To assess the durometer value for a given material, pressure is applied to the material with a durometer indenter foot, in accordance with ASTM procedure D2240-00, entitled, "Standard Test Method for Rubber Property-Durometer Hardness", which is fully incorporated herein by reference.

The indenter foot of the durometer can be applied to the material for a sufficient period of time, such as 15 seconds, for example, in which a reading is then taken on the appropriate scale.

Depending on the type of scale being used, a reading of 0 can be obtained when the indenter foot fully penetrates the material, and a reading of 100 can be obtained when no penetration into the material occurs.

This measure is dimensionless.

In various modalities, the durometer can be determined according to any suitable scale, such as type A and/or type OO scales, for example, in accordance with ASTM D2240-00. In various embodiments, the polymer composition of a fabric thickness compensator can have a Shore A hardness value of approximately 4 A to approximately 16 A, for example, which is approximately 45 OO to approximately 65 OO at Shore track OO.

In at least one such embodiment, the polymer composition can comprise a PLLA/PCL copolymer or a PGA/PCL copolymer, for example.

In various embodiments, the polymer composition of a fabric build-up may have a Shore A hardness value of less than 15 A.

In various embodiments, the polymer composition of a fabric thickness compensator can have a Shore A hardness value of less than 10 A.

In various embodiments, the polymer composition of a fabric thickness compensator can have a Shore A hardness value of less than 5 A.

In certain embodiments, the polymeric material may have a Shore composition value.

OO from approximately 35 OO to approximately 75 OO, for example.

[00659] In various embodiments, the polymer composition may have at least two of the properties identified above. In various embodiments, the polymer composition can have at least three of the properties identified above. The polymer composition can have a porosity of 85% to 97% by volume, a pore size of 5 micrometers to 2000 micrometers, a Shore A hardness value of 4 A to 16 A, and a Shore OO hardness value of 45 OO at 65 OO, for example. In at least one embodiment, the polymeric composition may comprise 70% by weight of the polymeric composition of PLLA and 30% by weight of the polymeric composition of PCL having a porosity of 90% by volume a pore size from 100 micrometers to

1,000 micrometers, and a Shore A hardness value of 4 A to 16 A and a Shore OO hardness value of 45 OO to 65 OO, for example. In at least one embodiment, the polymeric composition may comprise 65%, by weight, of the PGA polymeric composition and 35%, by weight, of the PCL polymeric composition having a porosity of 93% to 95%, by volume, of a size of pore from 10 micrometers to 100 micrometers, and a Shore A hardness value of 4 A to 16 A and a Shore OO hardness value of 45 OO to 65 OO, for example.

[00660] In various embodiments, a fabric thickness compensator may be releasably attached to the staple cartridge and/or anvil by means of a flowable attachment portion. The flowable clamping portion can be operatively associated with the staple cartridge and/or the anvil. In various embodiments, a flowable securing portion may be provided between the tissue thickness compensator and the staple cartridge and/or anvil. In various embodiments, at least a portion of an outer surface of the fabric thickness compensator may comprise the flowable securing portion.

In various embodiments, an adhesive laminate can comprise the fabric thickness compensator and the flowable fastening portion. The adhesive laminate may comprise a base layer comprising the fabric build-up and an adhesive layer on at least a portion of a surface of the base layer comprising the flowable fastening portion. The adhesive laminate may comprise a fabric contact surface comprising the fabric thickness compensator and an opposing surface comprising the flowable fastening portion. The adhesive laminate can be releasably attached to the adhesive laminate to a staple cartridge and/or an anvil.

[00661] In various embodiments, a flowable attachment portion may comprise a flowable polymeric composition, such as a pressure sensitive adhesive ("PSA"), for example. An effective amount of the PSA can be applied to the fabric thickness compensator to provide adequate cohesive strength to produce the desired adhesion properties on the staple cartridge and/or anvil. PSAs can be characterized by one or more of the following characteristics: (1) aggressive and permanent adhesion; (2) grip with no more than finger pressure; (3) sufficient capacity to attach to an adherent; and (4) sufficient cohesive strength to be cleanly removed from the adherent. In various embodiments, the flowable attachment portion can flow when pressure, heat and/or tension are applied thereto. Such pressure and/or tension can be applied directly by the hand and/or by a device, for example a mechanical device, and can be a manual process and/or an automated process.

[00662] In various embodiments, the flowable fixation portion may be responsive to a change in temperature and/or a change in pressure. In various embodiments, the flowable securing portion can flow from a first position to a second position when heat and/or pressure is applied thereto. In various embodiments, the flowable fixation portion may be flowable at body temperature (37°C) and/or room temperature (25°C). In various modalities, the flowable fixation portion may be flowable at body temperature (37°C) but not at room temperature (25°C). In various embodiments, the flowable fixation portion may be responsive to a change in temperature such that the flowable fixation portion is in the first position when the tissue thickness compensator is at a first temperature and in the second position when the fabric thickness compensator is at a second temperature. In various modes, the second temperature can be higher than the first temperature. In various embodiments, the first temperature can be room temperature and the second temperature can be body temperature. In various embodiments, the flowable fixation portion may be responsive to a change in pressure such that the flowable fixation portion is in the first position when the tissue thickness compensator is at a first pressure and in the second position. when the fabric thickness compensator is under a second pressure. In many modalities, the second pressure can be greater than the first pressure. In various embodiments, the first pressure can be atmospheric pressure and the second pressure can be finger pressure. In various embodiments, the flowable attachment portion can flow from a first position, with respect to ambient temperature and/or atmospheric pressure, to a second position, when at body temperature and/or under pressure. In various embodiments, the flowable fastening portion can flow from a first (untensioned) position to the second position when pressure and/or tension is applied thereto.

[00663] In various embodiments, the flowable clamping portion may flow into an empty space in the staple cartridge and/or anvil. In various embodiments, the flowable clamping portion may flow when heat and/or pressure is applied thereto and extend over at least a portion of the surface of the staple cartridge and/or anvil that does not have the flowable clamping portion. and/or filling at least a portion of an empty space in the staple cartridge and/or anvil, e.g., a slit and/or a staple cavity. In various embodiments, the flowable clamping portion can flow in vivo to fill at least a portion of an empty space in the staple cartridge and/or anvil. In various embodiments, the flowable fixation portion can flow such that the flowable fixation portion comprises a shape complementary to at least a portion of the void space in the staple cartridge and/or anvil. In various embodiments, the flowable polymeric composition can flow to fill at least a portion of a slit and/or staple cavity in the anvil. In various embodiments, the flowable attachment portion can flow into the gap when pressure is applied thereto, and take the shape of the gap. Without wishing to be bound by any particular theory, it is believed that filling at least a portion of an empty space in the staple cartridge and/or anvil with the flowable clamping portion can optimize the clamping of the thickness compensator of fabric to the staple cartridge and/or anvil.

