CN105899148A - Fastener cartridge comprising a cutting member for releasing a tissue thickness compensator - Google Patents

Abstract

A staple cartridge or fastener cartridge for a surgical stapler or fastening instrument is provided in the invention, wherein the staple cartridge includes a distally-located cutting blade arranged to cut a distal end portion of a layer, such as a tissue thickness compensator and/or a buttress material, for example, attached to the staple cartridge. The distally-located cutting blade can extend out of a distal cavity of the staple cartridge. The distally-located cutting blade can move in a direction that is perpendicular to a staple deck of the staple cartridge. The distally-located cutting blade can also move in any suitable direction relative to the staple deck.

Description

Fastener cartridge including the cutting element for discharging tissue thickness's compensating part

Cross-Reference to Related Applications

This non-provisional is the regulation according to 35U.S.C. § 120, to being filed in April, 2011 The U.S. Patent application sequence of entitled " the Compressible Staple Cartridge Assembly " of 29 days The part continuation application of row number 13/097,907 (they being now U.S. Patent Publication 2012/0080338), and beautiful State's patent application serial number 13/097,907 is the regulation according to 35U.S.C. § 120, to being filed in 2010 Year JIUYUE entitled " the Surgical Stapling Instrument with a Variable Staple of 30 days Forming System " U.S. Patent Application Serial Number 12/894,360 (be now U.S. Patent Publication 2012/0080484) part continuation application, the complete disclosure of these patent applications is accordingly to quote Mode is expressly incorporated herein.

Background technology

The present invention relates to surgical instruments, and in various embodiments, relate to being designed to cutting and Sew up the surgical cutting and suture instruments and nail bin thereof organized.

Accompanying drawing explanation

By combining accompanying drawing with reference to the following description of the embodiment of the present invention, the features and advantages of the present invention and Acquisition methods will become apparent from, and is better understood invention itself, in the accompanying drawings:

Fig. 1 is surgical stapling and the front, left perspective view cutting off apparatus, and wherein handle portions includes that connecting rod triggers Automatic retracted mechanism and ratchet manual retrieving mechanism；

Fig. 2 is surgical stapling and the right rear view of cut-out apparatus, a wherein part for slender axles of Fig. 1 Cut and shank shell right half-shell is removed to expose automatic firing end traveling cam mechanism with manual Percussion cam mechanism；

Fig. 3 is that the surgical stapling of Fig. 1 and having an X-rayed after cutting off the right side of the handle portions of apparatus and slender axles is disassembled View；

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

Fig. 5 is the surgical stapling that the part of Fig. 1 is disassembled and the right rear view cutting off apparatus, wherein closes Mechanism closes and clamping, and gemmule pawl firing lock completes the first stroke, and wherein manual retrieving machine Structure is removed to expose the distal link of link-type tooth bar, and this distal link triggers automatically returning of firing lock Contracting；

Fig. 6 is under the original state that end effector is opened and anti-inversion organization is engaged, the portion of Fig. 4 The surgical stapling that partition solves and the left side elevation view cutting off apparatus；

Fig. 7 is that immediately distal link has activated and locked forward anti-reversing trip lever to allow link-type After tooth bar retraction, the surgical stapling disassembled of Fig. 1 and thin portion, the left side front view of cut-out apparatus；

Fig. 8 be Fig. 1 surgical stapling and cut off the free pulley of manual retrieving mechanism of apparatus and backgear with And the right side of manual retrieving lever and ratchet pawl disassembles perspective view；

Fig. 9 is the surgical stapling of Fig. 1 and cuts off the left side elevation view that the part of apparatus is disassembled, the most anti-down Rotation mechanism was bonded to before activating the manual retrieving lever of Fig. 8 disconnect even from combination stretching/compressing spring The link-type tooth bar fired completely connect；

Figure 10 is the surgical stapling of Fig. 9 and cuts off the left side elevation view that the part of apparatus is disassembled, Qi Zhongfang The reversing hidden parts of trip lever, backgear and manual percussion trip lever are shown in phantom；

Figure 11 is after the actuating of manually percussion trip lever has made link-type tooth bar manual retrieving, figure The left side elevation view that the part of the surgical stapling of 10 and cut-out apparatus is disassembled；

Figure 12 is the surgical stapling of Figure 11 and cuts off the left side elevation view that the part of apparatus is disassembled, Qi Zhonglian Rod-type tooth bar is omitted, with depict depart from anti-inversion organization manually fire trip lever；

Figure 13 is the right side elevation view of the anti-reversing relieving mechanism of alternative, and wherein link-type tooth bar is in back Condensing and put, and anti-reversing trip lever is proximally positioned, the most anti-down flap is joined to trigger shaft；

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

Figure 15 is to make automatic retracted cam distad slide and lock anti-reversing to release at another percussion stroke Put lever, thus the right side elevation view of the automatic releasing mechanism after departing from anti-inversion organization；

Figure 16 is the front, left perspective view that assembly used by the nail opened, the right half part of the most replaceable nail bin It is included in nail passage；

Figure 17 is that group used by the nail of the Figure 16 with complete replaceable nail bin and non-joint connecting shaft configuration The decomposition diagram of part；

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

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

Figure 20 is the perspective view that the wedge-shaped slides of the nail bin of assembly used by nail；

Figure 21 is to use, along the nail of Figure 16, the left side that the centrage 21-21 of assembly intercepts in longitudinal cross-section Side front view；

Figure 22 is that the nail opened of Figure 16 not having replaceable nail bin and the distal part of not following closely passage is executed With the perspective view of assembly；

Figure 23 is to use, along the nail of Figure 16, the anterior elevational view that the line 23-23 of assembly intercepts in cross-section, Figure depicts the inside staple drivers of nail bin and two cuttves and a part for trigger shaft；

Figure 24 is that the nail of the Guan Bi substantially along Figure 16 uses the longitudinal axis 24-24 intercepting of assembly to include Between two center contact point between cutter and wedge-shaped slides but also lateral shift with in display nail bin Nail and the left side elevation view of staple drivers；

Figure 25 is thin portion, the left side front view that assembly used by the nail of Figure 24, and wherein two cuttves are than replacing nail bin Time typical case bounce back the most more；

Figure 26 corresponds to describe in Figure 24 the nail of Figure 25 of configuration and uses the thin portion, left side of assembly and face Figure, wherein two cuttves start percussion；

Figure 27 is that assembly used by the nail of the Guan Bi of Figure 24 after two cuttves and trigger shaft the most distad fire Left side cross-section front view；

Figure 28 is that the left side of assembly used by the nail of the Guan Bi of Figure 27 after nail bin percussion and two cutter retractions Cross-section front view；

Figure 29 is the left side cross-sectional details front view that assembly used by the nail of Figure 28, and wherein two cuttves are allowed to Fall into locked position of coupler；

Figure 29 A is that the local of the jaw of the end effector assembly of the various embodiments according to the disclosure is saturating View, the most various elements all remove from jaw, are depicted at the percussion group of non-firing position in figure Part, and also depict the sliding part that the release stop part with actuator engages；

Figure 29 B is the fragmentary, perspective view of the jaw of Figure 29 A, and the most various elements all remove from jaw, Figure is depicted at the percussion assembly of part firing position, and also only depicts the release with actuator The sliding part that block piece departs from；

Figure 30 is the perspective view of the surgery suturing appliance including axle and reseasable tip executor；

Figure 31 is axle and the fragmentary, perspective view of end effector of the surgery suturing appliance of Figure 30；

Figure 32 is the partial perspective of the end effector of the axle of the surgery suturing appliance being just assembled into Figure 30 Figure；

Figure 33 is that another local of the end effector of the axle of the surgery suturing appliance being just assembled into Figure 30 is saturating View；

Figure 34 is the partial cutaway of the end effector of the axle illustrating the surgery suturing appliance being not coupled to Figure 30 Face front view；

Figure 35 is the part section of the end effector of the axle illustrating the surgery suturing appliance being connected to Figure 30 Front view, and also show and be in the slip lining ring opening unlocked position；

Figure 36 is the part section of the end effector of the axle illustrating the surgery suturing appliance being connected to Figure 30 Front view, and also show the slip lining ring being in closed locked position；

Figure 37 is the exploded view of the end effector of Figure 30, the shape that this end effector is removed with parts State illustrates；

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

Figure 39 is nail bin and the longitudinal sectional drawing of anvil block in the close position, and nail bin includes rigid support Part and compressible tissue thickness compensating part, it is shown that nail never firing position during First ray is transported Move firing position；

Figure 40 is anvil block and another profile of nail bin of Figure 39, it is shown that after completing percussion sequence Anvil block in an open position；

Figure 41 is the local detail drawing of the nail bin of Figure 39, it is shown that be in the nail of non-firing position；

Figure 42 is the cross-section front view of nail bin, and this nail bin includes rigid support part and compressible tissue Thickness compensation part, it is shown that be in the nail of non-firing position；

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

Figure 44 is nail bin and the front view of anvil block in an open position, and this nail bin includes rigid support portion Divide and compressible tissue thickness compensating part, it is shown that be in the nail of non-firing position；

Figure 45 is nail bin and the front view of anvil block in the close position, and this nail bin includes rigid support portion Divide and compressible tissue thickness compensating part, it is shown that be in the nail of non-firing position and be trapped in anvil Tissue between seat and tissue thickness's compensating part；

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

Figure 47 is anvil block and the front view of nail bin of Figure 45, it is shown that be positioned between anvil block and nail bin There is the tissue of different-thickness；

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

Figure 49 is to illustrate the tissue thickness compensating the different tissues thickness being trapped in different nail The schematic diagram of compensating part；

Figure 50 is to illustrate the tissue thickness to being applied compression stress by one or more blood vessel that staple line is crosscutting The schematic diagram of compensating part；

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

Figure 52 is to illustrate the thick tissue and the schematic diagram of tissue thickness's compensating part being trapped in nail；

Figure 53 is to illustrate the thin tissue being trapped in nail and the schematic diagram of tissue thickness's compensating part；

Figure 54 is to illustrate the tissue thickness's compensating part being trapped in nail and the tissue with interior thickness Schematic diagram；

Figure 55 is the part section of the end effector of the surgery suturing appliance according at least one embodiment Figure；

Figure 56 is the part sectioned view of the end effector according at least one embodiment selected else；

Figure 57 is the part sectioned view of the end effector according to another embodiment selected else；

Figure 58 is the part sectioned view of the end effector being shown in deflected；

Figure 59 is the part sectioned view of the end effector of the Figure 58 being in release conditions；

Figure 60 is the profile perspective of nail bin, and this nail bin includes being configured to tissue thickness to be compensated What part remained to support section laterally retains component；

Figure 61 is the profile being just used to sew up the nail bin of Figure 60 of tissue；

Figure 62 is the perspective view of nail bin, and this nail bin includes warehouse and to fire attachment members attached by multiple Receive tissue thickness's compensating part of warehouse；

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

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

Figure 65 is the profile of the nail bin of Figure 62 of the taken along line along Figure 64, it is shown that be in The fired attachment members of non-firing position；

Figure 66 is the profile of the nail bin of Figure 62 of the taken along line along Figure 64, it is shown that be in The fired attachment members of the firing position disconnected；

Figure 67 is the perspective view of tissue thickness's compensating part；

Figure 68 is the perspective view of tissue thickness's compensating part of the Figure 167 being just assembled into nail bin；

Figure 69 is tissue thickness's compensating part and the exploded view of nail bin of Figure 68；

Figure 70 is the detail drawing of the proximal end of tissue thickness's compensating part；

Figure 71 is the partial elevation view of tissue thickness's compensating part of the Figure 70 being assembled into nail bin；

Figure 72 is tissue thickness's compensating part and the plane graph of nail bin of Figure 71；

Figure 73 is the front view of the installed part for tissue thickness's compensating part remains to nail bin；

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

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

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

Figure 77 is the part sectioned view of nail bin, and this nail bin includes being configured to tissue thickness to be compensated Part releasably holds the retaining pin of nail bin warehouse；

Figure 77 A is the perspective cutaway view of the nail bin of Figure 77, and wherein a part for this nail bin is because of diagram Purpose and be removed；

Figure 78 is the part sectioned view of the nail bin of Figure 77, it is shown that be in the retaining pin of revocation status；

Figure 79 is the perspective cutaway view of the nail bin of Figure 77, is also shown for being in the holding of revocation status Pin；

Figure 80 is the part sectioned view of nail bin, and this nail bin includes being configured to tissue thickness to be compensated Part releasably holds the clamp of warehouse, it is shown that be in the clamp of closure state；

Figure 81 is the part sectioned view of the nail bin of Figure 80, it is shown that be in the clamp of open mode；

Figure 81 A is to be disposed with layer such as tissue thickness's compensating part and/or the nail bin of buttress material on it Perspective view, wherein the cutting blade of this nail bin opposed end executor is arranged, and its end effector Remainder because diagram purpose and be removed；

