CN101873834B - Washer for use with a surgical stapling instrument - Google Patents

Washer for use with a surgical stapling instrument Download PDF

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Publication number
CN101873834B
CN101873834B CN 200880101756 CN200880101756A CN101873834B CN 101873834 B CN101873834 B CN 101873834B CN 200880101756 CN200880101756 CN 200880101756 CN 200880101756 A CN200880101756 A CN 200880101756A CN 101873834 B CN101873834 B CN 101873834B
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China
Prior art keywords
staple
embodiment
surgical
stapling
anvil
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CN 200880101756
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Chinese (zh)
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CN101873834A (en
Inventor
W·B·威森伯格
C·J·赫斯
L·E·小威尔斯
D·J·西贝纳尔
T·W·修特玛
J·R·莫甘
M·A·默里
A·M·茨沃林斯基
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伊西康内外科公司
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Priority to US11/824,299 priority Critical
Priority to US11/824,136 priority patent/US20080082126A1/en
Priority to US11/824,275 priority
Priority to US11/824,415 priority patent/US7604151B2/en
Priority to US11/824,079 priority
Priority to US11/824,389 priority
Priority to US11/823,988 priority patent/US20090005809A1/en
Priority to US11/824,251 priority
Priority to US11/824,252 priority
Priority to US11/824,298 priority
Priority to US11/824,298 priority patent/US7673782B2/en
Priority to US11/824,275 priority patent/US8727197B2/en
Priority to US11/824,136 priority
Priority to US11/824,363 priority
Priority to US11/824,079 priority patent/US7438209B1/en
Priority to US11/824,524 priority
Priority to US11/824,524 priority patent/US20090001130A1/en
Priority to US11/824,415 priority
Priority to US11/823,988 priority
Priority to US11/824,446 priority
Priority to US11/824,446 priority patent/US20090001121A1/en
Priority to US11/824,299 priority patent/US20080082125A1/en
Priority to US11/824,274 priority patent/US8590762B2/en
Priority to US11/824,274 priority
Application filed by 伊西康内外科公司 filed Critical 伊西康内外科公司
Priority to PCT/US2008/066461 priority patent/WO2009005969A2/en
Publication of CN101873834A publication Critical patent/CN101873834A/en
Application granted granted Critical
Publication of CN101873834B publication Critical patent/CN101873834B/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064Surgical staples, i.e. penetrating the tissue
    • A61B17/0643Surgical staples, i.e. penetrating the tissue with separate closing member, e.g. for interlocking with staple
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00004(bio)absorbable, (bio)resorbable, resorptive

Abstract

本发明涉及外科手术缝合器,其包括插入砧座中的“释放式”垫圈。 The present invention relates to a surgical stapler which includes an anvil is inserted into the "release" type washers. 在多个实施例中,垫圈可包括圆形内部和圆形外部。 In various embodiments, the gasket may include a circular inner and outer circle. 在一个不同的实施例中,外部可以包括多个限定开口的缝钉导向部分,当外科手术缝合器被击发时,外科手术缝钉的缝钉末端可穿过开口,并随后被砧座弯曲或转向。 In a different embodiment, it may include a plurality of outer staple guide portion defining an opening, when the surgical stapler is fired, the end of the surgical staple staple may pass through the opening, and is then bent or anvil turn. 在多个实施例中,缝钉末端然后可以接触缝钉导向部分并被其保持,使得缝钉末端不会再次穿透或以其它方式再次刺穿被缝合的组织。 Embodiment, the staple may then be in contact with the end portion of the staple guide and which holds, so that the end of the staple will not penetrate or otherwise pierce again be stapled tissue once again in a plurality of embodiments. 在一个不同的实施例中,垫圈可为可溶解的或生物可吸收的。 In a different embodiment, the washer may be dissolvable or bioabsorbable.

Description

与外科手术缝合器械一起使用的垫圈 For use with a surgical instrument washer

背景技术 Background technique

[0001] 本发明涉及下列共同拥有的美国专利申请,其全文以引用方式并入本文: [0001] The present invention is related to the following commonly-owned U.S. Patent Application, which is hereby incorporated herein by reference:

[0002] (I)与此同时提交的名称为RE-LOADABLE SURGICAL STAPLINGINSTRUMENT(可重装式外科手术缝合器械)、代理人案卷号为END6152USNP13/070199的美国专利申请; Name [0002] (I) at the same time filed RE-LOADABLE SURGICAL STAPLINGINSTRUMENT (refillable type surgical instrument), Attorney Docket No. U.S. Patent Application END6152USNP13 / 070199; and

[0003] (2)与此同时提交的名称为SURGICAL STAPLE HAVING A SLIDABLECROWN(具有可滑动式冠的外科手术缝钉)、代理人案卷号为END6152USNP1/070099的美国专利申请; [0004] (3)与此同时提交的名称为METHOD OF MANUFACTURING STAPLES (制造缝钉的方法)、代理人案卷号为END6152USNP2/070100的美国专利申请; [0003] Name (2) at the same time filed SURGICAL STAPLE HAVING A SLIDABLECROWN (having slidably surgical staple crown), Attorney Docket No. U.S. Patent Application END6152USNP1 / 070099; and [0004] (3) At the same time submit the name of (the method of manufacturing the staples) mETHOD oF mANUFACTURING sTAPLES, Attorney Docket No. US Patent application END6152USNP2 / 070100 of;

[0005] (4)与此同时提交的名称为SURGICAL STAPLES WITH IMPROVEDTISSUECOMPRESSION FEATURES(具有改善的组织压缩特征的外科手术缝钉)、代理人案卷号为END6152USNP3/070101的美国专利申请; Name [0005] (4) At the same time filed SURGICAL STAPLES WITH IMPROVEDTISSUECOMPRESSION FEATURES (tissue compression characteristics with improved surgical staples), Attorney Docket No. U.S. Patent Application END6152USNP3 / 070101; and

[0006] (5)与此同时提交的名称为STAPLE CARTRIDGE CAVITYC0NFI⑶RATIONS (钉仓钉仓腔的构造)、代理人案卷号为END6152USNP4/070102的美国专利申请; [0006] Name (5) at the same time filed STAPLE CARTRIDGE CAVITYC0NFI⑶RATIONS (configured staple cartridge chamber), Attorney Docket No. U.S. Patent Application END6152USNP4 / 070102; and

[0007] (6)与此同时提交的名称为STAPLE CARTRIDGE CAVITYCONFI ⑶ RAT I ON WITHCOOPERATIVE SURGICAL STAPLE (配有外科手术缝钉的钉仓钉仓腔的构造)、代理人案卷号为END6152USNP5/070103的美国专利申请; [0007] Name (6) at the same time filed STAPLE CARTRIDGE CAVITYCONFI ⑶ RAT I ON WITHCOOPERATIVE SURGICAL STAPLE (with surgical staples configured staple cartridge chamber), Attorney Docket No. END6152USNP5 / 070103 U.S. patent application;

[0008] (7)与此同时提交的名称为SURGICAL STAPLE HAVING A SLIDABLECR0WN(具有可滑动式冠的外科手术缝钉)、代理人案卷号为END6152USNP6/070111的美国专利申请; Name [0008] (7) at the same time filed SURGICAL STAPLE HAVING A SLIDABLECR0WN (having slidably surgical staple crown), Attorney Docket No. U.S. Patent Application END6152USNP6 / 070111; and

[0009] (8)与此同时提交的名称为SURGICAL STAPLING INSTRUMENTSHAVING ARELEASABLE STAPLE-FORMING POCKET (具有可释放式缝钉成形凹坑的外科手术缝合器械)、代理人案卷号为END6152USNP7/070112的美国专利申请; [0009] Name (8) at the same time filed SURGICAL STAPLING INSTRUMENTSHAVING ARELEASABLE STAPLE-FORMING POCKET (having a releasable staple forming pockets of the surgical instrument), Attorney Docket No. U.S. Patent Application END6152USNP7 / 070112 of ;

[0010] (9)与此同时提交的名称为SURGICAL PROCEDURE USING A CUTTINGAND STAPLINGINSTRUMENT HAVING RELEASABLE STAPLE-F0RMINGP0CKETS (使用具有可释放式缝钉成形凹坑的切割缝合器械的外科手术)、代理人案卷号为END6152USNP8/070113的美国专利申请; Name [0010] (9) filed concurrently herewith (having a releasable surgical staple forming pockets cutting stapling instrument to use) SURGICAL PROCEDURE USING A CUTTINGAND STAPLINGINSTRUMENT HAVING RELEASABLE STAPLE-F0RMINGP0CKETS, Attorney Docket No. END6152USNP8 / U.S. Patent application No. 070,113;

[0011] (10)与此同时提交的名称为SURGICAL STAPLE HAVING A DEFORMABLEMEMBER WITHA NON-CIRCULAR CROSS-SECTIONAL GEOMETRY(具有非圆形横截面几何形状的可变形的构件的外科手术缝钉)、代理人案卷号为END6152USNP9/070114的美国专利申请; Name [0011] (10) At the same time filed SURGICAL STAPLE HAVING A DEFORMABLEMEMBER WITHA NON-CIRCULAR CROSS-SECTIONAL GEOMETRY (deformable member has a non-circular cross-sectional geometry of the surgical staples), Attorney Docket U.S. Patent application No. END6152USNP9 / 070114; and

[0012] (11)与此同时提交的名称为SURGICAL STAPLE HAVING A DEFORMABLEMEMBER WITHA NON-CIRCULAR CROSS-SECTIONAL GEOMETRY(具有非圆形横截面几何形状的可变形的构件的外科手术缝钉)、代理人案卷号为END6152USNP10/070115的美国专利申请; Name [0012] (11) At the same time filed SURGICAL STAPLE HAVING A DEFORMABLEMEMBER WITHA NON-CIRCULAR CROSS-SECTIONAL GEOMETRY (deformable member has a non-circular cross-sectional geometry of the surgical staples), Attorney Docket U.S. Patent application No. END6152USNP10 / 070115; and

[0013] (12)与此同时提交的名称为SURGICAL STAPLING INSTRUMENT HAVINGARELEASABLE BUTTRESS MATERIAL (具有可释放式支撑材料支撑材料的外科手术缝合器械)、代理人案卷号为END6152USNP11/070197的美国专利申请;以及 [0013] Name (12) at the same time filed SURGICAL STAPLING INSTRUMENT HAVINGARELEASABLE BUTTRESS MATERIAL (releasable support material having a support material of surgical instrument), Attorney Docket No. U.S. Patent Application END6152USNP11 / 070197; and

[0014] (13)与此同时提交的名称为SURGICAL STAPLE HAVI NG ANEXPANDABLEPORTION(具有可膨胀部分的外科手术缝钉)、代理人案卷号为END6152USNP12/070198的美国专利申请。 [0014] Name (13) at the same time filed SURGICAL STAPLE HAVI NG ANEXPANDABLEPORTION (having an inflatable portion of the surgical staples), Attorney Docket No. U.S. Patent Application END6152USNP12 / 070198 of. 1.技术领域 1. FIELD

[0015] 本发明整体涉及外科手术器械,更具体地讲,涉及外科手术缝合器械以及随其使用的缝钉。 [0015] relates surgical instruments, and more particularly the present invention relates to a surgical instrument and a staple with its use.

[0016] 2.相关领域的说明 [0016] 2. Description of related art

[0017] 外科手术缝合器可在实施多种外科技术期间使用。 [0017] The surgical stapler embodiments may be used during a variety of surgical techniques. 在实施至少一种外科技术期间,可通过定位于小切口中的插管或管将外科手术缝合器插入患者体内。 During at least one surgical technique embodiment, it may be positioned through a small incision in the cannula or tube is inserted into the surgical patient. 这些外科技术称为内窥镜检查和/或腹腔镜检查外科技术,它们通常优于常规的或开放性外科技术,因为它们可缩短患者的恢复时间。 The surgical technique called endoscopic and / or laparoscopic surgical techniques, or they are generally superior to the conventional open surgical techniques, because they can shorten the recovery time of the patient. 在实施这种技术期间使用的外科手术缝合器通常包括可用于实现多种诊断和/或治疗效果的端部执行器。 In this embodiment is used during surgical techniques typically include an end effector can be used to implement various diagnostic and / or therapeutic effect. 在多个实施例中,这种外科手术缝合器可包括能够切开软组织并将缝钉插入切口相对侧上的软组织中的端部执行器。 In various embodiments, the surgical stapler can include a soft tissue incision and staples on soft tissue is inserted into the incision in the opposite side of the end effector. 在至少一个实施例中,端部执行器可包括一对可穿过插管的配合钳口构件,其中钳口构件中的一个可包括钉仓钉仓,另一个钳口构件可包括砧座。 In at least one embodiment, an end effector can include a pair of cooperating jaw members may pass through the cannula, wherein one of the jaw members may include a staple cartridge, the other jaw member can comprise an anvil. 在至少一个这种实施例中,钉仓可被构造为将至少两行缝钉定位到组织中,而砧座可包括被构造为可使缝钉在被定位时变形的缝钉成形凹坑。 In at least one such embodiment, the staple cartridge can be configured to locate at least two rows of staples into the tissue, and the anvil can include a staple can be configured to deform the staples when forming pockets positioned.

[0018] 一些外科手术缝合器,例如公布于1995年11月14日、名称为SURGICAL STAPLERINSTRUMENT (外科手术缝合器械)的美国专利No. 5,465,895中所述的那些(该专利的公开内容以引用方式并入本文),可包括具有切割构件和缝钉驱动器的端部执行器,例如,其中切割构件和缝钉驱动器可在端部执行器内沿着直线、弯曲和/或曲线路径移动。 Those (the disclosure of [0018] Some surgical stapler, for example, published on November 14, 1995, entitled SURGICAL STAPLERINSTRUMENT (surgical instrument) in U.S. Pat. No. 5,465,895 the incorporated by reference herein), can comprise an end effector having a cutting member and staple driver, for example, wherein the cutting member and staple driver can be along a straight, curved and / or curvilinear path of movement within the end effector . 通常将这种外科手术缝合器称为内切割器,其可在(例如)实施可减小患者胃尺寸的胃绕道外科技术期间利用。 This usually is called the surgical cutter, which may (for example) the size of the stomach embodiment may reduce gastric bypass patients during use of surgical techniques. 最常见的胃绕道外科技术中的一种为Roux-en-Y胃旁路手术方法。 The most common gastric bypass of a surgical technique Roux-en-Y gastric bypass method. 在这种技术中,可将胃横切成至少两个部分,其中可将这些部分中的一个成型为可直接连接到患者小肠的中部(即空肠)的小口袋。 In this technique, the stomach may be transversely into at least two parts, which can be molded into a patient may be directly connected to the middle portion of the small intestine (i.e. the jejunum) in small pockets. 在多种情况下,可用内切割器沿着所需的路径切割胃,并将缝钉定位到胃组织中,以将胃组织保持在一起。 In many cases, it is used within the cutter cuts along the desired path of the stomach, and the stomach staples to tissue targeting, to the stomach tissue together. 作为上述技术的结果,通过消化道的食物可绕过胃的另一个横切部分以及小肠的上部(即十二指肠)。 As a result of the above techniques, food through the digestive tract may bypass the other transverse portion of the stomach and the upper small intestine (duodenum).

[0019] 已经开发出了其它外科手术缝合器,例如管腔内缝合器或圆形缝合器,以在实施通称为吻合术的外科技术期间协助外科医生。 [0019] have been developed other surgical staplers, e.g. intraluminal stapler or a circular stapler to assist the surgeon during a surgical technique known as embodiment anastomosis. 吻合术是一种外科技术,在该手术中,横切小肠和/或大肠,切除其一部分,并将剩余的部分接合在一起。 Anastomosis is a surgical technique in which surgery, cross intestine and / or large intestine, removal of a portion thereof, and the remaining part are joined together. 该技术通常需要外科医生横切小肠,例如在形成第一末端、第二末端和中间部分的两个位置处横切。 The technique generally requires the surgeon to cross the small intestine, for example, forming the first end, the second transverse end and an intermediate portion of the two positions. 之后,可将中间部分移除,并将第一末端和第二末端设置为彼此相邻。 Thereafter, the intermediate portion may be removed, and the first and second ends disposed adjacent to each other. 为了连接第一末端和第二末端,可将第一末端和第二末端定位于管腔内缝合器或圆形缝合器内,使得可将缝钉定位到围绕其周边的第一末端和第二末端中,以将第一末端和第二末端保持在一起。 In order to connect the first and second ends, the first and second ends may be positioned within intraluminal stapler or a circular stapler such that the staples can be positioned around its periphery to the first end and a second in the end, to the first and second ends together. 这种缝合器在公布于1992 年4 月14 日、名称为INTRALUMINAL ANASTOMOTIC SURGICAL STAPLER WITH DETACHEDANVIL(具有分离砧座的腔内吻合外科缝合器)的美国专利No. 5,104,025以及公布于1994年5 月10 日、名称为CIRCULAR STAPLER TISSUE RETENTIONSPRING METHOD (圆形缝合器组织保持弹簧法)的美国专利No. 5,309,927中有所公开,其公开内容以引用方式并入本文。 This stapler in published April 14, 1992, the name INTRALUMINAL ANASTOMOTIC SURGICAL STAPLER WITH DETACHEDANVIL (with separate anvil cavity anastomosis surgical stapler) US Patent No. 5,104,025 and published in 1994 May 10, names (holding spring tissue method circular stapler) for the cIRCULAR sTAPLER tISSUE RETENTIONSPRING mETHOD U.S. Patent No. 5,309,927 are disclosed in, the disclosure of which is incorporated herein by reference.

发明内容 SUMMARY

[0020] 在本发明的多种形式中,外科手术缝合器的端部执行器可包括砧座和钉仓,其中钉仓可被构造为可移去地在其中储存缝钉。 [0020] In the various forms of the present invention, a surgical stapler end effector may include a staple cartridge and an anvil, wherein the staple cartridge can be configured to removably store staples therein. 在多个实施例中,钉仓可包括腔,腔被构造为可储存缝钉直至它们被缝钉驱动器从其中定位,缝钉驱动器可被构造为可横穿钉仓并使缝钉朝砧座移动。 In various embodiments, a staple cartridge can include a cavity, the cavity being configured to be stored until they are staple from the staple driver positioned therein, the staple driver can be configured to traverse staple cartridge and the staple toward the anvil mobile. 在至少一个实施例中,每一个缝钉都可包括至少一个可变形的构件,当其与砧座接触时可发生变形,使得可变形的构件可捕获(例如)冠与可变形的构件之间的软组织。 In at least one embodiment, each staple may include at least one deformable member, as it may deform upon contact with the anvil, (e.g.) between the crown member and the deformable member may be deformable such that captures the soft tissue. 在本发明的至少一种形式中,可变形的构件可包括非圆形横截面,其(在多个实施例中)可决定可变形的构件弯曲的方向和方式。 In at least one form of the invention, the deformable member may comprise a non-circular cross-section, which member (in various embodiments) can be determined and the bending direction deformable manner. 在至少一个实施例中,非圆形横截面可包括平坦部分,其可引起可变形的构件以平坦部分的方向弯曲。 In at least one embodiment, the non-circular cross-section may include a flat portion, which may cause the deformable member is bent in the direction of the flat portion. 在多个实施例中,横截面的非圆形部分可被构造为邻接软组织并对其施加压缩力或压力。 In various embodiments, the non-circular cross-sectional portion may be configured to abut the soft tissue and applying a compressive force or pressure. 在至少一个这种实施例中,外科手术缝钉的冠可至少部分地由可溶解的或生物可吸收的材料构成,使得冠可在软组织愈合时溶解,并且可(根据可变形的构件的横截面几何形状)减小可变形的构件施加到软组织上的力。 In at least one such embodiment, the surgical staple crown material may be at least partially dissolvable or bioabsorbable configuration, such that the crown may be dissolved in soft tissue healing, and may be (a cross-deformable member sectional geometry) reducing the deformable member force applied to the soft tissue.

[0021] 在本发明的至少一种形式中,外科手术缝钉可包括可变形的构件和冠,其中可变形的构件可相对于冠滑动。 [0021] In at least one form of the invention, a surgical staple can include a deformable member and a crown, wherein the deformable member may be slidable with respect to the crown. 在至少一个实施例中,钉仓可包括腔和平台,其中腔可被构造为接纳可变形的构件的至少一部分,冠可定位于平台中的开口内。 In at least one embodiment, a staple cartridge can include a cavity and a platform, wherein the chamber may be configured to receive a deformable member at least a portion of the crown may be positioned within an opening in the platform. 在多个实施例中,当软组织被捕获在砧座和钉仓之间时,甚至在缝钉驱动器将可变形的构件推向砧座之前,冠均可向软组织施加压缩力或压力。 Prior to this embodiment, when the soft tissue is captured between the anvil and the staple cartridge, the staple driver even in the deformable member into a plurality of anvil embodiments, the crown can apply a compressive force or pressure to soft tissue. 因此,在至少一个这种实施例中,外科手术缝钉与软组织之间的获取力和/或压缩力或压力可改善。 Thus, the force between the acquired embodiment, the surgical staple soft tissue and / or compressive force or pressure can improve at least one such embodiment. 在多个实施例中,两个或更多个相邻缝钉的冠可被连接。 Embodiment, two or more adjacent crown staples in a plurality of embodiments may be connected. 在至少一个这种实施例中,冠可向软组织施加均一的压力,并且在多种情况下,在缝钉定位到软组织中之后,冠可增加软组织的硬度。 After at least one such embodiment, a uniform pressure can be applied crown of soft tissue, and in many cases, the staples into the soft tissue positioned, the crown can increase the hardness of the soft tissue.

[0022] 在本发明的多种形式中,例如可将外科手术缝钉定位到软组织中,以便尤其在切开软组织后减少或消除从其中产生的出血。 [0022] In the present invention, in various forms, for example, the positioning of the surgical staples into the soft tissue, especially in order to reduce or eliminate bleeding from which the soft tissue after the incision. 在多个实施例中,可将缝钉排列在钉仓内,使得它们以至少两行或两行的形式定位到软组织中,以便使软组织中的血管收缩。 In various embodiments, the staples within the staple cartridge are arranged such that they are positioned to form at least two rows or two rows into the soft tissue to soft tissue vasoconstriction. 在至少一个实施例中,钉仓可包括其中的第一缝钉腔和第二缝钉腔,其中第一腔可限定第一轴线,第二腔可限定第二轴线,并且第一轴线可横越第二轴线。 In at least one embodiment, a staple cartridge can include a staple therein a first chamber and a second staple cavity, wherein the first cavity can define a first axis, the second chamber may define a second axis, the first axis and traversable the second axis. 在至少一个这种实施例中,第一腔和第二腔可以彼此不平行的方向延伸,并且由于其中设置的缝钉的排列方式,缝钉可更好地使软组织中的血管收缩并减少流经此处的血液流量。 In at least one embodiment, the first and second chambers may extend non-parallel to one another such embodiment, and since the arrangement of staples in which the staples may be better vasoconstriction soft tissue and reduce the flow blood flow through here. 在本发明的多种形式中,外科手术缝钉可包括可与钉仓中的缝钉腔配合的特征,当(例如)缝钉驱动器推动缝钉时,尤其是当缝钉以不同方向取向时,该特征可减少或甚至抑制缝钉在缝钉腔内摇动或倾斜。 In various forms of the present invention, a surgical staple can include staple cartridge engaged with staple cavities wherein, when (for example) the staple driver pushing the staple, especially when staple oriented in different directions when this feature may be reduced or even suppressed staples in the staple chamber panning or tilting. 在至少一个这种实施例中,缝钉的冠可包括弧形和/或圆柱形结构,其可与缝钉腔的弧形和/或圆柱形结构配合,以便减少缝钉与缝钉腔之间不必要的相对移动或旋转。 In at least one such embodiment, the staple crown may comprise an arcuate and / or cylindrical configuration, which can be used with arcuate staple cavity and / or cylindrical structure, in order to reduce the staple cavities of the staple between unwanted relative movement or rotation.

[0023] 在本发明的多种形式中,外科手术缝钉可包括(例如)可进一步减少软组织出血的结构。 [0023] In the various forms of the present invention, a surgical staple can include (e.g.) can be further reduced bleeding of the soft tissue structure. 在至少一个实施例中,缝钉可包括至少一个可变形的构件,当其经由软组织插入时可在软组织中穿孔,并且在多个实施例中,可变形的构件可在其上包括、或可由该材料构成,该材料可膨胀并能基本上填充软组织中的穿孔。 In at least one embodiment, the staples can include at least one deformable member may be perforated when it is inserted through the soft tissue in the soft tissues, and in this embodiment a plurality, the deformable member may comprise thereon, or may be the material, the expandable material can be perforated and can substantially fill the soft tissue. 在多个实施例中,可变形的构件的至少一部分可用(例如)亲水性材料涂覆,该亲水性材料在暴露于水或人体中的其它液体时可膨胀,并向穿孔的周边施加压缩力。 In the embodiment applied to the periphery, at least a portion of the available (e.g.) a hydrophilic material coated with the deformable member, the hydrophilic material may swell when exposed to water or other body liquids in a plurality of embodiments, and perforated compressive forces. 该压缩力可减少来自穿孔的出血,从而减少由此引起的任何可能的并发症。 The compressive force may reduce bleeding from the perforation, thereby reducing any possible complications caused thereby. 在本发明的至少一种形式中,外科手术缝钉的冠可包括围绕可变形的构件或邻近其设置的结构,其可压缩围绕可变形的构件的软组织并增加对其施加的压缩力或压力。 In at least one form of the invention, the surgical staple crown may comprise about a deformable member disposed adjacent to or in the structure of soft tissue around the compressible deformable member and increasing the compression force or pressure applied thereto . 由于压缩力或压力增大,可减少由可变形的构件造成的来自穿孔的血液流量。 Since the compressive force, or pressure, may reduce the blood flow from the perforations caused by the deformable member. [0024] 在本发明的多种形式中,外科手术缝合器可包括砧座、钉仓以及可移去地保持到砧座和/或钉仓的支撑材料。 [0024] In the various forms of the present invention, the surgical stapler can include an anvil and a staple cartridge removably holding buttress material to the anvil and / or staple cartridge. 在多个实施例中,钉仓可包括至少一个可移去地保存在其中的缝钉,当从其中定位或射出时,缝钉可接触支撑材料并将支撑材料从砧座和/或钉仓移除。 In various embodiments, a staple cartridge can comprise at least one removably staples stored therein, wherein when the positioning or exit from, the staples can contact the support material and the support material from the anvil and / or staple cartridge removed. 在至少一个实施例中,砧座可包括至少一个唇缘和/或凹槽,其被构造为将支撑材料可移去地保持到砧座,直到从外科手术缝钉延伸的可变形的构件(例如)被砧座弯曲并被导向和接触支撑材料。 In at least one embodiment, the anvil can include at least one lip and / or grooves, which are configured to removably retain buttress material to the anvil, a deformable member extending from the surgical staple until ( for example) is bent and guided in contact with the support material and the anvil. 在多个实施例中,支撑材料可被构造为使软组织变硬和/或至少阻碍缝钉撕裂软组织。 In various embodiments, buttress material can be configured such that the soft tissue hardening and / or at least impede staple soft tissue tear. 在本发明的至少一种形式中,外科手术缝合器的砧座可包括可释放式凹坑元件,其可捕获定位的或射出的缝钉的末端。 In at least one form of the invention, a surgical stapler anvil can include a releasable element recesses, which may capture the end or exit positioned staples. 在多个实施例中,凹坑元件可从砧座分离,使得在缝钉射出后,凹坑元件与缝钉以及缝合的组织保持在一起。 In various embodiments, the pits may be separated from the anvil member, such that after ejection of the staples, with the staples and the recesses element stapled tissue together. 在定位缝钉时,站座中的凹坑元件可弯转或弯曲缝钉的末端,之后,缝钉的末端可接触凹坑元件的缝钉末端固定表面,该固定表面可抑制缝钉末端再次刺穿或以其它方式再次穿透软组织。 When staple positioning station seat member may be a pit or end of the curved bending staples, after the end of the staples may contact the staple tip dimple fixing element, the fixing end surface of the staple again suppressed puncture or otherwise penetrate soft tissue again. 在至少一个实施例中,缝合器的缝合和/或切割动作期间产生的力可克服将凹坑元件保持在砧座中的压配合力,使得在射钉时凹坑元件被分离。 In at least one embodiment, the stapling stapler and / or forces generated during the cutting operation of press-fitting force can overcome the pit held in the anvil member so that the member is separated at the pit nail. 可释放式凹坑元件可由与缝钉的冠相同的材料制成,其可由(例如)生物可吸收的材料和/或非生物可吸收的材料构成。 Releasable member may be the same as the dimple staple crown material, which may be (e.g.) bioabsorbable material and / or bioabsorbable material constituted.