[00664] In various embodiments, a flowable fixation portion, such as the PSA, may be responsive to a change in temperature and/or a change in pressure to move between a first position and/or a first profile and a second position and/or a second profile. In various embodiments, the flowable securing portion may have a first position spaced from the staple cartridge and/or anvil. In various embodiments, the flowable fastening portion can be configured to penetrate an empty space in the car.

staple tappet and/or anvil and/or fill at least a portion of the void space in the staple cartridge and/or anvil when the flow clamping portion is in the second position. As described here, the flowable fixation portion can take the form of void space so that the flowable fixation portion comprises a profile complementary to the void space when the flowable fixation portion is in the second profile. In various embodiments, the first position and/or the first profile may be spaced apart relative to the staple cartridge and/or the anvil, and the second position and/or the second profile may contact the staple cartridge. staples and/or with the anvil. In various embodiments, the first position and/or the first profile may comprise a neutral (original) profile at ambient temperature and/or atmospheric pressure, and the second position and/or the second profile may comprise a profile complementary to the empty space in staple cartridge and/or anvil when at body temperature and/or under pressure. The profile of the flowable clamping portion can flow to achieve a complementary shape and/or void space dimension in the staple cartridge and/or anvil.

[00665] In various embodiments, a method of attaching a fabric thickness compensator to a substrate, such as a staple cartridge and/or an anvil, may generally comprise providing a thickness compensator of fabric; applying a flowable securing portion, such as a pressure sensitive adhesive, for example, to at least a portion of a tissue thickness compensator surface; and making the flowable attachment portion contact the substrate. In various embodiments, the method of attaching a fabric build-up to a substrate may comprise applying pressure to at least one of the fabric build-up and the substrate. The flowable attachment portion may flow from a first position on an outer surface of the compensator.

fabric thickness adjuster to a second position, further comprising an outer surface and/or an inner surface of the substrate. The flowable fixation portion may come into contact with the substrate, causing the fabric thickness compensator to adhere to the substrate. In various embodiments, the flowable attachment portion can attach the tissue thickness compensator to the substrate. In various embodiments, the flowable attachment portion can flow into at least one void in the substrate, such as, for example, a slot and/or clip cavity. In various embodiments, the flowable anchor portion can fill at least a portion of the at least one void in the substrate when in the second position.

[00666] In various embodiments, a method for attaching a tissue thickness compensator to a substrate, such as a staple cartridge and/or an anvil, may generally comprise applying at least one strand discrete and/or strip of a flowable polymeric composition, such as a pressure sensitive adhesive, for example, to a surface of the fabric thickness compensator; contacting the substrate and the at least one discrete strand and/or strip of the flowable polymeric composition; and pressing one of the substrate and the at least one discrete strand and/or strip of flowable polymeric composition onto the substrate and at least one discrete strand and/or strip of flowable polymeric composition to releasably secure the compound. - removal of tissue thickness on the substrate. In various embodiments, the method of securing the fabric thickness compensator to a substrate may comprise applying the at least one discrete strand and/or strip of flowable polymer composition to the substrate at a perimeter and/or central axis of the thickness compensator of tissue in an expected location on the substrate. In various embodiments, the method of securing the fabric thickness compensator to a substrate may comprise applying the at least one discrete strand and/or strip of flowable polymer composition in a longitudinal direction and/or in a lateral direction to the compensator. fabric thickness.

[00667] In various embodiments, the method of securing the fabric thickness compensator to a substrate may comprise applying the at least one discrete strand and/or strip of flowable polymer composition in a pattern and/or an amount that is pre- -selected based at least in part on expected loads on the fabric thickness compensator. The patterns and amount of the flowable polymeric composition to be applied can be selected to withstand the stresses, eg, shear stress, associated with manipulation of the medical device by a physician. The patterns and amount of the flowable polymeric composition to be applied can preferably be selected to balance the charges on the flowable polymeric composition due to manipulation by the physician, with ease of application and/or conservation of the flowable polymeric composition. vel. In addition, the composition of the flowable polymer can be considered when selecting patterns and the amount of flowable polymer composition to be applied.

[00668] In various embodiments, the flowable attachment portion may partially adhere the tissue thickness compensator to the staple cartridge and/or anvil and/or partially fully adhere the tissue thickness compensator to the staple cartridge. staples and/or anvil. A fully adhered fabric build-up may include a complete layer of the flowable polymer composition, such as a pressure sensitive adhesive, between the fabric build-up and the substrate. A fully adhered fabric build-up may not have a portion of the fabric build-up that is free of the flowable polymer composition. A partially adhered fabric build-up may include an effective amount of the flowable polymer composition between the fabric build-up and the substrate, including at least a portion of the fabric build-up free of the flowable polymer composition. A partially adhered fabric thickness compensator may exert greater shear stress on the flowable polymer composition relative to a fully adhered fabric thickness compensator. Therefore, the shear properties of the flowable polymeric composition and/or the amount and patterns of the flowable polymeric composition can be selected to support the expected manipulation of the medical device by the physician.

[00669] In various embodiments, the flowable polymeric composition can be applied to the fabric thickness compensator in one of a continuous pattern and a discontinuous pattern. In various embodiments, a continuous pattern of flowable polymeric composition can comprise a discrete strip of flowable polymeric composition applied to at least a portion of the fabric build-up pad. In various embodiments, a continuous pattern of flowable polymeric composition can comprise a continuous strand of flowable polymeric composition disposed along at least a portion of the central axis of the fabric thickness compensator in the longitudinal direction and/or at least one portion of a perimeter of the fabric thickness compensator. The flowable polymeric composition can be applied in various other patterns and configurations of the substrate, such as a crisscross pattern or other diagonal patterns, in a continuous complete sheet or layer, or in any other design to achieve the desired adhesive properties. In various embodiments, the continuous pattern of flowable polymeric composition can be applied along an inner periphery and/or outer periphery of the fabric thickness compensator. In various embodiments, the continuous pattern of flowable polymeric composition can be applied along an inner periphery of the fabric thickness compensator to be positioned along a central longitudinal axis of the substrate when attached thereto. In various embodiments, the continuous pattern of flowable polymeric composition can be applied along an inner periphery of the fabric thickness compensator to be aligned to at least one void, such as a slit and/or staple cavity, for example, when fixed there. In various embodiments, the continuous pattern of flowable polymer composition can be applied along an outer periphery of the fabric thickness compensator to be positioned along an outer perimeter of the substrate when secured thereto. In various embodiments, the flowable polymer composition can be applied to the fabric build-up to leave an inner portion and/or peripheral edge on the substrate that is free of flowable polymer composition.