Figure 82 is the profile view of the nail bin of Figure 81 A, it is shown that be arranged in nail bin distally for cut-out The cutting blade of the distal end of the layer in chamber, wherein cutting blade is not disposed, and for clarity will Nail therein omits；

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

Figure 84 is the perspective view of the jaw of the end effector assembly of the various embodiments according to the disclosure, Depict the tissue thickness's compensating part being fixed to warehouse by proximal connector and distal connector, and also It is depicted at the percussion assembly of non-firing position；

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

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

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

Figure 85 D is the front view of the jaw of Figure 84, is depicted at the actuator of actuated position, and Further depict proximal connector and the distal connector of disconnection；

Figure 86 is the partial elevation view of the jaw of Figure 84, and the most various elements all remove from jaw, describes The sliding part engaged with the tab of the actuator of Figure 85 A in warehouse；

Figure 87 is the partial elevation view of the jaw of Figure 84, and the most various elements all remove from jaw, describes The sliding part departed from from the tab of actuator in warehouse；

Figure 87 A is that the local of the jaw of the end effector assembly of the various embodiments according to the disclosure is put down Face figure, depicts the percussion assembly trigger shaft against the release stop part of actuator；

Figure 87 B is the partial plan layout of the jaw of Figure 87 A, depicts in percussion assembly and extends through cause The trigger shaft of the release stop part of dynamic device；

Figure 88 is the perspective view of the jaw of the end effector assembly of the various embodiments according to the disclosure, Depict the tissue thickness's compensating part being fixed to warehouse, and also be depicted at the percussion of non-firing position Assembly；

Figure 89 is the partial elevation view of the jaw of Figure 88, and the most various elements show in a transparent manner, Depict the actuator extending through jaw, and also be depicted at the percussion assembly of non-firing position；

Figure 90 is the part sectioned view of nail bin, and this nail bin includes being configured to tissue thickness to be compensated Part releasably holds the retaining pin of warehouse, it is shown that the retaining pin being active；

Figure 91 is the part sectioned view of the nail bin of Figure 90, it is shown that be in the retaining pin of dead status；

Figure 92 is the perspective view of the actuator of the nail bin of Figure 90, and this actuator is configured to make holding It is invalid to sell；

Figure 93 A is the fastener cartridge assembly of the end effector assembly of the various embodiments according to the disclosure Perspective view, depict the tissue thickness's compensating part discharged from the warehouse of fastener cartridge assembly；

Figure 93 B is the perspective view of the fastener cartridge assembly of Figure 93 A, depicts and is fixed to nail bin groupware Tissue thickness's compensating part of warehouse；

Figure 93 C is the front view of the fastener cartridge assembly of Figure 93 A, and the most various elements are all from securing member Storehouse assembly removal, is depicted at the percussion assembly of pre-firing position；

Figure 93 D is the front view of the fastener cartridge assembly of Figure 93 A, and the most various elements are all from securing member Storehouse assembly removal, is depicted at the percussion assembly of part firing position；

Figure 94 is the fastener cartridge assembly of the end effector assembly of the various embodiments according to the disclosure Fragmentary, perspective view, depicts the tissue thickness's compensating part discharged from the warehouse of fastener cartridge assembly；

Figure 95 is the fastener cartridge assembly of the end effector assembly of the various embodiments according to the disclosure Fragmentary, perspective view, depicts the tissue thickness's compensating part discharged from the warehouse of fastener cartridge assembly；

Figure 96 is the part sectioned view of the fastener cartridge assembly of Figure 95, depicts the bridge joint being maintained at warehouse The installed part of the tissue thickness's compensating part in part；

Figure 97 is the fastener cartridge assembly of the end effector assembly of the various embodiments according to the disclosure Perspective view, depicts the tissue thickness's compensating part discharged from the warehouse of fastener cartridge assembly；

Figure 98 is the perspective view of the fastener cartridge assembly of Figure 97, depicts and is fixed to fastener cartridge assembly Tissue thickness's compensating part of warehouse；

Figure 99 is the cross-section front view of the end effector assembly of Figure 97, depicts and is fixed to fastener cartridge Tissue thickness's compensating part of the warehouse of assembly, and also it is depicted at the end execution of unclamped position Device；

Figure 100 is the cross-section front view of the end effector assembly of Figure 97, depicts and is not attached to fastening Tissue thickness's compensating part of the warehouse of part storehouse assembly, and also it is depicted at the end execution of clamped position Device assembly；

Figure 101 is the perspective view of nail bin application device assembly, and this nail bin application device assembly includes upper group Knitting thickness compensation part and nail bin, this top tissue thickness compensation part includes the multiple holding features extended from it Structure, this nail bin includes bottom tissue thickness compensating part；

The nail bin application device assembly of Figure 101 that Figure 102 is located in staple cartridge channel and just at this nail bin The front view of the anvil block of Guan Bi on application device assembly；

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

Figure 104 is located at top tissue thickness compensation part and the bottom tissue thickness compensating part of Figure 101 The profile of middle tissue；

Figure 105 be the top tissue thickness compensation part that illustrates and be sewn onto tissue cut cutting of members and under The profile of tissue thickness of portion compensating part；

Figure 106 is the perspective view of the nail bin application device assembly according at least one embodiment, and this nail bin is executed The top tissue thickness compensation part being configured to be attached to anvil block is included with device assembly；

The nail bin application device assembly of Figure 106 that Figure 106 A is located in staple cartridge channel and just towards upper The front view of the anvil block of tissue thickness of portion compensating part motion；

Figure 106 B is shown in after top tissue thickness compensation part engages with anvil block, just performs from end The nail bin application device of Figure 106 that device removes；

Figure 107 is that the section end of the anvil block just moved towards the top tissue thickness compensation part of Figure 106 regards Figure；

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

Figure 109 is the perspective view of the nail bin of a non-limiting example according to the present invention, a piece of support Thing material releasably holds this nail bin；

Figure 110 is nail bin and the decomposition diagram of buttress material sheet of Figure 109, wherein buttress material Sheet includes the multiple components extended from it；

Figure 111 is the profile that line 111-111 along Figure 109 intercepts, it is shown that with according to the present invention The component of Figure 110 that engages of the nail chamber of a non-limiting example；

Figure 112 is the profile of a piece of buttress material, and this sheet buttress material includes and according to the present invention A non-limiting example nail bin nail chamber engage component；

Figure 113 is the exploded view of Figure 112, it is shown that with a non-limiting example according to the present invention The separate component in nail chamber of nail bin；

Figure 114 is the fragmentary, perspective view of the support section of nail bin, and this nail bin includes detachable and/or can replace The nail lower limb guide changed；

Figure 115 is the part sectioned view of the nail bin of Figure 114, it is shown that the nail just disposed from nail bin；

Figure 116 is after nail bin is by percussion, the detail drawing of the profile of Figure 114；

Figure 117 is the warehouse of various embodiments according to the disclosure, shell and the office of tissue thickness's compensating part Portion's perspective view, depicts the protuberance extended from warehouse；

Figure 118 is the warehouse of various embodiments according to the disclosure, shell and the office of tissue thickness's compensating part Portion's perspective view, depicts the protuberance extended from shell；

Figure 119 is the part sectioned view of the end effector assembly of the various embodiments according to the disclosure, retouches Paint the nail in the nail chamber of the warehouse being positioned at end effector assembly, and also be depicted at unshaped The nail of configuration；

Figure 120 is the part sectioned view of the end effector assembly of Figure 119, depicts from the injection of nail chamber Nail, and also it is depicted at the nail of shaped configuration；

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

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

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

Figure 124 is nail and the perspective view of lock of Figure 121, depicts and is in firing position in nail chamber Lock, and also it is depicted at the lock of unlocked configurations；

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

Figure 112 6 is the profile of the lock of Figure 125, is depicted at the lock of unlocked configurations and does not fixes Adapter to this lock；

Figure 126 A is the part sectioned view of the fastener cartridge assembly of Figure 125, depicts warehouse, connection Device, tissue thickness's compensating part and be in the lock of part assembling position；

Figure 127 is the part sectioned view of the fastener cartridge assembly of Figure 125, is depicted at locked configuration Lock, is depicted at the anvil block of clamped position, and is depicted at the driver key of non-firing position；

Figure 128 is the part sectioned view of the fastener cartridge assembly of Figure 125, is depicted at locked configuration Lock, is depicted at the anvil block of clamped position, and also is depicted at the driver of part firing position Key；

Figure 129 is the part sectioned view of the fastener cartridge assembly of Figure 125, is depicted at unlocked configurations Lock, be depicted at the anvil block of clamped position, further depict the driver key being in firing position；

Figure 130 is the profile of end effector, it is shown that be in the firing member of part firing position；

Figure 131 is the profile of the end effector of Figure 130, it is shown that the tissue just implanted away from part The support section of thickness compensation part motion；

Figure 132 is the nail bin of the staple drivers including having differing heights according at least one embodiment Partial sectional view；

Figure 133 is the staple drivers illustrating Figure 132 and having of being supported on Bu Tong does not fires height The schematic diagram of nail；

Figure 134 is the nail bin including tissue thickness's compensating part and support section according at least one embodiment Profile；

Figure 135 is the part section of tissue thickness's compensating part, nail guide layer and the nail being in non-firing position Figure；

Figure 136 is the tissue thickness's compensating part according at least one embodiment selected else, nail guide layer and place Part sectioned view in the nail of non-firing position；

Figure 137 is the tissue thickness's compensating part according at least one embodiment selected else, nail guide layer and place Part sectioned view in the nail of non-firing position；

Figure 138 is the tissue thickness's compensating part according at least one embodiment selected else, nail guide layer and place Part sectioned view in the nail of non-firing position；

Figure 139 is the tissue thickness's compensating part according at least one embodiment selected else, nail guide layer and place Part sectioned view in the nail of non-firing position；

Figure 140 is the tissue thickness's compensating part according at least one embodiment selected else, nail guide layer and place Part sectioned view in the nail of non-firing position；

Figure 141 is the tissue thickness's compensating part according at least one embodiment selected else, nail guide layer and place Part sectioned view in the nail of non-firing position；

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

Figure 143 is the tissue thickness's compensating part according at least one embodiment selected else, nail guide layer and place Part sectioned view in the nail of non-firing position；

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

Figure 145 is the tissue thickness's compensating part according at least one embodiment selected else, nail guide layer and place Part sectioned view in the nail of non-firing position；

Figure 146 is the nail guide layer according at least one embodiment selected else and to be in non-firing position many The perspective view of individual nail；

Figure 147 is the exploded view of tissue thickness's compensating part and staple cartridge body；

Figure 148 is the front view of disposable loading unit, and this disposable loading unit includes being configured to Enough support the pivotable jaw of nail bin；

Tissue thickness's compensating part application device that Figure 149 is located in the executor of disposable loading unit Perspective view；

Figure 150 is the top perspective of tissue thickness's compensating part application device of Figure 149；

Figure 151 is the bottom perspective view of tissue thickness's compensating part application device of Figure 149；

Figure 152 is the profile of the end effector of the surgery suturing appliance according at least one embodiment, This surgery suturing appliance includes having differing heights and the staple drivers of wavy platform surface；

Figure 153 is the profile of the end effector of the surgery suturing appliance according at least one embodiment, This surgery suturing appliance includes having differing heights and the staple drivers of staged platform surface；

Figure 154 is the tissue thickness's compensating part illustrating and including variable thickness, the nail driving with differing heights Device and there is the schematic diagram of nail of different unshaped height；

Figure 155 is nail and the schematic diagram of tissue thickness's compensating part of the Figure 154 illustrating and being implanted to tissue；

Figure 156 is attached to the part sectioned view of tissue thickness's compensating part of staple cartridge body；

Figure 157 is tissue thickness's compensating part and the part sectioned view of staple cartridge body of Figure 156；

Figure 158 is the partial exploded view of tissue thickness's compensating part of Figure 156；

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

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

Figure 161 is the bottom view of nail bin；

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

Figure 163 is the exploded view of nail bin, it is shown that staple drivers is arranged；

Figure 164 is attached to nail bin and has layer (such as tissue thickness in keeper and nail bin intermediate arrangement Compensating part) the perspective view of an embodiment of keeper, wherein keeper, layer and nail bin are relative to surgery Stiching instrument is arranged, and wherein staple cartridge channel is removed because of diagram purpose；

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

Figure 166 is the plane graph of the keeper of Figure 164, layer and nail bin；

Figure 167 is the profile of the keeper of Figure 164, layer and nail bin, and the top wherein followed closely is from nail bin Nail chamber extend and extend in layer；

Figure 168 is to maintain the perspective view of an embodiment of device, and wherein this keeper includes movable cam Part and lock tabs；

Figure 169 is attached to the perspective view of the keeper of Figure 168 of nail bin, and wherein nail bin and keeper are fixed Position becomes in the staple cartridge channel of the end effector inserting surgical stapling device；

Figure 170 is to be positioned to insert but is not fully inserted in the storehouse passage of the end effector of surgical stapling device The plane graph of keeper of Figure 168；