[0025] 在另一个一般方面,本发明的多种形式涉及使用本文所述的缝钉和缝合器械的外科手术,例如Roux-en-Y胃旁路手术方法或其它手术方法。 [0025] In another general aspect, the present invention relates to the use of various forms of the herein staples and surgical stapling instruments, such as Roux-en-Y gastric bypass surgery, or other surgical methods. 特别地,可进行多种外科手术,其中束带被布置在(例如)已切开并缝合的软组织周围。 In particular, various surgical procedures, wherein the band is disposed around (e.g.) was cut and sewn in the soft tissue. 在这种技术中,可使用缝钉和/或缝合器械,其中将缝钉末端插入软组织中之后是不暴露的,使得缝钉末端不会磨破或以其它方式损坏束带,在多种情况下,缝钉末端会刺激软组织。 In this technique, using staples and / or stapling instrument, wherein the insertion end of the staple after the soft tissue is not exposed, so that the end of the staple will not frayed or otherwise damaged band, in many cases , the end of the staple will stimulate the soft tissue. 例如,可以使用上述具有可释放式凹坑元件的器械在拟设置束带的区域缝合组织。 For example, the above-described apparatus may be used having a releasable element recesses provided in the proposed area of ​​suturing tissue band. 可释放式凹坑元件一旦从砧座上分离就可以保护软组织和束带免受缝钉末端的损坏。 Releasable once separated from the pit anvil member can protect the band from damage soft tissue and the staple ends. 在多种情况下,临床医生可使用两种器械以用于这种手术:一种没有可释放式凹坑元件,用于在未设置束带的软组织区域中形成的切口;而另一种器械则具有可释放式凹坑元件,用于在拟设置束带的软组织区域中形成的切口。 In many cases, the clinician may use two surgical instrument for this: one kind of element is not releasable pits, formed for notch band is not provided in soft tissue region; and another instrument the pits having a releasable element for setting the proposed incision made in the soft tissue of the band area. 在其它实施例中,临床医生可使用一种器械,并选择性地向器械装载具有可释放式凹坑元件的砧座,以用于在拟设置束带的软组织区域中形成的切口。 In other embodiments, the clinician may use one instrument, and selectively loading pit having a releasable element to the instrument anvil, for forming the incision in the soft tissue intended to set the band area.

[0026] 在另一个方面,本发明的多种形式涉及具有插入砧座中的所谓的“释放式”垫圈的缝合器。 [0026] In another aspect, the present invention relates to various forms of anvil having inserted a so-called "release" type gasket stapler. 在多个实施例中,垫圈可包括圆形外部和圆形内部。 In various embodiments, the gasket may include a circular external and internal circular. 在至少一个这种实施例中,所述外部可以包括多个缝钉导向部分,其限定当器械被击发时驱动外科手术缝钉的缝钉末端由其穿过的开口,并随后由砧座将缝钉末端弯曲或转向。 In at least one such embodiment, the outer staple may include a plurality of guide portions which define the actuation of the surgical staple when the instrument is fired the staples through the end of its opening, and subsequently the anvil bending or steering the staple tip. 转向后,缝钉末端可以接触缝钉导向部分,并可被其保持,使得缝钉末端不会再次穿透或以其它方式再次刺穿缝合的组织。 After turning, the staple ends may be in contact with the staple guide part, and which is held, so that the tip not penetrate the staple or otherwise pierce again stapled tissue again. 在多个实施例中,该外科手术器械还可以包括刀,当外科手术器械被击发时,该刀可切割垫圈,从而内部从外部分离,因此,在缝钉射入软组织中之后外部可与缝钉保持在一起。 In various embodiments, the surgical instrument may further include a knife, when the surgical instrument is fired, the knife can cut the gasket, thereby separating the inside from the outside, the outer slit may be incident after staple soft tissue nailed together. 因此,垫圈的外部可以提供固定的缝钉线,其尤其可以对某些类型的吻合术有利。 Thus, the gasket can provide a fixed external staple line, which may in particular be advantageous for certain types of anastomosis. 在多个实施例中,垫圈可用非生物可吸收的材料制成,但在其它实施例中,垫圈可由生物可吸收的材料制成。 Embodiment, the gasket material can be used non-bioabsorbable formed in a plurality of embodiments, in other embodiments, the gasket may be made of a material bioabsorbable.

附图说明 BRIEF DESCRIPTION

[0027] 通过结合附图参考本发明实施例的以下说明,本发明的上述和其它特征及优点及其获取方法将会变得更加明显,并可更好地理解发明本身,其中:[0028] 图I为根据本发明的一个非限制性实施例的外科手术器械的透视图; [0027] The following description with reference to the accompanying drawings embodiments of the invention in conjunction with the above and other features and advantages of the present invention and its acquisition method will become more apparent and the invention itself better understood, in which: [0028] Figure I is a perspective view of a surgical instrument in accordance with non-limiting embodiment of the present invention;

[0029] 图2为图I的外科手术器械的透视图; [0029] FIG. 2 is a perspective view of the surgical instrument of FIG. I;

[0030] 图3为图I的外科手术器械的端部执行器的分解图; [0030] FIG. 3 is an exploded view of the end effector of the surgical instrument of FIG. I;

[0031] 图4为正用于切开和缝合软组织的图I的外科手术器械的透视图; [0031] 4 a perspective view of the surgical instrument is being used to cut soft tissue suturing and I of FIG;

[0032] 图5为处于未变形形状的外科手术缝钉的前视图; [0032] FIG. 5 is in the shape of undeformed surgical staples front view;

[0033] 图6为处于第一变形形状的图5的缝钉的前视图; [0033] FIG. 6 is a staple in a first modification of the shape of a front view of FIG 5;

[0034] 图7为处于第二变形形状的图5的缝钉的前视图; [0034] FIG. 7 is a front view of a second modification of the shape of the staple of FIG 5;

[0035] 图8为处于第三变形形状的图5的缝钉的前视图; [0036] 图9为图5的缝钉的俯视图,其处于图8的第三变形形状; [0035] FIG. 8 is a front view showing a third modification of the shape of the staple 5; [0036] FIG. 9 is a top view of the staple of FIG 5, FIG 8 is a third modification of the shape;

[0037] 图10为正用于将图5的外科手术缝钉定位到软组织中的图I的外科手术缝合器的局部横截面图; [0037] FIG. 10 is a partial cross-sectional positive for surgical staple of FIG 5 is positioned into the soft tissue of FIG. I in FIG surgical stapler;

[0038] 图IOA为处于部分变形形状的外科手术缝钉的前视图; [0038] FIG IOA as being partially deformed shape of the surgical staples front view;

[0039] 图11为外科手术缝钉的第一可变形的构件和第二可变形的构件的透视图; [0039] FIG. 11 is a surgical staple of the first deformable member and a perspective view of a second deformable member;

[0040] 图12为包覆模制到图12的可变形的构件上的可溶解的或生物可吸收的材料的透视图; [0040] FIG. 12 is overmolded onto the dissolvable deformable member a perspective view of FIG. 12 or bioabsorbable material;

[0041] 图13为处于变形形状的图12的缝钉的透视图; [0041] FIG. 13 is a perspective view of the staple of FIG. 12, the deformed shape;

[0042] 图14为图12的缝钉的透视图,其中可溶解材料的一部分已经溶解,第一可变形的构件和第二可变形的构件已彼此相对移动; [0042] FIG. 14 is a perspective view of the staple of FIG. 12, a portion of the dissolvable material has been dissolved, the first deformable member and the second member is deformable relative to each other;

[0043] 图15为可溶解材料完全溶解之后的图12的缝钉的透视图; A perspective view of the staple of FIG. 12 after [0043] FIG. 15 is a dissolvable material completely dissolved;

[0044] 图16为正用于将图12的外科手术缝钉定位到软组织中的外科手术缝合器的局部横截面图; [0044] FIG. FIG. 16 is a positive for the surgical staples 12 to locate a partial cross-sectional view of the soft tissue of a surgical stapler;

[0045] 图17为图16的外科手术缝合器的额外的局部横截面图; [0045] FIG 17 is a diagram of a surgical stapler 16 an additional partial cross sectional view;

[0046] 图18为根据本发明的一个非限制性实施例的缝钉的可变形的构件的透视图; [0046] FIG. 18 is a staple non-limiting embodiment in accordance with one embodiment of the present invention, a perspective view of the deformable member;

[0047] 图19为图18的可变形的构件的俯视图; [0047] FIG. 19 is a plan view of the deformable member of FIG 18;

[0048] 图20为根据本发明的一个非限制性实施例包覆模制到图18的可变形的构件上的可溶解的或生物可吸收的材料的透视图; A perspective view of a dissolvable or bioabsorbable material on the [0048] FIG. 20 according to the present invention, a non-limiting embodiment of FIG. 18 overmolded onto deformable member;

[0049] 图21为根据本发明的一个非限制性实施例的缝钉的第一可变形的构件和第二可变形的构件的透视图; [0049] FIG. 21 is a first deformable member staple non-limiting embodiment and a perspective view of a second deformable member in accordance with the present invention;

[0050] 图22为图21的可变形的构件的俯视图; [0050] FIG. 22 is a top plan view of the deformable member of FIG 21;

[0051] 图23为根据本发明的一个非限制性实施例包覆模制到图21的可变形的构件上的可溶解的或生物可吸收的材料的透视图; [0051] FIG. 23 is a perspective view of a dissolvable to the deformable member of FIG. 21 or bioabsorbable material overmolding a non-limiting embodiment according to the present invention;

[0052] 图24为处于变形形状的图23的缝钉的透视图; [0052] FIG. 24 is a perspective view of the staple of FIG. 23, the deformed shape;

[0053] 图25为图23的缝钉的透视图,其中可溶解材料的一部分已经溶解,第一可变形的构件和第二可变形的构件已彼此相对移动; [0053] FIG. 25 is a perspective view of the staple of FIG. 23, a portion of the dissolvable material has been dissolved, the first deformable member and the second member is deformable relative to each other;

[0054] 图26为可溶解的或生物可吸收的材料完全溶解之后的图24的缝钉的透视图; A perspective view of the staple of FIG. 24 after the complete dissolution [0054] FIG. 26 is a dissolvable or bioabsorbable material;

[0055] 图27为根据本发明的一个非限制性实施例的具有在其上形成的可膨胀涂层的第一可变形的构件和第二可变形的构件的透视图; [0055] FIG. 27 according to the first deformable member having an expandable coating formed thereon in a non-limiting embodiment of the present invention and a perspective view of a second deformable member;

[0056] 图28为图27的可变形的构件的俯视图; [0056] FIG 28 FIG 27 is a top plan view of the deformable member;

[0057] 图29为根据本发明的一个非限制性实施例包覆模制到图27的第一可变形的构件和第二可变形的构件上的可溶解的或生物可吸收的材料的透视图; Perspective view [0057] FIG. 29 according to the present invention, a non-limiting embodiment overmolded to first deformable member 27 and the second soluble deformable member or bioabsorbable material Figure;

[0058] 图30为处于变形构型的图29的缝钉的透视图; [0058] FIG. 30 is a perspective view showing a modification of the configuration of the staple of Figure 29;

[0059] 图31为可溶解材料的至少一部分已溶解并且可膨胀的材料已膨胀之之后的图29的缝钉的透视图; A perspective view of the staple of FIG. 29 after [0059] FIG. 31 is a dissolvable material has dissolved and at least a portion of the expandable material expanded it;

[0060] 图32为示出处于膨胀形式的可膨胀涂层的图29的缝钉的俯视图; A top view [0060] FIG. 32 is a diagram illustrating the expandable coating in an expanded form of the staple of Figure 29;

[0061] 图33为可溶解材料和可膨胀的材料完全溶解之后的图29的缝钉的透视图; [0061] FIG. 33 is a perspective view of the staple of FIG. 29 after the complete dissolution of the dissolvable material and the expandable material;

[0062] 图34为根据本发明的一个非限制性实施例的可变形的构件的端部的透视图; [0062] FIG. 34 is a perspective view of an end portion according to the present invention may be a deformable member of a non-limiting embodiment;

[0063] 图35为图34的可变形的构件的横截面图; [0064] 图36为根据本发明的一个非限制性实施例的另一个可变形的构件的端部的透视图; [0063] FIG. 35 is a cross-sectional view of the deformable member of FIG. 34; the other is a perspective view of a deformable member in accordance with one non-limiting embodiment of the present invention, the end portion [0064] FIG 36;

[0065] 图37为图36的可变形的构件的横截面图; Cross-sectional view [0065] FIG 37 FIG 36 is a deformable member;

[0066] 图38为根据本发明的一个非限制性实施例的另一个可变形的构件的端部的透视图; [0066] FIG. 38 is a perspective view of an end portion of another member of a deformable non-limiting embodiment of the present invention;

[0067] 图39为图38的可变形的构件的横截面图; Cross-sectional view [0067] FIG 39 FIG 38 is a deformable member;

[0068] 图40为根据本发明的一个非限制性实施例的另一个可变形的构件的端部的透视图; [0068] FIG. 40 is a perspective view of an end portion of a deformable member in accordance with a further non-limiting embodiment of the present invention;

[0069] 图41为图40的可变形的构件的横截面图; Cross-sectional view [0069] FIG 40 FIG 41 is a deformable member;

[0070] 图42为根据本发明的一个非限制性实施例的另一个可变形的构件的端部的透视图; [0070] FIG. 42 is a perspective view of an end portion of another member of a deformable non-limiting embodiment of the present invention;

[0071] 图43为图42的可变形的构件的横截面图; Cross-sectional view [0071] FIG 43 FIG 42 is a deformable member;

[0072] 图44为根据本发明的一个非限制性实施例的另一个可变形的构件的端部的透视图; [0072] FIG. 44 is a perspective view of an end portion of a deformable member in accordance with a further non-limiting embodiment of the present invention;

[0073] 图45为图44的可变形的构件的横截面图; [0073] FIG 45 FIG 44 is a cross-sectional view of the deformable member;

[0074] 图46为根据本发明的一个非限制性实施例的另一个可变形的构件的端部的透视图; [0074] FIG. 46 is a perspective view of an end portion of a deformable member in accordance with a further non-limiting embodiment of the present invention;

[0075] 图47为图46的可变形的构件的横截面图; [0075] FIG 47 FIG 46 is a cross-sectional view of the deformable member;

[0076] 图48为根据本发明的一个非限制性实施例的另一个可变形的构件的端部的透视图; [0076] FIG. 48 is a perspective view of an end portion of another member of a deformable non-limiting embodiment of the present invention;

[0077] 图49为图48的可变形的构件的横截面图; Cross-sectional view [0077] FIG 49 FIG 48 is a deformable member;

[0078] 图50为根据本发明的一个非限制性实施例的另一个可变形的构件的端部的透视图; [0078] FIG. 50 is a perspective view of an end portion of another member of a deformable non-limiting embodiment of the present invention;

[0079] 图51为图50的可变形的构件的横截面图; [0079] FIG. 51 is a deformable member 50 of FIG cross-sectional view;

[0080] 图52为根据本发明的一个非限制性实施例的另一个可变形的构件的端部的透视图; [0080] FIG. 52 is a perspective view of an end portion of another member of a deformable non-limiting embodiment of the present invention;

[0081] 图53为图52的可变形的构件的横截面图; Cross-sectional view [0081] FIG 53 FIG 52 is a deformable member;

[0082] 图54为根据本发明的一个非限制性实施例的另一个可变形的构件的端部的透视图; [0082] FIG. 54 is a perspective view of an end portion of a deformable member in accordance with a further non-limiting embodiment of the present invention;

[0083] 图55为图54的可变形的构件的横截面图; [0083] FIG 54 FIG 55 is a cross-sectional view of the deformable member;

[0084] 图56为根据本发明的一个非限制性实施例的另一个可变形的构件的端部的透视图; [0084] FIG. 56 is a perspective view of an end portion of a deformable member in accordance with a further non-limiting embodiment of the present invention;

[0085] 图57为图56的可变形的构件的横截面图; [0085] FIG. 57 is a deformable member 56 of FIG cross-sectional view;

[0086] 图58为根据本发明的一个非限制性实施例的具有可滑动冠的外科手术缝钉的前视图; [0086] FIG. 58 is a crown having slidably surgical staples front view of a non-limiting embodiment of the present invention;

[0087] 图59为根据本发明的一个非限制性实施例的具有可滑动冠的另一个外科手术缝钉的前视图; [0087] FIG. 59 is a front view of another surgical staple having a slidable crown in a non-limiting embodiment of the present invention;

[0088] 图60为根据本发明的一个非限制性实施例的具有可滑动冠的另一个外科手术缝钉的前视图; [0088] FIG. 60 is a front view of another surgical staple having a slidable crown in a non-limiting embodiment of the present invention;

[0089] 图61为图58的外科手术缝钉的仰视图; [0089] FIG. 61 is a surgical staple of FIG. 58 is a bottom view;

[0090] 图62为图59的外科手术缝钉的仰视图; [0090] FIG 62 FIG 59 is a surgical staple bottom view;

[0091 ] 图63为图60的外科手术缝钉的仰视图; [0091] FIG. 63 is a surgical staple bottom view of FIG 60;

[0092] 图64为图58的外科手术缝钉的俯视图; [0092] FIG. 64 is a top plan view of the surgical staples 58;

[0093] 图65为图59的外科手术缝钉的俯视图; [0093] FIG. 65 is a plan view of the surgical staple of FIG 59;

[0094] 图66为图60的外科手术缝钉的俯视图; [0094] FIG. 66 is a plan view of the surgical staple of FIG 60;

[0095] 图67为根据本发明的一个非限制性实施例定位于钉仓内的图58的未定位的外科手术缝钉的透视横截面图; [0095] FIG. 67 is a perspective cross-sectional view of a surgical staple in accordance with the present invention a non-limiting embodiment positioned within the staple cartridge of FIG. 58 are not positioned;

[0096] 图68为处于部分定位位置的图67的缝钉的透视横截面图; [0096] FIG. 68 is a view of a portion positioned in a perspective cross-sectional view of the position of the staples 67;

[0097] 图69为处于完全定位位置的图67的缝钉的透视横截面图; [0097] FIG. 69 is a perspective cross-sectional view of the staple of FIG. 67, a position perfectly positioned;

[0098] 图70为处于完全定位位置的图67的缝钉的透视图; [0098] FIG 70 is perfectly positioned in the location of a perspective view of the staple of FIG 67;

[0099] 图71为图67的钉仓的透视图,其示出若干处于未定位位置的外科手术缝钉; [0099] FIG 71 FIG 67 is a perspective view of a staple cartridge, showing a plurality of position location in a non-surgical staple;

[0100] 图72为根据本发明的一个非限制性实施例的通过桥接件连接的多个图58的缝钉的组件的透视图; [0100] FIG. 72 is a perspective view of an assembly according to FIG plurality of staples through a bridge member of the present invention, non-limiting embodiment of the connection 58;

[0101] 图73为图72的组件的另一个透视图; [0101] FIG. 73 is another perspective view of the assembly of Figure 72;

[0102] 图74为根据本发明的一个非限制性实施例的具有位于其中的图72的组件的钉仓的俯视图; [0102] FIG. 74 is a plan view of the cartridge assembly of FIG. 72 located therein according to one non-limiting embodiment of the present invention has;

[0103] 图75为图74的钉仓的局部透视图; [0103] FIG. 75 is a partial perspective view of the cartridge of Figure 74;

[0104] 图76为根据本发明的一个非限制性实施例的钉仓和缝钉组件的俯视图; [0104] FIG. 76 is a plan view of a staple cartridge assembly and a non-limiting embodiment of the present invention;

[0105] 图77为根据本发明的一个非限制性实施例的具有可滑动式冠和从其中延伸的凸起的缝钉的前视图; [0105] FIG. 77 is a non-limiting embodiment having in accordance with an embodiment of the present invention may be sliding cap and a front view of the projection from which the staple extends;

[0106] 图78为处于定位位置的图77的缝钉的前视图; [0106] FIG 78 is positioned in the front view of the staple position 77;

[0107] 图79为图77的缝钉的俯视图; [0107] FIG. 79 is a staple of FIG. 77 a top view;

[0108] 图80为根据本发明的一个非限制性实施例的通过桥接件连接的图77的外科手术缝钉的若干组件的透视图; [0108] FIG. 80 is a perspective view of several components of the surgical staple bridge through a non-limiting embodiment of the present invention. FIG. 77 is connected;

[0109] 图81为根据本发明的一个非限制性实施例定位于钉仓内的图80的组件的局部透视图; [0109] FIG. 81 is a partial perspective view of the assembly of Figure 80, non-limiting embodiment positioned within a staple cartridge in accordance with the present invention;

[0110] 图82为具有处于未定位位置的缝钉组件的图81的钉仓的透视横截面图; [0110] FIG. 82 is a component having not positioned in the staple position 81 of the staple cartridge of FIG perspective cross-sectional view;

[0111] 图83为具有处于定位位置的缝钉组件的图81的钉仓的透视横截面图; [0111] FIG. 83 is a perspective cross-sectional view of a staple assembly is positioned in the position of the staple cartridge of FIG 81;

[0112] 图84为定位图77的缝钉的外科手术缝合器的横截面图; [0112] FIG. 84 is a cross sectional view of FIG positioning a surgical stapler 77 staples;

[0113] 图85为根据本发明的一个非限制性实施例用于形成缝钉的细长构件的平面图;[0114] 图86为图85的细长构件的平面图,其示出包覆模制到缝钉基部上的冠,其中缝钉具有将冠互连的连接区段; [0113] FIG. 85 is a plan view of the elongated member for staples according to the present invention, a non-limiting embodiment is formed; [0114] FIG. 86 is an elongated member in plan view in FIG. 85, showing overmoulded crown to the base of the staple, wherein the staple has a crown interconnecting the connecting section;

[0115] 图87为示出移除了连接区段的图85的细长构件的平面图; [0115] FIG. 87 is a plan view illustrating the elongated member removed showing the connection section 85;

[0116] 图88为已沿着轴线切割的图86的细长构件的平面图; [0116] FIG. 88 is a plan view of the elongated member is cut along the axis of FIG. 86;

[0117] 图89为根据本发明的一个非限制性实施例的替代性细长构件的平面图; [0117] FIG. 89 is a plan view of an alternative embodiment of the elongated member is a non-limiting embodiment of the present invention;

[0118] 图90为根据本发明的一个非限制性实施例已从图89的细长构件上单独设置的可变形的构件的平面图; [0118] FIG. 90 is a non-limiting embodiment in accordance with one embodiment of the present invention, a plan view of the deformable member separately provided from the elongated member 89 of FIG;

[0119] 图91为根据本发明的一个非限制性实施例的另一个替代性细长构件的平面图; [0119] FIG. 91 is a plan view of another alternative embodiment of the elongated member is a non-limiting embodiment of the present invention;

[0120] 图92为根据本发明的一个非限制性实施例示出包覆模制到缝钉基部上的冠的图91的替代性细长构件的平面图; [0120] FIG. 92 is a diagram illustrating a plan view of the overmoulded alternative the elongated member 91 of FIG staple crown on the base, according to one non-limiting embodiment of the present invention;

[0121] 图93为沿着轴线切割细长构件之后的图92的细长构件的平面图; [0121] FIG. 93 is an elongated member of FIG. 92 after cutting along the axis of a plan view of the elongated member;

[0122] 图94-99为根据本发明的非限制性实施例的多个替代性可变形的构件的平面图; [0122] 94-99 is a plan view of an alternate plurality of deformable members may be non-limiting embodiment of the present invention;

[0123] 图100为根据本发明的一个非限制性实施例由图85的细长构件制成的单独设置的缝钉的侧视图; [0123] FIG. 100 is a side view of the staple separately provided by an elongated member made of FIG. 85 according to one embodiment of the present invention, non-limiting embodiment;

[0124] 图101为图100的缝钉的前视图; [0124] FIG. 101 is a front view of the staple of FIG. 100;

[0125] 图102为图100的缝钉的透视图; [0125] FIG. 102 is a perspective view of the staple of FIG. FIG. 100;

[0126] 图103为根据本发明的一个非限制性实施例用于模制多个各个缝钉的处于封闭构型的转移块的透视图; [0126] FIG. 103 is a perspective view of the closed configuration of the transfer blocks for each of the plurality of staples molding according to one embodiment of the present invention, non-limiting embodiment;

[0127] 图104为根据本发明的一个非限制性实施例用于模制多个各个缝钉的处于开口构型的图103的转移块的透视图; [0127] FIG. 104 is a plurality of individual staples molding according to one non-limiting embodiment of the present invention in a perspective view of the transfer block configuration of FIG opening 103;

[0128] 图105为根据本发明的一个非限制性实施例的替代性转移块的平面图; [0128] FIG. 105 is a plan view of a block transfer in accordance with the present invention, an alternative non-limiting embodiment;

[0129] 图106为根据本发明的一个非限制性实施例的另一个替代性转移块的平面图; [0129] FIG transfer block 106 according to a plan view of another alternative embodiment of a non-limiting embodiment of the present invention is;

[0130] 图107为根据本发明的一个非限制性实施例的钉仓的透视图; [0130] FIG. 107 is a perspective view of a staple cartridge according to the present invention, non-limiting embodiment;

[0131] 图108为图107的钉仓的俯视图; [0131] FIG. 108 is a top view of the staple cartridge 107;

[0132] 图109为图107的钉仓的细部图; [0132] FIG staple cartridge 109 is a detail view of FIG. 107;

[0133] 图110为图107的钉仓的额外的细部图; [0133] FIG. 110 is a cartridge 107 of FIG extra detail view;

[0134] 图IlOA为根据本发明的一个非限制性实施例的钉仓的细部图; [0134] FIG IlOA is a detail of a staple cartridge embodiment of the present invention, non-limiting embodiment according;

[0135] 图111为被构造为定位于图107的钉仓的缝钉腔内的外科手术缝钉的透视图; [0135] FIG. 111 is a perspective view of a staple configured to be positioned within the staple cartridge lumen 107 of surgical staples;

[0136] 图112为图111的外科手术缝钉的平面图; [0136] FIG. 112 is a plan view of the surgical staple of FIG. 111;

[0137] 图113为根据本发明的一个非限制性实施例的钉仓的缝钉腔的平面图; [0137] FIG. 113 is a plan view of a staple cartridge according to the present invention, non-limiting embodiment of the staple cavity;

[0138] 图114为根据本发明的一个非限制性实施例的钉仓的缝钉腔的平面图; [0138] FIG. 114 is a plan view of the staple cavities of a staple cartridge according to the present invention, non-limiting embodiment;

[0139] 图115为根据本发明的一个非限制性实施例的钉仓的缝钉腔的平面图; [0139] FIG. 115 is a plan view of a staple cavity of the staple cartridge in accordance with one non-limiting embodiment of the present invention;

[0140] 图116为根据本发明的一个非限制性实施例的钉仓的缝钉腔的平面图; [0140] FIG. 116 is a plan view of the staple cavities of a staple cartridge according to the present invention, non-limiting embodiment;

[0141] 图117为沿着切口的缝钉图案的俯视图,其中图案具有基本上平行的行的缝钉; [0141] FIG. 117 is a top view along the cut staple pattern, wherein the pattern has substantially parallel rows of staples;

[0142] 图118为根据本发明的一个非限制性实施例的具有缝钉图案的钉仓的俯视图; [0142] FIG. 118 is a plan view of a staple cartridge having a pattern of non-limiting embodiment of the present invention;

[0143] 图119为图118的钉仓的透视图; [0143] FIG. 119 is a perspective view of the staple cartridge of FIG. 118;

[0144] 图120为根据本发明的一个替代实施例的具有缝钉图案的钉仓的局部平面图; [0144] FIG. 120 is a partial plan view of a staple cartridge having a staple pattern according to an alternative embodiment of the present invention;

[0145] 图121为根据本发明的另一个替代实施例的具有缝钉图案的钉仓的局部俯视图; [0145] FIG. 121 is a plan view of an alternative partial staple cartridge having staple pattern according to another embodiment of the present invention;

[0146] 图122为根据本发明的一个非限制性实施例的砧座、钉仓以及可移去地保持到砧座的支撑材料的部分的透视图; [0146] FIG anvil 122 according to one non-limiting embodiment of the present invention, the staple cartridge and removably retaining a perspective view of a portion of anvil buttress material;

[0147] 图123为图122的砧座和支撑材料的横截面图; [0147] FIG anvil 123 and a cross-sectional view of a support material 122 of FIG;

[0148]图124为根据本发明的一个替代非限制性实施例的砧座和支撑材料的横截面图; [0148] FIG. 124 is an alternative non-limiting embodiment of an anvil and a cross-sectional view of a support material according to the present invention;

[0149] 图125为相对于软组织设置并且外科手术缝钉处于未定位位置的图122的实施例的砧座、钉仓和支撑材料的横截面图; [0149] FIG. 125 relative to soft tissue and the surgical staples disposed in the position of non-targeted FIG anvil embodiment, cross-sectional view of a staple cartridge and buttress material 122;

[0150] 图126为图125的实施例的额外的横截面图,其示出处于定位位置的缝钉; [0150] FIG. 126 is a cross-sectional view of an additional embodiment of the embodiment of FIG. 125, which is shown positioned in the staple position;

[0151] 图127为图125的实施例的额外的横截面图,其不出处于打开位置的站座; [0151] FIG. 127 is a cross-sectional view of an additional embodiment of FIG. 125, the base station which is not in an open position;

[0152] 图128为示出在其上进行了Roux-en-Y胃旁路手术方法后的胃和小肠的示意图; [0152] FIG. 128 is a schematic diagram illustrating the stomach and small intestine after Roux-en-Y gastric bypass surgery in which the method;

[0153] 图129为根据本发明的一个非限制性实施例示出胃旁路手术方法步骤的流程图; [0153] FIG. 129 is a diagram illustrating the method steps gastric bypass surgery in accordance with one embodiment of the present invention, non-limiting embodiment of a flow chart;

[0154] 图130为根据本发明的一个非限制性实施例的具有可通过外科手术缝钉脱离的部分的站座的横截面图; [0154] FIG. 130 is a cross-sectional view of a detachable surgical staple base station portion of the embodiment according to one non-limiting embodiment of the present invention;