[00670] In various embodiments, a discontinuous pattern of flowable polymer composition may comprise a plurality of discrete strands and/or strips of flowable polymer composition spaced apart on the substrate. In various embodiments, at least a portion of the plurality of strands and/or strips of flowable polymer composition can be compressed together when pressure and/or tension is applied. In various embodiments, the compressed plurality of strands and/or strips of flowable polymeric composition can form a continuous pattern of flowable polymeric composition. In various embodiments, a partially adhered fabric thickness compensator may comprise a plurality of strands and/or discrete strips of flowable polymeric composition on a surface of the fabric thickness compensator spaced apart so that at least a portion of the fabric thickness compensator comprises headspace that does not have the flowable polymer composition when pressure is applied. The headspace may comprise a portion of the fabric thickness compensator where the strands and/or strips of flowable polymer composition do not come into contact with each other and/or a portion of the fabric thickness compensator where the strands and/or strips of flowable polymer composition are not applied. In various embodiments, the headspace can comprise an inner portion and/or peripheral edge in the substrate.

[00671] In various embodiments, the method of attaching the fabric thickness compensator to the substrate may comprise applying at least one discrete strip of flowable polymeric composition to the fabric thickness compensator. In various embodiments, a discrete strip of flowable polymeric composition may extend along a portion of the central longitudinal axis of the fabric thickness compensator. In at least one embodiment, a discrete strip of flowable polymeric composition may be applied across a portion of the fabric thickness compensator aligned to at least one void in the substrate, such as a slit and/or staple cavity. In various embodiments, the method of attaching the fabric thickness compensator to the substrate may comprise applying a plurality of parallel discrete strips of flowable polymeric composition to the fabric thickness compensator. In various embodiments, two discrete strips of flowable polymeric composition may extend in the longitudinal direction along opposite side edges of the fabric thickness compensator. In at least one embodiment, each of two discrete strips of flowable polymeric composition may be applied across a portion of the fabric thickness compensator aligned with at least one void in the substrate, such as a slit. and/or clip cavity, for example. In various embodiments, the distance between the strips and/or side edge can be preselected so that the flowable polymer composition can flow into at least one void in the substrate, such as, for example,

at least one staple cavity in an anvil, when attached.

[00672] In various embodiments, the distance between the plurality of parallel discrete strips of flowable polymer composition and/or side edge may be preselected to one of fully adhering the fabric thickness compensator to the substrate and adhering the compensator to thickness of fabric to the substrate. In various modes, a strip width can be at least 1 mm, for example. In various embodiments, a strip width can be between approximately 0.5 mm and approximately 1.5 mm, for example. In various embodiments, a strip width can be between approximately 1.0 mm and approximately 1.25 mm, for example. In various modes, a gap width between the adhesive strips and/or side edge can be at least 1 mm, for example. In various embodiments, the distance between the strips and/or the side edge can be preselected to partially adhere the fabric thickness compensator to the substrate with a pre-selected adhesive to void ratio based on expected compensator loads. of fabric thickness. In various modalities, the ratio of adhesive to empty space can be 1:10 to 10:1, such as 1:1, 1:2, 1:3, 1:4, 1:5 and 2: 3.

[00673] In various modalities, a minimum of 0.25 mm of the PSA substrate may be required to make it flowable, for example. In various embodiments, the PSA substrate can comprise a thickness between approximately 1.25 mm and approximately 1.50 mm, for example. In certain embodiments, the PSA substrate may comprise a thickness of between approximately 0.5mm and approximately 0.75mm, for example.

[00674] As described herein, in various embodiments, the flowable fixation portion may comprise a flowable polymeric composition.

xible.

The flowable polymeric composition may comprise a pressure sensitive adhesive.

The flowable securing portion may comprise a pressure sensitive adhesive laminate.

In various embodiments, the flowable fastening portion can comprise an adhesive laminate comprising the fabric build-up and the flowable polymeric composition.

The polymeric composition can comprise one or more synthetic polymers and/or one or more natural polymers.

The polymeric composition can be bioabsorbable, biocompatible and/or biodegradable.

Examples of natural polymers include, but are not limited to, lyophilized polysaccharide, glycoprotein, elastin, proteoglycan, gelatin, collagen, fibrin, fibronectin, fibrinogen, elastin, serum albumin, hemoglobin, ovalbumin, and oxidized regenerated cellulose (ORC) and combinations thereof.

Examples of polysaccharides include, but are not limited to, hyaluronic acid, chondroitin sulfate, hydroxy ethyl starch, hydroxy ethyl cellulose, hydroxy-propyl cellulose, carboxy ethyl cellulose, chitan/chitosan, agarose and alginate and combinations thereof.

Examples of synthetic polymers include, but are not limited to, poly(lactic acid) (PLA), poly(L-lactic acid) (PLLA), polycaprolactone (PCL), polyglycolic acid (PGA), poly(glycolic acid) poly( hydroxybutyrate), poly(phosphazine), polyester poly(trimethylene carbonate) (TMC), polyethylene terephthalate (PET), polyhydroxyalkanoate (PHA), a copolymer of glycolide and ε-caprolactone (PGCL) , a copolymer of trimethylene carbonate and glycolide, poly(glycerol sebacate) (PGS), polydioxanone, poly(orthoesters), polyanhydrides, polyacrylamides, polysaccharides, poly(ester-amides), tyrosine-based polyarylates, poly -tyrosine-based iminocarbonates, tyrosine-based polycarbonates, poly(D,L-lactide-urethane), poly(B-hydroxybutyrate), poly(E-caprolactone), polyethylene glycol (PEG), polyethylene oxide, poly[ bis(carboxylatophenoxy)phosphazene], poly(amino acids), pseudopoly(amino acids), absorbable polyurethanes, polyhydroxy ethylmethylacrylate, polyvinylpyrrolidone , polyvinyl alcohol, polyacrylic acid, polyacetate, polycaprolatone, polypropylene, nylon and combinations thereof.