Figure 171 is to be positioned to insert but the holding of Figure 168 that is not fully inserted in the staple cartridge channel of Figure 170 The section end view of device；

Figure 172 is the plane graph of the keeper of the Figure 168 in the staple cartridge channel of fully-inserted Figure 170；

Figure 173 is that the section end of the keeper of the Figure 168 in the staple cartridge channel of fully-inserted Figure 170 regards Figure, wherein this keeper is in released state and is just removing from nail bin；

Figure 174 is the plane graph of the end effector insert according at least one embodiment；

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

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

Figure 177 is the fragmentary, perspective view of the end effector insert of Figure 174, depicts outside engaging The end effector insert of the anvil block of the end effector of section's apparatus；

Figure 178 is the fragmentary, perspective view of the end effector insert of Figure 174, depicts outside engaging The end effector insert of the nail bin of the end effector of section's apparatus；

Figure 179 is the front view of the end effector insert of Figure 174, depicts just at fusion surgery device The end effector insert of the end effector of tool；

The end effector insert of Figure 174 that Figure 180 is located in the end effector of surgical instruments Front view；

Figure 181 is the fragmentary, perspective view of an embodiment of nail bin groupware, and this nail bin groupware includes nail bin layer The layer that the anvil block positioned with relative nail bin can be attached；

Figure 182 is the fragmentary, perspective view of the nail bin groupware of Figure 181, and the layer that wherein anvil block can be attached is fastened To nail bin；

Figure 183 is the fragmentary, perspective view of an embodiment of nail bin groupware, and this nail bin groupware includes nail bin layer The layer that the anvil block positioned with relative nail bin can be attached, wherein the proximal part of the layer that anvil block can be attached is by viscous Mixture or be attached to the attachment features structure of nail bin by welding, and the one of the layer that wherein anvil block can be attached Part is illustrated as transparent because of diagram purpose；

Figure 184 is the fragmentary, perspective view of the nail bin groupware of Figure 183, wherein the near-end of the layer that anvil block can be attached The turning of part is illustrated as separating with nail bin and from nail bin lift-off；

Figure 185 is the fragmentary, perspective view of an embodiment of nail bin groupware, and this nail bin groupware includes nail bin layer The layer that the anvil block positioned with relative nail bin can be attached, the layer that wherein anvil block can be attached is attached to nail bin layer；

Figure 186 is the nail bin layer of Figure 185 and is attached to the thin portion of the layer that the anvil block of this nail bin layer can be attached Figure；

Figure 187 is the partial plan layout of the layer embodiment that anvil block can be attached；

Figure 188 is the partial plan layout being just cut the layer that the anvil block of Figure 187 of blade cutting can be attached；

Figure 189 is the plane graph of the tissue compensating part of the sleeve according at least one embodiment；

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

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

Figure 192 is the perspective view of tissue thickness's compensating part；

Figure 193 is attached to the perspective view of tissue thickness's compensating part of Figure 192 of nail bin；

Figure 194 is the another of the most overlapping Figure 192 of tissue thickness's compensating part with Figure 192 The detail drawing of one tissue thickness's compensating part；

Figure 195 is the perspective view of the nail bin being attached with tissue thickness's compensating part on it；

Figure 196 is the another of the most overlapping Figure 195 of tissue thickness's compensating part with Figure 195 The detail drawing of one tissue thickness's compensating part；

Figure 197 is the exploded view of the nail bin including tissue thickness's compensating part, and this tissue thickness's compensating part includes Multiple layers；

Figure 198 is the tissue thickness's compensating part being shown on the side of patient tissue the Figure 197 implanted Section signal with another tissue thickness's compensating part of the Figure 197 implanted on the opposite side of this tissue Figure；

Figure 199 is the decomposition diagram of the end effector of the suture instruments according to various embodiments, this end Portion executor includes nail bin and tissue thickness's compensating part；

Figure 200 is the profile of Figure 199 tissue thickness compensating part according to various embodiments；

Figure 20 1 is the top view of the tissue thickness's compensating part according to various embodiments, and this tissue thickness compensates Part includes multiple circular piece；

Figure 20 2 is the top view of the tissue thickness's compensating part according to various embodiments, and this tissue thickness compensates Part includes multiple circular piece；

Figure 20 2A is the profile of the tissue thickness's compensating part according to various embodiments；

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

Figure 20 4 is the top view of the tissue thickness's compensating part according to various embodiments, and this tissue thickness compensates Part includes multiple hexagon sheet；

Figure 20 5 is the top view of tissue thickness's compensating part of the fastening according to various embodiments, this fastening Tissue thickness's compensating part includes multiple；

Figure 20 6 is the top view of the tissue thickness's compensating part according to various embodiments, and this tissue thickness compensates Part includes multiple slit；

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

Figure 20 7B is the layer between nail bin and anvil block of the capture according at least one embodiment and tissue T Profile；

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

Figure 20 8 is the profile of the layer in Figure 27 0C；

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

Figure 21 0 is the profile of the layer in Figure 20 9；

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

Figure 21 2 is the profile of the layer in Figure 21 1；

Figure 21 3 is the perspective view including layer that wire caves in according at least one embodiment；

Figure 21 4 is the profile of the layer in Figure 21 3；

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

Figure 21 6 is the profile of the layer in Figure 21 5；

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

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

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

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

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

Figure 22 2 is the profile of the layer in Figure 22 1；

Figure 22 3 is the perspective view of the layer including depression according at least one embodiment；

Figure 22 4 is the profile of the layer in Figure 22 3；

Figure 22 4A is that the layer including reduced thickness portions according at least one embodiment is including with capture Multiple nails shape the profile of the tissue T between anvil block and the nail bin of pit；

Figure 22 4B be the layer including multiple projection according at least one embodiment and capture include multiple Nail shapes the profile of the tissue T between anvil block and the nail bin of pit；

Figure 22 5 is the layer of the anvil block being fixed to surgical end effectors according at least one embodiment The perspective section view of (such as tissue thickness's compensating part)；

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

Figure 22 7 is the profile of the layer of Figure 22 5；

Figure 22 8 is the perspective view of the keeper embodiment being used together with nail bin；

Figure 22 9 is the nail bin group of the keeper of the Figure 22 8 including that the layer can being attached with nail bin and anvil block engages The perspective view of part；

Figure 23 0 is the plane graph of the nail bin groupware of Figure 22 9；

Figure 23 1 is the section end view of the nail bin groupware of Figure 22 9, and wherein nail bin groupware inserts end execution In the staple cartridge channel of device, and the anvil block of end effector positions relative to nail bin groupware；

Figure 23 2 is nail bin groupware shown in Figure 23 1 and the section end view of end effector, wherein anvil block It is located against layer and keeper pressing that anvil block can be attached；

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

Figure 23 4 is the profile view of end effector shown in Figure 23 1, the layer that wherein anvil block can be attached It is attached to anvil block and keeper removes；

Figure 23 5 is the perspective view of the layer embodiment that the anvil block according at least one embodiment can be attached；

Figure 23 6 is the perspective view of the layer embodiment that the anvil block according at least one embodiment can be attached；

Figure 23 7 is the perspective view of the layer embodiment that the anvil block according at least one embodiment can be attached；

Figure 23 8 is the perspective view of the layer embodiment that the anvil block having and can disposing attachment features structure can be attached, Wherein can dispose attachment features structure to be in and do not dispose configuration；

Figure 23 9 is the perspective view of the layer that the anvil block of Figure 23 8 can be attached, and wherein can dispose attachment features structure Illustrate with deployment configuration；

Figure 24 0 is the section of the layer that the anvil block of Figure 23 8 of the anvil block location of opposed end executor can be attached Plane graph, wherein can dispose attachment features structure and be deployed in the slit of anvil block；

Figure 24 1 is the perspective view of the layer embodiment that the anvil block having and can disposing attachment features structure can be attached, Wherein can dispose attachment features structure to be in and do not dispose configuration；

Figure 24 2 is the perspective view of the layer that the anvil block of Figure 24 1 can be attached, and wherein can dispose attachment features structure Illustrate with deployment configuration；

Figure 24 3 is the section of the layer that the anvil block of Figure 24 1 of the anvil block location of opposed end executor can be attached Plane graph, wherein can dispose attachment features structure and be deployed in the slit of anvil block；

Figure 24 4 is the anvil block according at least one embodiment and the decomposition diagram of tissue thickness's compensating part；

Layer (the such as tissue thickness that Figure 24 5 is the anvil block according at least one embodiment and anvil block can be attached Compensating part) profile view, this anvil block include multiple nail shape pit, the layer bag that this anvil block can be attached Include and shape multiple capsules that pit aligns；

Figure 24 6 is the detail drawing of the capsule of the layer that the anvil block of Figure 24 5 can be attached；

The signal of the layer that Figure 24 7 is the anvil block of the Figure 24 5 illustrating that relative organization positions and anvil block can be attached Figure, this tissue will be closed by the stapling from the nail bin being positioned on tissue opposite side；

Figure 24 8 is to illustrate Figure 24 5 anvil block of the nail bin motion towards Figure 24 7 and fire from this nail bin part The schematic diagram of nail；

Figure 24 9 is the profile of the layer embodiment that the anvil block that relative anvil block and patient tissue are arranged can be attached, Wherein the nail of nail bin is fired the layer and patient tissue can being attached through this anvil block；

Figure 25 0 is the profile of layer embodiment that the anvil block of relative anvil block and patient tissue location can be attached, Wherein the nail of nail bin is fired the layer and patient tissue can being attached through this anvil block；

Figure 25 1 illustrates the keeper assembly being just inserted in surgical instruments, and wherein this surgical instruments includes anvil Seat and staple cartridge channel, and wherein insert the part of instrument and be removed because diagram purpose；

Figure 25 2 illustrates the keeper assembly of the Figure 25 1 being just inserted in surgical instruments, wherein inserts instrument A part because diagram purpose and be removed；

Figure 25 3 illustrates the insertion instrument of Figure 25 1, and this insertion instrument just moves relative to keeper with jointing nail Nail bin in the passage of storehouse also engages the layer that the anvil block with anvil block can be attached (such as tissue thickness compensates Part), wherein a part for this insertion instrument is removed because of diagram purpose；

Figure 25 4 illustrate just relative to keeper motion so that the layer that can be attached from anvil block of keeper and nail bin depart from The insertion instrument of Figure 25 1, wherein a part for this insertion instrument is removed because diagram purpose；

Figure 25 5 is the perspective view of the keeper embodiment engaged with nail bin, wherein has and can dispose attachment spy Levy the layer that the anvil block of structure can be attached to engage with keeper, and wherein keeper is oriented to insert end In executor；

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

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

Figure 25 8 is to insert the layer that the keeper of Figure 25 5, nail bin and anvil block in end effector can be attached Front view, the attachment features the disposed structure of the layer that wherein anvil block can be attached is disposed, and wherein anvil A part for the layer that seat and anvil block can be attached is removed because of diagram purpose；

Figure 25 9 is the front view inserting the keeper embodiment in end effector, wherein has and can dispose The layer that the anvil block of attachment features structure can be attached is arranged on keeper, and wherein keeper, anvil block can The layer of attachment and a part for anvil block are removed because of diagram purpose；

Figure 26 0 is the front view of the keeper of Figure 25 9, the layer that wherein anvil block can be attached by keeper Attachment features structure can be disposed dispose, and layer that wherein keeper, anvil block can be attached and one of anvil block Divide and be removed because diagram purpose；

Figure 26 1 is the keeper of Figure 25 9, anvil block can be attached layer and the thin portion front view of anvil block, wherein Attachment features structure can be disposed not yet dispose, and layer that wherein keeper, anvil block can be attached and anvil block Part is removed because of diagram purpose；

Figure 26 2 is the keeper of Figure 25 9, anvil block can be attached layer and the thin portion front view of anvil block, wherein Attachment features structure can be disposed be deployed in the slit of anvil block, and wherein keeper, anvil block can be attached Layer and anvil block part because diagram purpose and be removed；

Figure 26 3 illustrates the tissue thickness including flowable attachment part according to some non-limiting example Compensating part；

Figure 26 4 illustrates that the nothing that is in alignd with the slit in nail bin according to some non-limiting example should The contact adhesive lamilated body of power position；

Figure 26 5 illustrates the Figure 26's 4 being releasably attached to nail bin according to some non-limiting example Contact adhesive lamilated body；

Figure 26 6 illustrates the tissue thickness including flowable attachment part according to some non-limiting example Compensating part；

Figure 26 7 illustrates being in without answering with what alignd in the nail chamber in nail bin according to some non-limiting example The contact adhesive lamilated body of power position；

Figure 26 8 illustrates the Figure 26's 7 being releasably attached to nail bin according to some non-limiting example Contact adhesive lamilated body；

Figure 26 9 to Figure 27 3 illustrates and includes the pressure-sensitive of binding agent tab according to some non-limiting example Adhesive phase is fit；

Figure 27 4 to Figure 27 9 illustrates and includes the pressure-sensitive of binding agent tab according to some non-limiting example Adhesive phase is fit；

Figure 28 0 to Figure 28 3 illustrate according to some non-limiting example include be attached for releasedly Contact adhesive lamilated body to the tab of anvil block；

Figure 28 4 to Figure 28 8 illustrates the use application device according to some non-limiting example releasedly It is attached to the contact adhesive lamilated body of anvil block；

Figure 28 9 to Figure 29 2 illustrates the anvil block that is releasably attached to according to some non-limiting example Contact adhesive lamilated body；

Figure 29 3 is the perspective view of the end effector of surgery suturing appliance, and this end effector includes from anvil The implantable transition portion that seat extends and the implantable transition portion from nail bin extension；

Figure 29 4 is the tissue between anvil block and the nail bin of the surgery suturing appliance that description is positioned at Figure 29 3 Schematic diagram.