[0155] 图131为示出处于定位构型的外科手术缝钉的图130的实施例的额外的视图; [0155] FIG. 131 is a view of an additional embodiment 130 is shown positioned in the configuration of FIG surgical staple;

[0156] 图132为根据本发明的一个替代非限制性实施例的具有可通过外科手术缝钉脱尚的部分的站座的横截面图; [0156] FIG. 132 is a non-limiting alternative embodiment cross-sectional view of the base station still has a detachable portion of the surgical staple in accordance with the present invention;

[0157] 图133为示出处于定位构型的外科手术缝钉的图120的实施例的额外的视图; [0157] FIG. 133 is a view of an additional embodiment 120 is shown positioned in a configuration of the surgical staple of FIG;

[0158] 图134为根据本发明的一个非限制性实施例的圆形外科手术缝合器械的透视图; [0158] FIG. 134 is a perspective view of a non-limiting embodiment of a circular surgical stapling instrument according to the embodiment of the present invention;

[0159] 图135为移除了缝合器械的某些部分的图134的缝合器械的局部透视图; [0159] FIG. 135 is removed certain portions of the stapling instrument of FIG partial perspective view of the stapling instrument 134;

[0160] 图136为图134的缝合器械的分解图; [0160] FIG. 136 is a stapling instrument 134 of FIG exploded view;

[0161] 图137为图134的外科手术器械的砧座和“脱离”垫圈的分解图; [0161] FIG. 137 is a diagram of the surgical instrument 134 and anvil "peeling" exploded view of the gasket;

[0162] 图138为图137的砧座和垫圈的装配图; [0162] FIG. 138 is a washer 137 and anvil assembly view;

[0163] 图139为图138的组件的平面图; [0163] FIG. 139 is a plan view of the assembly of Figure 138;

[0164] 图140为根据本发明的一个非限制性实施例的圆形缝合器的砧座构件的透视图; [0164] FIG. 140 is a perspective view of an anvil member of a circular stapler according to the present invention, non-limiting embodiment;

[0165] 图141为根据本发明的一个非限制性实施例的圆形缝合器的钉仓机构的透视图; [0165] FIG perspective view of the cartridge mechanism 141 in accordance with the present invention, a circular stapler is a non-limiting embodiment;

[0166] 图142为根据本发明的一个非限制性实施例组装到图140的砧座构件的图141的钉仓机构的透视图; [0166] FIG. 142 is a non-limiting embodiment of the present invention, a perspective view of the cartridge assembly of FIG mechanism anvil member 141 of FIG. 140;

[0167] 图143为根据本发明的一个替代非限制性实施例的圆形缝合器的砧座构件的透视图; [0167] FIG. 143 is a perspective view of an alternate non-limiting embodiments circular stapler anvil member of the embodiment of the present invention;

[0168] 图144为根据本发明的一个替代非限制性实施例的圆形缝合器的钉仓机构的透视图; [0168] FIG. 144 is a perspective view of a circular stapler according to an alternative non-limiting embodiment of the staple cartridge mechanism of the present invention;

[0169] 图145为根据本发明的一个非限制性实施例组装到图144的砧座构件的图143的钉仓机构的透视图; [0169] FIG. 145 is assembled to the anvil member 144 according to one non-limiting embodiment of the present invention, a perspective view of a staple cartridge embodiment 143 of the mechanism;

[0170] 图146为根据本发明的另一个替代非限制性实施例的圆形缝合器的砧座构件的透视图; [0170] 146 according to the present invention is another alternative perspective view of the anvil member of the circular stapler non-limiting embodiment;

[0171] 图147为根据本发明的另一个替代非限制性实施例的圆形缝合器的钉仓机构的透视图;以及 [0171] FIG. 147 is a perspective view of an alternative non-limiting embodiment of the circular stapler according to another embodiment of the present invention, the staple cartridge means; and

[0172] 图148为根据本发明的一个非限制性实施例组装到图147的砧座构件的图146的钉仓机构的透视图; [0172] FIG. 148 is assembled to the anvil member 147 according to one non-limiting embodiment of the present invention, a perspective view of a staple cartridge embodiment 146 of the mechanism;

[0173] 对应参考符号表明贯穿若干视图的对应部件。 [0173] corresponding reference characters indicate corresponding parts throughout the several views. 本文示出的范例(以一种形式)示出本发明的优选实施例,不应将这种范例理解为是以任何方式限制本发明的范围。 Examples illustrated herein (in one form) shows a preferred embodiment of the present invention, and such exemplifications are not to be construed as in any way limiting the scope of the present invention. 具体实施方式 Detailed ways

[0174] 现在将描述一些示例性实施例来提供对本文公开的器械和方法的结构、功能、制造和使用原理的全面理解。 [0174] Some exemplary embodiments will now be described to provide a thorough understanding of the structure, function, manufacture, and use of the principle of the devices and methods disclosed herein. 这些实施例中的一个或多个实例在附图中示出。 These embodiments of one or more examples illustrated in the accompanying drawings. 本领域的普通技术人员将会理解,本文特别描述和在附图中示出的器械和方法为非限制性的示例性实施例,并且本发明多个实施例的范围仅由权利要求书限定。 Those of ordinary skill in the art will appreciate that specifically described herein and illustrated in the accompanying drawings devices and methods for non-limiting exemplary embodiments, and the scope of the present invention, a plurality of embodiments is defined only by the claims. 结合一个示例性实施例示出或描述的特征可以与其它实施例的特征组合。 Characterized in connection with one exemplary embodiment illustrated exemplary embodiment or embodiments described herein may be in combination with other features of embodiments. 这种修改形式和变型形式旨在包括在本发明的范围内。 Such modifications and variations are intended to be included within the scope of the present invention. 图I和图2示出外科手术缝合和切割器械(即内切割器30)的一个实施例,其能够实践本发明的独特优势。 Figure I an embodiment and Figure 2 shows a surgical stapling and cutting instrument (i.e., the inner cutter 30), which is unique to practice the advantages of the present invention. 然而,应当认识到,在不脱离本发明精神和范围的情况下,可有利地结合多种其它缝合器和缝合器械应用本发明的独特和新颖方面。 However, it should be appreciated that, without departing from the spirit and scope of the present invention may be advantageously combined and a variety of other staplers stapling instrument applications unique and novel aspects of the invention. 因此,不应将给予本发明多个实施例的保护范围限制于仅用于本文所述的特定类型的外科手术缝合和切割器械。 Accordingly, the present invention should not be administered to a plurality of embodiments to limit the scope of the embodiments only described herein for a particular type of surgical stapling and cutting instrument.

[0175] 参见图I和图2,外科器械30可包括柄部32、轴34以及在铰接枢轴38处可枢转地连接到轴34的铰接端部执行器36。 [0175] Referring to FIGS. I and 2, surgical instrument 30 may include a handle portion 32, is connected to the hinge shaft 34 and the end 36 of shaft 34 at a pivot hinge 38 pivotally. 可通过柄部32上的控制装置调节端部执行器36的位置和取向,控制装置包括:(a)旋钮40,其用于在轴线周围旋转轴34和端部执行器36 ;以及(b)铰接控制装置44,其用于实现端部执行器36围绕铰接枢轴38相对于轴34实施旋转或铰接,如在提交于2006年I 月10 日、名称为SURGICAL INSTRUMENT HAVING ANARTICULATINGEND EFFECTOR(具有铰接端部执行器的外科器械)的共同拥有、共同未决的美国专利申请No. 11/329,020中有更详细的描述,该专利的公开内容以引用方式并入本文。 Means can be adjusted by controlling the position and orientation of the shank portion 32 of the end effector 36, the control apparatus comprising: (a) a knob 40 for rotating shaft 34 about the axis and an end effector 36; and (b) articulation control means 44, for implementing the end effector 36 about the articulation pivot axis 38 with respect to the axis of rotation or hinge 34 embodiment, as filed on 10 February 2006 I, entitled SURGICAL INSTRUMENT hAVING ANARTICULATINGEND eFFECTOR (having a hinged end surgical instrument actuator portion) of commonly owned, co-pending U.S. Patent application No. 11 / 329,020 described in more detail, the disclosure of which is incorporated herein by reference. 在多个实施例中,器械30的柄部32可以包括用于致动端部执行器36的闭合扳机46和击发扳机48,如下文中更详细的描述。 In various embodiments, the handle portion 32 of the instrument 30 may include a closure trigger for actuating the end effector 46 and firing trigger 36, 48, as described in more detail below. 然而,应当理解,具有被构造为可进行不同的外科手术任务的端部执行器的器械可以具有不同数量或类型的扳机或用于操作端部执行器36的其它合适的控制装置。 However, it should be understood that having an end effector configured to be different surgical tasks may have different numbers of the instrument or type of a trigger or other suitable control means operates the end effector 36 is used. 此外,应当理解,在本文中相对于器械30的医生握柄32使用了术语“近端”和“远端”。 Further, it should be understood that the instrument 30 to the handle 32 of the doctor the terms "proximal" and "distal" are used herein phases. 因此,端部执行器36相对于柄部32为远端。 Thus, the end effector 36 relative to the handle portion 32 to the distal end.

[0176] 在图示实施例中,端部执行器36可被构造为(例如)夹紧、切断和缝合软组织。 [0176] In the illustrated embodiment, the end effector 36 may be configured (e.g.) a clamping, cutting and stapling soft tissue. 在其它实施例中,可以使用不同类型的端部执行器,例如抓紧器、切割器、缝合器、施夹钳、进入装置、药物/基因治疗装置、超声、射频和/或激光装置。 In other embodiments, different types of end effectors, such as graspers, cutters, staplers, clip appliers, access devices, drug / gene therapy devices, ultrasound, RF and / or laser devices. 此外,端部执行器36还可包括缝钉通道50和可转移的夹紧构件,例如砧座52,其中缝钉通道50和砧座52可相对设置或隔开,以确保对夹在端部执行器36中的软组织被正确地缝合和切割。 In addition, the end effector 36 may further include a clamping member 50 and the staple channel may be transferred, such as an anvil 52, wherein the staple channel 50 and anvil 52 may be disposed opposite or spaced, to ensure clamped in the end soft tissue 36 is performed properly stapled and cut. 柄部32可包括手枪式握把54,可将闭合扳机46可枢转地拖向该握把,以使砧座52朝向缝钉通道50移动,并夹紧定位于砧座52与通道50之间的组织。 The handle 32 may include a pistol grip 54, the closure trigger 46 may be pivotably to the mop handle to the anvil 52 toward the staple channel 50 is moved and positioned to clamp anvil 52 and the channel 50 of the organization between. 换而言之,一旦临床医生对端部执行器36的定位满意,就可将闭合扳机46收回至使砧座52完全闭合的位置并将扳机46锁定就位。 In other words, once the clinician satisfied with the positioning of the end effector 36, the closure trigger 46 can be retracted into the anvil 52 fully closed position and the trigger 46 locked in place. 这种装置在提交于I 月31 日、名称为SURGICAL CUTTING AND FASTENING INSTRUMENT WITHCLOSURETRIGGER LOCKING MECHANISM (具有闭合扳机锁定机构的外科切割和紧固器械)的美国专利申请No. 11/343,321中有进一步的描述,该专利的公开内容以引用的方式并入本文。 This means I filed May 31, entitled SURGICAL CUTTING AND FASTENING INSTRUMENT WITHCLOSURETRIGGER LOCKING MECHANISM (having a closure trigger locking mechanism of the surgical cutting and fastening instrument) U.S. Patent Application No. 11 / 343,321 are further , the disclosures of which patent is incorporated by reference herein.

[0177] 其后,可将击发扳机48可枢转地拖向手枪式握把54,以缝合和切断夹在端部执行器36中的软组织。 [0177] Thereafter, firing trigger 48 may be pivotably drag to the pistol grip 54 to stapling and severing of clamped in the end effector 36 is soft tissue. 更具体地讲,参见图3,端部执行器36可进一步包括切割构件或刀60、拖运器62、可移去地定位于通道50内的钉仓64以及螺旋轴66。 More specifically, referring to FIG. 3, the end effector 36 may further include a cutting member or knife 60, sled 62, may be removably positioned within the channel 50 and staple cartridge 64 screw shaft 66. 启动击发扳机48后,螺旋轴66可旋转,以便驱动切割构件60和拖运器62相对于通道50移动,使得切割构件60可切割夹在端部执行器36中的组织,而拖运器62则可定位可移去地储存在钉仓64中的缝钉。 After starting the firing trigger 48, the screw shaft 66 is rotatable to drive cutting member 60 and the sled 62 to move relative to the channel 50, so that the cutting member 60 may be cut tissue clamped in the end effector 36 and sled 62 It can be positioned removably stored in the cartridge 64 of staples. 在多个实施例中,拖运器62可包括多个斜面,其可被构造为将可移去地储存在钉仓64中的缝钉推入夹紧的组织中。 Embodiment, the sled 62 may comprise a plurality of inclined surfaces, which can be configured to removably store a staple cartridge in the staple 64 is pushed into the tissue clamped in a plurality of embodiments. 在至少一个实施例中,砧座52可被构造为在缝钉插入组织后使缝钉的至少一部分变形。 In at least one embodiment, the anvil 52 may be configured as the staple is inserted into tissue at least a portion of the staples deformed. 这种器械在公布于2005年12月27日、名称为SURGICALSTAPLING INSTRUMENTINCORPORATING AN E-BEAM FIRING MECHANISM(结合了电子束发射机构的外科缝合器械)的美国专利No. 6,978,921,以及提交于2005年8月31日、名称为STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERINGFORMED STAPLE HEIGHTS(用于形成具有不同成型缝钉高度的缝钉的钉仓)的美国专利申请No. 11/216, 562中有所公开,其公开内容以引用方式并入本文。 This instrument published in the December 27, 2005, entitled SURGICALSTAPLING INSTRUMENTINCORPORATING AN E-BEAM FIRING MECHANISM (a combination of surgical stapling instrument electron beam firing mechanism) US Patent No. 6,978,921, filed in 2005 and on August 31, 2009, entitled sTAPLE CARTRIDGES fOR fORMING sTAPLES hAVING DIFFERINGFORMED sTAPLE hEIGHTS (for forming a staple cartridge having a different staple forming height of the staples) U.S. Patent application No. 11/216, 562 is disclosed in, the disclosure of which is incorporated herein by reference. 在多个实施例中,螺旋轴66可由如上文提到的美国专利No. 5,465,895中所述的手动齿轮组件驱动,或由如提交于2006年I月31日、名称为MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITHUSER FEEDBACKSYSTEM(具有使用者反馈系统的电动机驱动型外科切割和紧固器械)的美国专利申请No. 11/343,498(其公开内容以引用的方式并入本文)中所述的电动机驱动。 Embodiment, the screw shaft 66 by the above mentioned U.S. Patent No. 5,465,895 in the manual gear drive assembly in a plurality of embodiments, or by a 2006 I as filed on May 31, entitled MOTOR- dRIVEN sURGICAL cUTTING aND fASTENING iNSTRUMENT WITHUSER FEEDBACKSYSTEM (user feedback system having a motor-driven surgical cutting and fastening instrument) according to U.S. Patent application No. 11 / 343,498 (the disclosures of which are incorporated herein by reference) in motor drive.

[0178] 在多个实施例中,钉仓64可包括定位于其中的缝钉驱动器(未示出),该驱动器可被拖运器62提升,并可被构造为朝向砧座52驱动外科手术缝钉。 [0178] In various surgical embodiments, the staple cartridge 64 positioned therein may include a staple driver (not shown), the lift driver 62 can be sled, and may be configured to drive toward the anvil 52 staples. 在其它多个实施例中,夕卜科手术缝钉可直接由砧座52提升。 In other various embodiments, Xi Boke surgical staple 52 can be directly lifted by the anvil. 在这种实施例中,外科手术缝钉的冠可包括其上的坡面或斜面,其可与拖运器62配合,以提升如上所述的外科手术缝钉。 In such an embodiment, the surgical staple crown may include a ramp or inclined surface thereon, which can cooperate with the sled 62, to improve the surgical staple as described above. 这种外科手术缝钉在提交于2006 年9 月29 日、名称为SURGICAL STAPLES HAVING ATTACHED DRIVERSAND STAPLINGINSTRUMENTS FOR DEPLOYING THE SAME(具有附属驱动器的外科手术缝钉以及用于部署所述缝钉的缝合器械)的美国专利申请No. 11/529,935中有更详细的描述,该专利的公开内容以引用的方式并入本文。 Such surgical staples filed on September 29, 2006, entitled SURGICAL STAPLES HAVING ATTACHED DRIVERSAND STAPLINGINSTRUMENTS FOR DEPLOYING THE SAME (subsidiary surgical staple having a driver and a stapling instrument for deploying the staples) of U.S. Patent application No. 11 / 529,935 described in more detail, the disclosure of which patent is incorporated by reference herein. 在多个实施例中,参见图10,拖运器62可穿过钉仓64从图10所示的位置朝钉仓64的远端147前进。 In various embodiments, referring to FIG. 10, the sled 62 may pass through the distal end of the staple cartridge 64 from the position shown in FIG 10 toward the staple cartridge 147 to advance 64. 随着拖运器62沿着钉仓64向远端移动,拖运器62可接合缝钉120的冠122,使得缝钉120连续地被拖运器62朝砧座52提升。 As the sled 62 moves distally along the staple cartridge 64, the sled 62 can engage the staple crown 122 120, so that the staple 120 is continuously sled 62 toward the anvil 52 lift. 更具体地讲,冠122可包括斜面148(图5和图6),其可被构造为与拖运器62的斜面150配合,使得冠122可滑上拖运器表面150。 More specifically, the crown 122 may include a ramp 148 (FIGS. 5 and 6), which can be configured to cooperate with the inclined surface 150 of the sled 62, such that the crown 122 may slide on the surface of the sled 150.

[0179] 图4示出使用本文所述的多种外科手术切割和缝合器械中的任何一种对组织100进行的切割和缝合。 [0179] FIG. 4 shows a cutting and stapling described herein using any of a variety of surgical cutting and stapling instrument 100 of the tissue. 如图4所示,组织100的部分102已被切开,并沿着切口106进行了缝合。 4, portion 102 of tissue 100 has been cut, and the suture 106 along the cut. 已通过内切割器30将三行缝钉107插入了组织100的切割路径106的每一侧。 The cutter 30 has passed through the three rows of staples 107 are inserted tissue cutting path 100 on each side 106. 临床医生切开并缝合第一部分102之后,将取回器械,以便安装新的钉仓64。 The clinician cut and sewn first portion 102, the retrieved device to install a new staple cartridge 64. 图4示出在开始第二次切割和缝合过程之前端部执行器36的位置。 Figure 4 shows the position of the distal end portion of the actuator 36 of the cutting and stapling procedure of the second time. 从图4可看出,已经缝合的组织100的部分102的厚度T'小于组织100的其它部分104的厚度T”。 As can be seen from Figure 4, has a thickness 102 of the stapled tissue section 100 is T 'is smaller than the other portion 104 of tissue 100 of a thickness T. "

[0180] 在至少一个实施例中,参见图5-9,缝钉120可包括冠122以及从其中延伸的可变形的腿部或构件124和126。 [0180] In at least one embodiment, referring to FIGS. 5-9, staple 120 can include crown 122 and deformable members, or legs 124 extending therethrough and 126. 在多个实施例中,可变形的构件可由横截面基本一致的延长线材构成。 In various embodiments, the deformable member may be of substantially uniform cross-sectional configuration of the extension cable. 在其它多个实施例中,腿部124和126可包括其中的第一凹口130、第二凹口132和第三凹口133。 In other various embodiments, the legs 124 and 126 which may include a first recess 130, second recess 132 and third recess 133. 参见图6,由于腿部124和126在(例如)第一凹口130处的横截面减小,因此腿部124和126在这些位置可更容易变形。 Referring to Figure 6, since the leg portions 124 and 126 (for example) cross-section at the first recess 130 is reduced, so the legs 124 and 126 may be more easily deformable in these positions. 在至少一个实施例中,当腿部124和126在凹口130处弯曲时,第一段138可(例如)相对于腿部124和126的第二段140成大约90度角弯曲。 In at least one embodiment, when the leg portions 124 and 126 at the curved recess 130, first section 138 may be bent at an angle of approximately 90 degrees (for example) with respect to the leg portion 126 of second section 124 and 140 percent. 在其它实施例中,第一段138可相对于第二段140以任何合适的角度弯曲。 In other embodiments, the first section 138 relative to the second section 140 may be bent at any suitable angle. 在使用中,参见图5和图10,当腿部124和126的末端128接触砧座52的凹坑134时,腿部124和126可在第一凹口130、第二凹口132和第三凹口133处向内弯曲。 In use, referring to FIGS. 5 and 10, when 134, 124 and the legs 126 may be a first recess 130, second recess 132 and the second end leg portions 124 and 126 dimples 128 of the anvil 52 is in contact three recesses 133 bent inwardly. 在其它多个实施例中,参见图10A,缝钉120'可包括腿部124'和126',可将其成形为使得它们向外变形,即彼此远离。 In other various embodiments, referring to Figure 10A, the staple 120 'can include leg portions 124' and 126 ', which may be shaped such that they deform outwardly, i.e. away from each other. 在至少一个这种实施例中,这些缝钉的基部的长度可比基部121短,使得腿部124'和126'可接触砧座凹坑134的一部分,并向外变形。 In at least one such embodiment, the staple length of the base of the base 121 shorter than that leg portions 124 'and 126' may contact a portion 134 of anvil pockets, and outward deformation. 因此,在多个实施例中,这些缝钉可与如上所述用于使缝钉120向内变形的相同砧座一起使用。 Thus, in various embodiments, the staples described above can be used to the same staple 120 inwardly deformable for use with the anvil. 除了上文所述之外,尽管并未示出,但是本文所述的任何其它合适的缝钉也可包括可被构造为向外变形的腿部。 In addition to the above, although not shown, but described herein, any other suitable staple may also be configured to include a leg portion outwardly deformed.

[0181] 在多个实施例中,参见图8,随着腿部124和126从图7所示的形状变成图8所示的形状,可变形的构件124和126的末端128可接触冠122。 [0181] In various embodiments, referring to FIG. 8, with the leg portions 124 and 126 into a shape shown in FIG. 8 from the shape shown in FIG. 7, the deformable member 124 and the end 126 of the crown 128 may contact 122. 为了有利于可变形的构件的弯曲,冠122可包括成形表面或砧座,以在腿部124和126接触冠122时可导向它们和/或使其变形。 In order to facilitate the bending of the deformable member 122 may include a crown shaped surface or anvil to the legs 124 and 126 may be in contact with the guide crown thereof and / or 122 deform. 为了导向末端128,冠122的砧座143可包括凹槽144,其可导向末端128使其如图8所示向外移动,或以任何其它合适的方向移动。 To the end of the guide 128, the crown 122 of the anvil 143 may include a groove 144, the guide tip 128 so that it may move outwardly as shown in FIG. 8, or move in any other suitable direction. 在多个实施例中,凹槽144不会使腿部124和126显著变形,然而,在图示实施例中,凹槽144可被构造为使腿部124和126以大约90度的角度变形。 In various embodiments, groove 144 so that the legs 124 and 126 will not deform significantly, however, in the illustrated embodiment, the groove 144 may be configured such that the legs 124 and 126 at an angle of about 90 degrees deformation . 因此,在多个实施例中,缝合器30的砧座52和冠122的砧座143可配合,使缝钉120变成(例如)图8所示的形状,或任何其它合适的形状。 Thus, in this embodiment, the stapler anvil 52 and the crown 30 of the anvil 122 may be fitted in a plurality of embodiments 143, 120 staples into a shape (e.g.) as shown in FIG. 8, or any other suitable shape. [0182] 参见图5和6,缝钉120的基部121可嵌入冠122中。 [0182] Referring to FIGS. 5 and 6, the staple 120 may be embedded in base 121 in the crown 122. 在多个实施例中,可将冠122包覆模制到基部121上,使得冠122可紧紧围绕和包封基部121。 In various embodiments, crown 122 can be overmolded onto the base 121, so that the crown 122 may be tightly around the base 121 and the encapsulation. 在至少一个实施例中,材料123可围绕包括基部121以及可变形的构件124和126的单根连续线材形成。 In at least one embodiment, material 123 may include a base 121 and formed around the deformable member 124 and 126 of a single continuous wire. 在其它实施例中,可变形的构件124和126可分别嵌入材料123中。 In other embodiments, deformable members 124 and 126 may be embedded in the material 123, respectively. 不管怎样,在至少一个实施例中,冠122可包括包覆模制到基部121上的材料123,其中材料123可由塑性材料构成,例如可溶解的、生物可分解的或生物可吸收的塑性材料。 In any event, in at least one embodiment, crown 122 may include overmolded material 123 on the base 121, wherein the material 123 may be composed of a plastic material, such as a soluble, biodegradable plastic material or bioabsorbable . 在使用这种材料的实施例中,塑性材料可包括(例如)得自Ethicon,Inc.的Vicryl或FOS。 In embodiments using such a material, the plastic material may comprise (e.g.) available from Ethicon, Inc. Of Vicryl or FOS. 如本文所用,术语可溶解的、生物可吸收的和生物可分解的通常是指在植入(例如)患者体内后可被人体至少部分地吸收的材料。 As used herein, the terms dissolvable, bioabsorbable and biodegradable implants generally refers to a material (e.g.) the patient may be at least partially absorbed by the body. 在多个实施例中,除了上述塑性材料外或者作为替代,塑性材料可包括不可溶解的、非生物可分解的或非生物可吸收的塑性材料。 In various embodiments, in addition to the plastic material or, alternatively, the plastic material may comprise insoluble, non-biodegradable or bioabsorbable plastic material. 不管怎样,在多个其它实施例中,可单独制造冠122,然后再组装到基部121。 In any event, in various other embodiments, crown 122 may be manufactured separately and then assembled to the base 121.

[0183] 除了上文所述外,在至少一个实施例中,可溶解的、生物可分解的或生物可吸收的材料可在愈合过程中至少部分地溶解,从而允许压缩在缝钉120内的组织伸展和生长。 [0183] In addition to the above, but in at least one embodiment, soluble, biodegradable material or bioabsorbable may be at least partially dissolved during the healing process, thereby allowing the compression in the staple 120 stretching and tissue growth. 在至少一个实施例中,参见图11-15,缝钉160可包括冠162、第一可变形的构件164和第二可变形的构件166,其中可变形的构件164和166各可包括基部168、可变形的腿部170以及第二腿部172。 In at least one embodiment, referring to FIGS. 11-15, staple 160 can include crown 162, first deformable member 164 and a second deformable member 166, wherein the deformable member 164 and 166 may each include a base 168 , deformable leg portion 170 and a second leg portion 172. 当缝钉160最初被定位时,可变形的构件164和166可向定位于缝钉160内的软组织施加较大的压缩力,以限制其中的出血。 When the staple 160 is initially positioned, deformable members 164 and 166 may be applied to a large compressive force to the staples 160 positioned within the soft tissue, which is to limit bleeding. 然而,随着冠162分解,变形构件164和166与冠162之间的间隙会变大,从而减轻作用在软组织上的压缩力。 However, decomposition with crown 162, a gap between the deformable members 164 and 166 and the crown 162 becomes large, thereby reducing the compressive force to the soft tissue. 在一些应用中,愈合过程中减轻这些压缩力可使组织在一段时间内缓慢伸展并恢复其正常厚度。 In some applications, the healing process can reduce these compressive forces stretch and slow tissue restore normal thickness over a period of time. 在一些实施例中,冠162可用亲水性材料涂覆,这种材料最初可膨胀以压缩捕获在缝钉内的组织,然后会溶解掉。 In some embodiments, crown 162 may be coated with a hydrophilic material, such a material may be initially expands to compress the captured tissue staples and dissolves away. 在这些实施例中,亲水性材料可通过(例如)从周围组织中吸水或吸收液体而膨胀。 In these embodiments, the hydrophilic material may be (e.g.) from the surrounding tissue expands water or absorption liquid.

[0184] 作为上述结果,当将多个缝钉160插入软组织中时,缝钉160可使软组织变硬,并在多种情况下,可抑制组织在愈合过程中移动和伸展。 [0184] As the result, when a plurality of staples 160 is inserted into soft tissue, the staples 160 may harden the soft tissue, and in many cases, extension and inhibit movement of tissue during the healing process. 然而,在缝钉160的冠162至少部分地溶解后,缝钉160的可变形的构件164和166能够相对于彼此移动,同时仍将下面的组织保持在一起。 However, after crowns 160 of the staples 162 at least partially dissolved, staples 160 may be deformable member 164 and 166 can be moved relative to each other while still holding the underlying tissue together. 更具体地讲,参见图14,冠162的材料可分解到某一程度,其中第一构件164和第二可变形的构件166可变得彼此分离,如图15所示。 More specifically, referring to FIG. 14, crown 162 decomposable material to a certain degree, wherein the first member 164 and second deformable member 166 may become separated from each other, as shown in FIG. 第一构件164和第二构件166分离后,它们可相对于彼此移动,并且软组织可变得稍软。 After separation of the first member 164 and second member 166, which may be moved relative to each other, and the soft tissue may become slightly softer. 在多个实施例中,冠162充分溶解所需的时间可取决于所用的材料和/或冠162的大小。 In various embodiments, the time required to fully dissolve the crown 162 may depend on the size of the material used and / or crown 162. 例如,以商品名Vicryl销售的Polyglatin 910材料可在7至14天内溶解。 For example, Polyglatin 910 material, sold under the trade name Vicryl may be dissolved in 7-14 days.