[00675] In various embodiments, the flowable polymer composition may comprise a copolymer of ε-caprolactone and glycolide (PCL/PGA). In various embodiments, the flowable polymer composition can comprise from about 50% to about 90%, by weight, of the PGA polymeric composition and about 50% to about 10%, by weight, of the PCL polymeric composition, per example. In various embodiments, the flowable polymer composition can comprise from about 50% to about 75%, by weight, of the PGA polymer composition and about 50% to about 25%, by weight, of the poly composition. - PCL meric, for example. In various embodiments, the flowable polymer composition can comprise from about 50% to about 60%, by weight, of the PGA polymeric composition and about 50% to about 40%, by weight, of the PCL polymeric composition, per example. In at least one embodiment, the flowable polymer composition can comprise about 70% by weight of the PGA polymer composition and about 30% by weight of the PCL polymer composition, for example. In at least one embodiment, the flowable polymer composition can comprise about 64% by weight of the PGA polymer composition and about 36% by weight of the PCL polymer composition, for example.

[00676] In various embodiments, the flowable polymer composition may comprise a copolymer of ε-caprolactone and lactide, including L-lactide, D-lactide, mixtures thereof and copolymers of lactic acid. In various embodiments, the flowable polymer composition can comprise a molar ratio of PCL to PGA of 30:70 to 70:30, such as, for example, 35:65 to 65:35, 45:55 to 35:65, and 50: 50. In various embodiments, the amount of ε-caprolactone can be between 30 and 45 mole percent with the remainder being glycolide, e.g.

plo, 35 to 40 mol percent ε-caprolactone with the remainder being glycolide. In various embodiments, the PSA can comprise a 36:64 (mol/mol) [poly(ε-caprolactone-co-glycolide)] copolymer. In various embodiments, the flowable polymeric composition can comprise a p-dioxanone copolymer. ,4-dioxan-2-one) and lactide, including L-lactide, D-lactide and lactic acid. In various embodiments, the flowable polymeric composition can comprise a molar ratio of p-dioxanone to lactide of 40:60 to 60:40. In various embodiments, the flowable polymer composition can comprise a copolymer of ε-caprolactone and p-dioxanone. In various embodiments, the flowable polymer composition can comprise a molar ratio of ε-caprolactone to p-dioxanone of from 30:70 to 70:30.

[00677] In various embodiments, the fabric thickness compensator and the flowable fixation portion may comprise one of an equal polymeric composition and a different polymeric composition. In various embodiments, the tissue thickness compensator and the flowable fixation portion may each comprise the same bioabsorbable material such as, for example, an ε-caprolactone glycolide (PCL/PGA) copolymer. tissue thickness thinker and the flowable fixation portion may differ in at least one characteristic selected from composition, modulus, elongation, inherent viscosity, crystallinity and bio-absorption. In various embodiments, the tissue thickness compensator and the flowable fixation portion can comprise the same copolymer that differs in at least one characteristic selected from composition, modulus, elongation, inherent viscosity, crystallinity and bioabsorption. For example, the tissue thickness compensator and the e.g. flowable fixation may each comprise a PCL/PGA copolymer which differs in the weight percentage of ε-caprolactone and glycolide and/or molar ratio between ε-caprolactone and glycolide. In at least one embodiment, the fabric thickness compensator can comprise about 50 wt% PGA polymer composition and about 50 wt% PCL polymer composition, and the flowable anchor portion can comprise about 64% by weight PGA polymeric composition and about 36% by weight PCL polymeric composition. In at least one embodiment, the tissue thickness compensator can comprise a PCL/PGA copolymer that has a molar ratio of ε-caprolactone to glycolide of 50:50, and the flowable fixation portion can comprise a PCL copolymer. /PGA having a molar ratio of ε-caprolactone to glycolide of 36:64.

[00678] In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the fabric thickness compensator can differ by at least 1 percent by weight from the polymer compositions, respectively. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the tissue thickness compensator can differ by at least 5 percent by weight. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the tissue thickness compensator can differ by at least 10 percent by weight. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the tissue thickness compensator can differ by at least 15 percent by weight. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the tissue thickness compensator can differ by 1 to 15 percent by weight. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε- concentration

caprolactone in the fabric thickness compensator may differ by 15 percent by weight. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the tissue thickness compensator may differ by 14 percent by weight. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive may differ from an ε-caprolactone concentration in the tissue thickness compensator, as described above, such that an ε-caprolactone concentration in the sensitive adhesive pressure can be one of greater and less than a concentration of ε-caprolactone in the tissue thickness compensator.

In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the fabric thickness compensator may differ by at least 1 percent by weight. In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the fabric thickness compensator can differ by at least 5 percent by weight. In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the fabric thickness compensator can differ by at least 10 percent by weight. In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the fabric thickness compensator can differ by at least 15 percent by weight. In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the fabric thickness compensator can differ by at least 20 percent by weight. In various embodiments, a concentration of poly(glycolic acid) in the pressure sensitive adhesive and a concentration of poly(glycolic acid)

in the fabric thickness compensator it may differ by 1 to 20 percent in weight. In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the fabric thickness compensator can differ by 15 to 20 percent by weight. In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the fabric thickness compensator can differ by 16 percent by weight. In various embodiments, a concentration of poly(glycolic acid) in the pressure sensitive adhesive may differ from a concentration of poly(glycolic acid) in the fabric thickness compensator, as described above, such that a concentration of poly(glycolic acid) ) in the pressure sensitive adhesive can be one of greater and less than a concentration of poly(glycolic acid) in the tissue thickness compensator.

[00680] In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the tissue thickness compensator may differ by at least 1 mol percent. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the tissue thickness compensator may differ by at least 5 mole percent. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the tissue thickness compensator may differ by at least 10 mole percent. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the tissue thickness compensator may differ by at least 15 moles percent. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the tissue thickness compensator may differ by 1 to 15 mole percent. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the tissue thickness compensator may differ by 10 to 15 mole percent. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive and an ε-caprolactone concentration in the tissue thickness compensator may differ by 14 mole percent. In various embodiments, an ε-caprolactone concentration in the pressure sensitive adhesive may differ from an ε-caprolactone concentration in the tissue thickness compensator, as described above, such that an ε-caprolactone concentration in the sensitive adhesive pressure can be one of greater and less than an ε-caprolactone concentration in the tissue thickness compensator.