In multiple views, the parts that corresponding reference marks instruction is corresponding.Example shown herein as is with one The form of kind shows certain embodiments of the present invention, and should be interpreted as by any way by this type of example Limit the scope of the present invention.

Detailed description of the invention

Present applicant also has the U.S. Patent application of following qualification, and these U.S. Patent applications are every The individual this paper that is the most each integrally incorporated:

Entitled " SURGICAL INSTRUMENTS WITH RECONFIGURABLE SHAFT SEGMENTS " U.S. Patent Application Serial Number 12/894,311 (be now that United States Patent (USP) is public Cloth 2012/0080496)；

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

Entitled " JAW CLOSURE ARRANGEMENTS FOR SURGICAL INSTRUMENTS " U.S. Patent Application Serial Number 12/894,327 (be now U.S. Patent Publication 2012/0080499)；

Entitled " SURGICAL CUTTING AND FASTENING INSTRUMENTS WITH SEPARATE AND DISTINCT FASTENER DEPLOYMENT AND TISSUE CUTTING SYSTEMS " U.S. Patent Application Serial Number 12/894,351 (existing for U.S. State's patent disclosure 2012/0080502)；

Entitled " IMPLANTABLE FASTENER CARTRIDGE HAVING A NON- UNIFORM ARRANGEMENT " U.S. Patent Application Serial Number 12/894,338 (existing for U.S. State's patent disclosure 2012/0080481)；

Entitled " IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER " U.S. Patent Application Serial Number 12/894,369 (be now United States Patent (USP) Announce 2012/0080344)；

Entitled " IMPLANTABLE FASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS " U.S. Patent Application Serial Number 12/894,312 (be now that United States Patent (USP) is public Cloth 2012/0080479)；

Entitled " SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE " U.S. Patent Application Serial Number 12/894,377 (be now U.S. Patent Publication 2012/0080334)；

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

Entitled " SURGICAL STAPLING INSTRUMENT WITH A VARIABLE STAPLE FORMING SYSTEM " U.S. Patent Application Serial Number 12/894,360 (existing for U.S. State's patent disclosure 2012/0080484)；

Entitled " SURGICAL STAPLING INSTRUMENT WITH INTERCHANGEABLE STAPLE CARTRIDGE ARRANGEMENTS " the U.S. special Profit patent application serial numbers 12/894,322 (being now U.S. Patent Publication 2012/0080501)；

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

Entitled " IMPLANTABLE FASTENER CARTRIDGE COMPRISING BIOABSORBABLE LAYERS " U.S. Patent Application Serial Number 12/894,383 (existing for U.S. State's patent disclosure 2012/0080345)；

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

Entitled " FASTENERS SUPPORTED BY A FASTENER CARTRIDGE SUPPORT " U.S. Patent Application Serial Number 12/894,345 (be now U.S. Patent Publication 2012/0080483)；

The U.S. Patent application sequence of entitled " COLLAPSIBLE FASTENER CARTRIDGE " Row number 12/894,306 (being now U.S. Patent Publication 2012/0080332)；

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

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

Entitled " FASTENER SYSTEM COMPRISING A RETENTION MATRIX " U.S. Patent Application Serial Number 12/894,361 (be now U.S. Patent Publication 2012/0080333)；

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

Entitled " FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND A COVER " U.S. Patent Application Serial Number 12/894,388 (be now U.S. Patent Publication 2012/0080487)；

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

Entitled " SURGICAL STAPLER ANVIL COMPRISING A PLURALITY OF FORMING POCKETS " U.S. Patent Application Serial Number 13/097,865 (be now that the U.S. is special Profit announces 2012/0080488)；

Entitled " TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER " U.S. Patent Application Serial Number 13/097,936 (be now U.S. Patent Publication 2012/0080339)；

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

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

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING DETACHABLE PORTIONS " U.S. Patent Application Serial Number 13/097,928 (be now the U.S. Patent disclosure 2012/0080490)；

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

Entitled " STAPLE CARTRIDGE COMPRISING AN ADJUSTABLE DISTAL PORTION " U.S. Patent Application Serial Number 13/097,948 (be now U.S. Patent Publication 2012/0083836)；

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

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

The United States Patent (USP) Shen of entitled " STAPLE CARTRIDGE LOADING ASSEMBLY " Please serial number 13/097,869 (being now U.S. Patent Publication 2012/0160721)；

Entitled " COMPRESSIBLE STAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS " U.S. Patent Application Serial Number 13/097,917 (be now that the U.S. is special Profit announces 2012/0083834)；

Entitled " STAPLE CARTRIDGE COMPRISING A RELEASABLE PORTION " U.S. Patent Application Serial Number 13/097,873 (be now U.S. Patent Publication 2012/0083833)；

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

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

The United States Patent (USP) of entitled " SURGICAL STAPLER WITH FLOATING ANVIL " Patent application serial numbers 13/242,029 (being now U.S. Patent Publication 2012/0080493)；

Entitled " CURVED END EFFECTOR FOR A STAPLING INSTRUMENT " U.S. Patent Application Serial Number 13/242,066 (be now U.S. Patent Publication 2012/0080498)；

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

Entitled " STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK ARRANGEMENT " U.S. Patent Application Serial Number 13/241,912；

Entitled " SURGICAL STAPLER WITH STATIONARY STAPLE DRIVERS " U.S. Patent Application Serial Number 13/241,922；

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

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

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

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF LAYERS " U.S. Patent Application Serial Number 13/433,103 (be now that the U.S. is special Profit announces 2012/0241498)；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A RESERVOIR " U.S. Patent Application Serial Number 13/433,098 (be now U.S. Patent Publication 2012/0241491)；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A RESERVOIR " U.S. Patent Application Serial Number 13/433,102 (be now U.S. Patent Publication 2012/0241497)；

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

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING AT LEAST ONE MEDICAMENT " U.S. Patent Application Serial Number 12/433,136 (existing for U.S. State's patent disclosure 2012/0241492)；

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

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

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

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING RESILIENT MEMBERS " U.S. Patent Application Serial Number 13/433,155 (be now United States Patent (USP) Announce 2012/0241502)；

Entitled " METHODS FOR FORMING TISSUE THICKNESS COMPENSATOR ARRANGEMENTS FOR SURGICAL STAPLERS " the U.S. Patent application serial number 13/433,163 (being now U.S. Patent Publication 2012/0248169)；

The U.S. Patent application sequence of entitled " TISSUE THICKNESS COMPENSATORS " Row number 13/433,167 (being now U.S. Patent Publication 2012/0241503)；

The U.S. of entitled " LAYERED TISSUE THICKNESS COMPENSATOR " is special Profit patent application serial numbers 13/433,175 (being now U.S. Patent Publication 2012/0253298)；

Entitled " TISSUE THICKNESS COMPENSATORS FOR CIRCULAR SURGICAL STAPLERS " U.S. Patent Application Serial Number 13/433,179 (be now United States Patent (USP) Announce 2012/0241505)；

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING CAPSULES DEFINING A LOW PRESSURE ENVIRONMENT " United States Patent (USP) Patent application serial numbers 13/433,115；

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

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

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

Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING CHANNELS " U.S. Patent Application Serial Number 13/433,147；

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

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

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

Present applicant also has the U.S. Patent application of following qualification, and these U.S. Patent applications are every The individual this paper that is the most each integrally incorporated:

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

Entitled " SURGICAL STAPLING DEVICE WITH ANVIL HAVING STAPLE FORMING POCKETS OF VARYING DEPTHS " U.S. Patent application sequence Row number 11/714,049 (being now U.S. Patent Publication 2007/0194082)；

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

Entitled " SURGICAL STAPLING DEVICE WITH STAPLE DRIVERS OF DIFFERENT HEIGHT " U.S. Patent Application Serial Number 11/711,975 (be now that United States Patent (USP) is public Cloth 2007/0194079)；

Entitled " SURGICAL STAPLING DEVICE WITH STAPLE DRIVER THAT SUPPORTS MULTIPLE WIRE DIAMETER STAPLES " United States Patent (USP) Shen Please serial number 11/711,977 (being now United States Patent (USP) 7,673,781)；

Entitled " SURGICAL STAPLING DEVICE WITH MULTIPLE STACKED ACTUATOR WEDGE CAMS FOR DRIVING STAPLE DRIVERS " the U.S. special Profit patent application serial numbers 11/712,315 (being now United States Patent (USP) 7,500,979)；

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

Entitled " SURGICAL STAPLING SYSTEMS THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS " U.S. Patent application sequence Row number 13/020,263 (being now U.S. Patent Publication 2011/0147434)；

Entitled " ROBOTICALLY-CONTROLLED SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS " U.S. Patent Application Serial Number 13/118,278 (be now U.S. Patent Publication 2011/0290851)；

Entitled " ROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS " U.S. Patent Application Serial Number 13/369,629 (be now U.S. Patent Publication 2012/0138660)；

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

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

Present applicant also has the U.S. Patent application of following qualification, these U.S. Patent applications with The application submits on the same day, and is each each integrally incorporated herein with way of reference:

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

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

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

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

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

Entitled " FASTENER CARTRIDGE COMPRISING A RELEASABLY ATTACHED TISSUE THICKNESS COMPENSATOR " (attorney END6848USCIP6/100533CIP6) U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

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

Entitled " ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR " U.S. of (attorney END7102USCIP2/110604CIP2) Patent application serial number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " LAYER COMPRISING DEPLOYABLE ATTACHMENT MEMBERS " the United States Patent (USP) Shen of (attorney END7102USCIP3/110604CIP3) Please serial number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " END EFFECTOR COMPRISING A DISTAL TISSUE ABUTMENT MEMBER " (attorney END7102USCIP4/110604CIP4) U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES " U.S. of (attorney END6232USCIP1/070348CIP1) is special Profit patent application serial numbers _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

Entitled " IMPLANTABLE ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES " U.S. of (attorney END6232USCIP2/070348CIP2) is special Profit patent application serial numbers _ _ _ _ _ _ _ _ _ _ _ _ _ _ _；

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

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

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

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

Some exemplary embodiment now will be described, to understand the knot of apparatus as disclosed herein on the whole Structure, function, the principle of manufacture and purposes and method.One or more examples of these embodiments are attached Shown in figure.It will be understood by those skilled in the art that specifically describe in this article and be illustrated in attached Apparatus and method in figure are nonrestrictive exemplary embodiment, and multiple embodiments of the present invention Scope is limited only by the appended claims.The spy of graphic extension or description is carried out in conjunction with an exemplary embodiment Levy, can be combined with the feature of other embodiments.These modification and version are intended to be included in Within the scope of the present invention.

" various embodiment ", " some embodiments ", " enforcement that this specification is mentioned in the whole text Example " or " embodiment " etc., it is meant that combine specific features, structure or characteristic that described embodiment describes Including at least one embodiment.Therefore, the phrase that this specification occurs in the whole text is " in various embodiments In ", " in certain embodiments ", " in one embodiment " or " in an embodiment " etc. not One establishes a capital the embodiment that finger is identical.Additionally, in one or more embodiments, specific features, structure or Characteristic can combine in any suitable manner.Therefore, under unconfined situation, in conjunction with an embodiment Specific features, structure or the characteristic illustrated or describe can be implemented with one or more other whole or in part The feature of example, structure or characteristic combine.These modification and version are intended to be included in the present invention's Within the scope of.

Terms used herein " nearside " and " distally " are the handle portions relative to manipulation of surgical apparatus For clinician.Term " nearside " refers to the part near clinician, and term is " remote Side " then refer to the part of clinician.It is also understood that for succinct and clear for the sake of, herein can To combine accompanying drawing and use such as " vertically ", " level ", the space art of "up" and "down" etc Language.But, surgical instruments can use in many orientations and position, and these terms non-limiting And/or absolutization.

The invention provides various for performing abdominal cavity mirror surgical procedures and micro-wound surgical operation operation Exemplary means and method.But, those of ordinary skill in the art will readily appreciate that, institute is public herein The various method and apparatus opened can be used in many surgical operations and application, including such as with open surgical Operation combines.With continued reference to this detailed description of the invention, those of ordinary skill in the art will manage further Solving, various apparatuses disclosed herein can insert internal by any way, such as passes through nature aperture, leads to Cross the otch being formed in tissue or puncturing hole etc..The working portion of apparatus or end effector portion can quilts It is inserted directly into and the most maybe can insert by having the entrance device of service aisle, the end of surgical instruments Executor and slender axles can be advanced by service aisle.