[0185] 在多个实施例中,可变形的构件164和166可由基本上不可溶解的或非生物可吸收的材料构成,例如钛、钛合金或不锈钢。 [0185] In various embodiments, deformable members 164 and 166 may be substantially insoluble materials or non-bioabsorbable configuration, for example, titanium, titanium alloy or stainless steel. 在其它实施例中,可变形的构件164和166中的至少一者可由生物可吸收的材料构成,例如镁或铁。 In other embodiments, deformable members 164 and 166 may be in one of the bioabsorbable material constituting at least, for example, magnesium or iron. 在至少一个实施例中,铁为纯铁。 In at least one embodiment, the iron is pure iron. 不管怎样,可对构件164和166的可溶性材料进行选择,使得它们的溶解速率与冠162的可溶性材料相同、更慢或更快。 In any case, the pair of members 164 and the soluble material 166 is selected such that their rate of dissolution of the soluble material and the crown 162 is the same, slower or faster. 例如,可选择冠162的材料使得其在可变形的构件164和166仍将软组织保持在一起时完全溶解掉。 For example, materials may be selected such that the crown 162 remains completely dissolved away together in the deformable member 164 and 166 remain soft tissue. 此外,在多个实施例中,可选择第一可变形的构件164的材料使得其比第二可变形的构件166的材料溶解得更快。 Further, in various embodiments, the materials may be selected first deformable member 164 such that the deformable than the material of the second member 166 may be dissolved faster. 因此,在这些实施例中,可变形的构件164和166可允许组织的交错释放。 Thus, in these embodiments, deformable members 164 and 166 may allow for a staggered release of the tissue. 除上文所述外,在多个实施例中,可在将缝钉160定位到组织中之前和/或之后通过桥接件将至少两个相邻的缝钉160连接在一起。 Save for the above, in various embodiments, it can be taken together at least two adjacent staples 160 are connected by bridges and / or after the tissue before staples 160 target. 在这些实施例中,第一缝钉160可由比与其连接的第二缝钉160的材料溶解得更快的生物可吸收材料构成。 In these embodiments, the first slit 160 may be a second ratio of the staples connected thereto material dissolve faster 160 bioabsorbable material. 类似地,连接缝钉160的桥接件可由溶解速率与第一和第二缝钉160相同和/或不同的材料构成。 Similarly, the bridge connecting the staples 160 may be configured with the same rate of dissolution and / or different material as the first and second staple 160. 在这些实施例中,第一缝钉160可先于第二缝钉160溶解掉,从而与上文所述相似,允许组织交错释放。 In these embodiments, a first staple 160 may precede the second staple 160 dissolved away, so that similar to the above, allow the release of tissue interleaving.

[0186] 在多个实施例中,参见图12,冠162可包括在部分176与178中间的缩小的横截面174。 [0186] In various embodiments, referring to FIG. 12, crown 162 may include a reduced cross-section portion 176 178 174 middle. 在使用中,由于中间部分174具有比部分176和178更小的横截面,因此它可先于部分176和178完全溶解掉,从而在整个冠162溶解之前,使第一构件164与第二构件166变得不连接(图15)。 In use, since the intermediate portion 174 has a smaller cross-section than portions 176 and 178, it may first portion 176 and 178 in completely dissolved away, so that the crown 162 was dissolved before the whole, the first member and the second member 164 166 becomes connected (FIG. 15). 在至少一个实施例中,可选择部分174、176和178的横截面使得可变形的构件164和166在愈合过程的所需阶段分离。 In at least one embodiment, the selectable cross-sectional portion 174, 176 and 178 such that the deformable members 164 and 166 may be separated at the desired stage of the healing process. 在其它实施例中,冠162可包括刻痕(未示出),其可减小冠162在刻痕区域中的厚度。 In other embodiments, the crown 162 may include a score (not shown), which may reduce the thickness of the crown 162 in the scoring zone. 在至少一个实施例中,缝钉120的冠122(图5-9)和/或缝钉160的冠162 (图11-15)可包含至少一种治疗性药物。 In at least one embodiment, staple crown 122 (FIG. 5-9) 120 and / or staple crown 162 160 (FIG. 11-15) may comprise at least one therapeutic drug. 在这些实施例中,当可溶解材料分解时,治疗性药物可被缝钉周围的组织吸收。 In these embodiments, when the dissolvable material decomposition, therapeutic drugs can be absorbed by the surrounding tissue staples. 在一些实施例中,将药物分散于整个可溶性材料中,使得药物在愈合过程中稳定释放,然而,在其它实施例中,治疗性药物可不均匀地分散在整个可溶性材料中,或可在材料中和/或在材料上成层,以增加愈合过程中特定阶段的药物剂量。 In some embodiments, the drug is dispersed throughout the dissolvable material such that the drug stabilizers released during the healing process, however, in other embodiments, the therapeutic drug may be unevenly dispersed throughout the dissolvable material, or may be in the material and / or into a layer on a material to increase the dose of a particular stage in the healing process.

[0187] 在多个实施例中,参见图18-20,外科手术缝钉200可包括基部202、第一可变形的构件204和第二可变形的构件206,其中可变形的构件204和206可从基部202延伸。 [0187] In various embodiments, referring to FIGS. 18-20, surgical staple 200 can include base 202, first deformable member 204 and a second deformable member 206, wherein the deformable member 204 and 206 It may extend from the base 202. 在至少一个实施例中,基部202、第一可变形的构件204和/或第二可变形的构件206的至少一部分可具有非圆形横截面。 In at least one embodiment, the base 202, first deformable member 204 and / or second deformable member 206 may have at least a portion of non-circular cross-section. 更具体地讲,参见图19,例如可变形的构件204的横截面可包括弧形部分203和平坦部分205。 More specifically, referring to FIG. 19, for example, the cross section of deformable member 204 may include an arcuate portion 203 and flat portion 205. 在多个实施例中,参见图18,基部202以及可变形的构件204和206可构成线材201,其中线材201可包括沿着线材201的整个长度基本上不变的横截面。 In various embodiments, referring to FIG. 18, the base member 202 and a deformable wire 204 and 206 may be configured 201, which may include a wire 201 wire 201 along the entire length of substantially constant cross-section. 然而,在其它实施例中,例如,第一可变形的构件204和第二可变形的构件206可具有不同的横截面。 However, in other embodiments, for example, a first deformable member 204 and the second deformable member 206 may have different cross sections. 在至少一个这种实施例中,第一可变形的构件204可包括基本上为圆形的横截面,而第二可变形的构件206则可包括非圆形横截面。 In at least one embodiment, 204 may comprise a substantially circular cross-section, and the second deformable member 206 may comprise a non-circular cross-section of the first deformable member of this embodiment. 在其它多个实施例中,第一可变形的构件204可包括与第二可变形的构件206的非圆形横截面不同的非圆形横截面。 In other various embodiments, first deformable member 204 may include a non-circular cross-section of the second deformable member 206 may be a different non-circular cross section.

[0188] 在多个实施例中,如上所述,可变形的构件204和206的横截面几何形状可控制它们被砧座52变形时,可变形的构件204和206发生弯曲的方式和方向。 When the [0188] embodiment, as described above, the cross-section of deformable members 204 and 206 may control the geometry of the anvil 52 which are deformed in a plurality of embodiments, deformable members 204 and 206 and bent in the direction of the generating pattern. 在至少一个实施例中,参见图19,可对平坦部分205进行取向使得它们彼此面对和/或面向轴线207,因此,当向其施加力时,平坦部分205可使可变形的构件204和206朝轴线207弯曲。 In at least one embodiment, referring to FIG. 19, the pair of flat portions 205 are oriented such that they face each other and / or oriented axis 207, and therefore, when a force is applied thereto, the flat portion 205 of member 204 can be deformable and 206 207 is bent toward the axis. 在其它多个实施例中,平坦部分205可任何合适的方式取向,以允许可变形的构件沿所需的方向弯曲。 In other various embodiments, flat portions 205 may be oriented in any suitable manner to allow the deformable member is bent in the desired direction. 实际上,平坦部分205的尺寸和位置可影响横截面的惯性矩,并相应地影响可变形的构件对施加在其上的弯曲应力的响应方式。 Indeed, the size and position of the flat portion 205 may affect the moment of inertia of the cross section, and correspondingly affect the deformable members respond to the bending stress exerted thereon. 在这种实施例中,可控制可变形的构件204和206的变形,以便向捕获在缝钉200内的软组织施加所需的压缩力。 Modification may be controlled deformable members 204 and 206 in this embodiment, in order to apply the required compressive force to the soft tissue captured within the staples 200. 更具体地讲,在至少一个实施例中,可变形的构件可弯曲直至它们接触软组织并向软组织施加压缩力,其中力的大小主要由可变形的构件204和206变形的量和方向决定。 More particularly, in at least one embodiment, the deformable member may be bent until they contact the soft tissue and apply a compressive force of soft tissue, wherein the magnitude of the force is mainly determined by the deformable member 204 206 deformation amount and direction and.

[0189] 在至少一个实施例中,参见图19和20,可将冠208模制或定位于基部202上,其中冠208可由可溶解的、生物可分解的或生物可吸收的材料构成。 [0189] In at least one embodiment, referring to FIGS. 19 and 20, the crown 208 may be molded or positioned on the base 202, wherein the crown 208 may be dissolvable, biodegradable material or bioabsorbable configuration. 在多个实施例中,冠208可包括压缩表面,当软组织被捕获在缝钉200内时,软组织可压在该表面上。 In various embodiments, crown 208 may include a compression surface, when the soft tissue captured within the staple 200, soft tissue can be pressed on the surface. 在至少一个实施例中,参见图20,缝钉200可包括压缩表面209,其中压缩表面209可具有比基部202的表面211更宽的轮廓或更大的表面积。 In at least one embodiment, referring to FIG. 20, the staple 200 may include a compression surface 209, wherein the compression surface 209 than the surface of the base 202 may have a wider or larger surface area 211 profile. 因此,在这种实施例中,压缩表面209更宽的表面积可减小施加到捕获在其中的软组织上的应力。 Accordingly, in such an embodiment, the compression surface 209 can be wider surface area to reduce the stress applied to the soft tissue captured therein. 更具体地讲,对于施加在软组织上的给定压缩力而言,软组织中的所得的应力与施加压缩力的面积成反比。 More specifically, for a given compressive force exerted on the soft tissue, the soft tissue resulting in stress and is inversely proportional to the area of ​​applying a compressive force. 换而言之,当将力施加到较小面积的软组织上时,所得的应力较大,而当相同的力施加到较大面积的软组织上时,所得的应力较小。 In other words, when a force is applied to the small area of ​​the soft tissue, resulting in stress is large, when the same force is applied to a large area of ​​soft tissue, resulting in less stress. 根据上文所述,可选择压缩表面209的尺寸以在捕获在缝钉200内的软组织中实现所需的应力。 Based on the above, selectable compression of the size of the surface 209 to achieve the desired stress in the soft tissue captured within the staple 200.

[0190] 在多个实施例中,如上所述,平坦部分205可与冠208的压缩表面209配合以控制和/或减小施加到捕获在缝钉200内的软组织上的应力。 [0190] In various embodiments, as described above, the flat portion 208 of the crown 205 may cooperate to control the compression surface 209 and / or decreasing the voltage applied to the soft tissue captured within the staples 200 stress. 更具体地讲,在可变形的构件的圆形部分接触软组织的实施例中,施加到软组织上的压缩力可施加在非常小的面积上,从而可能导致软组织中非常高的应力集中。 More specifically, in the embodiment the circular portion in contact with the soft tissue of the deformable member, the compressive force applied to the soft tissue can be applied in a very small area, which may lead to soft tissue in a very high stress concentration. 在可变形的构件的平坦部分接触软组织的实施例中,施加到软组织上的力可施加在较大的表面积上,从而导致较低的应力集中。 In the flat portion of the deformable member may be in contact with soft tissue embodiment, the force applied to the soft tissue may be applied over a larger surface area, resulting in lower stress concentration. 根据上文所述,可选择可变形的构件204和206的横截面几何形状以及压缩表面209的尺寸,使得它们可相互配合以向软组织施加所需的应力。 Based on the above, the cross section members 204 and 206 can be selected geometry and dimensions of the deformable compression surface 209, such that they can cooperate with each other to apply a desired stress to the soft tissue. 如上所述,在冠208由可溶解的、生物可分解的或生物可吸收的材料构成的实施例中,施加到软组织上的压缩力或应力可随着冠208溶解而减小。 As described above, in the embodiment 208 of crown material dissolvable, biodegradable or bioabsorbable configuration, stress or compressive force applied to the soft tissue can be reduced as the crown 208 is dissolved. 更具体地讲,在至少一个实施例中,当缝钉200最初被插入软组织中时,平坦部分205和压缩表面209可限定两者间的第一距离,这时会产生施加在软组织上的第一力和应力,然后在压缩表面209的至少一部分溶解掉之后,平坦部分205和压缩表面209可限定两者间的较大距离,其可使施加到软组织上的压缩力以及相应的应力减小。 More specifically, the first applied to the soft tissue in at least one embodiment, when the staple 200 is initially inserted into the soft tissue, the flat portion 205 and the compression surface 209 may define a first distance between them, then it will produce after at least a portion of a force and stress, and the compression surface 209 dissolved away, flat portion 205 and the compression surface 209 may define a greater distance between them, which allows the compressive force applied to the soft tissue and the corresponding stress reduction . 在多个实施例中,可变形的构件204和206中的至少一者可由可溶解的、生物可分解的或生物可吸收的材料构成。 In various embodiments, deformable members 204 and 206 may be formed of at least one soluble, biodegradable material or bioabsorbable configuration. 在这种实施例中,与上文所述相似,可变形的构件204和206的部分可溶解掉,以减小施加到软组织上的压缩力和应力。 In such an embodiment, similar to the above, the deformable portion 206 of member 204 and dissolved away to reduce stress and the compressive force applied to the soft tissue.

[0191] 参见图21-26,缝钉252可包括第一可变形的构件256和第二可变形的构件258,其中每一个可变形的构件都可包括基部260、第一可变形的腿部262和第二可变形的腿部263。 [0191] Referring to FIGS. 21-26, staple 252 can include a first deformable member 256 and a second deformable member 258, wherein each deformable member may comprise a base 260, first deformable leg 262 and a second leg portion 263 may be deformable. 缝钉252还可包括冠254,其可由至少一种包覆模制或共同模制的材料构成。 252 further comprises a staple crown 254, which may be at least one over-molded or co-molded materials. 在至少一个实施例中,例如,冠254可由包覆模制到可变形的构件256和258的第一材料以及包覆模制到第一材料的第二材料构成。 In at least one embodiment, for example, the crown 254 can be overmolded onto deformable members 256 constituting the first material 258 and a second material overmolded onto the first material. 在至少一个这种实施例中,第二材料可被构造成迅速溶解掉,从而允许可变形的构件256和258在愈合过程的早期彼此分离。 In at least one such embodiment, the second material may be configured to dissolve away quickly thereby allowing deformable members 256 and 258 may be separated from each other in the early stage of the healing process. 然而,可选择第一材料使其溶解速率比第二材料慢,以便即使在第二材料完全溶解掉之后缝钉252的冠254仍可继续对软组织提供压缩力。 Alternatively, however, the rate of dissolved material of the first material is slower than the second, so that even after the complete dissolution of the second material 252 out of the staple crown 254 can continue to provide a compressive force to the soft tissue. 在至少一个实施例中,可将第一材料注射模制到可变形的构件256和258上,然后在将第二材料注射模制到第一材料上之前,让第一材料固化和/或基本上凝固。 In at least one embodiment, the first material may be injection molded onto deformable members 256 and 258, then the second material injection molded onto the first material prior to braking, so that the first curable material and / or substantially on solidification. 在其它多个实施例中,可将第一材料和第二材料基本上同时地或快速连续地注射模制到可变形的构件256和258上。 In other various embodiments, the first and second materials substantially simultaneously or in rapid succession, injection molded onto deformable members 256 and 258. 在这些实施例中,可通过化学方法将第一材料和第二材料结合在一起,以在两者间提供足够的强度,使得可在第一材料和第二材料彼此不分离的情况下处理缝钉252。 In these embodiments, the method may be chemically bonded together by a first material and the second material, to provide sufficient strength therebetween so that the seam can be processed in the case where the first and second materials are not separated from each other 252 nails. 在其它实施例中,第一材料和第二材料可形成机械互锁特征,以获得相同的结果。 In other embodiments, the first and second materials can form mechanically interlocking features to achieve the same results.

[0192] 与上文所述相似,参见图21-26,可变形的构件256和258的至少一部分可包括非圆形横截面。 [0192] Similar to the above, referring to FIGS. 21-26, at least part of the deformable member 256 and 258 may include a non-circular cross-section. 在图34-57所示的多个实施例中,可变形的构件的横截面可包括平坦、弧形和/或弧形表面的多种组合。 A plurality of embodiments shown in FIGS. 34-57 embodiment, the cross-section of the deformable member may comprise various combinations of flat, curved and / or curved surfaces. 例如,在图34和图35所示的实施例中,可变形的构件的横截面可包括多个弧形表面282。 For example, in the embodiment shown in FIG. 34 and FIG. 35, the cross-section of the deformable member may comprise a plurality of arcuate surfaces 282. 在图36和图37所示的实施例中,可变形的构件的横截面可包括多个基本上平坦的表面278和280。 In the embodiment illustrated in FIG. 36 and FIG. 37, the cross-section of the deformable member may comprise a plurality of substantially planar surfaces 278 and 280. 在多个实施例中,横截面可具有三角形、矩形、正方形、椭圆形、六边形、五边形、梯形或任何其它合适的形状。 In various embodiments, the cross section can have a triangular, rectangular, square, oval, hexagonal, pentagonal, trapezoidal or any other suitable shape. 不管怎样,横截面可是对称的或非对称的。 In any case, but the cross section symmetric or asymmetric. 在多个实施例中,如上所述,横截面可被构造为允许可变形的构件以特定的方向弯曲。 In various embodiments, as described above, the cross section can be configured to allow the deformable member is bent in a specific direction. 在至少一个实施例中,参见图40和41,平坦表面278和280可包括沟槽或凹槽283,其可减小围绕至少一条轴的横截面的惯性矩,其中可变形的构件在此轴周围更易弯曲。 In at least one embodiment, referring to FIGS. 40 and 41, the flat surfaces 278 and 280 may comprise grooves or recesses 283, which may reduce the cross-sectional moment of inertia about the at least one shaft, wherein the deformable member in this axis around more flexible.

[0193] 如上所述,例如,当可变形的构件256和258经由软组织插入时,可变形的构件可刺穿软组织,在其中形成孔。 [0193] As described above, for example, when deformable members 256 and 258 inserted through the soft tissue, the deformable member may pierce the soft tissue, a hole is formed therein. 因此,尽管可变形的构件可基本上填充穿孔,但至少在最初,穿孔周围的软组织仍会出血。 Thus, although the deformable member may be substantially filled with perforations, but at least initially, the soft tissue around the perforation is still bleeding. 在本发明的多个实施例中,可变形的构件的至少一部分可膨胀并向软组织施加压缩力,以停止或至少减轻穿孔周围软组织的出血。 In various embodiments of the present invention, the deformable member expanding at least a portion of the soft tissue and apply a compressive force to stop or at least mitigate perforation soft tissue bleeding. 在至少一个实施例中,参见图27-33,第一可变形的构件256和第二可变形的构件258的至少一部分可涂覆可膨胀的涂层274。 In at least one embodiment, referring to FIGS. 27-33, first deformable member 256 and a second deformable member 258 may be coated at least a portion of the expandable coating 274. 在多个实施例中,参见图28,可膨胀的涂层274在最初经由软组织插入时可具有第一直径,并可根据可变形的构件和穿孔的尺寸向围绕可变形的构件的软组织施加第一压缩力。 In various embodiments, referring to FIG 28, expandable coating 274 is initially inserted through the soft tissue may have a first diameter, and is applied to the soft tissue surrounding the first deformable member in accordance with the size and perforated deformable member a compressive force. 其后,参见图32,可膨胀涂层274的尺寸会增大,从而向围绕可变形的构件的软组织施加更大的压缩力或第二压缩力。 Thereafter, referring to FIG. 32, the size of the expandable coating 274 is increased, thereby applying a greater compressive force or a second compressive force to the soft tissue surrounding the deformable member. 在多个实施例中,该第二压缩力可足以闭合或至少压缩穿孔周围软组织中的血管,从而消除或至少减轻该处的出血。 In various embodiments, the second compressive force may be sufficient to close the soft tissue around the perforation or compressing at least a vessel, so as to eliminate or at least alleviate bleeding thereat.

[0194] 在多个实施例中,可膨胀的涂层274可由亲水性材料或对水具有亲和力的任何其它合适的材料构成,其可吸收外科手术部位的血液或其它液体,从而如上文所述发生膨胀。 [0194] In various embodiments, expandable coating 274 may be a hydrophilic material or any other suitable material having an affinity for water constituting, it can absorb blood or other liquid to the surgical site so as hereinbefore said expansion occurs. 在至少一个实施例中,可将液体引入外科手术部位,这可使可膨胀的涂层274发生膨胀。 In at least one embodiment, the liquid may be introduced into the surgical site, which can be expandable coating 274 expands. 在多个实施例中,可膨胀的涂层274可由(例如)具有聚乙二醇基聚合物的交联酯化合物构成。 Embodiments, the expandable coating 274 may be (e.g.) a crosslinking compound having a polyethylene glycol ester-based polymer constituting the plurality of embodiments. 在至少一个这种实施例中,可通过注模法将可膨胀的涂层274包覆模制到缝钉252的至少一部分上。 At least a portion of at least one such embodiment, by injection molding the expandable coating 274 can be overmolded to the staple 252. 在其它多个实施例中,可变形的构件和/或冠可全部由可膨胀的材料构成。 In other various embodiments, deformable members and / or crown may all be formed of expandable material. 不管怎样,在可膨胀的材料274膨胀后,其至少一部分可开始溶解并可被患者的身体吸收。 In any case, after expansion of the expandable material 274, which begins to dissolve at least a portion of the patient's body and can be absorbed. 在这种实施例中,施加在软组织上的第二压缩力可减小,并可允许软组织伸展和生长,以便填充穿孔。 In such embodiments, the second compressive force to the soft tissue can be reduced, and may allow the soft tissue growth and spread, so as to fill the perforations. 当可变形的构件也由如上所述的可溶解的或生物可吸收的材料构成时,这种实施例尤其有用。 When the material of the deformable member also soluble or bio-absorbable configuration described above, this embodiment is particularly useful. 在多个实施例中,可膨胀的涂层还可包含(例如)治疗剂,其可随着可膨胀的涂层274溶解而释放。 In various embodiments, expandable coating may also comprise (e.g.) a therapeutic agent, which may be expandable with release coating 274 dissolves. [0195] 尽管结合具有基本上为圆形横截面的可变形的构件的缝钉示出可膨胀的涂层274,但也可将可膨胀的涂层274施加到具有非圆形横截面的可变形的构件上,这些横截面包括(但不限于)图34-57中所公开的横截面。 [0195] While the binding of staples having a substantially deformable member of circular cross section illustrating the expandable coating 274, but may be applied to the expandable coating 274 may have a non-circular cross-section the deformable member, the cross-section include (but are not limited to) cross-section as disclosed in FIGS. 34-57. 在其它多个实施例中,可将可膨胀的涂层274施加到任何其它合适类型的外科手术紧固件上。 In other various embodiments, expandable coating may be applied 274 to any other suitable type of surgical fasteners. 在至少一个这种实施例中,缝线或手术线可至少部分地涂覆有可膨胀的涂层。 In at least one such embodiment, the surgical suture or wire may be at least partially coated with an expandable coating. 在使用中,当将缝线或手术线插入软组织中时,它们会在软组织中形成穿孔,而可膨胀的涂层则可膨胀以填充穿孔,如上所述。 In use, when the surgical suture or wire is inserted into the soft tissue, they form perforations in the soft tissues, the expandable coating can be expanded to fill the perforation, as described above.

[0196] 在多个实施例中,参见图58-66,缝钉302可包括基部304、第一可变形的构件306和第二可变形的构件308。 [0196] In various embodiments, referring to FIGS. 58-66, staple 302 can include base 304, first deformable member 306 and second member 308 may be deformable. 在至少一个实施例中,缝钉302还可包括冠310,其具有限定在其中的孔312,该孔可被构造为接纳第一可变形的构件306和第二可变形的构件308。 In at least one embodiment, staple 302 can further include crown 310 having apertures 312 defined therein, which hole may be configured to receive a first deformable member 306 and second member 308 may be deformable. 如下文中更详细的描述,可变形的构件306和308可被构造为在孔312内移动或滑动,使得基部304可相对于冠310移动。 As described in more detail below, deformable members 306 and 308 may be configured to move or slide within the bore 312, such that the base 304 may be moved relative to crown 310. 在至少一个这种实施例中,每个孔312可限定由其延伸穿过的轴314,其中可变形的构件306和308可被构造为当它们在孔内移动时可沿着轴314移动。 In at least one such embodiment, each aperture 312 may be defined by its shaft 314 extending therethrough, wherein the deformable member 306 and 308 may be configured to be at when they are moved along the shaft 314 moves bore. 在多个实施例中,参见图61-63,冠310可包括凹槽320,其可被构造为接纳基部304并至少限制(即使不阻止)基部304与冠310之间的相对移动。 In various embodiments, referring to FIGS. 61-63, the crown 310 may include a recess 320, which may be configured to receive base 304 and at least limit (if not prevent) the relative movement between the base 304 and crown 310. 在至少一个实施例中,可将基部304可移动地定位于凹槽320内,使得凹槽320可允许可变形的构件304和306沿着轴314 移动,但至少阻止基部304横越轴314移动。 In at least one embodiment, base 304 may be movably positioned within recess 320, such that the groove 320 may allow the deformable members 304 and 306 move along the shaft 314, but prevents movement of the base 304 across the axis of at least 314. 在多个实施例中,凹槽320可被构造为以压配合和/或搭扣配合构型接纳基部304,使得基部304设置到凹槽320中之后基部304可相对于冠310基本上固定。 In various embodiments, the groove 320 may be configured as a press-fit and / or snap-fit ​​configuration of the receiving base 304, such that the base 304 is provided after the groove 320 to the base 304 with respect to the crown 310 may be substantially fixed.

[0197] 在多个实施例中,参见图67-70,可将缝钉302可移去地储存在钉仓(例如钉仓318)内。 [0197] In various embodiments, referring to FIGS. 67-70, staples 302 can be removably stored within a staple cartridge (e.g., staple cartridge 318). 在至少一个实施例中,钉仓318可包括主体326,其具有限定在其中的腔316。 In at least one embodiment, staple cartridge 318 can include body 326 having a cavity 316 defined therein. 钉仓主体326还可包括具有顶部表面330的平台328,其中腔316在顶部表面330中可包括开口。 It may further include a cartridge body 326 having a top surface 330 of the platform 328, wherein the top surface of the cavity 316 330 may include an opening. 在多个实施例中,每一个腔316可被构造为接纳缝钉302的基部304以及可变形的构件306和308的至少一部分,其中平台328可包括凹槽334,其可被构造为接纳冠310。 In various embodiments, each cavity 316 can be configured to receive a staple 304, and 306 of the base 302 and at least a portion of the deformable member 308, wherein the platform 328 may include a recess 334, which may be configured to receive the crown 310. 在使用中,参见图67,基部304在朝冠310移动之前可位于腔316中的第一位置。 In use, referring to Figure 67, base 304 may be located toward a first position in cavity 316 before moving the crown 310. 在至少一个实施例中,可变形的构件306和308可包括末端336,其中在该第一位置,末端336可定位于孔312内或其附近。 In at least one embodiment, deformable members 306 and 308 may include a tip 336, wherein in the first position, the tip 336 may be positioned at or near the aperture 312. 因此,在这种实施例中,当可变形的构件306和308如上所述相对于冠310移动时,可变形的构件306和308已经与轴314对齐,并可降低可变形的构件306和308偏离孔312的可能性。 Accordingly, in such embodiments, when moved relative to crown 310, the deformable members 306 and 308 have been aligned with the axis 314 of the deformable members 306 and 308 as described above, and reduce the deformable member 306 and 308 the possibility of deviation of the hole 312.