[00681] In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the tissue thickness compensator may differ by at least 1 mol percent. In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the fabric thickness compensator can differ by at least 5 mole percent. In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the fabric thickness compensator may differ by at least 10 mole percent. In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the tissue thickness compensator can differ by at least 15 mole percent. In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the fabric thickness compensator can differ by at least 20 mole percent. In various modalities,

a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the tissue thickness compensator may differ by 1 to 20 mole percent. In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the fabric thickness compensator can differ by 15 to 20 mole percent. In various embodiments, a poly(glycolic acid) concentration in the pressure sensitive adhesive and a poly(glycolic acid) concentration in the tissue thickness compensator may differ by 16 mole percent. In various embodiments, a concentration of poly(glycolic acid) in the pressure sensitive adhesive may differ from a concentration of poly(glycolic acid) in the tissue thickness compensator, as described above, such that a concentration of poly(glycolic acid) ) in the pressure sensitive adhesive can be one of greater and less than a concentration of poly(glycolic acid) in the tissue thickness compensator.

[00682] In various embodiments, polymeric compositions may comprise additional optional components to further optimize the processability of the compositions and/or mechanical properties and other characteristics such as tackiness, resistance to aging by light, oxygen and heat , and visual appearance, for example. Such optional components can include other copolymers that can be included in the polymeric composition to obtain a desired property, for example, to increase adhesion or compatibility with the substrate. In various embodiments, additional optional components can include, but are not limited to, other polymers or copolymers, fillers, crosslinkers, tackifiers, plasticizers, pigments, dyes, antioxidants, colorants and stabilizers. In various embodiments, the polymeric composition can comprise a tackifier in a finite amount of at least 0.1, at least 2, or at least 5 to 10, 25, or 50 percent by weight, based on total weight. of the polymeric composition. In various embodiments, the polymer composition can comprise a plasticizer in a finite amount of at least 0.1, at least 2, or at least 5 to 10, 25, or 50 percent by weight, based on the total weight of the composition. polymeric.

[00683] In various embodiments, the flowable attachment portion may comprise a flowable (plastically deformable) polymeric composition. In various embodiments, the flowable polymer composition can become tacky, typically at room temperature (eg, 20°C to 25°C) and releasably adhere to a variety of substrates using only moderate pressure, such as finger pressure. , for example, to form the bond for attaching to substrates. In various embodiments, the flowable polymer composition can be a solid up to 40°C, up to 45°C, up to 50°C, up to 55°C, and/or up to 60°C. In various modes, the flowable polymer composition can melt without degradation at over 40°C, over 45°C, over 50°C, over 55°C, over 60°C, and/ or more than 120°C. In various embodiments, the flowable polymer composition can melt without degradation up to 600°C, up to 500°C, up to 400°C, up to 300°C, up to 240°C, and/or up to 180°C. In various embodiments, the flowable polymer composition can melt without degradation from 40.1°C to 600°C, 120°C to 240°C, and/or 180°C.

[00684] In various embodiments, the flowable polymer composition can be characterized by an inherent viscosity in a solution of hexafluoroisopropanol at 0.1 g/dl at 25°C from 0.6 to 4.0 dl/g, 0.8 to 3.2 g/dl, 1.0 to 2.4 g/dl, and/or 1.6 g/dl. In various embodiments, the flowable polymeric composition may not comprise a gel.

[00685] In various embodiments, the flowable polymer composition may be characterized by one or more of the following properties: a percent crystallinity less than about 25 percent, a percent crystallinity less than about 15 percent, and a percent crystallinity from 15 to 25 percent; a percent elongation greater than about 200, a percent elongation greater than about 500, and a percent elongation of about 200 to about 500; and a modulus less than about 275.79 MPa (40,000 psi), a modulus less than about 137.89 MPa (20,000 psi), and a modulus of about 137.89 (20,000) at about 275.79 MPa (40,000 psi).

[00686] In various embodiments, the flowable fastening portion may comprise one of a strip, tape, tape roll, blade, and film affixed to a surface and/or edge of the fabric thickness compensator. In various embodiments, the flowable securing portion can comprise a pressure sensitive tape comprising an adhesive and a backing layer. In various embodiments, the backing layer can comprise one of a flexible backing layer material and an inflexible backing layer material. Examples of flexible support material include, but are not limited to, plastic films such as polypropylene, polyethylene, polyvinyl chloride, polyester (polyethylene terephthalate), polycarbonate, polymethyl (meth)acrylate (PMMA), cellulose acetate, triacetate of cellulose and ethyl cellulose. Foam support layers can be used. Examples of inflexible backing layer materials include, but are not limited to, metal, metallized polymeric film, indium tin oxide coated glass and polyester, PMMA board, polycarbonate board, glass or ceramic material. In various embodiments, the pressure sensitive tape can comprise a release liner. In various embodiments, pressure sensitive tape can be applied by removing the release liner, thereby exposing the adhesive.

[00687] In various embodiments, the flowable fastening portion can be applied to the fabric thickness compensator using conventional coating techniques such as roll coating, flow coating, dip coating, spin coating, coating by spraying, knife coating and die coating. In various embodiments, the flowable attachment portion may have an initial thickness of from approximately 1.25 mm to approximately 1.50 mm, for example. In some embodiments, the flowable fixation portion may have an initial thickness of approximately 0.5 mm to approximately 0.75 mm, for example. In various embodiments, the flowable fixation portion may have a final thickness of at least 0.25 mm, however, when pressure is applied.