In fig. 1 and 2, surgical stapling and cut-out apparatus 8010 can include anvil block 8014, this anvil block Can be repeatedly opened around it to the pivotal attachment of elongate staple channel 8016 and be closed.Assembly used by nail 8012 can include anvil block 8014 and passage 8016, and wherein assembly 8012 can proximally be attached to formation and holds The slender axles 8018 of row part 8022.When nail is used when assembly 8012 closes or at least substantially closes Time, executable portion 8022 can present sufficiently small cross section, and this cross section is suitable to make nail use assembly 8012 insert through the trocar.In various embodiments, assembly 8012 can be by the handle being connected to axle 8018 Portion 8020 handles.Shank 8020 can include user control such as knob 8030, and this knob makes slender axles 8018 use the assembly 8012 longitudinal axis rotation around axle 8018 with nail.Closure trigger 8026 can Be depressed to close nail and use assembly 8012, this closure trigger can pistol grip 8036 front wall around The closure trigger pin 8152 (Fig. 3) laterally coupled across shank shell 8154 pivots.In various enforcements In example, when closure trigger 8026 is clamped, Guan Bi release button 8038 can outwards be present in shank On 8020 so that release button 8038 can be depressed to unclamp closure trigger 8026 and open nail to use Assembly 8012, as being described in more below.The percussion trigger that can pivot before closure trigger 8026 8034 can make nail use assembly 8012 cuts off simultaneously and sews up and be clamped in tissue therein.In various feelings Under condition, as being described in more below, can use percussion trigger 8034 to use multiple percussion stroke with Reduce every stroke and need the size of the power applied by surgical hands.In certain embodiments, shank The 8020 rotatable right indicator wheel 8040 that can include indicating percussion progress and/or left indicator wheel 8041 (Fig. 3).Such as, percussion traveling may need three of percussion trigger 8034 to hit completely completely Distribution journey, thus indicate that device wheel 8040 and 8041 each can be in every stroke of percussion trigger 8034 Rotate up to 1/3rd circles.As being described in more below, if it is desired, manually fire trip lever 8042 can allow trigger system firing retraction before traveling completes completely, and if additionally, percussion system System blocks and/or lost efficacy, and percussion trip lever 8042 can allow surgeon or other clinicians to make to hit The system of sending out retraction.

Seeing Fig. 1 and Fig. 3, slender axles 8018 can include external structure, and this external structure includes longitudinal direction Upper reciprocating Guan Bi pipe 8024, this Guan Bi pipe is in response to the closure trigger 8026 of shank 8020 Press under nearside and make anvil block 8014 pivot towards its make position.Elongated passageway 8018 can be managed by Guan Bi Framework 8028 (Fig. 3) within 8024 is connected to shank 8020.Framework 8028 be rotatably engaged to Shank 8020 so that the rotation of knob 8030 (Fig. 1) can make executable portion 8022 rotate.Concrete ginseng Seeing Fig. 3, knob 8030 can be made up of two half-shell, and the two half-shell can include one or more to inwardly projecting Going out portion 8031, this protuberance can extend across the one or more elongated sides openings in Guan Bi pipe 8024 8070 and engage framework 8028.Therefore, knob 8030 and framework 8028 can together with or revolved simultaneously Turn so that the position of rotation of knob 8030 determines the position of rotation of executable portion 8022.In various enforcements In example, the longitudinal length long enough of longer opening 8070, so that Guan Bi pipe 8024 can carry out longitudinally closing Resultant motion and open motion.About producing the closing motion closing pipe 8024, referring primarily to Fig. 3 and Tu 5, the upper part 8160 of closure trigger 8026 can promote forward Guan Bi via Guan Bi connecting rod 8164 Yoke 8162 (Fig. 4).Guan Bi connecting rod 8164 at its distal end by Guan Bi yoke pin 8166 with can Pivotably it is attached to closed yoke 8162, and by Guan Bi link pin 8168 at its proximal end Can pivotably be attached.In various embodiments, closure trigger 8026 can be closed triggering Device stretching spring 8246 is advanced into open position, and this stretching spring is proximally connected to closure trigger The upper part 8160 of 8026 and the shank shell formed by right half-shell 8156 and left shell half 8158 8154.The tension force applied by stretching spring 8246 can be applied to the Guan Bi of closure trigger 8026 and make every effort to overcome Clothes, in order to advance yoke 8162, Guan Bi connecting rod 8164 and Guan Bi pipe 8024 towards distally.

When closure trigger 8026 is activated as mentioned above or is depressed, if it is desired, Guan Bi release is pressed Button 8038 can be oriented so that surgeon or other clinicians can press Guan Bi release button 8038, and enable the remainder of closure trigger 8026 and surgical instruments to be back to not activate shape State.In various embodiments, Guan Bi release button 8038 can be connected to by central authorities' transverse pivot 8173 Pivoting latch arm 8172 so that transmitting movement between button 8038 and lock arm 8172 can discharged.Again The secondary Fig. 3 that sees, compression spring 8174 can by Guan Bi release button 8038 proximally bias, i.e. as from The right side is observed, and biases clockwise around central authorities' transverse pivot 8173, and closure trigger 8026 is upper Portion's part 8160 can include the nearside tooth top 8170 with rear recess 8171.When closure trigger 8026 When being depressed, pivoting latch arm 8172 can straddle on nearside tooth top 8170, and works as closure trigger During 8026 its fully depressed position of arrival, it will be appreciated that rear recess 8171 is present in pivoting latch arm Below 8172, this pivoting latch arm compression spring 8174 force fall into after recess 8171 and will after Recess 8171 is locked.Now, the manual depression of Guan Bi release button 8038 makes pivoting latch arm 8172 Rotate up and rotate from rear recess 8171, thus closure trigger 8026 is unlocked and makes Guan Bi Trigger 8026 can be back to its unclamped position.

Once closure trigger 8026 is proximally clamped as mentioned above, and percussion trigger 8034 can be drawn To pistol grip 8036, so that trigger shaft 8032 is advanced towards distally from shank 8020.In various enforcements In example, percussion trigger 8034 can pivot around percussion trigger pin 8202, and this percussion trigger pin is horizontal To through the right half-shell 8156 of shank 8020 and left shell half 8158 and engaging with them.When percussion triggers When device 8034 activated, it can advance link-type transmission firing lock 8150.Link-type transmission percussion lock Structure 8150 can be forced to the non-firing position of retraction, this spring 1 by spring 8184) it is attached to shank The pistol grip 8036 of 8020, and 2) it is attached to the company of such as link-type transmission firing lock 8150 One of bar, as being described in more below.Spring 8184 can include the non-athletic end being connected to shell 8154 End 8186, and it is connected to the moving end 8188 of the proximal end 8190 of steel band 8192.Steel band 8192 The end 8194 being arranged at distally can be attached to the front rod in multiple connecting rod 8196a to 8196d Attachment features structure 8195 on 8196a, the plurality of connecting rod 8196a to 8196d defines link-type tooth Bar 8200.Link-type tooth bar 8200 can be flexible so that it can easily retract to pistol grip In 8036 and minimize the length of shank 8020, and form straight rigid toothed assembly, this tooth bar assembly Significant percussion force can be transferred to and/or be transferred through trigger shaft 8032.As being described in more below, Percussion trigger 8034 can percussion trigger 8034 first time activate during with first connecting rod 8196a Engage, engage with second connecting rod 8196b during the second time of percussion trigger 8034 activates, hitting Engage with third connecting rod 8196c during sending out the third time actuating of trigger 8034, and trigger in percussion Engage with fourth link 8196d during 4th actuating of device 8034, wherein fire trigger 8034 Link-type tooth bar 8200 all can be advanced the amount being incremented by by actuating towards distally every time.In various embodiments, As to above supplement, percussion trigger 8034 multiple strokes can make right indicator wheel 8040 and a left side Indicator wheel 8041 rotates, with the distance indicating link-type tooth bar 8200 to advance.

Referring now to Fig. 3 and Fig. 5, anti-inversion organization 8250 can prevent from combining stretching/compressing spring 8184 Link-type tooth bar 8200 is made to bounce back between percussion stroke.In various embodiments, sliding tube is coupled 8131 adjoin first connecting rod 8196a and are connected to trigger shaft 8032 to transmit firing action.Trigger shaft 8032 proximal end proximally extending framework 8028 also extend through the through hole of anti-down flap 8266 8408.Being sized to when with trigger shaft 8032 vertical alignment receive slidably of through hole 8408 is hit Send out bar 8032, and it is the most motionless to make trigger shaft 8032 roll in through-holes when inclined.Lower tabs attachment 8271 proximally extend from the lower lip of the proximal end of framework 8028, extend through anti-down flap 8266 Lower limb on hole 8269.This lower tabs attachment 8271 is by the low portion of anti-down flap 8266 It is drawn to adjacent with framework 8028 so that the anti-down flap 8266 when trigger shaft 8032 is advanced towards distally For vertical, and anti-down flap 8266 can make top tilt backwards when trigger shaft 8032 attempts retraction To bound state.Anti-reversing compression spring 8264 is retrained towards distally by the proximal end of framework 8028, and And proximally adjoin the top section of anti-down flap 8266, thus anti-down flap 8266 is biased to locking State.Spring biasing resisted by anti-inverse cam pipe 8268 and cincture slidably couples sliding tube 8131 neighbour Take over control reversing plate 8266.It is attached to the proximally prominent anti-reversing yoke 8256 of anti-inverse cam pipe 8268 Extend beyond closed yoke 8162.

Seeing Fig. 3, the automatic retracted mechanism 8289 that connecting rod triggers is attached to surgical stapling and cuts off apparatus In 8010, so that cutter bounces back at the end of firing traveling completely.To this end, distal link 8196d includes handle Foot 8290, when distal link 8196d is advanced in closed yoke 8162 rack passage 8291 of formation (Fig. 3), time in, this tang 8290 is upwardly.Align this tang 8290 to start anti-reversing release Bottom proximal cam 8292 on lever 8248 (Fig. 6).Referring specifically to Fig. 6, in right half-shell 8156 Motion with the structural constraint anti-reversing trip lever 8248 formed in left shell half 8158.It is respectively formed in Pin socket 8296 and circular pegs 8293 between right half-shell 8156 and left shell half 8158 pass longitudinal tensile strain Hole 8294 received, this hole 8294 be formed at bottom proximal cam 8292 distally anti-reversing release In lever 8248, thus allow longitudinal translation and rotate around circular pegs 8293.In right half-shell 8156 In, the passage proximally opened include with upwards and towards distally angulation partially communicating nearside horizontal component, This upwards and towards one-tenth angle part, distally receive anti-reversing trip lever 8248 proximal end near to the right Rear pin 8297, thus when anti-reversing trip lever 8248 arrive its translation farthest side part time, compose Give rotation upwards.The most anti-reversing trip lever 8248 is assembled, is formed at position in right half-shell 8156 Barrier structure in anti-reversing trip lever 8248 nearside just stops anti-reversing trip lever 8248 proximally Motion, so that rear pin 8297 to the right is maintained in the passage proximally opened as described above.

As to supplementing above, referring now to Fig. 3 and Fig. 7, anti-reversing trip lever 8248 remote Side end 8254 thus towards distally and be forced to downwards, make front pin 8298 to the right fall into and be formed at right half In the hierarchic structure 8299 opened towards distally in shell 8156, this is engaged through compression spring 8300 (figure 3) the anti-reversing release thick stick being fixed between front pin 8298 to the right and the hole 8294 of longitudinal tensile strain Hook 8301 to the left on bar 8248 and realize.The other end of compression spring 8300 is attached to be formed In right half-shell 8156 closed yoke 8266 immediately above closer to and the hook 8302 (figure of lower position 6).Compression spring 8300 thus by the distal end 8254 of anti-reversing trip lever 8248 downwards and to Rear tractive, makes front pin 8298 to the right lock onto the hierarchic structure opened towards distally towards distally when advancing In 8299.Therefore, the most released, see Fig. 7, anti-reversing trip lever 8248 just keep to Before, it is held vertically throughout anti-down flap 8266, so that link-type tooth bar 8200 can bounce back.When pine When open end executor 8012, closed yoke 8266 bounces back subsequently, on closed yoke 8266 to The reset tang 8303 of upper process contacts the bottom distal cam 8305 of anti-reversing trip lever 8248, will Front pin 8298 to the right lifts from the hierarchic structure 8299 opened towards distally so that anti-reversing compression spring Anti-inverse cam pipe 8268 and anti-reversing trip lever 8248 can be proximally pushed to returning of they by 8264 Condense and put (Fig. 6).