[0198] 在多个实施例中,参见图67和68,可通过驱动器338使可变形的构件306和308以及基部304相对于冠310移动或滑动。 [0198] embodiment, referring to FIGS. 67 and 68, through the drive member 338 so that the deformable crown 306 and 310 to move or slide with respect to base 304 and 308 in a plurality of embodiments. 在至少一个实施例中,钉仓还可包括拖运器,其被构造为提升驱动器338并使基部304朝冠310移动。 In at least one embodiment, the staple cartridge may further include a sled configured to lift driver 338 and move base 304 toward crown 310. 尽管在图67和图68中并未示出拖运器,但示例性拖运器在本专利申请中有所描述和示出,包括图3和图10中的拖运器62。 Although not shown in FIGS. 67 and sled 68, the sled but example described and illustrated in this patent application, including in FIG. 3 and FIG. 10 sled 62. 在多个实施例中,参见图68,驱动器338可推动或滑动基部304,直到基部304如上所述接触冠310并与凹槽320接合,并且可变形的构件306和308被插入定位于顶部表面330上的软组织中。 In various embodiments, referring to FIG 68, driver 338 can push or slide base 304, as described above until the base 304 contacts crown 310 and engages with the recess 320, and deformable members 306 and 308 are positioned on the top surface of the inserted soft tissue on the 330. 其后,参见图69,驱动器338迫使基部304和冠310向上移动,使得冠310脱离凹槽334。 Thereafter, referring to FIG. 69, the driver 338 forces the base 304 and the crown 310 is moved upward, so that the crown 310 from recess 334. 在多个实施例中,可将冠310压配合或搭扣配合在凹槽334内,使得驱动器338必须施加足够的力以使冠310从凹槽334移开。 In various embodiments, crown 310 may be press fit or snap fit in the recess 334, such that driver 338 must apply sufficient force to the crown 310 is removed from the recess 334. 在其它多个实施例中,尽管未示出,但冠310可与平台328整体模制,使得驱动器338必须向基部304施加足够的力以使冠310挣脱钉仓主体326。 In other various embodiments, although not illustrated, crown 310 may be integrally molded with the platform 328, such that the driver 338 must apply a sufficient force to base 304 to break so that the crown 310 cartridge body 326. [0199] 在多个实施例中,驱动器338可被构造为驱动可变形的构件306和308顶靠砧座,使得砧座将可变形的构件变形,如上所述。 [0199] In various embodiments, driver 338 can be configured to drive deformable members 306 and 308 against the anvil, the anvil such that the deformable member is deformed, as described above. 其后,如上文所述,可变形的构件可捕获软组织并将其顶靠冠310压缩。 Thereafter, as described above, the deformable members can capture the soft tissue against the crown 310 and the top compression. 在多个实施例中,冠310还可包括组织接触表面324,其可用于控制施加到软组织上的压缩力。 In various embodiments, crown 310 may further include tissue-contacting surface 324, which may be used to control the compressive force applied to the soft tissue. 更具体地讲,当表面324具有可压紧软组织的较大面积时,施加到软组织上的压缩力可远小于表面324具有较小面积时的压缩力。 More specifically, when the surface 324 has a large area of ​​soft tissue may be pressed, when the compressive force applied to the soft tissue compressive force may be much smaller than the surface 324 having a smaller area. 在至少一个实施例中,组织接触表面324可具有第一宽度,基部304可具有第二宽度。 In at least one embodiment, tissue-contacting surface 324 may have a first width, the base portion 304 may have a second width. 在至少一个这种实施例中,组织接触表面324的第一宽度可比基部304的第二宽度更宽,使得在推入或射出缝钉302的过程中,只有组织接触表面324与组织接触。 In at least one such embodiment, the width of the first tissue contacting surface 324 of the base 304 than the second width is wider so that during push or eject staples 302, only the tissue contacting surface 324 in contact with the tissue.

[0200] 在多个实施例中,在将缝钉302定位到软组织中之前,可将组织捕获并压缩在钉仓318与砧座之间。 [0200] In various embodiments, the staple 302 is positioned prior to the soft tissue, the tissue can be captured and compressed between staple cartridge 318 and anvil. 在至少一个实施例中,可将冠310定位于钉仓主体326的凹槽334内,使得冠310的表面324可与平台328的顶部表面330对齐或基本上齐平。 In at least one embodiment, crown 310 may be positioned within the recess 334 of the cartridge body 326, so that the surface 324 of the crown 310 may be aligned with the top surface of the platform 330 or 328 is substantially flush. 在至少一个这种实施例中,平台328和冠310施加到软组织上的压缩力或压力可基本上相同。 It may be substantially the same as at least one such embodiment, the platform 328 and the crown 310 is applied to the compressive force or pressure on the soft tissue. 在其它多个实施例中,可将冠310定位于凹槽334内,使得表面324定位于缝钉平台328的顶部表面330之上。 In other various embodiments, crown 310 may be positioned within the recess 334, so that the surface 324 is positioned above the top surface 330 of the staple 328 platform. 在这种实施例中,冠310施加到软组织上的压缩力或压力可大于平台318施加的压缩力或压力。 In such an embodiment, the crown 310 to the compressive force or pressure is applied on the soft tissue or the pressure may be greater than the compressive force 318 applied internet. 在多个实施例中,可选择表面324与顶部表面330之间的相对距离,以向软组织提供所需的推入前压缩力或压力。 In various embodiments, the selectable relative distance between the surface 324 and the top surface 330 to provide a compressive force required to push the front or pressure to soft tissue. 在其它多个实施例中,可将表面324定位于平台328的顶部表面330之下,使得表面324施加到软组织上的压缩力或压力小于平台328施加的压缩力或压力。 In other various embodiments, surface 324 may be positioned below the top surface 330 of the platform 328, so that the surface 324 of the compressive force applied to soft tissue or a pressure or a pressure less than the compressive force 328 applied to the internet.

[0201] 在多个实施例中,参见图59、图62和图65,缝钉302'可包括可变形的构件306和308,其可被构造为刺穿冠310',而不是穿过孔312。 [0201] In various embodiments, referring to FIG. 59, FIGS. 62 and 65, staple 302 'can include deformable members 306 and 308, which may be configured to pierce crown 310', rather than through the holes 312. 在这种实施例中,可变形的构件的末端336可足够锐利,以刺穿冠310',并在其中形成洞,该孔可允许可变形的构件306和308相对于其移动或滑动。 In such an embodiment, the end of the deformable member 336 may be sufficiently sharp to pierce crown 310 ', and holes formed therein, the hole may allow the deformable member 306 and 308 to move or slide relative thereto. 在其它多个实施例中,参见图60、图63和图66,可将可变形的构件306 ”和308”定位于冠310”的周边之外。在至少一个这种实施例中,尽管未示出,但冠310”可包括凹槽或狭槽,其可被构造为可滑动地接纳可变形的构件306”和308”。 In other various embodiments, referring to FIG. 60, FIG. 63 and FIG. 66, the deformable member 306 'and 308 "is positioned outside the periphery of the crown 310". In at least one such embodiment, although not illustrated, crown 310 "can include a groove or slot, which can be configured to slidably receive deformable members 306" and 308. "

[0202] 在多个实施例中,参见图72-76,可将若干缝钉连接在一起,以便控制施加到捕获在缝钉内的软组织上的压缩力或压力的分布。 [0202] In various embodiments, referring to FIGS. 72-76, may be a plurality of staples joined together in order to control compressive force applied to the capture or distributed pressure on the soft tissue of the staple. 在至少一个实施例中,可通过桥接件340将若干缝钉302的冠310连接在一起,使得桥接件340和冠310可在软组织的较大面积上施加压缩力,并减小施加到软组织上的压力和应力。 In at least one embodiment, may be applied to the soft tissue by a bridge 340 connecting together a plurality of staples 302 crown 310 and crown 340 such that the bridge member 310 may exert a compressive force over a large area of ​​soft tissue and reduces the pressure and stress. 在多个实施例中,桥接件340还可有助于抑制缝钉302撕破软组织或从软组织中拖出。 In various embodiments, the bridge member 340 may also help to inhibit the staple 302 from tearing out of the soft tissue or soft tissue. 更具体地讲,当向特定的缝钉302施加极大的力时,可通过桥接件340将该力分散到一个或多个其它缝钉302上,并可能抑制损伤软组织。 More specifically, when a great force is applied to a particular staple 302, the force can be dispersed by the bridge 340 to one or more other staple 302, and may be inhibited from soft tissue damage. 在多个实施例中,组织接触表面324可定位于桥接件340之上,使得桥接件340向软组织施加的压缩力或压力小于冠310施加的压缩力或压力。 In various embodiments, tissue-contacting surface 324 may be positioned above the bridge member 340, such bridge member 340 is less than the compressive force, or pressure applied to the crown 310 or compressive force applied to the soft tissue pressure. 在其它多个实施例中,尽管未示出,但桥接件340的顶部表面可与表面324对齐或基本上齐平,使得冠310和桥接件340可向软组织施加基本上相同的压缩力或压力。 In other various embodiments, although not shown, a top surface of the bridging member 340 and the surface 324 may be aligned with or substantially flush, such that the crown member 310 and the bridge 340 may be applied to substantially the same pressure or compressive force to the soft tissue . 在多个实施例中,桥接件340可是平的、波形、弧形或任何其它合适的形状,并可具有任何合适的横截面布局。 Embodiment, the bridge member 340 flat, however, the waveform, curved or any other suitable shape in various embodiments, may have any suitable cross-section layout.

[0203] 在多个实施例中,参见图74和75,钉仓318还可包括限定在平台328中的中间凹槽342,其中凹槽342可被构造为接纳桥接件340。 [0203] In various embodiments, referring to FIGS. 74 and 75, staple cartridge 318 may further include a platform 328 defining a recess 342 in the middle, where the groove 342 may be configured to receive the bridge member 340. 在多个实施例中,可将桥接件340定位于凹槽342内,使得当如上所述定位缝钉302时它们可从其中脱离。 In various embodiments, the bridge member 340 may be positioned within recess 342, it is positioned such that when the staples described above which they can be disengaged from 302. 在其它多个实施例中,桥接件340可与平台328压配合、搭扣配合或整体模制。 In other various embodiments, the bridge 340 and platform 328 may be press fit, snap fit, or integral molding. 与上文所述类似,缝钉驱动器可被构造为向缝钉302和/或桥接件340施加足够的力以使桥接件340从平台328移开。 Similar to the above, staple driver can be configured to apply sufficient force to the staple 302 and / or the bridge member 340 such that the bridge member 340 is removed from the platform 328. 不管怎样,尽管在图72-76中并未示出,但驱动器可被构造为基本上同时定位连接的缝钉302。 In any case, although not shown in FIGS. 72-76, but the drive may be configured to be positioned substantially simultaneously connected staples 302. 在其它多个实施例中,桥接件340可足够柔韧,以允许驱动器连续定位连接的缝钉302。 In other various embodiments, the bridge member 340 may be sufficiently flexible to allow the continuous positioning drive 302 connected staples. 在多个实施例中,尽管未示出,但可使用一个以上的桥接件340连接相邻缝钉302的冠310。 In various embodiments, although not illustrated, but may be used more than one bridge member 340 connected adjacent the staple crown 310,302. 在至少一个实施例中,可通过桥接件340连接四个或更多个相邻的缝钉302,然而,也可设想包括多于或少于四个连接的缝钉的其它实施例。 In at least one embodiment, connector 340 may be four or more adjacent staples by the bridge member 302, however, contemplated that other embodiments may include more or less than four connected staples.

[0204] 在多个实施例中,参见图74,可将缝钉302设置成几排或几行,其中桥接件340可连接同一行和/或不同行中的缝钉302。 [0204] In various embodiments, referring to FIG. 74, the staples 302 may be arranged rows or lines, wherein the bridge member 340 may be connected to the same row and / or different rows of staples 302. 以举例的方式,参见图74-76,可将第一行中的缝钉302的冠310连接在一起,同时在同一实施例中,可将这些缝钉的冠310与第二行和/或第三行中的缝钉302的冠310连接。 By way of example, referring to FIGS. 74-76, the crown 310 may be 302 connected to the first row of staples together, simultaneously in the same embodiment, crown 310 may be the second row of staples and / or third row staple crown 310 302 connection. 在多个实施例中,可将桥接件340和冠310注射模制到基部304上。 In various embodiments, the bridge member 340 may be injection molded and a crown 310 onto the base 304. 在至少一个实施例中,桥接件340和冠310或它们的一部分可由可吸收的、生物可分解的或可溶解的材料构成。 In at least one embodiment, the bridge member 340 and a crown 310 or a portion thereof may be absorbable, dissolvable, or biodegradable material. 在多个实施例中,桥接件340和冠310可至少部分地由如上所述的治疗性药物构成。 In various embodiments, the bridging member 340 and the crown portion 310 may be formed of at least a therapeutic drug described above.

[0205] 在多个实施例中,如上文所述,在缝钉从钉仓定位之前,软组织可被压缩在(例如)砧座与钉仓之间。 [0205] embodiment, a plurality of embodiments as described above, prior to the staples from the staple cartridge positioned, the soft tissue can be compressed between (e.g.) an anvil and the staple cartridge. 在多个实施例中,参见图84,软组织360可被压缩在砧座346、钉仓318的顶部表面330以及冠310的组织接触表面324之间。 In various embodiments, referring to FIG. 84, the soft tissue 360 ​​may be compressed between the anvil 324 contacts 346, top surface 318 of staple cartridge 330 in the crown 310 and the tissue surface. 在至少一个实施例中,在将缝钉插入软组织之前,这种压缩会从软组织360中挤出血液或其它液体,并使软组织360的厚度减小,这可使缝钉在软组织中获得更大的夹紧力或获取力。 In at least one embodiment, prior to inserting the staple soft tissue, such compression will be out of blood or other liquid 360 from the soft tissue, soft tissue and reduced thickness 360, which allows greater staples in the soft tissue clamping force or get a force. 在至少一个实施例中,砧座346可包括压缩表面350,其可被构造为如上所述接触软组织360。 In at least one embodiment, anvil 346 can include a compression surface 350, which may be configured to contact soft tissue 360 ​​as described above. 在多个实施例中,压缩表面350包括限定在其中的砧座凹坑348,其可被构造为接纳可变形的构件306和308的末端336并使其变形,使得缝钉302可将软组织360捕获在其中。 In various embodiments, comprises a compression surface 350 defined therein anvil pockets 348, which may be configured to receive the end of a deformable member 306 and 308 and 336 deform, such that the staple 302 can be soft tissue 360 trapped therein. 然而,在至少一个实施例中,软组织360会流入砧座凹坑348内,从而允许软组织在插入缝钉前伸展。 However, in at least one embodiment, soft tissue 360 ​​will flow into the anvil pockets 348, allowing the soft tissue prior to inserting the staple extends. 因此,砧座凹坑348下面区域中的软组织会较厚,并且相应地,可变形的构件306和308周围的软组织也较厚,这会降低缝钉在软组织中的夹紧力或获取力。 Thus, the soft tissue region below the pit 348 will anvil thick, and accordingly, the soft tissue 306 and deformable member 308 is also the surrounding thick, which reduces the clamping force of the staples in the soft tissue acquisition or force.

[0206] 在多个实施例中,外科手术缝钉(例如)可包括可阻碍或甚至抑制该现象发生的特征。 [0206] embodiment, the surgical staple in the embodiment a plurality of (e.g.) may impede or even comprise inhibiting characteristics of the phenomenon. 更具体地讲,参见图77-79,外科手术缝钉302可包括从冠310延伸的凸起344,其可与砧座凹坑348配合,从而决定定位于两者之间的软组织所受的压力。 More specifically, referring to FIGS. 77-79, surgical staple 302 may include a projection 344 extending from the crown 310, which can be fitted with the anvil pockets 348, which determines the soft tissue positioned therebetween suffered pressure. 在至少一个实施例中,凸起344可被构造为使得凸起344与砧座凹坑348之间的距离和冠310的组织接触表面324与砧座346的组织压缩表面350之间的距离基本上相同。 In at least one embodiment, projection 344 can be configured such that the distance between the protrusion 344 and the tissue contacting surface 348 and the anvil pockets 324 of the crown 310 and anvil 346 the distance between the tissue compression surface 350 substantially on the same. 因此,在这些实施例中,施加到软组织上的力或压力在缝钉302进入软组织之前可基本均一。 Thus, in these embodiments, the force or pressure applied to the soft tissue before staples into the soft tissue 302 may be substantially uniform. 在其它多个实施例中,凸起344与砧座凹坑348之间的距离可小于缝钉表面324与砧座压缩表面350之间的距离。 In other various embodiments, projection 344 and anvil pockets 348 may be smaller than the distance between the staple and the anvil surface 324 a distance between the compression surface 350. 在这种实施例中,施加到软组织上的力或压力在可变形的构件306和308周围的软组织区域中较大。 In such embodiments, the force applied to or greater pressure on the soft tissue in the soft tissue region 306 and the deformable member 308 surrounding. 因此,在至少一个实施例中,较多的血液或液体会从可变形的构件306和308周围的软组织中挤出,并且缝钉302可产生较大的夹紧力或压力。 Thus, in at least one embodiment, more blood or liquid may be extruded from the soft tissue 306 and deformable member 308 surrounding and staples 302 may have a greater clamping force or pressure. 在多个实施例中,凸起344还可与砧座凹坑348配合,以减轻可变形的构件306和308在软组织中形成的穿孔处的软组织出血。 In various embodiments, projection 344 may cooperate with the anvil pockets 348, 306 in order to reduce the soft tissue deformable member and the perforations 308 formed in the soft tissue bleeding. 在这种实施例中,凸起344基本上可起到夹钳的作用,并可改善与穿孔周围软组织出血相关的问题。 In such an embodiment, the protrusions 344 may function substantially clamps, can be improved and bleeding problems associated soft tissue perforation.

[0207] 在多个实施例中,如上所述,凸起344的位置可与可变形的构件306和308相邻,然而,也可设想其它实施例,其中可在缝钉的任何合适位置使用一个或多个凸起以控制施加到软组织上的力或压力。 [0207] In various embodiments, as described above, the position of the projections 344 and 306 may be adjacent to a deformable member 308, however, other embodiments may be contemplated, in which any suitable location using staples one or more projections in order to control the force or pressure applied to the soft tissue. 在至少一个实施例中,例如,凸起344可在注射模制过程中与冠310a 一体地形成,和/或可将凸起344组装到缝钉302上。 In at least one embodiment, for example, projection 344 may be formed integrally with the crown 310a in the injection molding process, and / or a projection 344 may be assembled onto the staple 302. 不管怎样,凸起344可由与构成冠310的材料相同或不同的材料构成。 In any case, the protrusion 344 may be the same or different materials constituting the crown 310 of a material. 虽然以通常为半圆形部分描述和示出了凸起344,但是凸起344还可包括任何(例如)能将组织压缩在砧座凹坑348内的其它合适形状。 Although generally described and illustrated semicircular portion of the projection 344, but the projection 344 may also include any other suitable shape (e.g.) capable of tissue compression in the anvil pockets 348. 在多个实施例中,尽管并未示出,但是凸起344或任何其它合适的凸起可从钉仓318的平台328和/或可变形的构件306和308延伸。 In various embodiments, although not shown, the projection 344 or any other suitable projection 328 may extend and / or deformable member 306 and staple cartridge 308 from the platform 318.

[0208] 在本发明的多个实施例中,外科手术缝钉可通过注模法制备。 [0208] embodiment, the surgical staple may be prepared by injection molding in a plurality of embodiments of the present invention. 在至少一个实施例中,参见图85-88和图105,可将细长构件402置于模具中。 In at least one embodiment, referring to FIGS. 85-88 and 105, the elongated member 402 may be placed in the mold. 在多个实施例中,可将细长构件402直接置于模具中,或者作为另外一种选择,参见图105,可将细长构件402置于转移块404中,然后再将转移块404置于模具中,如下文更详细的描述。 In various embodiments, elongated member 402 may be directly placed in a mold, or alternatively, referring to FIG. 105, the elongated member 402 may be placed in a transfer block 404, then block 404 transfers set in a mold, as described in greater detail. 不管怎样,参见图85,细长构件402可具有多个可变形的构件406,其中每一个可变形的构件406都可包括基部408和至少一条腿部410。 In any case, referring to Figure 85, the elongated member 402 may have a plurality of deformable member 406, wherein each deformable member 406 may include a base 408 and at least one leg portion 410.

[0209] 在多个实施例中,细长构件402可由任何合适的材料构成,例如塑料、钛或任何其它合适的金属。 [0209] Example, 402 may be made of any suitable material constituting the elongated member in a plurality of embodiments, for example, plastic, titanium or any other suitable metal. 在至少一个实施例中,参见图85,细长构件402可由线材构成,并可具有通常为蛇形的形状。 In at least one embodiment, referring to FIG. 85, the elongated member 402 may be composed of a wire, and has a generally serpentine shape. 在多个实施例中,术语“蛇形”可包括任何能够允许细长构件分成两个缝钉部分的非线性形状。 In various embodiments, the term "serpentine" may include any elongated member capable of allowing the non-linear shape staple is divided into two portions. 在至少一个实施例中,可在将细长构件402置于模具或转移块404之前和/或期间将细长构件402成型为通常为蛇形的形状。 In at least one embodiment, the elongated member 402 may be positioned generally molded into a serpentine shape and / or before or during transfer of the mold 404 in the block 402 of the elongated member.

[0210] 除了上文所述之外,细长构件402可具有包括上述任何形状的横截面形状,或适于制备缝钉的任何其它横截面形状。 [0210] In addition to the above, the elongated member 402 may have any other cross-sectional shapes including any of the above cross-sectional shape of, or for the preparation of staples.

[0211 ] 在多个实施例中,参见图105,可将细长构件402置于模具或转移块404中,使得可变形的构件406的基部408可位于多个预先限定的腔409中。 [0211] In various embodiments, referring to FIG. 105, the elongated member 402 may be placed in a mold or the transfer block 404, the deformable member 406 such that the base 408 may be located in a plurality of predefined cavity 409. 在至少一个实施例中,例如,可将模具关闭,使得可将熔融材料注入浇口腔411并流入流道腔403中,以便用熔融材料填充腔409并至少部分地封装基部408。 In at least one embodiment, for example, the mold may be closed, so that the poured molten material may be injected into the mouth 411 and chamber 403 flows into the flow passage, and so that the cavity 409 is filled with molten material at least partially enclosing the base 408. 在多个实施例中,熔融材料可包括塑料、金属和/或任何其它合适的材料。 In various embodiments, the molten material may comprise plastic, metal, and / or any other suitable material. 在腔409被熔融材料填充后,熔融材料会停止流动,参见图86,熔融材料随后会硬化,从而形成包覆模制的冠426。 After filling the cavity 409 is the molten material, the molten material will stop the flow, see FIG. 86, the molten material is then cured to overmoulded crown 426 is formed. 在多个实施例中,冠426可具有腔409的形状,并且在至少一个实施例中,还可在腿部410的至少一部分上形成冠426。 In various embodiments, crown 426 may have a shape of the cavity 409, and in at least one embodiment, crown 426 may be formed on at least a portion of the leg 410. 其后,在多个实施例中,细长构件402可构成缝钉条412,其可通过连接区段434以及第一缝钉413和第二缝钉415的腿部410连接在一起。 Thereafter, in various embodiments, elongated member 402 may be composed of staple bar 412, which may be connected together by connecting section 434, and a first leg portion 413 and a second staple staple 415 410.

[0212] 在多个实施例中,如上所述,作为模制过程的结果,每一个缝钉条412均可包括连接区段434。 [0212] In various embodiments, as described above, as a result of the molding process, each staple strip 412 can comprise a connection section 434. 更具体地讲,模具或转移块404可包括可让腔409 (例如)彼此以流体连通的流道腔403。 More specifically, the mold or the transfer block 404 so that chamber 409 may include (e.g.) to each other chamber in fluid communication with the flow channel 403. 这种流道腔403可用于确保每一个腔409都被熔融材料填充,并由于熔融材料在流道腔403中硬化,连接区段434可在(例如)第一缝钉413和第二缝钉415的冠426之间延伸。 This runner cavity 403 may be used to ensure that each chamber 409 are filled with molten material and the molten material is cured in the runner cavity 403, connecting section 434 may be (e.g.) a first staple and a second staple 413 extending between the crown of 426,415. 参见图87,在多个实施例中,可将连接区段434从第一缝钉413和第二缝钉415移除。 Referring to Figure 87, in various embodiments, may be removed from the first connection section 434 and a second staple 413 415 staple. 在至少一个实施例中,可通过(例如)可操作地与模具和/或转移块404接合的切割机构或热刀从缝钉移除连接区段434。 In at least one embodiment, by (e.g.) operatively associated with the mold and / or the transfer block 404 or hot knife cutting mechanism engaging the connecting section 434 is removed from the staple. 在其它实施例中,可在从模具和/或转移块404中取出缝钉条412之后再将连接区段434从缝钉413和415移除。 In other embodiments, the connection section and then after removing the staple bar 412 from the mold and / or transferring blocks 404,434 and 413 are removed from the staple 415. 在其它多个实施例中,在将缝钉条412装入钉仓中时,连接区段434可与缝钉413和415保持连接,并且在多个实施例中,可在将缝钉条412从钉仓定位后将连接区段434从缝钉条412移除,或仍与其保持连接。 In other various embodiments, when the staple cartridge is loaded strip 412, the connecting sections 434 may remain connected to the staples 413 and 415, and a plurality of embodiments, the staples can be 412 bar 434412 positioned after the cartridge is removed from the connection section from staple strip, or still remain connected thereto. [0213] 在移除连接区段434之后、之前或同时,可切割缝钉条412,以便使第一缝钉413与第二缝钉415分离。 [0213] After removal of the connecting section 434, prior to or simultaneously with the staple strip 412 may be cut, so that the first staple and a second staple 413 415 separation. 在多个实施例中,参见图88,可沿着线401切割腿部410,使得腿部410的长度基本相同。 In various embodiments, referring to FIG. 88, the legs 410 may be cut along line 401, so that the length of the leg 410 is substantially the same. 在可供选择的实施例中,参见图87,例如可沿着线401'和/或401”切割腿部410,使得腿部410的长度不同。在多个实施例中,例如,与具有较长腿部的缝钉相t匕,具有较短腿部的缝钉可向捕获在其中的软组织提供不同的压缩力或压力。在这种实施例中,可将腿部410切成所需的长度,使得它们可向软组织施加所需的压缩力或压力。不管怎样,在尚未移除连接区段434的多个实施例中,参见图88,可将第一缝钉413的腿部410与第二缝钉415的腿部410分离,以便分离缝钉条412。尽管以基本线性的缝钉条示出缝钉条412,但是缝钉条412可形成缝钉的圆环或任何其它合适的构型。在已移除连接区段434的实施例中,参见图87,可通过切割使第一缝钉413与第二缝钉415分离。 In an alternative embodiment, referring to FIG. 87, for example, along lines 401 'and / or 401 "cut legs 410, 410 such that the legs of different lengths. In various embodiments, for example, and has a more long staple legs dagger phase t, with the shorter legs of the staple may provide different compressive forces or pressure to soft tissue captured therein. in such an embodiment, the legs 410 may be cut to the desired length, so that they can apply the required compressive force or pressure to soft tissue. in any case, a plurality of connecting section 434 is not removed embodiments, referring to FIG. 88, a first leg 413 of staple 410 can be the second staple leg portions 415 of slits 410 separated so that the strip of staples 412. While staples in a substantially linear section 412 shows the staple strip, but the strip of staples 412 may be formed as a ring of staples or any other suitable configuration. in the embodiment of connector section 434 has been removed, referring to FIG. 87, may be cut by the first staple and a second staple 413 415 separation.

[0214] 在多个实施例中,参见图105,可在细长构件402已定位于转移块404中时通过使用转移块404进行切割。 [0214] In various embodiments, referring to FIG. 105, may have been positioned in the transfer block 404 by using a transfer time of cutting the elongated member 402 at block 404. 更具体地讲,转移块404可包括多个狭槽428,其可被构造为接纳切割构件(未示出),其中切割构件可如上文所述切断腿部410。 More specifically, block 404 may comprise a plurality of transfer slots 428, which may be configured to receive a cutting member (not shown), wherein the cutting member can cut the leg portion 410 as described above. 在至少一个实施例中,切割构件可被构造为可在狭槽428内的任何合适位置切断腿部410,使得可将腿部410切成合适的长度。 In at least one embodiment, the cutting member can be configured to be any suitable location within the slot 428 in the leg 410 is cut, so that the leg portion 410 may be cut to the appropriate length. 在多个实施例中,例如,可切割第一缝钉413使得其具有比第二缝钉415短的腿部410。 In various embodiments, for example, a first staple 413 may be cut such that it has a shorter than the second staple leg 415 410. 在其它多个实施例中,切割构件还可在狭槽428内的不止一个位置处切断腿部410。 In other various embodiments, the cutting member may also be within slot 428 cut in more than one position leg 410. 在这种实施例中,转移块404可保持闭合,并在分离腿部410时将缝钉条412保持在合适的位置。 In such an embodiment, the transfer block 404 can be kept closed and separated from the legs when the staple strip 410,412 held in position. 在其它实施例中,可在打开模具或转移块404之后进行切割。 In other embodiments, the cutting may be performed after the opening of the mold or the transfer block 404. 在多个实施例中,可在从模具中取出转移块404后进行切割,使得可通过手或任何其它合适的切割方法在切割工位进行切割。 In various embodiments, it can be cut after removal from the mold, the transfer block 404, so that can be cut at the cutting station by hand or any other suitable cutting method.