[00688] In various embodiments, with reference to Fig. 263, the flowable fastening portion 30000 may comprise a continuous strip centrally disposed in a longitudinal direction along a portion of the central axis of the fabric thickness compensator 30010. The width of the strip can be at least 1 mm, for example. The width of the strip can be between approximately 0.5 mm and approximately 1.5 mm, for example. The strip width can be between approximately 1.0 mm and approximately 1.25 mm, for example. The first position of the flowable attachment portion 30000 may be spaced apart from the anvil 30020, and the first profile of the flowable attachment portion 30000 may comprise a neutral (original) profile. As shown in Fig. 264, the flowable clamping portion 30000 can be aligned with a void 30025 in the anvil 30020, such as a centrally disposed slit, for example. As shown in Fig. 265, the flowable clamping portion 30000 can flow into the slot 30025 and enter into engagement with the anvil 30020 when a threshold pressure level is applied to the flowable clamping portion 30000. The flowable clamping portion 30000 can fill at least a portion of the slit 30025 such that the flowable fixation portion 30000 can assume the shape of the slit 30025. The second position of the flowable fixation portion

30000 may contact anvil 30020 and the second profile of flowable fastening portion 30000 may comprise a profile complementary to slot 30025. Flowable fastening portion 30000 may releasably grip fabric thickness compensator 30010 to anvil 30020.

[00689] In various embodiments, with reference to Fig. 266, the flowable fastening portion 30000 may comprise two continuous strips parallel to each other and arranged in a longitudinal direction along a portion of the fabric thickness compensator 30010. The width of the strip can be at least 1 mm, for example. The strip width can be between approx. 0.5 mm and approx. 1.5 mm, for example. The width of the strip can be between approximately 1.0 mm and approximately 1.25 mm, for example. The two discrete strips can be spaced apart from the central axis and side edges of the 30010 fabric thickness compensator. The width of a gap between each strip can be at least 1 mm, for example, and the width of a gap between each strip and the side edge can be at least 1mm, for example. The ratio of adhesive to empty space can be between approximately 1:4 and approximately 1:2, for example. The ratio of adhesive to empty space can be at least 1:10, for example. Under various circumstances, the ratio of adhesive to empty space may be zero. A constant layer over the entire surface may be desirable in some circumstances. The first position of the flowable attachment portion 30000 may be spaced apart from the anvil 30020 and the first profile of the flowable attachment portion 30000 may comprise a neutral (original) profile. As shown in Fig. 267, the flowable fastening portion 30000 may be aligned with the clip forming cavities 30030, for example. As shown in Fig. 268, the flowable clamping portion 30000 can flow into clamp cavities 30030 and enter into engagement with anvil 30020 when a threshold pressure level, such as finger pressure, for example, is applied to the flowable attachment portion

30000. The flowable attachment portion 30000 may fill at least a portion of the clamp cavity 30030 such that the flowable attachment portion 30000 can take the shape of the clamp cavity 30030. At least a portion of the clamp pockets 30030 may be free of the The flowable fixation portion 30000. The second position of the flowable fixation portion 30000 may contact the anvil 30020 and the second profile of the flowable fixation portion 30000 may comprise a profile complementary to the clamp cavities 30030. The fixation portion flowable 30000 can releasably secure the fabric thickness compensator 30000 to the anvil 30020.

[00690] In various embodiments, now referring to figures 269 to 273, a staple cartridge 30100 comprising a support portion 30102 and a tissue thickness compensator 30110, can be loaded into a staple cartridge channel with a 30140 staple cartridge applicator, for example. In various embodiments, an applicator 30140 can be configured to position an upper tissue thickness compensator 30110 relative to an anvil 30120 in addition to positioning a staple cartridge 30100 within a staple cartridge channel. The applicator 30140 may comprise locking arms 30141 releasably engageable with locking projections extending from a support portion 30102 of the staple cartridge 30100 so that the applicator 30140 can be held in position over a tissue thickness compensator 30110 of staple cartridge 30100. In various embodiments, upper tissue thickness compensator 30110 may be removably attached to applicator 30140 so that the anvil 30120 of a surgical instrument can be closed over the applicator

30140, engages fabric thickness compensator 30110, and releases fabric thickness compensator 30110 from applicator 30140. In various embodiments, fabric thickness compensator 30110 and/or anvil 30120 may comprise one or more retaining elements that can be configured to releasably secure the fabric thickness compensator 30110 to the anvil 30110. In various embodiments, the retaining features can comprise a sheet of adhesive and/or an adhesive tab 30112.

[00691] In various embodiments, the adhesive sheet and/or adhesive tab may be integrally formed from a portion of the 30110 fabric thickness compensator. In various embodiments, the 30110 fabric thickness compensator may comprising at least one adhesive tab 30112 along an edge of the fabric thickness compensator 30100. The adhesive tab 30112 may comprise a release liner 30113. Referring to Fig. 271, the anvil 30120 may be moved to a closed position to engage fabric thickness compensator 30110. Release liner 30113 may be removed to expose an adhesive surface of adhesive tab 30112. Referring to Figures 272 and 273, a first end of adhesive tab 30112 may be secured to the anvil and a second end of adhesive tab 30112 can be secured to the anvil to releasably secure the Fabric Thickness Compensator 30100 to the anvil. The adhesive tab 30112 can be pulled distally to separate the tissue thickness compensator 30110 from the applicator 30140. Thereafter, the anvil and staple cartridge 30100 can be positioned relative to the tissue to be stapled and/or incised. The physician may pull adhesive tab 30112 to separate Fabric Thickness Compensator 30110 from the anvil.

[00692] With reference to figures 284 to 288, in various modes.

Thereafter, tissue thickness compensator 30210 may comprise at least one adhesive tab 30212 along a distal edge of tissue thickness compensator 30210. Adhesive tab 30212 may comprise a release liner 30213. As described herein, an applicator for staple cartridge 30240 may be configured to position an upper fabric thickness compensator 30210 relative to an anvil 30220. Release liner 30213 may be removed to expose an adhesive surface of adhesive tab 30212. Adhesive tab 30212 may be folded over and secured to the anvil 30220 to releasably secure the tissue thickness compensator 30210 to the anvil 30220. Adhesive tab 30212 can be pulled distally to separate the tissue thickness compensator 30210 from the applicator 30240 After that, the anvil 30220 and staple cartridge 30200 can be positioned relative to the tissue that is to be stapled and/or incised. Referring to Figures 289 and 290, in use, a staple positioning slider can be advanced distally through the staple cartridge by a trigger member that can advance a knife edge 30211 through the tissue thickness compensator 30210 in order to incise at least a portion of the adhesive tab 30212 and progressively separate the fabric thickness compensator 30210 from the anvil 30220. The clinician may pull the remainder of the adhesive tab 30212 from the anvil 30220 before reloading a new staple cartridge 30200.