In various embodiments, see Fig. 1 to Fig. 3, percussion trigger 8034 can with any properly Mode be operatively engaged to link-type tooth bar 8200.Referring specifically to Fig. 2 and Fig. 3, fire trigger 8034 pivot around the percussion trigger pin 8202 being connected to shell 8154.When percussion trigger 8034 Towards pistol grip 8036 depress time, percussion trigger 8034 upper part 8204 around percussion touch Send out device pin 8202 towards distal movement, thus the percussion trigger stretching spring 8206 that will proximally place (Fig. 3) stretching, this stretching spring 8206 is proximally connected to fire the upper part of trigger 8034 Between 8204 and shell 8154.Under percussion trigger every time during pressure, fire the upper of trigger 8034 The side detent mechanism 8210 engagement link formula tooth bar 8200 that portion's part 8204 biases via spring.Work as percussion When trigger is released, side detent mechanism departs from link-type tooth bar 8200, and fire trigger can It is back to the most non-non-depressed firing position.In use, by the connecting rod 8196a to 8196d face in each one The right rail of the inclination that proximad and inclined-plane to the right 8284 are formed is connect by gemmule claw assembly 8285 Close.Specifically, ratchet slide block 8270 (Fig. 3 and Fig. 4) has lower left quarter guide and right lower quadrant guides Part 8272, this lower left quarter guide and right lower quadrant guide Guan Bi below rack passage 8291 respectively Right track in the left track 8274 (Fig. 3) formed in yoke 8266 and in closed yoke guide rail 8276 Sliding in 8275, this closed yoke guide rail parallel is in rack passage 8291 and is attached to rack passage lid 8277, what this rack passage lid closed the rack passage 8291 in closed yoke 8266 opens to the right part, Described part of opening to the right is positioned at the distally of ratchet slide block 8270 direct of travel.In Fig. 3 to Fig. 5, Compression spring 8278 is attached at the hook 8279 in the top proximal position being positioned on closed yoke guide rail 8276 And between the hook 8280 on the right side of the distal end of ratchet slide block 8270, this makes ratchet slide block 8270 are proximally pulled into and contact with the upper part 8204 firing trigger 8034.

Referring specifically to Fig. 3, pawl block 8318 is positioned on ratchet slide block 8270, around vertical rear pin 8320 pivot, and this rear pin 8320 turns through the left proximal of pawl block 8318 and ratchet slide block 8270 Angle.Kick out of in the distal part of the top surface that block groove 8322 is formed at pawl block 8318, to receive Therein block 8324 is kicked out of can pivotably be fixed on, this normal pin 8326 by normal pin 8326 Bottom apex extend in the ratchet spring groove 8328 on the top surface of ratchet slide block 8270.Spine Ratchet spring 8330 in latch spring groove 8328 extends to, on the right side of vertical front pin 8326, force spine Rest shoe 8318 rotates counterclockwise to engage with the right rail 8282 tilted time viewed from above.Kick out of Little wind spring 8332 in block groove 8322 forces kicks out of block 8324 dextrorotation time viewed from above Turn so that it is proximal end be forced with the closed yoke 8266 above rack passage 8291 in formation wavy Antelabium 8334 contacts.As it is shown in figure 5, ratchet spring 8330 has higher than little wind spring 8332 Mechanical dominance means pawl block 8318 to be prone to the block 8324 of kicking out of turned clockwise to engage.At Fig. 3 In, when firing trigger 8034 and being fully depressed and start to be released, kick out of block 8324 sliding at ratchet Block 8270 runs into the ridge 8336 in wavy antelabium 8334 when bouncing back, force and kick out of block 8324 when from top Turn clockwise during observation, thus pawl block 8318 is kicked out of and does not engages with link-type tooth bar 8200. Kick out of the shape backstop of block groove 8322 and kick out of block 8324 to the orientation being perpendicular to wavy antelabium 8334 Turn clockwise, eliminate ratcheting noise being fully retracted period this disengaging of holding.

In Fig. 3, Fig. 4, Fig. 8 and Figure 12, surgical stapling and cut-out apparatus 8010 can include manually Cam mechanism 8500, this manual retrieving mechanism 8500 provides the manual release of firing lock, manually returns Contracting, and also perform automatically at the end of firing traveling completely in a kind of pattern (Figure 13 to Figure 15) Retraction.Referring now to Fig. 3 and Fig. 8, specifically, front idler gear 8220 and link-type tooth bar 8200 Surface, dentation upper left 8222 engage, wherein before idler gear 8220 also engage there is less right-side ratchet The rear idler gear 8230 of gear 8231.Front idler gear 8220 and rear idler gear 8230 are rotatable Be connected to lay respectively at the shank shell 8154 on front idler axle 8232 and rear idler wheel axle 8234. Each end of rear idler wheel axle 8232 extends through corresponding right half-shell 8156 and left shell half 8158, and And be attached to left indicator wheel 8040 and right indicator wheel 8041, and owing to rear idler wheel axle 8234 exists Shank shell 8154 rotates freely and is bonded to rear idler gear 8230 with bonding pattern, thereby indicate that Device wheel 8040,8041 rotates together with rear idler gear 8230.Link-type tooth bar can be advantageously selected 8200, the gear relation between front idler gear 8220 and rear idler gear 8230 so that table on dentation Face 8222 has a teeth size that intensity is suitable, and make at link-type transmission firing lock 8150 complete During full percussion is advanced, the rotation of rear idler gear 8230 is less than a circle.Gear mechanism 8502 except Instruction intuitively fires outside stroke or progress, it may also be used for manually make cutter bounce back.In various embodiments In, the less right-side ratchet gear 8231 of rear idler gear 8230 extends to manual retrieving lever 8042 Wheel hub 8506 in, specifically, with by wheel hub 8506 to point vertical longitudinally-aligned slit 8508 (Fig. 8) alignment.The cross through hole 8510 of wheel hub 8506 connects with upper grooves 8512.Front part 8514 are shaped as the locking pawl 8516 that reception proximally guides, and this locking pawl 8516 is around formation Transverse bolt 8518 to the right in the distal end of upper grooves 8512 pivots.Rear portion 8520 Be shaped as reception L-shaped spring tab 8522, this spring tab 8522 force locking pawl 8516 to The lower ratchet gear 8231 less with right side engages.Barrier structure 8524 (Fig. 6) is from right half-shell 8156 Project in upper grooves 8512；When manual retrieving lever 8042 is downward (Figure 10), this blocking junction Structure 8524 stops locking pawl 8516 to engage less right-side ratchet gear 8231.Wind spring 8525 (figure 3) force manual retrieving lever 8042 downward.

In use, as Fig. 9 and Figure 10 describes, combination stretching/compressing spring 8184 can be with location Link-type tooth bar in distally disconnects.In Figure 11 and Figure 12, when manual retrieving lever 8042 During lifting, locking pawl 8516 turns clockwise and is no longer blocked structure 8524 and stops, and engages relatively Little right-side ratchet gear 8231, so that rear idler gear 8230 dextrorotation when from left sides Turn.Therefore, front idler gear 8220 responds counterclockwise, makes link-type tooth bar 8200 bounce back.Additionally, Curved ridges 8510 to the right highlights from wheel hub 8506, and it is sized to contact anti-reversing trip lever 8248 and make anti-reversing trip lever towards distal movement, thus when manual retrieving lever 8042 rotates will Anti-inversion organization 8250 discharges.

In Figure 13 to Figure 15, the automatic retracted mechanism 8600 of surgical stapling and cut-out apparatus can be complete It is attached to automatic retracted at the end of full percussion stroke to have in the front idler gear 8220a of tooth 8602； Move in this front idler gear 8220a circular groove 8604 in cam 8606, until corresponding to The nearly whole process of three percussion strokes meets with obstruction after rotating till thing.In such situations, to the right Ridge 8610 is rotated upwardly to contact bottom cam groove 8612, so that anti-reversing trip lever 8248a court Distal movement.Include operating as described above referring specifically to Figure 13, anti-reversing trip lever 8248a Distal end 8254.It is formed at the circular pegs 8293 between right half-shell 8156 and left shell half 8158 and pin Socket 8296 is formed through in the anti-reversing trip lever 8248a after bottom cam 8192 substantially The hole 8294a of rectangle is received, thus allows that longitudinal translation and anti-reversing trip lever 8248a's is remote The downward lock motion of side end 8254.In right half-shell 8156, the passage proximally opened of level Receive the rear pin to the right near anti-reversing trip lever 8248a proximal end.

In operation, before percussion in figs. 13 and 14, link-type tooth bar 8200 and anti-reversing Cam tube 8268 is in advanced position, thus makes anti-down flap 8266 in anti-reversing compression spring 8264 When proximally tilting, anti-inversion organization 8250 is locked.Automatic retracted mechanism 8600 is in initial shape State, the most anti-reversing trip lever 8248a bounces back, and connecting rod 8196a connects with front idler gear 8220a Touch.Tooth 8602 is in six-o ' clock position, and the total travel of circular groove 8604 is carried out, to the right counterclockwise Ridge 8610 just adjacent teeth 8602.After a percussion stroke, link-type tooth bar 8200 has made one far Side connecting rod 8196b moves upward as contacting with front idler gear 8220a.Tooth 8602 is by fixing convex Wheel 8606 circular groove 8604 advanced 1/3rd circle.After the second percussion stroke, this link-type Tooth bar has made another connecting rod 8196c move upward as contacting with front idler gear 8220a.Tooth 8602 By the circular groove 8604 of fixing cam 8606 advanced 2/3rds circle.Stroke is fired the 3rd After, link-type tooth bar 8200 made another distal link 8196d move upward into front idler gear 8220a contacts.Tooth 8602 proceeds to and obstruction thing mentioned above around circular groove 8604 whole process Contact, thus the rotation (when observing from right side) counterclockwise of starting cam 8606, make to the right then Ridge contact with anti-reversing trip lever 8248a.In fig .15, anti-reversing trip lever 8248a pair It responds towards distal movement, thus front pin 8298 to the right is locked onto the rank opened towards distally Ladder structure 8299 in and discharge anti-inversion organization 8250.Similar surgery suturing appliance is in August, 2006 The United States Patent (USP) 7 announced for 1st, disclosed in 083,075, the complete disclosure of this patent is with way of reference also Enter herein.

Seeing Figure 16, the nail of surgery suturing appliance 9010 is used assembly 9012 and is implemented function such as: Tissue clamps, by along axle 9016 relative to two kinds of different motion of the longitudinal going down of pedestal 9070 Drive nail and cut off tissue.This pedestal 9070 is proximally attached to the shank of surgery suturing appliance, and It is attached to this shank to be rotated about longitudinal axes.For surgical stapling and cut off apparatus exemplary many Stroke shank is at CO-PENDING and entitled " the SURGICAL STAPLING that owns together INSTRUMENT INCORPORATING A MULTISTROKE FIRING POSITION INDICATOR AND RETRACTION MECHANISM " U.S. Patent Application Serial Number Being described in more detail in 10/374,026, the disclosure of this patent application is incorporated by reference accordingly It is expressly incorporated herein.Other application meeting the present invention can be in conjunction with clicking distribution journey, such as at CO-PENDING and altogether With entitled " the SURGICAL STAPLING INSTRUMENT HAVING having SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS " U.S. Patent application Serial number 10/441, described in 632, the disclosure of this patent application is incorporated by reference accordingly It is expressly incorporated herein.

Referring specifically to Figure 17, the distal end of pedestal 9070 is attached to follow closely passage 9018.Anvil block 9022 Having nearside hub switch side 9072, this nearside hub switch side 9072 is logical can pivotably be received in nail In the proximal end 9074 in road 9018, it is placed exactly in the distally of itself and pedestal 9070 joint.Work as anvil When seat 9022 pivots downwards, anvil block 9022 makes tissue contacting surface 9028 and shapes pit 9026 towards right The nail bin motion in face, as being described in more detail the most further.The hub switch side 9072 of anvil block 9022 includes closing Close feature structure 9076, this closure feature structure 9076 adjacent to its with nail passage 9018 pivotal attachment Place, but the distally at itself and the pivotal attachment of nail passage 9018.Therefore, (it is remote for Guan Bi pipe 9078 Side end includes the shape of a hoof hole 9080 engaging this closure feature structure 9076) optionally indulge at nearside Motion will be opened during motion and give anvil block 9022, and during the lengthwise movement of distally, Guan Bi be transported Dynamic imparting anvil block 9022, this Guan Bi pipe 9078 slides above at pedestal 9070 in response to closure trigger, Similarly as described above.Pedestal 9070 promotes and guides firing action from shank through longitudinally reciprocating motion Two cuttves and trigger shaft 9090.Specifically, pedestal 9070 includes longitudinal trigger shaft slit 9092, should Longitudinal trigger shaft slit 9092 receives two cuttves and the portions of proximal of trigger shaft 9090, in particular lamination Tapered trigger shaft 9094.Should be appreciated that the tapered trigger shaft 9094 of lamination can be by solid trigger shaft And/or any other suitable material replaces.