[0215] 在多个实施例中,制备缝钉的方法可包括自动化方法。 [0215] In various embodiments, the method may include preparing staple automated methods. 在至少一个实施例中,自动化方法可包括线材成形机,其可将线材弯曲以形成细长构件402。 In at least one embodiment, the automated method may comprise a wire forming machines, which can be a wire bent to form an elongated member 402. 自动化方法还可包括转移块404,其可定位于转盘或输送机上,并可被构造为接纳细长构件402。 An automated method may further include the transfer block 404, which may be positioned on the turntable or conveyor, and may be configured to receive the elongated member 402. 在多个实施例中,自动化方法还可包括用于将一个或多个细长构件402放入转移块404中的机械臂或其它转移机构。 In various embodiments, the automated method may also include one or more elongated members 402 into the transfer block 404 robotic arm or other transfer mechanism. 其后,自动化方法可利用(例如)穿梭机构将转移块404移动到模具中,其中可将熔融材料注入该模具中。 Thereafter, the method may be automated using (e.g.) a shuttle mechanism moves to block 404 to transfer a mold, wherein the molten material is injected into the mold. 在多个实施例中,例如,穿梭机构可将转移块404从模具中取出,使得可将转移块404移动到如上所述的切割工位,以切割细长构件402和/或连接区段434。 In various embodiments, for example, the shuttle mechanism 404 can be transferred block removed from the mold, so that the moving block 404 may be transferred to a cutting station as described above, to cut the elongated member 402 and / or the connecting section 434 . 在其它实施例中,如上所述,可在转移块404定位于模具中时进行切割。 In other embodiments, as described above, may be transferred in the cutting block 404 is positioned in the mold. 不管怎样,可打开转移块404,并取出缝钉条412和/或单独设置的缝钉413和415,然后再重复该自动化过程。 In any case, the transfer block 404 can be opened and removed staples strip 412 and / or the staple 413 and 415 separately provided, and then repeating this automated process.

[0216] 在其它多个实施例中,参见图89,细长构件402'的可变形的构件406'各可包括两个基部408'、两条腿部410'和可连接基部408'的中间部分420。 Intermediate [0216] In other various embodiments, 89, the elongated member 402 'of the deformable member 406' may comprise two Referring to FIG Each base portion 408 ', two legs 410' and base 408 may be connected apos section 420. 在至少一个实施例中,参见图90,可切断中间部分420以形成两条中间腿部418。 In at least one embodiment, referring to FIG. 90, the intermediate portion 420 may be cut to form two intermediate leg portion 418. 在其它多个实施例中,参见图91-93,细长构件430的可变形的构件406”可被安排为使得缝钉以并列构型设置,并通过连接器432连接。在这种实施例中,每一个缝钉可具有两个可变形的腿部424、两个基部416,并且在至少一个实施例中,可将中间部分420分离以形成如上所述的两条中间腿部418。在至少一个这种实施例中,参见图106,例如,可将细长构件430放置在转移块404'中,使得可将冠426'(参见图92)模制到基部416上。在至少一个不同的实施例中,转移块404'可包括孔或狭槽428',切割构件可穿过该孔或狭槽可操作地使连接器432与腿部424分离。在多个实施例中,与上文所述相似,切割构件可被构造为在狭槽428'内的不同位置处切断腿部424,以便选择性地将腿部424切成所需的长度。 In other various embodiments, referring to FIGS. 91-93, the deformable member 430 is an elongated member 406 'may be arranged such that the staples disposed in a parallel configuration and connected through the connector 432. In such an embodiment , each staple may have two deformable legs 424, two bases 416 and, in at least one embodiment, the intermediate portion 420 may be separated to form two intermediate leg portion 418. As described above in at least one such embodiment, referring to FIG. 106, for example, the elongated member 430 may be placed in the transfer block 404 'so that the crown 426 may be' (see FIG. 92) molded onto the base portion 416. in at least one different embodiment, the transfer block 404 'may include a hole or slot 428', the cutting member may be holes or slots through which the connector is operably separated from the leg portion 432,424. in various embodiments, the upper similar hereinabove, the cutting member can be configured to cut the leg 424 at a different location 428 'in the slot 424 to selectively cut to the desired length of the leg.

[0217] 在其它多个实施例中,参见图94-104,可将分离的可变形的构件436放置在模具和/或转移块404”中。在至少一个这种实施例中,参见图94,各个可变形的构件436可包括至少一条腿部438和至少一个基部440,其中可将各基部440定位于模具或转移块404”的腔409”内(参见图104),以接纳模制在其上的冠426”。 [0217] In other various embodiments, referring to FIG. 94-104, may be separated from the deformable member 436 is placed in the mold and / or the transfer block 404. "In at least one such embodiment, referring to FIG. 94 each deformable member 436 may include at least one leg portion 438 of the base 440 and at least one, wherein each base portion 440 may be positioned in a mold or the transfer block 404, "the chamber 409 'within (see FIG. 104) to receive molded crown 426 "on it.

[0218] 在本发明的多个实施例中,如上所述,可将外科手术缝钉可移去地储存在钉仓内,并可通过拖运器将其从钉仓定位,而拖运器可被构造为横穿钉仓。 [0218] In various embodiments of the present invention, as described above, a surgical staple can be removably stored within a staple cartridge, and can be positioned by the sled from the staple cartridge, the sled It may be configured to traverse staple cartridge. 在至少一个实施例中,如上所述,钉仓还可包括驱动器,其可被拖运器提升并可相应地将缝钉从钉仓定位。 In at least one embodiment, as described above, the staple cartridge may further include a driver that can be lifted and sled correspondingly positioned staples from the staple cartridge. 在多个实施例中,也如上文所述,缝钉可包括可直接与拖运器配合的特征,使得可在无驱动器的情况下将缝钉从钉仓定位。 In various embodiments, also described above, the staples can include cooperating directly with the sled features, positioned such that the staples from the staple cartridge drive without a case. 不管怎样,定位缝钉时缝钉可在钉仓的缝钉腔中移动,并且在多种情况下,缝钉会在缝钉腔内旋转或倾斜,这会导致缝钉以不期望的取向定位或卡在缝钉腔内。 In any case, positioning the movable staple staple staple staple cartridge chamber, and in many cases, the staple will be inclined rotating cavity or staple, which causes the staples undesirable orientation or positioning card staple cavity. 在本发明的多个实施例中,缝钉和/或钉仓腔可包括可至少阻碍(即使不抑制)缝钉发生不期望的旋转或倾斜的特征。 Embodiment, the staples and / or staple cartridge may include at least hinder the cavities (if not suppressed) wherein undesired rotation or inclination occurs in a plurality of staples embodiment of the present invention.

[0219] 在多个实施例中,参见图107-110,钉仓451可包括至少一个限定在其中的缝钉腔452。 [0219] In various embodiments, referring to FIG. 107-110, staple cartridge 451 can include at least one staple therein defining a lumen (452). 在至少一个实施例中,首先参见图109和图110,缝钉腔452可包括一个或多个弧形部分或侧面454,其可被构造为与定位于腔452内的外科手术缝钉配合,使得缝钉基本上不会相对于轴450旋转。 In at least one embodiment, referring primarily to FIGS. 109 and 110 of staple cavity 452 may include one or more curved portions or sides 454, which can be configured to fit within the cavity 452 and the positioning of surgical staples, such that the staples do not substantially with respect to the axis 450 of rotation. 在多个实施例中,参见图111和图112,外科手术缝钉456可包括冠462和至少一条腿部460,其中冠462可包括弧形部分或侧面464,其可被构造为与缝钉腔452的弧形部分454配合。 In various embodiments, referring to FIGS. 111 and 112, the surgical staple 456 can include crown 462 and at least one leg 460, wherein the crown 462 may include an arcuate portion or side 464 which may be configured as a staple and cavity 452 with the arcuate portion 454. 更具体地讲,缝钉腔452的弧形部分454可提供支承面,当缝钉456沿着腔的z轴或轴450移动时,缝钉456的弧形部分464可顶靠该支承面,这可抑制或至少阻碍缝钉456和冠462在腔454中倾斜或摇动。 More specifically, staple cavities 452 of arcuate portion 454 may provide a support surface, when the staple 456 is moved along the z-axis or the axis of the cavity 450, the staple 456 arcuate portion 464 may abut against the support surface, this can suppress or at least hinder the staple crown 456 and 462 is inclined or shaken in the cavity 454. 在至少一个实施例中,冠462的弧形部分464可带有摩擦地接合腔452的弧形部分454,使得作用于冠462的弧形部分464上的摩擦力基本上均一。 In at least one embodiment, the arcuate portion 464 of the crown 462 can be frictionally engaged with the arcuate portion 454 of cavity 452, such that a substantially uniform frictional force acting on the arc-shaped portion 464 of the crown 462. 在多种情况下,例如,参见图110中的区域465,弧形部分454还可使腔452紧密排列。 In many cases, e.g., see FIG. 110 in a region 465, arcuate portion 454 also allows the chamber 452 are closely arranged.

[0220] 在多个实施例中,参见图111-113,缝钉456的弧形部分464可具有圆柱形、或至少部分地为圆柱形的部分,其中圆柱形部分可抑制缝钉456在缝钉腔452内倾斜或摇动。 [0220] In various embodiments, referring to FIG. 111-113, staples 456 arcuate portion 464 may have a cylindrical, or at least partially cylindrical portion, wherein the cylindrical portion in the slit can be suppressed staples 456 452 within the staple cavities tilted or shaken. 更具体地讲,圆柱形部分可与缝钉腔452的弧形部分454配合,使得缝钉456的一端基本上不会低于或高于缝钉456的另一端。 More specifically, the cylindrical portion 454 engaging the curved portion may be staple cavities 452, 456 such that one end of the staple does not substantially lower or higher than the other end 456 of the staple. 在至少一个实施例中,参见图110-112,缝钉456可包括远端457和近端459,此外,缝钉腔452也可包括远端461和近端463。 In at least one embodiment, referring to FIG. 110-112, staple 456 can include a distal end 457 and a proximal end 459, in addition, staple cavities 452 may also include a distal end 461 and proximal end 463. 在多个实施例中,腔452的末端461和463可被构造为沿着轴450导向冠462,使得末端457和459基本上不会朝向或背离轴450倾斜或摇动。 In various embodiments, the end 461 of the chamber 452 and 463 may be configured as a guide shaft 450 along the crown 462, 457 and 459 such that the end does not substantially toward or away from the shaft 450 is inclined or shaken. 因此,在这种实施例中,砧座可基本上同时使可变形的构件460变形,而且可使其变形量基本上相同,以向捕获在缝钉456内的软组织施加基本上相同的压缩力。 Thus, in this embodiment, the anvil may substantially simultaneously deform deformable member 460 in this embodiment, but it may be substantially the same as the amount of deformation, in order to capture the soft tissue within the staple 456 is applied to substantially the same compressive force . 在多个实施例中,外科手术缝钉的冠可包括整个的弧形面(未示出),并且参见图116,缝钉腔可包括弧形侧壁454,其可被构造为与如上所述的缝钉弧形面配合。 In various embodiments, the surgical staple crown may include the entire arcuate surface (not shown), and referring to FIG. 116, staple cavities 454 can include an arcuate sidewall, which may be configured with the above said staple mating arcuate surfaces.

[0221] 尽管上文描述了弧形和圆柱形部分,但本发明并不限于这种构型。 [0221] Although a cylindrical portion and an arcuate above, but the present invention is not limited to this configuration. 在多个实施例中,参见图110-112,缝钉腔454可包括基本上为矩形的凹口470,其可被构造为接纳从冠462延伸的凸起486。 In various embodiments, referring to FIG. 110-112, staple cavities 454 can comprise a substantially rectangular recess 470 which can be configured to receive projection 486 extending from the crown 462. 在至少一个实施例中,凹口470和凸起486可被构造为抑制或至少阻碍缝钉456在腔454中旋转或倾斜,如上所述。 In at least one embodiment, the recess 470 and the projection 486 can be configured to inhibit or at least 456 staples rotated or tilted in the chamber 454 as described above. 在多个实施例中,参见图114-116,外科手术缝钉的冠可包括至少一个斜的或成角的部分(未示出),其中缝钉腔可包括与之配合的斜的或成角的部分472。 In various embodiments, referring to FIG. 114-116, the surgical staple crown may comprise at least one helical or part (not shown) is angled, wherein the staple cavities may include a beveled or angled mating therewith corner portion 472. 在多个可供选择的实施例中,参见图110A,钉仓451'可包括缝钉腔452',其中腔452'可包括一个或多个方的或至少基本上为方的角454'。 In various alternative embodiments, referring to FIG. 110A, staple cartridge 451 'may comprise staple cavities 452', wherein the cavity 452 'may comprise one or more parties, or at least substantially square angle 454'. 在这种实施例中,角454'可被构造为与定位于腔452'内的缝钉上的相应方角或基本上为方形的角配合,以抑制或至少限制在图IlOA中所示的X轴和y轴上发生相对移动。 Example X In this embodiment, the angle 454 'may be configured to be positioned in the cavity 452' within the respective square corners of the nail joints or with a substantially square angle to inhibit or at least limit as shown in FIG IlOA and y axes relative movement. 在多个实施例中,当缝钉拖运器在钉仓451'内以箭头D所示的方向移动时,拖运器会使腔452'内的缝钉沿方向D偏移,使得缝钉的一个或多个方角在方角454'内对齐。 In various embodiments, when the sled in staple cartridge 451 'is moved in the direction indicated by arrow D, the chamber 452 will sled' staples offset in the direction D, so that the staples one or more square corners aligned within square corners 454 '. 在这些情况下,配合的方角特征可抑制或至少抵抗缝钉相对于(例如)x轴和y轴旋转。 In these cases, features with square corners is suppressed or at least against the staple with respect to (e.g.) x-axis and y-axis. 除了上文所述之外,对齐方角还可抑制或至少阻碍缝钉挤在或卡在缝钉腔452'内。 In addition to the above, may also inhibit or square corners aligned at least in the extrusion or impede staple card 452 'of the staple cavities. 在多个实施例中,如图IlOA所示,缝钉腔452'可同时包括弧形和方形结构,并至少获得上述每一个结构的优点。 In various embodiments, as shown in FIG ILOA, staple cavities 452 'may include arcuate square structure and at the same time, and obtain at least the advantages of each of the above-described structure.

[0222] 在多个实施例中,参见图107-110,钉仓451可包括钉仓主体453,其包括第一末端474和第二末端476。 [0222] In various embodiments, referring to FIG. 107-110, staple cartridge 451 can include staple cartridge body 453 includes a first end 474 and second end 476. 在至少一个实施例中,可在第一末端474与第二末端476之间形成狭槽478,其中狭槽478可被构造为接纳切割构件。 In at least one embodiment, the slot 478 may be formed between the first end 474 and second end 476 wherein the slot 478 can be configured to receive cutting member. 除了上文所述之外,狭槽478可限定钉仓主体453的第一侧面480和第二侧面482,其中钉仓主体453的第一侧面480和/或第二侧面482上可限定多个缝钉腔452。 In addition to the above, the slot 478 may define a staple cartridge body 480, a first side 453 and second side 482, wherein staple cartridge body 453 on the first side surface 480 and / or the second side surface 482 may define a plurality of staple cavities 452. 在至少一个实施例中,第一侧面480和第二侧面482上的腔452可横越狭槽478或与其成锐角,并且在至少一个实施例中,腔452可基本上彼此平行。 In at least one embodiment, a first side surface 480 and the cavity 482 on the second side surface 452 may traverse slit 478 or an acute angle, and in at least one embodiment, the cavity 452 may be substantially parallel to each other.

[0223] 在多个实施例中,如上所述,外科手术缝合器可被构造为在切口的相对侧上插入平行的行的外科手术缝钉。 [0223] In various embodiments, as described above, the surgical stapler can be configured as surgical staples on opposing sides of the incision is inserted in parallel rows. 在这种实施例中,参见图117,可用一行或多行缝钉500连接或压缩软组织502,以抑制或减轻(例如)切口504两侧上的软组织出血。 Embodiment, referring to FIG. 117, one or more rows of staples can be used 500 or connector 502 in this soft tissue compression embodiment, to inhibit or reduce (e.g.) the soft tissue on both sides of the notch 504 of bleeding. 在多个实施例中,这些排的缝钉500可相对于彼此偏移或交错,使得缝钉500相互交搭并压缩软组织502中的血管,尤其是垂直于或基本上垂直于切口504延伸的血管。 In various embodiments, these rows of staples 500 may be staggered or offset with respect to one another, such that the staples 500 overlap each other and compress the soft tissue of the blood vessel 502, in particular extending perpendicular or substantially perpendicular to the slit 504 blood vessels. 尽管这种缝钉图案可适用于其预期目的,但还可对其进行改进,尤其是在涉及横越和/或平行于切口504延伸的血管的方面进行改进。 Although such staple pattern applied for its intended purpose, but may also be improved, especially improvements in aspect relates to traverse and / or parallel to the vessel 504 extending slit.

[0224] 在多个实施例中,参见图118和119,钉仓506可包括钉仓主体508,其中钉仓主体508可包括顶部表面510、底部表面512、远端514、近端516以及两个侧壁518。 [0224] In various embodiments, referring to FIGS. 118 and 119, staple cartridge 506 can include staple cartridge body 508, wherein staple cartridge body 508 may include a top surface 510, bottom surface 512, a distal end 514, a proximal end 516, and two sidewalls 518. 在至少一个实施例中,钉仓主体508的侧壁518可在顶部表面510与底部表面512之间延伸,而顶部表面510和底部表面512可被限定在远端514与近端516之间。 In at least one embodiment, the staple cartridge body side walls 518,508 may extend between the top surface 510 and the bottom surface 512, and the top surface 510 and bottom surface 512 may be defined between a distal end 514 and proximal end 516. 在多个实施例中,参见图118和图119,钉仓主体508还可包括狭槽520,其中狭槽520的纵向轴线可平行于或基本上平行于主体508的纵向轴线。 In various embodiments, referring to FIGS. 118 and 119, the staple cartridge body 508 further includes a slot 520, wherein the longitudinal axis of the slot 520 may be parallel to or substantially parallel to the longitudinal axis of the body 508. 在至少一个实施例中,“基本上平行”就本文而言可指以任一方向偏离平行方向约15度以内。 In at least one embodiment, "substantially parallel" for purposes herein may refer to any deviation from a direction parallel to a direction within about 15 degrees. 在多个实施例中,例如,狭槽520可通过近端516和/或远端514限定,并可被构造为接纳适于切断软组织的切割构件。 In various embodiments, for example, slots 520 may be through the proximal end 516 and / or distal end 514 is defined, and may be configured to receive a cutting member adapted to cut soft tissue. 不管怎样,狭槽520可限定钉仓主体508的第一侧面522和第二侧面524。 In any case, the slot 520 may define a first cartridge side surface 508 of the body 522 and the second side 524.

[0225] 在多个实施例中,参见图118和图119,钉仓主体508可包括至少一个第一缝钉腔526和至少一个第二缝钉腔528,其中第一腔526和第二腔528可限定在顶部表面510和/或底部表面512中。 [0225] In various embodiments, referring to FIGS. 118 and 119, the staple cartridge body 508 may include at least one first staple cavities 526 and at least one second staple cavities 528, wherein the first chamber 526 and second chamber 528 may be defined in a top surface 510 and / or bottom surface 512. 在至少一个实施例中,第一腔526和第二腔528可位于钉仓主体508的第一侧面522和/或第二侧面524上。 In at least one embodiment, the first chamber 526 and second chamber 528 may be positioned on the second side 524 or 508 of the first side surface 522 and / or staple cartridge body. 在多个实施例中,第一腔526和第二腔528每个都可具有第一末端530和第二末端532,其中在第一腔526的第一末端530与第二末端532之间可限定第一轴线534,相似地,在第二腔528的第一末端530与第二末端532之间可限定第二轴线536。 In various embodiments, the first chamber 526 and second chamber 528 can each have a first end 530 and a second end 532, wherein between the first end 530 and second end 532 of the first chamber 526 may be defining a first axis 534, similarly, a second chamber between the first end and the second end 530 528 532 536 may define a second axis. 在至少一个这种实施例中,第一腔526的第一轴线534可横越第二腔528的第二轴线536,使得轴线534和536之间可形成锐角或钝角。 In at least one such embodiment, the first axis 534 of the first chamber 526 may traverse the second axis 536 of the second chamber 528, such that an obtuse angle between the axis or form an acute angle 534 and 536. 在其它多个实施例中,第一腔526的第一轴线534可垂直于或基本上垂直于第二腔528的第二轴线536。 In other various embodiments, the first chamber 526 may be a first axis 536 perpendicular or substantially perpendicular to the second axis 536 of the second chamber 528. 在多个实施例中,仍然参见图118和图119,多个第一腔526可彼此平行或基本上平行,同样,多个第二腔528也可彼此平行或基本上平行。 In various embodiments, still see FIGS. 118 and 119, a first plurality of cavities 526 may be parallel or substantially parallel to each other, similarly, a second plurality of chambers 528 may be parallel or substantially parallel. 在其它多个实施例中,多个第一腔526可不彼此平行或基本上平行,多个第二腔528也不彼此平行或基本上平行。 In other various embodiments, the plurality of the first chamber 526 may not be parallel or substantially parallel to, a second plurality of chambers 528 are not parallel or substantially parallel.

[0226] 在至少一个实施例中,第一腔526可被构造为接纳第一缝钉,第二腔528可被构造为接纳第二缝钉,其中每一个缝钉都可包括第一腿部544和第二腿部546。 [0226] In at least one embodiment, the first chamber 526 may be configured to receive a first staple, the second chamber 528 may be configured to receive a second staple, wherein each staple includes a first leg portion may 544 and a second leg 546. 在至少一个实施例中,参见图120,第一缝钉的第一腿部544可位于第一腔538的第一末端548处,第一缝钉的第二腿部546可位于第一腔538的第二末端550处。 In at least one embodiment, referring to FIG. 120, the first staple leg portion 544 may be located at a first end of the first chamber 548 of the first 538, a second leg portion of the first staple 546 may be positioned in the first chamber 538 second end 550. 以相似的方式,第二缝钉的第一腿部544可位于第二腔540的第一末端548处,第二缝钉的第二腿部546可位于第二腔540的第二末端550处。 In a similar manner, the first leg portion 544 of the second staple may be located at the first end 548 of the second cavity 540, a second leg portion of the second staple 546 can be located at the second end 550 of the second cavity 540 . 在多个实施例中,第一缝钉的第一腿部544和第二缝钉的第二腿部546均可位于公用轴线552上或紧邻该轴。 The second leg portion 546 of the first leg portion 544 and a second plurality of staples in embodiments, a first staple 552 may be positioned on or proximate to the common axis of the shaft. 在这种实施例中,公用轴线552可限定第一公用轴线侧554和第二公用轴线侧556。 Embodiment, the common axis 552 may define a first common axis 554 and second side 556 side of the common axis in this embodiment. 在多个实施例中,第一腔538中的第一缝钉的第二腿部546可位于第一公用轴线侧554上,第二腔540中的第二缝钉的第一腿部544可位于第二公用轴线侧556上。 In various embodiments, the first chamber 538 of the first staple leg portion 546 may be located on a second common axis of the first side 554, second chamber 540 of the second staple leg portion 544 may be first located on the second side 556 of the common axis. 作为这种构型的结果,参见图120,例如,第一和第二缝钉可被构造为压缩或束紧垂直于轴552延伸的血管,以及横越和/或平行于轴552延伸的血管。 As a result of this configuration, see FIG. 120, for example, the first and second staple may be configured to compress a blood vessel or a fastener extending perpendicular to the axis 552, and the traverse and / or parallel to the axis 552 extending vessel.

[0227] 在多个实施例中,参见图120,第一轴线558可限定在第一腔538内的第一缝钉的第一腿部544与第二腿部546之间,并相似地,第二轴线560可限定在第二腔540内的第二缝钉的第一腿部544与第二腿部546之间。 [0227] In various embodiments, referring to FIG. 120, 558 may be defined between the first axis 546 within the first chamber 538 of the first staple leg portion of the first and the second leg portion 544, and similarly, between the second axis 560 may be defined within the second chamber 540 of the second staple leg portion of the first leg portion 544 and the second 546. 在至少一个实施例中,第一轴线558可横越第二轴线560,使得实际上第一腔538与第二腔540可彼此横向。 In at least one embodiment, the first axis 558 may traverse a second axis 560, so that in fact the first chamber 538 and second chamber 540 may be laterally to each other. 在其它多个实施例中,第一轴线558可垂直于或基本上垂直于第二轴线560,使得第一腔538与第二腔540彼此垂直。 In other various embodiments, the first axis 558 may be perpendicular or substantially perpendicular to the second axis 560, perpendicular to each other such that the first chamber 540 and second chamber 538.

[0228] 在多个实施例中,参见图121,钉仓主体508可包括限定在其中的多个第一腔562和多个第二腔564,所述腔可被构造为分别接纳第一缝钉和第二缝钉,其中每一个缝钉都可包括第一腿部568和第二腿部570。 [0228] In various embodiments, referring to FIG. 121, 508 may include a cartridge body defining therein a plurality of first cavity 562 and a plurality of second chambers 564, the chamber may be configured to respectively receive the first slit staple and a second staple, wherein each staple leg portion may include a first leg 568 and second 570. 在多个实施例中,与上文所述相似,第一缝钉的第一腿部568可位于第一腔562的第一末端574处,类似地,第一缝钉的第二腿部570可位于第一腔562的第二末端576处。 A second leg portion in a plurality of embodiments, similar to the above, staple first leg portion 568 may be located at a first end of the first chamber 574 of the first 562, and similarly, a first staple 570 It may be located at the second end 576 of the first chamber 562. 在至少一个实施例中,第二缝钉的第一腿部568可位于第二腔564的第一末端574处,第二缝钉的第二腿部570可位于第二腔564的第二末端576处。 In at least one embodiment, the second staple leg portion 568 may be located at a first end 574 of the second chamber of the first 564, the second staple leg portion 570 may be located at a second end of the second chamber 564 of the second 576. 在多个实施例中,再次参见图121,第一缝钉的第一腿部568可定位于轴578的一侧上,而第一缝钉的第二腿部570可定位于轴578的另一侧上。 In various other embodiments, referring again to FIG. 121, the first leg of the first staple 568 may be positioned on the side of the shaft 578, a first and a second leg portion 570 may be positioned in the staple shaft 578 one side. 在至少一个实施例中,第二缝钉的第一腿部568可与第一缝钉的第二腿部570定位于轴578的同一侧上。 In at least one embodiment, a first leg portion a second leg portion 568 may be the first second staple staples 570 positioned on the same side of the shaft 578. 在多个实施例中,第二缝钉的第二腿部570与第二缝钉的第一腿部568可定位于轴578的相对侧上。 In various embodiments, the second staple leg portion 570 and a second leg portion of the first second staple 568 can be positioned on the opposite side of the shaft 578. 在其它多个实施例中,第一缝钉和第二缝钉可按照任何其它合适的构型排列,只要第一缝钉566的腿部568和570以及第二缝钉572的腿部568和570各自分别位于公用轴线578的相对侧上。 In other various embodiments, a first staple and a second staple may be of other suitable configuration in any arrangement, as long as the leg portion of the first leg 566 of staple 568 and 570 and a second staple 572 and 568 570 each respectively located on opposite sides of the common axis 578.

[0229] 在本发明的多个实施例中,可用支撑材料加硬和/或加强缝合后的软组织。 Embodiment, the hardened material can be used to support and / or reinforcement of soft tissue after the suture [0229] In various embodiments of the present invention. 在至少一个实施例中,参见图122-127,可将支撑材料600与外科手术缝合器结合使用,其中外科手术缝合器可包括砧座602和钉仓610。 In at least one embodiment, referring to FIG. 122-127, buttress material 600 may be used in conjunction with a surgical stapler, wherein the surgical stapler can include an anvil 602 and staple cartridge 610. 在这种实施例中,外科手术缝钉可从钉仓610中定位并被砧座602变形,以便捕获支撑材料600使其靠在位于钉仓610与砧座602之间的软组织612上。 In such an embodiment, the surgical staple 602 may be positioned and deformation of the anvil from the staple cartridge 610, so as to capture the support material 600 against the soft tissue positioned between staple cartridge 612 and anvil 610 602. 在多个实施例中,支撑材料600以可释放的方式保留在砧座602和/或钉仓610上。 In various embodiments, buttress material 600 can be releasably retained in the anvil 602 and / or staple cartridge 610. 更具体地讲,在至少一个实施例中,砧座602可包括从其中延伸的第一唇缘604,其可被构造为以可释放的方式将支撑材料600捕获到砧座602上。 More particularly, in at least one embodiment, anvil 602 may include a first lip 604 extending therefrom which can be configured to be releasably support material 600 captured onto the anvil 602. 在多个实施例中,第一唇缘604可完全围绕支撑材料600的周边,或在其它实施例中,第一唇缘604可不接触支撑材料600的整个周边。 In various embodiments, the first lip 604 completely around the perimeter of the support material 600, or in other embodiments, the first lip 604 may not contact the entire periphery 600 of the support material. 在多个实施例中,术语“周边”可包括支撑材料的几何周边,以及支撑材料的外部、外缘或外区。 Geometry periphery embodiment, the term "perimeter" In various embodiments may include a support material, and an outer, outer periphery or outer region of the support material. 在至少一个实施例中,砧座602还可包括从其中延伸的第二唇缘606,其可与第一唇缘604相似以可释放的方式捕获支撑材料600。 In at least one embodiment, anvil 602 may also include a second lip 606 extending therethrough, which may be similar to the first lip 604 to releasably capture support material 600. 在至少一个可供选择的实施例中,参见图124,砧座602可包括一个或多个凹口或狭槽608,其以可释放的方式将支撑材料600保持在砧座602上。 In at least one alternative embodiment, referring to FIG. 124, the anvil 602 may include one or more notches or slots 608, which is releasably retaining the support material 600 on the anvil 602. 在多个实施例中,例如,凹口或狭槽608可与第一唇缘602和/或第二唇缘604结合使用。 In various embodiments, for example, a notch or slot 608 may be used in conjunction with a first lip 602 and / or the second lip 604.