[00693] In various embodiments, the adhesive sheet and/or the adhesive tab can be separated from the fabric thickness compensator. With reference to Figures 274 to 276, in at least one embodiment, an adhesive tab 30312 (see also Figures 288 and 292) may be provided between the staple cartridge 30300 and the fabric thickness compensator 30310. fabric thickness compensator

30310 may comprise a notch 30311 configured and sized to coordinate with adhesive tab 30312 to releasably retain fabric thickness compensator 30310 on the anvil.

30320. A first end of adhesive tab 30312 can be secured to fabric thickness compensator 30310 adjacent notch 30311 and a second end of adhesive tab 30312 can be secured to anvil 30320. As shown in Figure 277, adhesive tab 30312 not engaging notch 30311. Thereafter, anvil 30320 and staple cartridge 30300 can be positioned relative to tissue T that is to be stapled and/or incised.

[00694] As described above, in use, a staple positioning slider may be advanced distally through the staple cartridge by a firing member to eject the staples from the staple cartridge as outlined above. As the staples are deformed, each staple can trap a portion of the tissue thickness compensator against the upper tissue surface. At the same time, the trigger member can advance a knife edge through the fabric thickness compensator 30310, wherein, in at least one embodiment, the knife edge can be advanced through the fabric thickness compensator 30310 to moving tissue thickness compensator 30310 distally and aligning adhesive tab 30312 and notch 30311, as shown in Figures 277 to 279, so as to incise tissue thickness compensator 30310 and separate tissue thickness compensator 30310 of the anvil 30320. In various embodiments, as the staples are moved from their unfired positions to their triggered positions by the staple drivers, as discussed above, the fabric thickness compensator 30310 that does not have a notch may move. down, as shown in figures 280 and 281, to disengage the adhesive tabs 30312 and se-

stop the tissue thickness compensator 30310 from the anvil 30320. After the clips have been positioned, the anvil 30320 can be reopened and moved in the opposite direction to the implanted tissue thickness compensator 30310, as shown in Figure 283. The reader will understand, By comparing Figures 282 and 283, the tissue thickness compensator 30310 can be attached to tissue T and incised by the cutting member, as discussed above.

[00695] In various embodiments, the flowable attachment portion can be applied by removing the first release liner from the first adhesive tab, thus exposing the flowable attachment portion, which comprises a pressure-sensitive adhesive, for example. The first adhesive tab can be applied or pressed onto the outer surface of the substrate. Then, the second release liner can be removed from the second adhesive tab to thereby expose the PSA. The second adhesive tab can be pressed onto the outer surface of the substrate and/or the first adhesive tab. Once the PSA has been applied to the tissue thickness compensator, it is placed in contact with the staple cartridge and/or anvil. The PSA can lock the fabric thickness compensator to the substrate.

[00696] Various embodiments described in the present invention are described in the context of staples removably stored within staple cartridges for use with surgical stapling instruments. In some circumstances, staples may include wires that are deformed when they come into contact with an anvil of the surgical stapler. These wires can be composed of metal, such as stainless steel, for example, and/or any other suitable material. These modalities, and their teachings, can be applied to modalities that include fasteners removably stored in fastener cartridges for use with any suitable fastening instruction.

[00697] Various embodiments described herein are within the context of tissue thickness compensators attached to, and/or for use with, staple cartridges and/or fastener cartridges. Such tissue thickness compensators can be used to compensate for variations in tissue thickness from one end of a staple cartridge to the other, or for variations in tissue thickness captured within a staple, or fastener, compared to other. Such tissue thickness compensators can also be used to compensate for variations in tissue thickness from one side of a staple cartridge to the other. Such embodiments, and their teachings, can be applied to embodiments which include a layer or layers of material attached to and/or for use with staple cartridges and/or fastener cartridges. A layer can include reinforcing material.

[00698] Various embodiments described in the present invention are described in the context of linear end actuators and/or linear fastener cartridges. These embodiments, and the teachings thereof, can be applied to non-linear end actuators and/or non-linear fastener cartridges, such as, for example, circular and/or contoured end actuators. For example, several end actuators, including non-linear end actuators, are shown in US Patent Application Serial No. 13/036,647, filed February 28, 2011, entitled SURGICAL STAPLING INSTRUMENT, now publication of application for US Patent No. 2011/0226837, which is incorporated in its entirety into the present invention by reference. Additionally, US Patent Application Serial No. 12/893,461, filed September 29, 2012, entitled STAPLE CARTRIDGE, now US Patent Application Publication No. 2012/0074198, which is incorporated in its entirety.

the present invention by reference. US Patent Application Serial No. 12/031,873, filed February 15, 2008, entitled

END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT, now US Patent No. 7.980,443, is also incorporated in its entirety into the present invention by way of reference.

[00699] Any patent, publication or other material of description, in whole or in part, which is said to be incorporated into the present invention by reference, is incorporated into the present invention only to the extent that the incorporated materials do not conflict with existing definitions, statements or other descriptive material presented in this disclosure. Accordingly, and to the extent necessary, the disclosure as explicitly presented herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, incorporated herein by reference, but which conflicts with the existing definitions, statements, or other descriptive materials presented herein will be incorporated herein only to the extent that there is no conflict between the embedded material and the existing description material.

[00700] While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the disclosure. It is therefore intended that this application will cover any variations, uses or adaptations of the invention with the use of its general principles. Additionally, this application is intended to cover deviations from the present disclosure that may occur with known or customary practice in the art to which this invention is concerned.