E type crossbeam 9102 is two cuttves and the distal part of trigger shaft 9090, and it is conducive to individually Guan Bi And percussion, and during firing, anvil block 9022 and elongate staple channel 9018 are separated.Referring specifically to figure 17 and Figure 19, in addition to any attachment processes such as solder brazing or binding agent, two cuttves and trigger shaft 9090 are also formed by the vertical attachment hole of spill 9104 being proximally formed in E type crossbeam 9102, and this is attached Connect hole 9104 and receive the correspondingly convex attachment members presented in distally by the trigger shaft 9094 that lamination is tapered 9106, so that each part is by being suitable to its difference in functionality (such as intensity, pliability, frictional force) Selected material and method are formed.E type crossbeam 9102 can be advantageously by the material with suitable material attribute Material is formed.This material is for forming a pair top pin 9110, a pair intermediate pin 9112 and base pins Or leg 9114, and it is obtained in that sharp cutting edge 9116.Additionally, it is each to hold cutting edge 9116 The proximally prominent one-body molded top guide part 9118 of vertical end and intermating guides 9120 are further defined by Set of organizations tie region 9122, contributes to guiding to sharp cutting edge before cutting off tissue 9116.Intermating guides 9120 is additionally operable to the staged by adjacent wedge-shaped slides 9126 (Figure 20) Central member 9124 engages and fires nail and uses assembly 9012, thus is used assembly 9012 by nail and realize Nail shapes, as being described in more below.These feature structures (such as, top pin 9110, centre Pin 9112 and bottom supports 9114) and E type crossbeam 9102 global formation, relatively it is used multiple parts group Dress, is conducive to producing the structure of needs with the most tightened up tolerance limit, so that it is guaranteed that in the percussion phase Between and/or use assembly 9012 with nail various locking feature structure effective interactions during, it is achieved the phase The operation hoped.

In Figure 21 and Figure 22, nail is used assembly 9012 and is illustrated as in opened condition, and now E type is horizontal Beam 9102 is fully retracted.During assembly, the lower leg 9114 of E type crossbeam 9102 is dropped through nail Widening hole 9130 in passage 9018, E type crossbeam 9102 is pushed into subsequently so that E type crossbeam 9102 slide along the lower tracks 9132 being formed in nail passage 9018 towards distally.Specifically, bottom Track 9132 includes narrower slots 9133, and this slit is opened for widening on the lower surface of nail passage 9018 Slit 9134, to form the T-shaped of reversion, as having in Figure 109 322 and Figure 23 in lateral cross Body is described；This narrower slots 9133 connects with widening hole 9130.Once will be connected to lamination gradually at nearside Each assembling components of the trigger shaft 9094 of contracting is good, and these assemblies the most no longer allow lower leg 9114 towards closely Skidding proceeds to widen hole 9130 and allow to widen hole from this and depart from.See Figure 24, the percussion that lamination is tapered Nail is used assembly 9012 and is inserted through the trocar by bar 9094 beneficially user.Specifically, horizontal when E type When beam 9102 is fully retracted, E type crossbeam 9102 is just lifted by the portion that is downwardly projected 9136 of farther side. This is subjected to displacement in certain point realizes by being downwardly projected portion 9136, at this point, and this protuberance Upwards eject in 9136 proximal widening hole 9130 in nail passage 9018.Referring now to figure, 25, the tapered trigger shaft 9094 of lamination is also by include strengthening closer to the portion that projects upwards 9138 of side can It is attached to follow closely the operation of some the locking feature structure in passage 9018.Described projecting upwards closer to side Portion 9138 is ordered about downwards by pedestal 9070 during the initial part of percussion stroke.Specifically, transverse bar Between 9140 square holes 9142 being limited in pedestal 9070 (Figure 17).Surround transverse bar The clamp spring 9144 of 9140 forces downwards a part for the tapered trigger shaft 9094 of lamination from longitudinal percussion Bar slit 9092 is prominent towards distally, it is ensured that the when of suitably, some favourable locking feature structure is connect Close.When projecting upwards portion 9138 and contacting clamp spring 9144, this motive force becomes apparent from or only limits to This part in percussion stroke.

In Figure 21 and Figure 22, E type crossbeam 9102 bounces back, and its top pin 9110 is positioned at anvil block 9022 Pivot proximal end near anvil block pit 9150 in.The vertical anvil slot 9152 opened downwards (Figure 16) in anvil block 9022, lateral widening is anvil block inner tracks 9154, and this track 9154 is hitting The top pin 9110 of capture E type crossbeam 9102 when advancing towards distally during sending out, in Figure 24 and Figure 25 Described, thus anvil block 9022 is separated clearly with nail passage 9018.Therefore, when E type crossbeam After 9102 retractions, surgeon can be repeatedly opened and close nail and use assembly 9012, until to capture Till the placement of tissue that is the most to be stapled and that cut off and orientation please oneself, and E type crossbeam 9102 reduce even for diameter and the nail that reduces accordingly of rigidity is used assembly 9012 and also contributed to tissue just Work as location.In Figure 16, Figure 17, Figure 20, Figure 21, Figure 23 and Figure 29, assembly 9012 used by nail It is shown to have the replaceable nail bin 9020 including wedge-shaped slides 9126.Longitudinally-aligned and parallel many The individual wedge slot 9202 (Figure 23) opened downwards receives and the corresponding wedge of wedge-shaped slides 9126 one Shape part 9204.In Figure 23 to Figure 25, wedge-shaped slides 9126 is therefore by multiple staple drivers 9206 Upwards jack-up, the plurality of staple drivers 9206 can in staple drivers groove 9208 vertical sliding motion.? In this exemplary version, each staple drivers 9206 includes two vertical contact pins, each vertical contact pin to On move in corresponding nail 9210 or cavity 9024, will rest against the nail 9023 on vertical contact pin Upwards extrude, and make nail 9023 deform against the nail profiled surface 9214 (Figure 25) of anvil block 9022. Central authorities' percussion groove 9216 (Figure 17) being limited in the nail bin 9020 of neighbouring nail passage 9018 allow The bottom horizontal portion 9218 (Figure 20) of wedge-shaped slides 9126 and the centre of E type crossbeam 9102 Pin 9112 passes through.Specifically, nail bin pallet 9220 (Figure 17 and Figure 23) is attached to polymer nail bin Body 9222 is also positioned under；This polymer staple cartridge body 9222 has that to be formed at staple drivers therein recessed Groove 9208, nail 9210 and central authorities' percussion groove 9216.When therefore nail 9023 shapes at either side Time, sharp cutting edge 9116 enters vertical through slot 9230, except the only farthest side of this vertical through slot Outside portion, this vertical through slot is through the longitudinal axis of nail bin 9020.

Percussion nail is used assembly 9012 and is started as Figure 25 describes.In fig. 25, by two cuttves With trigger shaft 9090 proximally tractive, until being downwardly projected portion 9136 by E type crossbeam 9102 Between till guide 9120 upwardly and rearwardly jack-up, thus, when anvil block 9022 is opened, can be by new Nail bin 9020 inserts in nail passage 9018, as Figure 16 and Figure 21 describes.In fig. 26, two Cutter and trigger shaft 9090 advance a small distance towards distally, when clamp spring 9144 acts on lamination gradually When the projecting upwards portion 9138 of trigger shaft 9094 of contracting, is downwardly projected portion 9136 and can fall into lower rail Widening in hole 9130 of road 9132.Intermating guides 9120 prevents owing to resting in wedge-shaped slides The rotation further downward produced in the staged central member 9124 of 9126, thus by E type crossbeam Intermediate pin 9112 is maintained in central authorities' percussion groove 9216.In figure 27, two have been fired towards distally Sheet cutter and trigger shaft 9090, thus advance wedge-shaped slides 9126 so that nail 9023 shaping, use cutting edge of a knife or a sword simultaneously The cutting edge 9116 of profit cuts off the tissue 9242 being clamped between anvil block 9022 and nail bin 9020.With After, in Figure 28, two cuttves and trigger shaft 9090 bounce back, and leave the wedge-shaped slides that distally positions 9126.In Figure 29, intermediate pin 9112 be allowed to pan-down to nail passage 9018 (referring also to Figure 22 and Figure 25) in formed latch groove 9240 in.Therefore, when wedge-shaped slides 9126 (not Figure 29 illustrates) the most proximally location (that is, nail bin 9020 lack or nail bin 9020 exhausts) Time, if intermediate pin 9112 runs into the distal side edge of latch groove 9240, operator will receive tactile Feel and indicate.The United States Patent (USP) 7,380,696 that similar surgery suturing appliance was announced on June 3rd, 2008 Disclosed in, the complete disclosure of this patent is incorporated by reference herein.

In various embodiments, turning now to Figure 30 to Figure 38, surgical instruments 12000 can include shank 12010, from shank 12010 extend axle 12020 and axle 12020 can be removably attached to End effector 12040, as being described in more detail the most further.Shank 12010 can include trigger 12014, this trigger 12014 can activated to perform following operation: 1) Guan Bi end effector 12040, and 2) firing member 12043 is advanced through end effector 12040 towards distally.Although Not shown in Figure 30 to Figure 38, but shank 12010 can include any suitable drivetrain, this drivetrain It is configured to transmit the rotary motion of trigger 12014, and this rotary motion is converted into percussion structure Part 12023 extends through the linear movement of axle 12010.In use, trigger 12014 can by towards The pistol grip 12012 of shank 12010 activates, in order to by firing member 12023 in axle 12020 Advance along longitudinal axis 12039 towards distally, and when axle firing member 12023 hits with end effector Send out component 12043 when being operatively coupled, as being described in more detail the most further, axle firing member The distal movement of 12023 can be passed to end effector firing member 12043.When end effector hits Sending out component 12043 when advancing towards distally, end effector firing member 12043 is just configured to connect Close and include the first jaw 12040a of anvil block and/or include the second jaw 12040b of staple cartridge channel, and make At least one jaw in first jaw 12040a and the second jaw 12040b moves towards another jaw. As to above supplement, referring primarily to Figure 30 to Figure 32, end effector 12040 can be laterally Axle 12010 it is assembled on the direction of longitudinal axis 12039.Such as, end effector 12040 can On the direction of perpendicularly to the longitudinal axis 12039, axle 12010 it is assembled to (such as).In these type of feelings Under condition, end effector 12040 can move towards axle 12010 so that end effector 12040 Framework 12041 is engaged and connected to framework 12021, and makes the proximal end of firing member 12043 12044 engage the distal end 12024 being coupled to firing member 12023.Pedestal 12021 can include Being defined in passage 12022 therein, this passage may be structured to can receive axle firing member slidably 12023 and limit longitudinal axis 12039.In order to by end effector frame 12041 and pedestal 12021 Alignment, in various embodiments, the proximal end 12045 of end effector frame 12041 and pedestal The distal end 12025 of 12021 can include that (such as) can make end effector 12040 mutually countershaft The cooperation dovetail feature structure of 12020 orientations.Pedestal 12021 may also include and is defined in installation therein Hole 12026, these installing holes 12026 may be structured to can receive from end effector frame 12041 The installation protuberance 12046 extended.Due to mounting characteristic structure 12026 and 12046 and/or end The cooperation dovetail feature structure of 12025 and 12045, so in all cases, can hold end Row device 12040 is fixedly secured to axle 12020.In various embodiments, surgical instruments 12000 also may be used Including lock lining ring 12030, this lock lining ring 12030 may be structured to be locked by end effector 12040 Surely axle 12020 is arrived.Referring now primarily to Figure 34 to Figure 36, lock lining ring 12030 can be at unlocked position Move between (Figure 34 and Figure 35) and latched position (Figure 36).When lock lining ring 12030 unlocks at it (see Figure 34) during position, end effector 12040 can be assembled into axle 12020.Once end is held Row device 12040 engages with axle 12020, and lock lining ring 12030 can be at end effector 12040 and axle Slide in interconnection between 12020, so that end effector 12040 is locked in appropriate location.More Body ground, at least one embodiment, lock lining ring 12030 can limit endoporus 12031, this endoporus 12031 may be structured to be closely received end effector 12040 and the neighboring of axle 12020. In certain embodiments, surgical instruments 12000 can include spring or biasing member, this spring or biasing structure Part is configured to lock lining ring 12030 to be biased to its latched position.In this type of embodiment, clinical Doctor can resist the bias force of spring will lock lining ring 12030 proximally tractive, then release lock lining ring 12030, allow spring that lock lining ring 12030 is back to its latched position.