[0230] 在多个实施例中,如上所述,砧座602和钉仓610可构成钳口构件,其可被构造为向捕获在两者间的软组织612施加压缩力或压力。 [0230] In various embodiments, as described above, an anvil 602 and staple cartridge 610 can be configured jaw member, which may be configured to apply a compressive force or pressure in the soft tissue 612 therebetween to capture. 参见图125,钉仓610可包括多个位于其中的缝钉614,其中每一个缝钉614都可包括至少一个具有末端616的可变形的构件。 Referring to FIG. 125, the staple cartridge 610 may comprise a plurality of staples 614 positioned therein, wherein each staple 614 may include a deformable member having at least one terminal 616. 在至少一个实施例中,支撑材料600可包括位于其中的孔620,其中孔620可被构造为接纳缝钉末端616,使得缝钉614的可变形的构件可相对于支撑材料600移动或滑动。 In at least one embodiment, buttress material 600 can include an aperture 620 positioned therein, wherein the apertures 620 may be configured to receive staple tip 616, such that staples 614 may be deformable member with respect to the supporting material 600 to move or slide. 在可供选择的实施例中,缝钉末端616可被构造为刺穿支撑材料600,以在其中形成孔。 In an alternative embodiment, the staple tip 616 may be configured to pierce the support material 600 to form a hole therein. 不管怎样,可朝砧座602定位缝钉614,使得缝钉末端610可接触砧座602中的砧座凹坑618,并且缝钉614的可变形的构件可如图126所示发生弯曲。 Anyway deformable member may be positioned toward the anvil 602 staple 614, so that the end 610 may contact the staple anvil pockets of the anvil 618 602, 614 and staples 126 may be bent as shown in FIG. 因此,在至少一个实施例中,可变形的构件可接触支撑材料600并向其施加力,从而使支撑材料600成功砧座602移开。 Thus, in at least one embodiment, the deformable member may contact buttress material 600 and apply a force to the supporting material 600 of the anvil 602 successfully removed. 换而言之,可变形的构件可第一方向延伸穿过支撑材料600并在被砧座602变形后以第二方向接触支撑材料600。 In other words, the deformable member may extend through the support material in a first direction 600 and second direction 600 in the support material in contact with the anvil 602 after being deformed. 在至少一个实施例中,支撑材料600可在可变形的构件变形后立即脱离砧座602。 In at least one embodiment, buttress material 600 can be disengaged immediately after the anvil 602 to the deformable member is deformed. 在这种实施例中,参见图127,支撑材料600可在砧座602进入其打开位置时脱离砧座602。 In such an embodiment, referring to FIG. 127, buttress material 600 may be entered from the anvil 602 in its open position the anvil 602.

[0231] 在多个实施例中,如上所述,支撑材料600可加强或加硬软组织612。 [0231] In various embodiments, as described above, buttress material 600 may be strengthened or hardened soft tissue 612. 更具体地讲,在至少一个实施例中,支撑材料600在附连到软组织上之后可增加软组织的弹性模量。 More specifically, in the embodiment, the support material 600 may increase the modulus of elasticity of the soft tissue after the soft tissue attached to at least one embodiment. 在多个实施例中,支撑材料可将缝钉的压缩负荷分布到较大的面积上,从而减小在软组织内产生的应力。 Embodiment, the support material may be staples distributed compressive load to a larger area in a plurality of embodiments, to reduce the stress generated in the soft tissue. 在至少一个实施例中,支撑材料600(例如)可抑制或至少阻碍软组织进入砧座凹坑618。 In at least one embodiment, buttress material 600 (for example) can be suppressed or at least impede the soft tissue into the anvil pockets 618. 更具体地讲,当将砧座602闭合到软组织上并向其施加压缩力时,软组织会流入砧座凹坑618,使该压力减小,并因此影响缝钉正确接合和保持软组织的能力。 More specifically, when the anvil 602 is closed onto the soft tissue and which is applied a compressive force, the soft tissue can flow into anvil pockets 618, so that the pressure is reduced, and thus affect the staples are properly engaged, and the ability of soft tissue retention. 然而,当使用了支撑材料600时,支撑材料600可被构造为阻止或至少基本上阻止软组织进入砧座凹坑618。 However, when the support material 600, buttress material 600 may be configured to prevent, or at least substantially prevent the soft tissue into the anvil pockets 618. 在多个实施例中,支撑材料600可由可吸收的、生物可分解的或可溶解的材料构成,正如上述可用于形成冠310和桥接件340的材料。 Embodiment, buttress material 600 may be formed in a plurality of embodiments of absorbable, biodegradable or dissolvable material, it may be used as the above-described materials crown member 310 and the bridge 340 is formed. 在至少一个实施例中,支撑材料600可包含如上所述能够释放以促进愈合的治疗性物质。 In at least one embodiment, buttress material 600 can be released as described above may comprise a therapeutic substance to facilitate healing. 在多个实施例中,可采用韧性、刚性或半刚性物质形成支撑材料600。 In various embodiments, buttress material 600 can be ductile, rigid or semirigid material are formed.

[0232] 本发明的多个实施例涉及使用内切割器30(参见图I)的外科手术,其中对于该手术的至少一部分而言,将内切割器30的端部执行器36装上具有缝钉(带一体化冠-驱动器)的钉仓64(参见图3)。 [0232] the present invention, a plurality of embodiments of surgical procedures involving the use of a cutter 30 (see FIG. I), wherein for at least part of the procedure, the apparatus 36 having an end effector 30 of the slit cutter nail (with integrated crown - drive) staple cartridge 64 (see FIG. 3). 此外,一体化冠-驱动器可以包括凹槽,例如图5-9中所示的凹槽144,用于弯转缝钉的末端。 In addition, the integration of the crown - driver may comprise grooves, such as grooves 144 shown in FIG. 5-9, for bending staple tip. 这种钉仓64可用于Roux-en-Y胃旁路手术方法。 Such staple cartridge 64 may be used Roux-en-Y gastric bypass method. 在这种手术中,结合图128,通过在胃12的顶部形成小口袋10使胃变小,其中可将小胃袋10直接连接到小肠的中部(空肠)14,从而绕过胃的其余部分16和小肠的上部(十二指肠)18。 In this procedure, in conjunction with FIG. 128, a small pocket formed by the top of the stomach 10, the stomach 12 becomes smaller, which may be a small stomach pouch 10 is connected directly to the rest of the small intestine stomach middle (jejunum) 14, thereby bypassing 16 and the upper small intestine (duodenum) 18. 如图128所示,有时将可调式束带20围绕胃袋10布置,以控制小口袋10的膨胀。 128 shown in FIG, 20 may be adjustable band disposed around the gastric pouch 10, 10 to control the expansion of the small pocket. 束带20施加到胃袋10上的压力可通过与束带20连通的端口22控制。 Band 20 pressure applied to the gastric pouch 10 through port 22 in communication with the band 20 controls. 结合图I和图3,可将用于手术的内切割器30装上具有带一体化冠-驱动器(可有或无缝钉末端弯转凹槽144)的缝钉的钉仓64,以在拟设置胃束带20的部位附近进行切割。 And FIG. 3 in conjunction with Figure I, may be used having a crown 30 with integrally attached surgical endocutter - staple drivers (with or nail tip seamless bending groove 144) staple cartridge 64 in order to Quasi disposed near the band portion 20 is cut. 这样,将会保护组织和/或束带20的外表面免受缝钉末端的伤害,从而降低缝钉末端切割或磨破或以其它方式损坏束带20的可能性,并降低束带20加重缝钉负担的可能性。 Thus, the outer surface will protect tissues and / or damage to the band 20 from the end of the staple, the staple to reduce or frayed end cutting or otherwise damage the possibility of the band 20, the band 20 and reduces the increase sew possibility nail burden.

[0233] 在多个实施例中,临床医生可在手术中使用一个内切割器30。 [0233] embodiment, a clinician can use the cutter 30 during surgery in a plurality of embodiments. 可将内切割器30装上具有常规缝钉的钉仓(例如美国专利5,465,895所述),用于不在束带20区域中的切害I],例如图128中的区域820、821。 May be a staple cartridge (e.g., the U.S. Patent No. 5,465,895) has a conventional staple 30 is mounted on the inner cutter for cutting the band 20 does not damage the I region], for example, region 820 in FIG. 128, 821. 对于在束带20的区域822内的切割,可将内切割器30装上具有带一体化冠-驱动器的缝钉的钉仓。 In the region of 822 for cutting the band 20 may be integrated with a crown having inner cutter 30 is mounted on - a staple cartridge of the staple driver. 在另一个实施例中,临床医生在手术中可使用两个(或更多个)单独的内切割器30。 In another embodiment, the clinician during surgery may use two (or more) separate inner cutter 30. 一个内切割器30可用于不在束带20附近的区域820,821中的切割,另一个内切割器30(安装了具有带一体化冠-驱动器的缝钉的钉仓)则用于束带20区域中的区域822中的切割。 An inner cutter 30 may be used to cut the band area 820, 821 is not in the vicinity of 20 and the other inner cutter 30 (installed with the crown with integrated - the staple cartridge of the staple driver) 20 is used in the band area cut region 822.

[0234] 图129为根据多个实施例的方法的流程图。 [0234] FIG. 129 is a flowchart of a method of the various embodiments. 在步骤830中,临床医生使用具有常规钉仓的内切割器30,用于区域820(参见图128)中的切割。 In step 830, the clinician using conventional inner cutter 30 having a staple cartridge for cutting a region 820 (see FIG. 128). 当然,在多个实施例中,对于区域820内的每次切割将需要使用不同的常规钉仓。 Of course, in various embodiments, the inner region 820 of each cut will require the use of different conventional staple cartridge. 在临床医生靠近拟设置束带20的区域822后,在步骤832中,可将内切割器30装上具有带一体化冠-驱动器的缝钉的钉仓。 After the clinician intends disposed near the band 20 region 822, in step 832, may be integrated with a crown having inner cutter 30 is mounted on - a staple cartridge of the staple driver. 然后在步骤834中,临床医生可对区域822进行必要的一次切割或多次切割。 Then in step 834, the clinician 822 may be a region necessary one or more cutting cutting. 当然,如果区域822中需要一次以上的切割,对于每次这种切割而言,可将内切割器30装上具有带一体化冠-驱动器的缝钉的钉仓。 Of course, if more than one cut region 822 is required, for each such cutting, it may be integrated with a crown having inner cutter 30 is mounted on - a staple cartridge of the staple driver. 在临床医生越过拟设置束带20的区域后,在步骤836中,可将内切割器30装上常规钉仓,用于区域821内各另外必需的切割(步骤838),以形成小口袋10。 After the band 20 in the region beyond the intended setting the clinician, in step 836, the cutter 30 may be mounted on a conventional staple cartridge, for each of the additional cutting region 821 (step 838) necessary to form a small pocket 10 . 一旦形成小口袋10,在步骤840中,就可将患者小肠的中部(空肠)14缝合到胃袋10上。 Once a small pocket 10, at step 840, the patient can be the middle of the small intestine (jejunum) 10 14 sewn to the gastric pouch. 然后在步骤842中,可将胃束带20围绕胃袋10布置,使得束带20放置在使用带一体化冠-驱动器的缝钉的区域中。 Then in step 842, the gastric band 20 may be disposed around the gastric pouch 10, such that the band 20 is placed in use with integrated crown - region staple driver's. 这样,降低了缝钉末端磨破或穿破束带20的可能性,以及束带20加重缝钉负担的可能性。 Thus, reducing the possibility of rupturing or staple frayed end of the band 20, the band 20 and increase the possibility of the staples burden. 根据多个实施例,可将装有具有一体化冠-驱动器的钉仓64的内切割器30用于形成胃袋10的每次切割。 According to various embodiments, a crown may be fitted with an integrated - the staple cartridge 64 drives the cutter 30 for forming a gastric pouch 10 of each cut.

[0235] 因此,根据多个实施例,本发明涉及用于进行Roux-en-Y胃旁路手术的方法,其包括使用内切割器30在患者的胃上进行多次切割/固定步骤,以将胃切成两部分(如小口袋10和绕过的胃16)并沿着切割路径用缝钉将两个部分密封。 [0235] Thus, in accordance with various embodiments, the present invention relates to a method for performing the Roux-en-Y gastric bypass surgery, which comprises the use of a cutter 30 for cutting multiple / fixing step in the stomach of the patient to the stomach was cut into two portions (e.g., small pockets 10 and 16 to bypass the stomach) and the sealing portions of two staples along the cutting path. 对于每次切割而言,可将内切割器30装上新的钉仓,并且对于至少一次切割而言,钉仓包含带一体化冠-驱动器的缝钉,如上所述。 For each cut, the cutter 30 may be installed within a new cartridge, and for at least one cut, the cartridge comprising a crown with integrated - the staple driver, as described above. 然后可使用(例如)本领域已知的技术将患者小肠的中部(空肠)14缝合到胃袋10上。 It may then be used (e.g.) techniques known in the art of the middle of the small intestine of patients (jejunum) 10 14 sewn to the gastric pouch. 然后可将胃束带20围绕胃袋10布置,使得束带20放置在使用带一体化冠-驱动器的缝钉的区域中。 Gastric band 20 may then be disposed around the gastric pouch 10, such that the band 20 is placed in use with integrated crown - region staple driver's.

[0236] 图130和131为根据本发明的其它多个实施例的端部执行器36的一部分的横截面侧视图。 [0236] FIGS. 130 and 131 are cross-sectional side view of part of the present invention according to other plurality of end effector 36 of the embodiment. 在图示实施例中,将多个可释放式凹坑元件650安装到砧座52中。 In the illustrated embodiment, a plurality of recesses releasable element 650 is mounted to anvil 52. 在图示实施例中,钉仓内每一个缝钉652都具有相应的可释放式凹坑元件650,但在其它实施例中,如下文进一步所述,也可使用不同比率的可释放凹坑元件650与缝钉。 In the illustrated embodiment, each of the staples within the staple cartridge 652 have corresponding recesses releasable element 650, in other embodiments, described further below, it may also be used different ratios of dimples releasable element 650 and staples. 可释放式凹坑元件650可(例如)在使用内切割器30之前与砧座52 —体地形成、与其搭扣配合或以其它方式插入其中。 Releasable element recesses 650 may be (e.g.) in use prior to the cutter 30 with the anvil 52 - the body is formed, its snap fit or otherwise inserted.

[0237] 如图130和图131的实施例所示,可释放式凹坑元件650可限定凹坑654,当内切割器30射钉时,缝钉652的末端656被推入该凹坑。 [0237] Example 130 and 131 as shown, the releasable element recesses 650 may define a pocket 654, when the nail cutter 30, the end 652 of the staple 656 is pushed into the pit. 射钉时,如图131所不,末端656可首先接合凹坑654的上表面658并被其折弯。 When the nail, not shown in FIG 131, the tip 656 may engage the first surface of the pits 654 and 658 thereof bent. 凹坑654的上表面658可将缝钉652的末端656转向凹坑元件650下边缘的缝钉末端保持表面660。 Upper surface 654 of the pits 658 may end 656 of the staple 652 at the steering element recesses 650 end edge of the staple holding surface 660. 缝钉末端保持表面660可将缝钉652的末端656保持或捕捉在凹坑654中。 The end surface of the staple holder 660 may end 652 of the staple 656 held or captured in the recesses 654.

[0238] 射钉操作的力优选地大于将凹坑元件650保持在砧座52中的力,使得凹坑元件650在射钉时从砧座52上分离或弹出,如图131所示。 [0238] nail operation force is preferably greater than the pit 650 to maintain anvil member 52 in force, such that the dimple element 650 separated from the nail when the anvil 52 or the pop-up, 131 as shown in FIG. 这样,在切割/固定操作之后,凹坑元件650可与组织662中的缝钉652保持在一起,如图131所示。 Thus, after the cutting / fixing operation, with recesses element 650 may remain in the tissue 662 with staples 652, 131 as shown in FIG. 从图131中还可看出,例如,凹坑元件650可在从砧座52上释放后分离,并与组织662 —起移动。 It can also be seen in FIG. 131, for example, element 650 may be separated from the pit after being released from the anvil 52, and 662 with tissue - from moving.

[0239] 保持表面660可抑制缝钉652的末端656从凹坑654中伸出并进入已被缝钉652固定的组织662中。 [0239] suppressed the staple holding surface 660 extends from end 656 652 and into the pit 654 has been fixed staples 652 in tissue 662. 此外,对于在已缝合的组织周围使用束带的手术而言,例如上述Roux-en-Y胃旁路手术方法中的胃束带20(参见图128),凹坑元件650可抑制缝钉652的末端656损坏束带20,以及抑制束带20损坏缝钉线。 Furthermore, for surgical use straps around the tissue has been stapled, the above-described example, Roux-en-Y gastric bypass method in the band 20 (see FIG. 128), element 650 can be suppressed pit staples 652 the end 656 is damaged band 20, the band 20 and to suppress damage staple line. 此外,这还可降低束带布置部位发生感染的风险。 In addition, it can reduce the risk of infection strap placement spot.

[0240] 保持表面660优选地足够强韧,使得缝钉652的末端656不会刺穿保持表面660,并且强韧得足以抵抗将凹坑元件650从砧座52上分离所需的力。 [0240] Preferably the holding surface 660 strong enough, so that the end 652 of the staple 656 without piercing the holding surface 660, and tough enough to resist the force from the pit 650 of the anvil member 52 the desired separation. 此外,保持表面660优选地足够小,使得不会阻碍缝钉末端656插入凹坑654。 Furthermore, the holding surface 660 is preferably small enough such that tip 656 does not hinder the insertion of the staple 654 dimples. 根据多个实施例,保持表面660与凹坑元件650的其余部分相似,可用热塑性材料(例如Victrex PEEK塑料)制成。 According to various embodiments, retaining the rest of the surface element 660 and the recesses 650 are similar, made of thermoplastic material can be used (e.g. Victrex PEEK plastic). 保持表面660的厚度可根据所用缝钉652的大小进行选择,并根据多个实施例,保持表面660的厚度可为约O. 010英寸。 Maintaining the thickness of the surface 660 may be selected according to the size of the staples used 652, and according to various embodiments, the thickness of the holding surface 660 may be about O. 010 inches.

[0241] 根据多个实施例,凹坑元件650可由与缝钉652的冠664相同的材料制成。 [0241] According to various embodiments, pits made of the same elements may be formed with the staple crown 650 664 652 material. 例如,它们均可用生物可吸收的材料或非生物可吸收的材料制成。 For example, they may be made of a material with a bioabsorbable or non-bioabsorbable material. 另外,凹坑元件650和/或冠664可掺有或以其它方式包含可被周围组织662吸收的治疗剂或药物,例如镇痛药或抗菌剂。 Further, dimples element 650 and / or crown 664 may be doped or otherwise contained therapeutic agent or drug can be absorbed by the surrounding tissue 662, for example analgesics or anti-bacterial agents.

[0242] 图132和图133示出可释放式凹坑元件650的另一个实施例,其中所示实施例的每一个可释放式凹坑元件650都具有一个凹坑654。 [0242] FIGS. 132 and 133 show another releasable element recesses 650 embodiment, wherein each of the releasable element recesses 650 of the illustrated embodiment has a dimple 654. 这样,在这种实施例中,对于每一个缝钉652可对应两个凹坑元件650。 Thus, in this embodiment, for each of two staple recesses 652 may correspond to elements 650 in this embodiment. 应该指出的是,在多个实施例中,可在砧座52中设置多个供同时使用的不同凹坑兀件650。 It should be noted that, in various embodiments may be provided for a plurality of different pit Wu member 650 while using the anvil 52. 例如,对于一次使用,一些凹坑兀件650可具有两个(或更多个)凹坑654, —些则可只具有一个凹坑654。 For example, for single use, a number of dimples 650 may have Wu two (or more) dimples 654, - some may have only a pit 654. 典型的钉仓64具有成六行的六十六个缝钉(切口的每一侧各三行)。 A typical staple cartridge 64 has a staple into sixty-six six rows (three rows on each side of each incision). 因此优选地,布置在砧座52中的所有凹坑元件650中具有132个凹坑,也就是说每一个缝钉652对应两个凹坑(即每一个缝钉末端656对应一个凹坑)。 Thus Preferably, all dimples 650 disposed on the anvil member 52 having a pit 132, a staple 652 that is corresponding to each of two pits (i.e., the end of each staple 656 corresponding to a pit).

[0243] 具有安装了这种释放凹坑元件的砧座52的内切割器也可用于要在切割的组织周围布置束带的区域中的切割步骤,例如上述Roux-en-Y胃旁路手术方法。 Such release pit anvil member 52 of the cutter [0243] having a mounting band region it can also be used in the cutting step to cut tissue disposed in surrounding, such as the above Roux-en-Y gastric bypass method. 临床医生可使用单独的内切割器30,其具有带可释放式凹坑元件650的砧座52,用于在拟设置束带20的区域中进行切割,或者临床医生可在手术中使用一个内切割器30,其中外科医生(和/或其团队成员)可改进砧座52,向其插入可释放式凹坑元件650,用于在拟设置束带20的区域中进行切割。 Clinicians may use a separate inner cutter 30 having an anvil 52 with a releasable element recesses 650, in a region intended for cutting is provided in the band 20, or the clinician can use within a surgical the cutter 30, which the surgeon (and / or team members) may improve the anvil 52, can be inserted into its recesses releasable element 650, intended for cutting the band 20 is provided in the region. 在另一个实施例中,内切割器30可允许使用可互换的砧座52,其中一个砧座52没有可释放式凹坑元件650,而另一个则有。 Embodiment, the cutter 30 may allow the use of interchangeable anvil 52, the anvil 52 is not one releasable member recesses 650, while the other has in another embodiment. 然后,可将具有可释放式凹坑元件650的砧座52用于束带20区域中的切割。 Then, the can having a releasable element recesses 650 of the anvil 52 for cutting the band 20 in the region. [0244] 在多个实施例中,上述或以引用方式并入本文的外科手术缝钉不仅可用于线性缝合器,还可用于圆形外科手术缝合器。 [0244] In various embodiments, the above-described or incorporated by reference herein surgical staple not only for linear stapler, can be used for circular surgical stapler. 在圆形缝合器的实施例中,外科手术缝钉可具有与上述缝钉相同的特征、功能和组成。 In an embodiment of the circular stapler, the surgical staple staple described above may have the same features, functions and components. 不再将缝钉装入具有线性构型的钉仓的多个腔中,而是将缝钉装入具有圆形构型的钉仓的多个腔中。 A plurality of chambers charged with staples having longer linear configuration of the staple cartridge, the staple loaded but the cavity has a plurality of circular configuration in the staple cartridge.

[0245] 在多个实施例中,参见图134-136,圆形缝合器900可包括头部902、砧座904、调节旋钮组件906以及扳机908,其中头部902可通过弧形轴组件912连接到柄部组件910。 [0245] In various embodiments, referring to FIG. 134-136, circular stapler 900 may include a head 902, an anvil 904, adjustment knob 906 and a trigger assembly 908, wherein the head portion 902 by an arcuate shaft assembly 912 910 is connected to the handle assembly. 在至少一个实施例中,扳机908可可枢转地受柄部组件910支持,并在释放安全机构(未示出)时可起到操作缝合器900的作用。 In at least one embodiment, the cocoa trigger 908 is pivotally supported by the handle assembly 910, and may function in the operation of the stapler 900 upon release of safety mechanism (not shown). 当激活扳机908时,射钉机构(图134未示出)可在轴组件912内运转,使得缝钉914从头部902射出或定位,形成与砧座904的接触。 When the activation trigger 908, the nail means (not shown in FIG. 134) may be operated within the shaft assembly 912, such that staples 914 902 emitted from the head, or positioned, into contact with the anvil 904. 同时, 可操作地支持在头部902中的刀916可用于切割夹在头部902与砧座904之间的组织。 Meanwhile, operable to support the blade 916 of the head 902 may be used to cut tissue clamped between the anvil 902 and head 904. 然后可将缝合器900从手术部位取下,将缝合好的组织保留在其原位。 The stapler 900 can then be removed from the surgical site, the tissue sutured remain in its place.

[0246] 图135和图136示出了可结合本主题发明的多个实施例使用的砧座904和头部902的一种形式。 [0246] FIGS. 135 and 136 illustrate one form of anvil 904 and the head may be used in conjunction with embodiments of the subject invention the plurality of embodiments 902. 从这些图中可看出,砧座904可包括圆形主体部分920,其具有用于连接套针(未示出)的砧座轴922。 As can be seen from these figures, the anvil 904 may include a circular body portion 920 that has an anvil shaft connecting trocar (not shown) 922. 在至少一个实施例中,砧座主体920可包括其上的缝钉成形表面924,并还可包括附接到其远端的覆盖物926。 In at least one embodiment, anvil 920 can include a body on which the staple forming surface 924, and may further include a distal end thereof attached to the cover 926. 砧座904还可设置有一对套针固定夹或叶式弹簧928,其可用于以可释放的方式固定套针,使其与砧座轴922保持接合。 The anvil 904 may be further provided with a pair of trocar retaining clips or leaf spring 928, which may be used to releasably fixed trocar, so that the anvil shaft 922 remains engaged. 在多个实施例中,可将塑料刀板930安装到砧座主体904的腔932中。 In various embodiments, the plastic knife board 930 may be mounted to the anvil in the body cavity 932,904.

[0247] 在多个实施例中,参见图136,头部902可具有壳体构件940,其支持其中的圆形缝钉驱动器组件942形式的钉仓支持组件,圆形缝钉驱动器组件942适于与圆形钉仓944连接并驱动支持在其中的缝钉914,使其与砧座904的缝钉成形表面924形成接触。 Cartridge support assembly [0247] In various embodiments, referring to FIG. 136, the head 902 may have a housing member 940, where it supports a circular staple driver assembly 942 in the form of a circular staple driver assembly 942 adapted in connection with a circular staple cartridge 944 and drive staples supported therein 914, 924 to the surface 904 of the anvil staple forming into contact. 在至少一个实施例中,圆形刀构件916也居中定位于缝钉驱动器组件942中。 In at least one embodiment, the circular knife member 916 is also centrally located in the staple driver assembly 942. 在多个实施例中,壳体构件940的近端可通过远端套圈构件948连接到弧形轴组件912的外部管状覆盖物946上。 Embodiment, the proximal housing member 940 may be connected to the arcuate member 948 of the outer tubular shaft assembly 912 on the object 946 by covering the distal end of the ferrule in a plurality of embodiments. 有关圆形缝钉和缝合器的更多详细信息可见于2006年9月29日提交的、名称为SURGICALCUTTING AND STAPLING DEVICE WITH CLOSUREAPPARATUS FOR LIMITING MAXIMUM TISSUECOMPRESSION FORCE(具有用于限制最大组织压缩力的闭合装置的外科手术切割缝合器械)的美国专利申请No. 11/541,151,该专利的公开内容以引用的方式并入本文。 For more details about the circular staple and the stapler can be found in, filed September 29, 2006, entitled SURGICALCUTTING AND STAPLING DEVICE WITH CLOSUREAPPARATUS FOR LIMITING MAXIMUM TISSUECOMPRESSION FORCE (having a closure means for limiting the maximum force of tissue compression U.S. Patent cutting surgical stapling instrument) application No. 11 / 541,151, the disclosure of which patent is incorporated by reference herein.