Claims (20)

1. A staple cartridge for use with a surgical stapler end actuator characterized in that the end actuator includes a staple cartridge channel configured to receive said staple cartridge, said staple cartridge comprises: a cartridge body comprising a plurality of clamp cavities, a plurality of clamps positioned within said clamp cavities; a layer disposed with respect to said cartridge body; and a retainer comprising a cover portion and at least one attachment portion, said attachment portion being releasably engaged with said cartridge body, said layer being positioned intermediately to said body. of cartridge and to said cover portion, said at least one securing portion being configured to be displaced by the end actuator when said staple cartridge is received by the staple cartridge channel, so that said attachment portion disengages from said cartridge body. 2. Staple cartridge according to claim 1, characterized in that said layer comprises a fabric thickness compensator. 3. Staple cartridge according to claim 1, characterized in that each of said plurality of staples comprises a base and a leg, said leg comprising a tip, and said tip extending from said cartridge body. A staple cartridge according to claim 3, characterized in that said tip extends into said layer. 5. A staple cartridge according to claim 1, characterized in that said cartridge body comprises a ridge, said at least one fastening portion of said retainer comprising a tab extending from said covering portion which is removably engaged with said ridge, and wherein said tab comprises a surface configured to engage the end actuator when said staple cartridge is received by the staple cartridge channel of the ex-actuator. tremor so that the end actuator displaces said tab, and said tab disengages from said ridge. 6. Staple cartridge according to claim 5, characterized in that said covering portion of said retainer defines a plane, and wherein said at least one flap extends from said portion coverage outside said plan. 7. Staple cartridge according to claim 5, characterized in that said covering portion of said retainer defines a plane, and wherein said at least one flap extends from said portion of coverage in said plan. 8. Staple cartridge according to claim 1, characterized in that said cartridge body comprises a slit, said cover portion of said retainer defining a plane, said at least one securing portion comprises a first securing portion comprising: a first displaceable member extending from said cover portion, said first displaceable member being displaceable with respect to said covering portion in said plane of the said covering portion; a first tab extending from said displaceable first member which is removably engaged with said slot of said cartridge body; and wherein said first displaceable member comprises a surface configured to engage the end actuator when said staple cartridge is received by the staple cartridge groove of the end actuator, such that the end actuator displaces the said first member and said first tab, and said first tab disengages from said slit. 9. A clip cartridge according to claim 8, characterized in that it further comprises a second fastening portion comprising: a second displaceable member extending from said cover portion, wherein the said second displaceable member is displaceable with respect to said cover portion in said plane of said cover portion; a second tab extending from said second displaceable member which is removably engaged with said slot of said cartridge body; ee wherein said second displaceable member comprises a surface configured to engage the end actuator, wherein said staple cartridge is received by the slot of the end actuator staple cartridge, so that the end actuator displace said second member and said second tab, and said second tab disengagement from said slit. 10. Staple cartridge according to claim 9, characterized in that said first attachment portion and said second attachment portion are displaceable in relation to each other. 11. Staple cartridge according to claim 9, characterized in that said covering portion comprises a first neck portion from which said first fastening portion extends, said covering portion comprising - ends a second neck portion from which the second attachment portion extends, and wherein said first and second neck portions comprise a resilient material forcing said first attachment portion and said second attachment portion. fastening to an undisplaced position. 12. Staple cartridge according to claim 9, characterized in that said cartridge body comprises a first ridge, wherein said retainer further comprises a third attachment portion comprising a third extending tab from said cover portion which is removably engaged with said first crest, and wherein said third tab comprises a surface configured to engage the end actuator when said staple cartridge is received by the channel of the staple cartridge. end actuator clamps such that the end actuator displaces said third tab and said third tab disengagement from said first ridge. 13. Staple cartridge according to claim 12, characterized in that said third flap extends from said covering portion out of said plane of said covering portion. 14. A staple cartridge according to claim 12, characterized in that said cartridge body comprises a second crest, said retainer further comprising a fourth flap extending from said portion which is removably engaged with said second ridge, and wherein said fourth tab comprises a surface configured to engage the end actuator, said staple cartridge being received by the staple cartridge channel of the end actuator. , such that the end actuator displaces said fourth tab and said fourth tab disengagement from said second ridge. 15. A staple cartridge according to claim 14, characterized in that said first crest is on a first side of said cartridge body, and said second crest is on a second side of said cartridge body , as opposed to said first lateral. 16. A staple cartridge characterized in that it is for use with an end actuator of a surgical stapler, wherein the end actuator includes a staple cartridge channel configured to receive said staple cartridge. said staple cartridge comprises: a cartridge body comprising a plurality of staple cavities, a plurality of staples positioned within said staple cavities; a layer disposed with respect to said cartridge body; and a retainer, said layer being positioned intermediately to said cartridge body and said retainer, and wherein said retainer comprises a removable attachment means for releasably attaching said retainer to said retainer. cartridge body, such that said retainer disengages from said cartridge body when said staple cartridge is received by the staple cartridge channel of the end actuator. 17. A staple cartridge for use with a surgical stapler, the staple cartridge being characterized in that it comprises: a cartridge body comprising a platform and a plurality of staple cavities defined in said platform; a plurality of staples at least partially positioned within said cartridge body; a layer positioned on said platform, said clamps being configured to at least partially capture a portion of said layer when said clamps are moved between an unfired position and a fired position; and a cover extending over at least a portion of said layer, said cover being releasably locked to said cartridge body, said cover comprising installation unlocking means for unlocking said cover when said staple cartridge is installed in the surgical stapler, whereby said cover can then be removed from said cartridge body. 18. Staple cartridge according to claim 17, characterized in that the surgical stapler comprises a channel configured to receive said staple cartridge, and said installation unlocking means being configured to engage the channel when said staple cartridge is inserted into the channel and unlocking said cover. 19. A staple cartridge for use with a surgical stapler, wherein the staple cartridge is characterized in that it comprises: a cartridge body comprising a platform and a plurality of staple cavities defined in said platform; a plurality of staples at least partially positioned within said cartridge body; a layer positioned on said platform, said clamps being configured to capture therein, at least partially, a portion of said layer when said clamps are moved between an unfired position and a fired position; and a cover releasably locked onto said cartridge body, said cover comprising: a first side portion which at least partially covers a first side of said layer; a first latch extending from said first side portion; a second side portion that at least partially covers a second side of said layer; and a second latch extending from said second side portion, said first latch and said second latch being configured to be tightened inwardly by the surgical stapler to unlock said cover from said cartridge body when said cartridge of staples is inserted into the surgical stapler. 20. A staple cartridge for use with a surgical stapler, said staple cartridge being characterized in that it comprises: a cartridge body comprising: a platform; a plurality of clamp cavities defined in said platform; a reference surface; a plurality of staples positioned, at least partially, within said cartridge body; a layer positioned on said platform, said clips being configured to at least partially capture a portion of said layer when said clips are moved between an unfired position and a fired position. rada; and a cover extending over at least a portion of said layer, said cover being releasably locked to said cartridge body by an installation latch, wherein said installation latch is positioned a predetermined distance from said reference surface, and said installation latch being configured to engage a defined key in the surgical stapler when the staple cartridge is properly positioned within the surgical stapler.