[0248] 在进行吻合术时,可用圆形外科手术缝合器缝合腔管(例如大肠或小肠),在肠的目标部分(即样本)每一侧上安放至少两行缝钉。 [0248] When performing the anastomosis, circular available surgical stapling lumen (e.g., large or small intestine), the target portion of the intestine is placed at least two rows of staples on each side (i.e., sample). 在多个实施例中,通常一边切割目标部分一边进行缝合。 In various embodiments, the target portion side cutting while generally stitched. 接下来,在移除样本后,外科医生可在缝钉线近侧将砧座插入腔管的近端。 Next, after removal of the sample, the surgeon may proximal staple line inserts the anvil into the proximal end of the lumen. 在至少一个实施例中,这可通过将砧座头部插入外科医生在近腔管切开的入口来完成。 In at least one embodiment, which may be inserted by the anvil head surgeon lumen near the inlet to complete the cut. 有时,可经肛门或甚至经口放置砧座,即通过将砧座头部放在缝合器的远端并分别通过直肠或嘴插入器械。 Sometimes, even, or may be placed through the anus anvil orally, i.e. by the anvil head on the distal end of the stapler and inserting the instrument through the rectum or each nozzle. 为了使砧座可操作地与外科手术缝合器接合,在多个实施例中,例如,可将缝合器的远端经肛门插入。 To the anvil is operably engaged with a surgical stapler, in various embodiments, e.g., the distal end of the stapler may be inserted through the anus. 然后外科医生可用缝合线或其它常规的系结装置将肠的近端系在砧座轴上。 The surgeon then suture or other conventional tying device proximal end of the intestine to the anvil shaft based. 接下来,外科医生可切掉邻近打结处的多余组织,并可将砧座连接到缝合器的致动轴上。 Next, the surgeon can cut the excess tissue adjacent to the tie, and the anvil is connected to the actuating shaft of the stapler. 然后外科医生可闭合砧座与钉仓之间的间隙,从而使间隙中切开的肠近端与远端接合。 The surgeon may then close the gap between the anvil and the staple cartridge, such that the proximal end of the intestine in the gap and engage the distal end of the cut. 接着,外科医生可启动缝合器,使得驱动至少两行缝钉穿过切开的肠近端和远端,从而将肠的末端连接在一起并在缝钉成形后形成管状通道。 The surgeon then actuates the stapler may be such that the proximal and distal gut drive at least two rows of staples through the cut, the end of the intestine to connect together and form the tubular passage after the staple forming. 同时,在驱动并成形缝钉时,可驱动同心的圆形刀片、刀或切割构件穿过肠组织末端,从而切割邻近内行缝钉的末端。 Meanwhile, when the driving and forming the staples are driven concentric circular blade, knife or cutting member through the intestinal tissue ends, cutting the ends adjacent to the expert of the staples. 然后外科医生可从肠中取出缝合器,并完成吻合术。 The surgeon may then withdraws the stapler from the intestine and the anastomosis is completed. [0249] 在多个实施例中,参见图137-139,本发明涉及外科手术缝合器900,其具有插入砧座904的垫圈970,如图137 (为垫圈970和砧座904的分解图)和图138 (示出插入砧座904的垫圈970)所示。 [0249] In various embodiments, referring to FIG. 137-139, the present invention relates to a surgical stapler 900 having an anvil insert 904 a gasket 970, as 137 (FIG exploded washer 970 and anvil 904) and 138 (shown washer 970 is inserted into the anvil 904) shown in FIG. 在至少一个实施例中,可将垫圈904压配合或搭扣配合到砧座904的开口中,使得垫圈904在手术过程中保持在合适的位置。 In at least one embodiment, the gasket 904 may be press fit or snap fit into the opening in the anvil 904, such that the washer 904 held in place during surgery. 从图139中可看出,垫圈904可包括内部972和外部974。 As can be seen in FIG. 139, the washer 904 may include an inner 972 and outer 974. 外部974可包括缝钉导向部分的内行976和外行978。 974 may include external expert staple guide portions 976 and 978 lay. 在多个实施例中,每一个缝钉导向部分976、978都可包括孔979,当圆形缝合器900射钉时,可分别驱动缝钉914的内行和外行的末端通过该孔。 Embodiment, each staple guide portions 976,978 may include a hole 979, 900 when the circular stapler nail, drive the expert and can lay the end of the staple through the aperture 914 in a plurality of embodiments. 缝钉的末端被驱动穿过孔979后,其可被砧座904的缝钉成形凹坑901折弯或变形。 After the end of the staple is driven through the aperture 979, which may be the anvil staple forming pockets 904 or 901 bending deformation. 在被砧座904折弯后,缝钉914的末端可接触缝钉导向部分976、978,从而抑制缝钉914的末端伸入被切割/缝合的组织。 After being bent anvil 904, the end 914 may contact the staples of the staple guide portion 976,978, thereby suppressing the tips of the staple 914 extending into the cutting / stapling tissue. 从图139中还可看出,垫圈970的外部974可具有在内行976与外行978的缝钉导向部分之间的弹簧部分980。 139 can also be seen from the figure, outer 974 may have a gasket 970 between the staple guide portion 976 and the lay 978. experts spring portion 980. 在至少一个实施例中,弹簧部分980可提供相对于环972标称直径的离散量的柔韧性。 In at least one embodiment, the spring portion 980 may be provided with respect to the nominal diameter of the flexible ring 972 of the discrete quantity. 此外,内部缝钉导向部分976可通过接片982连接到垫圈的内部972。 Further, the inner staple 976 can be connected to the guide portion 972 through the inner gasket tab 982.

[0250] 在多个实施例中,包括内部972和外部974的垫圈970可用模制塑料一体地形成。 [0250] In various embodiments, gasket 970 includes inner 972 and outer 974 available integrally formed of molded plastic. 其原因在下文中将显而易见,垫圈970可由不能吸收的材料(例如PEEK牌热塑性塑料)制成,但是,在其它实施例中,垫圈970的至少一部分可由可吸收的塑性材料制成。 The reason for this will hereinafter become apparent, the gasket 970 may be made of a material not absorbing (e.g., PEEK thermoplastics card), however, in other embodiments, the gasket 970 is made of a plastic material by at least a portion of absorbable. 在使用中,当被击发时,刀916可切割接片982,从而使垫圈970的外部974在接片982处从垫圈970的内部972上断开,使得内部972可在切割/缝合步骤后保留在砧座904内,而外部974可在移除缝合器900后与缝钉和组织保持在一起。 In use, when fired, the knife 916 can cut the tabs 982, 970 so that the outer gasket 974 in contact washer 972 is disconnected from the inner sheet 970 at 982, such that the interior 972 may remain after the cutting / stapling step within the anvil 904 and the outer staple 974 can be held with the tissue and after removal of the stapler 900 together. 具有这种在手术后可与缝钉和组织保持在一起的环状垫圈部分972可具有若干优势。 Such an annular gasket having staple holding the tissue after surgery and together portions 972 may have several advantages. 例如,对于接受减小胃容积的手术(例如Roux-en-Y胃旁路手术方法)的患者而言,环状垫圈部分972可通过提供固定尺寸的缝钉线(即通过环状垫圈部分972的尺寸进行固定)抑制胃空肠吻合处的扩张。 For example, surgery for reducing stomach volume (e.g. Roux-en-Y gastric bypass method) of the patient, the annular gasket portion 972 may be fixed by providing a staple line size (i.e., through the annular gasket portion 972 fixed size) inhibiting expansion at gastrojejunostomy. 固定胃空肠吻合处的尺寸可抑制造口的扩张,从而可能使患者获得长期的体重减轻。 Size is fixed at the gastrojejunostomy inhibit the expansion of the stoma, which may cause the patient to obtain long-term weight loss.

[0251] 根据其它实施例,弹簧部分980可由可包覆模制在环972上的弹性材料形成。 [0251] According to other embodiments, the spring portion 980 may be overmolded on the ring 972 is formed of an elastic material. 而且,尽管图中以大体为圆形示出环972,但应当认识到,环972也可设想其它形状,例如椭圆形。 Further, although in FIG substantially circular ring 972 is shown, it should be appreciated, the ring 972 may also be contemplated that other shapes, such as oval. 在肠吻合术中,椭圆形环972可能提供比圆形环更大的腔管。 In the intestinal anastomosis, the ring 972 may provide an elliptical annular ring larger than the lumen. 此外,如果环972使用不能吸收的材料,腔管则可能保持恒定的尺寸和形式。 Further, if the material used can not absorb loop 972, the lumen may remain constant size and form.

[0252] 此外,在多个实施例中,环972可掺有或以其它方式包含康复剂,当其接触组织时,将有助于吻合部位组织的愈合。 [0252] Further, in various embodiments, the ring 972 may be doped with or otherwise contain healing agents, when it contacts tissue, the anastomotic site will help heal tissue. 另外,环972可包含或以其它方式具有可远程检测的材料,其允许在以后感测环972在患者体内的位置和取向。 Further, the ring 972 may comprise a material, or otherwise remotely detectable, which allows the position and orientation of the patient after the sensing loop 972. 例如,环972可由某些频率的无线电波不可透过的或以其它方式可由电磁辐射检测到的材料制成。 For example, ring 972 may be a radio wave of a certain frequency or a material impermeable to the electromagnetic radiation detector may be otherwise made. 这样,环972在吻合部位的位置和取向可用(例如)X射线检测机确定。 Thus, the ring 972 the position and orientation of the anastomotic site available (e.g.) X-ray detector is determined. 在其它实施例中,环972可由具有或以其它方式包含可用荧光镜装置检测的荧光纳米粒子的材料制成。 In other embodiments, ring 972 may be formed with or otherwise contain a fluorescent material may be a mirror means for detecting fluorescent nanoparticles made. 纳米粒子可是(例如)无机纳米粒子,如半导体纳米晶;基于二氧化硅的纳米粒子,如在名称为FLUORESCENT SILICA-BASED NANOPARTICLES (基于二氧化硅的荧光纳米粒子)、提交于2003年11 月26 日的美国专利申请No. 11/536,569,名称为PHOTOLUMINESCENT SILICA-BASEDSENSORS ANDMETHODS OF USE(基于二氧化硅的光致发光传感器及其使用方法)、提交于2005年5月2日的美国专利申请No. 11/119,969,以及名称为FLUORESCENT SILICA-BASEDNANOPARTICLES (基于二氧化硅的荧光纳米粒子)、提交于2002年11月26日的美国专利申请No. 11/306,614中所述的那些,以上专利的公开内容以引用方式并入本文;或任何其它能够结合或包含荧光材料的无机粒子。 However, nanoparticles (e.g.) inorganic nanoparticles, such as semiconductor nanocrystals; silica-based nanoparticles, as the name FLUORESCENT SILICA-BASED NANOPARTICLES (silica-based fluorescent nanoparticles), filed November 26, 2003 Japanese Patent application U.S. No. 11 / 536,569, entitled pHOTOLUMINESCENT sILICA-BASEDSENSORS ANDMETHODS oF uSE (silica photoluminescence-based sensor and method of use), filed on May 2, 2005 U.S. Patent application No. 11 / 119,969, and entitled fLUORESCENT sILICA-BASEDNANOPARTICLES (silica-based fluorescent nanoparticles), filed on November 26, 2002, U.S. Patent application No. 11 / 306,614 of those, more than disclosure of which is incorporated herein by reference; or any other capable of binding to or inorganic particles containing a fluorescent material. 纳米粒子也可是有机纳米粒子,如脂质体微球、二聚体结构或者能够结合或包含荧光材料的其它有机结构。 Nanoparticles may also be organic nanoparticles, microspheres such as liposomes, or a dimeric structure capable of binding, or other organic structure containing a fluorescent material.

[0253] 在其它实施例中,砧座904的缝钉成形凹坑901可与环972集成。 [0253] In other embodiments, the anvil 904 of the staple forming pockets 901 may be integrated with the ring 972. 这样,环972将包括针对每一个腿部开口979的凹坑(未示出),其从环972的平面向远端延伸,使得腿部将被背靠在环972上的凹坑折弯。 Thus, the pit ring 972 includes an opening 979 for each of the leg portions (not shown) which extends from the plane of the ring 972 distally such that the leg portion is a depression in the back of the ring 972 is bent. 在这种实施例中,可无需砧座904中的凹坑。 In such embodiments, anvil 904 can be without a pit.

[0254] 在多个实施例中,参见图140-148,圆形外科手术缝合器700可包括钉仓机构702、细长轴704和砧座构件706。 Embodiment, referring to FIG. 140-148, a circular surgical stapler 700 may include a staple cartridge bodies 702, elongate shaft 704 and anvil member 706 [0254] In various embodiments. 在至少一个实施例中,钉仓机构702可被可移去地附接到外科手术缝合器700上,使得第一钉仓机构702中的缝钉被定位后,例如可取下第一钉仓机构702并更换为第二钉仓机构702。 After at least one embodiment, staple cartridge means 702 may be removably attached to the surgical device 700, such that the first staples in the staple cartridge means 702 is positioned, for example, a first removable staple cartridge means 702 and replaced with a second staple cartridge mechanism 702. 在多个实施例中,参见图141和图144,钉仓机构702可包括钉仓部分716和从其中延伸的致动轴714。 Embodiment, referring to FIGS. 141 and 144, staple cartridge 702 can include staple cartridge mechanism portion 716 and the actuator shaft 714 extending therethrough in a plurality of embodiments. 在至少一个实施例中,参见图140-142,致动轴714可被构造为延伸穿过砧座构件706中的孔712。 In at least one embodiment, referring to FIG. 140-142, actuation shaft 714 may be configured to extend through the aperture 706 in anvil member 712. 在这种实施例中,外科手术缝合器700还可包括致动机构(图140-148中未示出),其可被构造为促动致动轴714,并因此使钉仓机构702相对于站座构件706移动。 In such embodiments, the surgical stapler 700 may also include an actuator mechanism (not shown in FIG. 140-148), which may be configured actuated actuation shaft 714, and thus the staple cartridge 702 with respect to the mechanism station seat member 706 to move. 在至少一个实施例中,孔712可定位于致动机构的远端,并可被构造为以搭扣配合和/或压配合的布置方式接纳致动轴714。 In at least one embodiment, the apertures 712 may be positioned at the distal end of the actuation mechanism, and may be configured to snap-fit ​​and / or press-fit arrangement receiving the actuating shaft 714. 在多个实施例中,尽管未示出,但致动轴714和致动机构中的至少一者可包括制动机构,其以可释放的方式将致动轴714保持在致动机构上。 In various embodiments, although not illustrated, the actuating shaft 714 and the actuation mechanism may comprise at least one of a braking mechanism, which is releasably holding the actuation shaft 714 on the actuating mechanism.

[0255] 在多个实施例中,当致动轴714接合在上述孔712中或以其它方式可操作地与致动机构接合时,致动机构可控制砧座构件706与钉仓机构702之间的距离。 When [0255] In various embodiments, when the actuating shaft 714 to engage or operably engaged with the actuating means in the hole 712 in other ways, the actuating mechanism may control the anvil member 706 and staple cartridge 702 of the mechanism the distance between. 在至少一个实施例中,为了定位可移去地储存在钉仓716中的缝钉,外科医生或临床医生可启动该致动机构,以便将致动轴714朝砧座构件706拉动,并因此使缝钉接触砧座构件706,并固定其中的软组织,如上所述。 In at least one embodiment, to removably positioned in the staple cartridge 716 is stored in the staple, the surgeon or clinician can activate the actuating mechanism to the actuating shaft 714 is pulled toward the anvil member 706, and thus contacting the staples anvil member 706, wherein the soft tissue and fixed, as described above. 在多个实施例中,钉仓机构702还可包括缝钉驱动器(未示出),其可操作地与致动轴714接合,使得在致动机构拉动致动轴714时,致动轴714可使缝钉驱动器相对于钉仓部分716移动,并从其中定位缝钉。 In various embodiments, the staple cartridge 702 may further include a mechanism staple driver (not shown), which is operatively engaged with the actuating shaft 714, such that when the actuation shaft 714 is pulled in the actuating mechanism, the actuating shaft 714 allows the staple driver relative to the staple cartridge portion 716 moves, and from which the staple is positioned. 不管怎样,然后可使致动轴714与致动机构脱离,并取出用过的钉仓机构702。 In any case, the actuating shaft 714 may then be disengaged from the actuating mechanism, and remove the spent staple cartridge mechanism 702. 在这种实施例中,例如,当安装新的钉仓机构172时,夕卜科手术缝合器700的其余部分可留在手术部位。 In such embodiments, for example, when installing a new staple cartridge bodies 172, Xi Boke remainder of surgical stapler 700 may be left in the surgical site. 这种实施例是对先前的外科手术器械的改进,后者需要外科医生从手术部位取出整个外科手术器械,以便重新安装新的钉仓。 This embodiment is a modification of a previous surgical instrument, which requires the surgeon to remove the entire surgical instrument from the surgical site to reinstall the new staple cartridge. 在多个实施例中,可缩短完成特定外科手术的时间,并在多种情况下,手术对患者的创伤可更小。 In various embodiments, it can shorten the time to complete a particular surgical procedure, and in many cases, surgical trauma to the patient may be less.

[0256] 在多个可供选择的实施例中,参见图146和147,钉仓机构702的钉仓部分716可与致动轴714分离。 [0256] In various alternative embodiments, referring to FIGS. 146 and 147, the staple cartridge portion 702 of the staple cartridge means 716 may be separated from the actuating shaft 714. 在这种实施例中,当更换用过的钉仓部分716时,致动轴714可与致动机构保持可操作地接合。 In such embodiments, the spent staple cartridge when replacing portion 716, the actuator shaft 714 may remain operatively engaged with the actuation mechanism. 不管怎样,在多个实施例中,刀或切割构件718可安装在砧座构件706 (图140)上或钉仓机构702 (图144)上。 In any case, in this embodiment, the knife or cutting member 718 may be mounted on the upper member 706 (FIG. 140) or the cartridge mechanism 702 (FIG. 144) in a plurality of embodiments of the anvil. 当将切割构件718安装在砧座构件706上时,参见图140,刀718可安装在多个砧座凹坑710的内侧,并可朝向或远离钉仓机构702轴向移动。 When the cutting member 718 is mounted on the anvil member 706, see FIG. 140, the knife 718 can be installed inside a plurality of anvil pockets 710, toward or away from the staple cartridge and mechanism 702 to move axially. 当安装在钉仓机构702上时,参见图144,刀718可安装在钉仓716的内侧,并可朝向或远离砧座构件706轴向移动。 When the cartridge is mounted on a mechanism 702, see FIG. 144, 718 may be mounted inside the blade cartridge 716, and toward and away from the anvil member 706 to move axially. 在至少一个不同的实施例中,切割构件718如上文所述轴向移动时可旋转,并可被构造为修剪靠近缝钉线的肠的部分。 In at least one various embodiment, the cutting portion described above may be rotated axially movable, and may be configured to trim the intestine near the staple lines and member 718 as described above.

[0257] 本文所公开的器械可被设计为单次使用后丢弃,或者它们可被设计为可使用多次。 [0257] The devices disclosed herein can be designed to be discarded after a single use, or they can be designed to be used multiple times. 然而,无论在哪种情况下,都可对该器械进行修复,以便在至少使用一次后重复使用。 However, In either case, the instrument can be reconditioned for reuse after at least one. 修复可包括以下步骤的任何组合:拆卸器械,然后清洗或更换特定零件,以及重新组装。 Reconditioning can include any combination of the following steps: Removing the instrument, followed by cleaning or replacement of particular pieces, and subsequent reassembly. 特别地,可拆卸该器械,并且可按照任何组合选择性地更换或拆下器械的任何数量的特定零件或部件。 In particular, the removable device, and may be selectively replaced or removed in any number of particular pieces or parts of the instrument in any combination. 清洗和/或更换特定部件后,可在紧接外科手术之前在修复设备上或由外科手术团队将器械重新组装好,以供后续使用。 Cleaning and / or replacement of particular parts, the device can be repaired or on the instrument reassembled by a surgical team immediately prior to a surgical good, for subsequent use. 本领域的技术人员将会知道,修复器械时可利用多种技术进行拆卸、清洗/更换和重新组装。 Those skilled in the art will appreciate that reconditioning of a device may utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. 这种技术的使用以及所得的修复器械均在本发明的范围内。 This technique is used and the resulting reconditioned device, are all within the scope of the present invention.

[0258] 优选的是,本文所述的发明将在外科手术前进行处理。 [0258] Preferably, the invention described herein will be processed before surgery. 首先,获取新的或用过的器械,并根据需要进行清洗。 First, obtain a new or used instrument, and clean as necessary. 然后对器械进行消毒。 The instrument can then be sterilized. 在一种消毒技术中,将器械置于闭合并密封的容器中,例如塑料或TYVEK 口袋中。 In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. 然后将容器和器械置于可穿透该容器的辐射场,例如Y辐射、X射线或高能电子。 The container and instrument are then placed in the radiation field can penetrate the container, such as Y radiation, X-rays, or high-energy electrons. 辐射将杀死器械上和容器中的细菌。 The radiation kills bacteria on the instrument and in the container. 然后可将消毒后的器械保存在消毒容器中。 The sterilized instrument can then be stored in the sterile container. 该密封容器将器械保持在无菌状态,直到在医疗设备中打开该容器。 The sealed container keeps the instrument sterile until it is opened in the medical facility.

[0259] 尽管已经将本发明作为示例性设计进行了描述,但还可以在本公开的精神和范围内对本发明进行修改。 [0259] Although this invention has been described as having exemplary designs, but the present invention can be modified within the spirit and scope of the present disclosure. 因此本发明旨在涵盖采用本发明一般原理的任何变型型式、用途或适应型式。 Thus, the present invention is intended to cover any variations invention using its general principles, uses, or adaptations. 此外,本发明旨在涵盖本发明之外但在本发明所属领域的已知或惯有实践范围内的偏差型式。 Further, the present invention is intended to cover, but the present invention than in the known or customary in the field of the invention within the pattern deviation range of practice.

Claims (20)

1. 一种圆形切割和缝合外科手术器械,包括: 头部,其包括: 圆形切割器械;和钉仓,其包括多个缝钉; 砧座,其面向所述头部;和垫圈,其插入所述砧座中,使得所述垫圈位于所述砧座与所述头部之间,其中所述垫圈包括内部和外部,所述垫圈还包括在所述内部与所述外部之间的接片,所述接片将所述内部连接到所述外部,并且其中所述垫圈被构造在所述砧座中,使得当所述圆形切割和缝合外科手术器械被击发时,所述圆形切割器械切割所述接片,使得所述内部从所述外部分离。 A circular surgical stapling and cutting instrument, comprising: a head comprising: a circular cutting instrument; and staple cartridge including a plurality of staples; anvil facing said head portion; and a washer, inserted in the anvil, such that the washer is located between the anvil and the head portion, wherein said washer comprises inner and outer, further comprising a gasket between the interior and the exterior of the tab, said tab connecting the interior to the exterior, and wherein said gasket is configured in the anvil so that when said circular surgical cutting and stapling instrument when fired, the circle cutting the shaped tab cutting instrument, such that the internal separation from the outside.
2.根据权利要求I所述的圆形切割和缝合外科手术器械,其中所述垫圈的所述外部包括多个缝钉导向部分,每一个缝钉导向部分限定至少一个开口,使得当所述圆形切割和缝合外科手术器械被击发时,所述钉仓的所述缝钉的末端被驱动穿过所述开口并顶靠所述砧座成形。 The circular surgical stapling and cutting instrument according to claim I, wherein said outer gasket comprising a plurality of said staple guide portions, each staple guide portion defines at least one opening, such that when the circle when the cutting and stapling shaped surgical instrument is fired, the end of said staple cartridge to be driven through the opening and against the anvil shaped top.
3.根据权利要求2所述的圆形切割和缝合外科手术器械,其中每一个缝钉导向部分被构造为使得在所述圆形切割和缝合外科手术器械被击发时,所述缝钉的所述末端在顶靠所述砧座成形后接触所述缝钉导向部分。 The claimed circular cutting and stapling of the surgical instrument 2, wherein each staple guide portion is configured such that when said circular cutting and stapling surgical instrument is fired, the staples after a top end of said anvil against said staple forming contact said guide portions.
4.根据权利要求3所述的圆形切割和缝合外科手术器械,其中所述垫圈包含非生物可吸收的材料。 According to claim 3, said circular cutting and stapling surgical instrument, wherein the gasket comprises a non-bioabsorbable material.
5.根据权利要求3所述的圆形切割和缝合外科手术器械,其中所述垫圈包含康复剂。 The circular cutting and stapling claim 3 surgical instrument according to claim, wherein the gasket comprises a recovery agent.
6.根据权利要求3所述的圆形切割和缝合外科手术器械,其中所述垫圈包含可远程检测的材料。 6. A circular cutting and stapling claim 3 surgical instrument according to claim, wherein the gasket material comprises a remotely detectable.
7.根据权利要求6所述的圆形切割和缝合外科手术器械,其中所述可远程检测的材料包括可由电磁辐射检测的材料。 6, 7. The circular cutting and stapling the surgical instrument according to claim, wherein said remotely detectable material comprises a material may be an electromagnetic radiation detector.
8.根据权利要求7所述的圆形切割和缝合外科手术器械,其中所述电磁辐射包括X射线。 According to claim circular surgical cutting and stapling instrument of claim 7, wherein said electromagnetic radiation comprises X-rays.
9.根据权利要求6所述的圆形切割和缝合外科手术器械,其中所述可远程检测的材料包含荧光纳米粒子。 9. The circular cutting and stapling of the surgical instrument 6, wherein said material comprises a remotely detectable fluorescent nanoparticle.
10.根据权利要求3所述的圆形切割和缝合外科手术器械,其中: 所述钉仓至少包括内行缝钉和外行缝钉;和所述垫圈的所述外部包括: 内行缝钉导向部分,其与所述内行缝钉对齐;和外行缝钉导向部分,其与所述外行缝钉对齐。 10. A circular cutting and stapling claim 3 surgical instrument according to claim, wherein: the cartridge comprises at least experts and lay staples staples; the outer and the gasket comprising: a staple guide part expert, experts aligned with said staples; and lay staple guide part, which is aligned with the outer row of staples.
11.根据权利要求10所述的圆形切割和缝合外科手术器械,其中所述垫圈的所述外部还包括多个弹簧,使得每一个弹簧在所述内行缝钉导向部分中的一个与所述外行缝钉导向部分中的一个之间。 11. The circular surgical cutting and stapling instrument of claim 10, wherein said exterior of said gasket further comprises a plurality of springs, each spring so that a staple of the experts and the guide portion lay staple between a guide portion.
12.根据权利要求I所述的圆形切割和缝合外科手术器械,其中所述垫圈的所述外部为圆形。 I according to claim circular cutting and stapling of the surgical instrument, wherein the exterior of the washer is circular.
13.根据权利要求I所述的圆形切割和缝合外科手术器械,其中所述垫圈的所述外部为椭圆形。 I according to claim circular cutting and stapling of the surgical instrument, wherein said outer gasket is elliptical.
14.根据权利要求I所述的圆形切割和缝合外科手术器械,还包括: 轴组件,其连接到所述头部; 柄部组件,其连接到所述轴组件;和扳机,其连接到所述柄部组件以用于使所述圆形切割和缝合外科手术器械击发。 I 14. The circular cutting and stapling of the surgical instrument as claimed in claim, further comprising: a shaft assembly connected to the head; handle assembly connected to the shaft assembly; and a trigger, which is connected to the handle assembly for the circular cutting and stapling firing surgical instrument.
15.根据权利要求10所述的圆形切割和缝合外科手术器械,还包括: 轴组件,其连接到所述头部; 柄部组件,其连接到所述轴组件;和扳机,其连接到所述柄部组件以用于使所述圆形切割和缝合外科手术器械击发。 10 15. A circular cutting and stapling the surgical instrument according to claim, further comprising: a shaft assembly connected to the head; handle assembly connected to the shaft assembly; and a trigger, which is connected to the handle assembly for the circular cutting and stapling firing surgical instrument.
16.根据权利要求10所述的圆形切割和缝合外科手术器械,其中所述砧座包括缝钉成形表面,其面向所述头部,使得当被击发时所述缝钉顶靠所述砧座的所述缝钉成形表面成形。 10 16. A circular cutting and stapling the surgical instrument according to claim, wherein said anvil includes staple forming surface facing the head portion, such that when fired the staples against the anvil top the seat staple forming surface of the forming.
17.根据权利要求10所述的圆形切割和缝合外科手术器械,其中所述垫圈的所述外部包括缝钉成形凹坑。 10 17. A circular cutting and stapling the surgical instrument according to claim, wherein said outer gasket comprising said staple forming pockets.
18.根据权利要求10所述的圆形切割和缝合外科手术器械,其中所述垫圈由注射模制的塑料制成。 10 18. A circular cutting and stapling the surgical instrument according to claim, wherein said gasket is made of injection molded plastic.
19.根据权利要求I所述的圆形切割和缝合外科手术器械,其中所述垫圈由注射模制的塑料制成。 19. The round as claimed in claim surgical cutting and stapling instrument of claim I, wherein the gasket is made of injection molded plastic.
20.根据权利要求I所述的圆形切割和缝合外科手术器械,其中所述垫圈由不能吸收的注射模制的塑料制成。 I 20. The circular cutting and stapling of the surgical instrument as claimed in claim, wherein said gasket is made of an injection molded plastic can not absorb.
CN 200880101756 2006-09-29 2008-06-11 Washer for use with a surgical stapling instrument CN101873834B (en)

Priority Applications (25)

Application Number Priority Date Filing Date Title
US11/824,275 2007-06-29
US11/824,415 US7604151B2 (en) 2007-06-29 2007-06-29 Surgical stapling systems and staple cartridges for deploying surgical staples with tissue compression features
US11/824,079 2007-06-29
US11/824,389 2007-06-29
US11/823,988 US20090005809A1 (en) 2007-06-29 2007-06-29 Surgical staple having a slidable crown
US11/824,251 2007-06-29
US11/824,252 2007-06-29
US11/824,298 2007-06-29
US11/824,298 US7673782B2 (en) 2007-06-29 2007-06-29 Surgical stapling instrument having a releasable buttress material
US11/824,275 US8727197B2 (en) 2007-06-29 2007-06-29 Staple cartridge cavity configuration with cooperative surgical staple
US11/824,136 2007-06-29
US11/824,363 2007-06-29
US11/824,079 US7438209B1 (en) 2007-06-29 2007-06-29 Surgical stapling instruments having a releasable staple-forming pocket
US11/824,524 2007-06-29
US11/824,524 US20090001130A1 (en) 2007-06-29 2007-06-29 Surgical procedure using a cutting and stapling instrument having releasable staple-forming pockets
US11/824,415 2007-06-29
US11/823,988 2007-06-29
US11/824,446 2007-06-29
US11/824,446 US20090001121A1 (en) 2007-06-29 2007-06-29 Surgical staple having an expandable portion
US11/824,299 US20080082125A1 (en) 2006-09-29 2007-06-29 Surgical staple having a deformable member with a non-circular cross-sectional geometry
US11/824,274 US8590762B2 (en) 2007-06-29 2007-06-29 Staple cartridge cavity configurations
US11/824,274 2007-06-29
US11/824,299 2007-06-29
US11/824,136 US20080082126A1 (en) 2006-09-29 2007-06-29 Surgical staple having a deformable member with a non-circular cross-sectional geometry
PCT/US2008/066461 WO2009005969A2 (en) 2007-06-29 2008-06-11 Washer for use with a surgical stapling instrument

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CN101873834B true CN101873834B (en) 2012-12-05

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