Refer again to Figure 30 to Figure 38, and referring primarily to Figure 32 and Figure 33, surgical instruments 12000 can Including actuated articulation joints 12050.In various embodiments, actuated articulation joints 12050 can be constructed For can allow for the axle that the distal part of end effector 12040 limits around actuated articulation joints 12050 Line pivots.In this embodiment, end effector 12040 can include being fixedly secured to axle 12020 Portions of proximal and the distal part that can rotate around actuated articulation joints 12050 relative to portions of proximal. In certain embodiments, surgical instruments 12000 can include lock, and this lock is configured to engage and depart from The distal part of end effector 12040.Such as, end effector 12040 can include end effector Latching segment 12047, this end effector latching segment 12047 can be promoted towards distally with by end effector The distal part of 12040 locks onto appropriate location, and/or can be by proximally tractive so that end effector The distal part of 12040 unlocks.Surgical instruments 12000 may also include (such as) and shank 12010 phase Adjacent lock actuator 12060, this lock actuator 12060 can be by proximally tractive, in order to proximally tractive End effector latching segment 12047.In such an embodiment, lock actuator 12060 can with extend through The latching segment 12027 crossing axle 12020 is operatively coupled, and this axle 12020 is operatively coupled or energy Enough it is operably coupled to end effector latching segment 12047.In at least one such embodiment, When end effector 12040 is assembled to axle 12020, the nearside of end effector latching segment 12047 End 12048 can be assembled to the distal end 12028 of latching segment 12027.Such at least one In embodiment, end effector latching segment 12047 can be assembled at end effector firing member 12043 While axle firing member 12023, it is assembled to latching segment 12027.

In various embodiments, as it has been described above, nail bin can include warehouse, this warehouse includes multiple being defined in Nail chamber therein.Warehouse can include platform and top platform surface, and the most each nail chamber can be at platform surface Middle restriction opening.As also described above, nail can be positioned in each nail intracavity so that nail is stored in warehouse It is interior until it penetrates from warehouse.In various embodiments, before nail is penetrated from warehouse, nail can It is installed in warehouse so that nail does not protrudes into above platform surface.In this type of embodiment, when nail is determined When position is below platform surface, follows closely damaged and/or premature contact destination organization probability and can reduce. In all cases, nail can move between non-firing position and firing position, in non-firing position, Nail is not from warehouse projection；In firing position, nail has exposed from warehouse and can contact and has been positioned at nail bin opposite Anvil block.In various embodiments, anvil block and/or the nail that is defined in anvil block shape pit and can be positioned Become anomaly platform surface one preset distance so that when nail is disposed from warehouse, it is predetermined that nail is deformed into one Forming height.In some cases, the thickness variable of the tissue being trapped between anvil block and nail bin. Therefore, thicker tissue can be trapped in some nail, and relatively thin tissue can be trapped in some additionally Nail in.In either case, nail it is applied to the clamping pressure of tissue or power (such as) can be because of nail And different, or can be different between nail and the nail of this nail row other end of nail row one end.In some situation Under, the gap between anvil block and nail bin platform can be controlled so that nail applies a certain minimum in each nail Clamping pressure.But under some these type of situations, the notable change of the clamping pressure in different nails is still There may be.

In use, as to supplementing above, and referring primarily to Figure 39, such as, anvil block is (such as Anvil block 10060) it is moveable to the make position relative with nail bin 10000.As being described in more below, Tissue can be positioned by anvil block 10060 against tissue thickness's compensating part 10020, and in various embodiments In, such as tissue thickness's compensating part 10020 is pressed to the platform surface 10011 of support section 10010. Once anvil block 10060 is appropriately positioned, so that it may disposing nail 10030, this also figure 39 illustrates.? In various embodiments, as it has been described above, nail percussion sliding part 10050 can be from the proximal end of nail bin 10000 10001 move towards distal end 10002, as shown in figure 40.When sliding part 10050 is pushed into, Sliding part 10050 can contact stud driver 10040 and nail chamber 10012 in by staple drivers 10040 to On lift.In at least one embodiment, sliding part 10050 and staple drivers 10040 can each include One or more slopes or inclined surface, these one or more slopes or inclined surface can cooperate so that following closely and driving Dynamic device 10040 moves upward from their non-firing position.In at least one such embodiment, often Individual staple drivers 10040 can include at least one inclined surface, and sliding part 10050 can include one Or multiple inclined surface so that when sliding part 10050 is advanced towards distally in nail bin, sliding part inclines Skewed surface can be in driver inclined surface slid underneath.When staple drivers 10040 is at the nail of each of which When being lifted up in chamber 10012, nail 10030 can be lifted up by staple drivers 10040 so that nail 10030 can be exposed from their nail chamber 10012 by the opening in nail platform 10011 (Figure 41). In exemplary percussion sequence, sliding part 10050 can contact the first nail 10030 and start to follow closely first 10030 are lifted up.When sliding part 10050 is advanced towards farther side, sliding part 10050 can start Other nail 10030 and any other follow-up nail are lifted with sequential order.Sliding part 10050 can be by Nail 10030 drives up so that the lower limb 10032 of the nail contacted with relative anvil block is deformed into desired shape Shape, and penetrate from support section 10010.In all cases, as a part for percussion sequence, Sliding part 10050 can make multiple nail move upward simultaneously.

Seeing Figure 49 to Figure 54, each nail 10030 can be deformed into so that wherein limiting a constricted zone 10039.Such as, each nail 10030 can include base portion 10031 and from base portion 10031 extend one Or multiple lower limb 10032.During the deformation of these lower limbs, can cooperate restriction with base portion 10031 can be by tissue T and group Knit thickness compensation part 10020 and capture region wherein.In constricted zone 10039, tissue thickness is mended Repay part 10020 and can apply pressure to tissue T, and in some cases, different depending on the thickness of tissue T Present different compression heights.In some cases, tissue thickness's compensating part 10020 can flexibly be filled Gap in the constricted zone 10039 limited by nail 10030, i.e. free space.

As mentioned above and see Figure 41, when following closely the non-firing position that 10030 are in them, 10030 are followed closely Nail lower limb 10032 may extend into above the platform surface 10011 of support section 10010.In various enforcements In example, when following closely the non-firing position that 10030 are in them, the top of nail lower limb 10032 or nail lower limb Any other part of 10032 may the top contact tissue of Tu Chuan tissue thickness compensating part 10020 Surface 10021.When following closely 10030 and moving to their firing position from their non-firing position, nail Tissue contacting surface convex may be worn in the top of lower limb.In various embodiments, the top of nail lower limb 10032 can Including the pointed tip that can cut and penetrate tissue thickness's compensating part 10020.In certain embodiments, Tissue thickness's compensating part 10020 can include that multiple hole, the plurality of hole may be structured to accommodate nail lower limb 10032 and allow follow closely lower limb 10032 slide relative to tissue thickness's compensating part 10020.In some embodiment In, support section 10010 may also include the multiple guides 10013 extended from platform surface 10011 (Figure 41).Guide 10013 can be positioned so that adjacent with the nail chamber opening in platform surface 10011, Make to follow closely lower limb 10032 can be supported by guide 10013 at least in part.In certain embodiments, guide Part 10013 can be positioned at proximal end and/or the distal end of nail chamber opening.In various embodiments In, the first guide 10013 can be positioned at the first end of each nail chamber opening, and second leads At the second end that part 10013 can be positioned in each nail chamber opening so that each first guide The first of 10013 sustainable nails 10030 follows closely lower limb 10032, and each second guide 10013 can prop up Second nail lower limb 10032 of nail 10030.In at least one embodiment, Figure 41, each guiding are seen Part 10013 may for instance comprise groove or slit, such as groove 10016, and nail lower limb 10032 can be slided Receive in this groove or slit dynamicly.In various embodiments, can include can for each guide 10013 Extend and may extend into the anti-skid stud tissue thickness's compensating part 10020 from platform surface 10011, dash forward Rise and/or spike.In at least one embodiment, as being described in more below, anti-skid stud, prominent Rise and/or spike can reduce between tissue thickness's compensating part 10020 with support section 10010 relative transport Dynamic.In certain embodiments, the top of nail lower limb 10032 can be positioned in guide 10013, and The top table of guide 10013 may be may not extend to when nail 10030 is in their non-firing position Above face.In the most this embodiment, guide 10013 can limit guiding height, and when nail During the non-firing position that 10030 are in them, nail 10030 may may not extend on this guiding height Side.

In various embodiments, tissue thickness's compensating part (such as tissue thickness's compensating part 10020) is such as Can be made up of single material piece.In at least one embodiment, tissue thickness's compensating part can include continuous material Tablet, this continuous sheet can cover the whole top platform surface 10011 of support section 10010, or Person does not covers whole platform surface 10011.In certain embodiments, this material piece can cover supporting part Divide the nail chamber opening in 10010, and in other embodiments, this material piece can include can be with nail chamber opening Alignment or the opening being directed at least in part.In various embodiments, tissue thickness's compensating part can be by multilamellar Material is constituted.In certain embodiments, tissue thickness's compensating part can include compressible core and can press around this The wrappage of contracting core.

In various embodiments, tissue thickness's compensating part can include for compressible core being releasably held Wrappage to support section 10010.In at least one such embodiment, nail bin may also include guarantor Holder fixture, this keeper fixture may be structured to suppress wrappage and compressible core prematurely with 10010 separation are divided in support part.In certain embodiments, as it has been described above, tissue thickness's compensating part can be by nail 10030 are removably attachable to support section 10010.More specifically, as also described above, when nail 10030 When being in their non-firing position, the lower limb of nail 10030 may extend into tissue thickness's compensating part 10020 In, thus tissue thickness's compensating part 10020 is releasably held support section 10010.At least In one embodiment, the lower limb of nail 10030 can the sidewall contact in its corresponding nail chamber 10012, Qi Zhongyou There is friction between nail lower limb 10032 and sidewall, nail 10030 and tissue thickness's compensating part 10020 can quilts It is held in place, until nail 10030 is deployed from nail bin 10000.After nail 10030 is deployed, It is kept in tissue thickness's compensating part 10020 can be trapped in nail 10030 and against the tissue T sewed up. When anvil block is subsequently moved into open position with release tissue T, support section 10010 is movable away from It is fixed to tissue thickness's compensating part 10020 of tissue.In certain embodiments, binding agent can be used group Knit thickness compensation part 10020 and remain to support section 10010 removedly.In at least one embodiment In, two-part adhesive can be used.In at least one embodiment, the Part I of wherein this binding agent Can be placed on platform surface 10011, and the Part II of this binding agent can be placed on tissue thickness On compensating part 10020 so that be close to platform surface 10011 when tissue thickness's compensating part 10020 and place Time, Part I can contact Part II to enable this binding agent can by tissue thickness's compensating part 10020 It is bonded to support section 10010 discretely.In various embodiments, any other can be used the most square Tissue thickness's compensating part is remained to the support section of nail bin by method separably.

In various embodiments, as to above supplement, sliding part 10050 can proximally be pushed away end Enter distal end, to be disposed completely by all nails 10030 being contained in nail bin 10000.At least one In individual embodiment, referring now to Figure 44, sliding part 10050 can be in the longitudinal chamber in support section 10010 Internal by the knife bar 10052 of firing member or surgical stapling device towards distally advance.In use, nail bin 10000 can be inserted in the staple cartridge channel in surgical stapling device jaw, and firing member 10052 can advance Contact to sliding part 10050, as shown in figure 44.When sliding part 10050 is by firing member 10052 When advancing towards distally, sliding part 10050 can contact one or more staple drivers 10040 of recent side, And nail 10030 is fired (that is, injection) from warehouse 10010 as mentioned above.As shown in figure 44, hit Send out component 10052 and may also include cutting edge 10053, when following closely 10030 and being fired, this cutting edge 10053 can be advanced towards distally by the cutter slit in support section 10010.In various embodiments, phase The cutter slit answered can extend across the anvil block being positioned at nail bin 10000 opposite so that implements at least one In example, cutting edge 10053 can extend and cut between anvil block and support section 10010 and is positioned at anvil block And the tissue between support section 10010 and tissue thickness's compensating part.In all cases, sliding part 10050 can be advanced towards distally by firing member 10052, until sliding part 10050 arrives nail bin 10000 Distal end till.Now, firing member 10052 can proximally bounce back.In certain embodiments, Sliding part 10050 proximally can bounce back with firing member 10052, but in various embodiments, when hitting Sending out component 10052 when bouncing back, sliding part 10050 can stay the distal end 10002 of nail bin 10000 In.Once firing member 10052 the most fully bounces back, and anvil block can be again turned on, now can be by tissue thickness Compensating part 10020 separates with support section 10010, and can plant non-for the residue exhausting nail bin 10000 Enter part (including support section 10010) to remove from staple cartridge channel.

To exhaust nail bin 10000 after staple cartridge channel removes, as to supplementing above, can newly Nail bin 10000 or any other suitable nail bin insert in staple cartridge channel.In various embodiments, make For to above supplement, staple cartridge channel, firing member 10052 and/or nail bin 10000 can include cooperation spy Levying structure, these cooperation feature structures can be positioned at nail bin lead to not yet there being the new nail bin 10000 that do not fires Prevent firing member 10052 from again advancing towards distally time in road 10070.More specifically, work as firing member 10052 when being advanced to contact with sliding part 10050, and does not fires when sliding part 10050 is in its nearside During position, the nose that supports of firing member 10052 can be positioned on the support lugn on sliding part 10050 And/or top so that firing member 10052 is maintained at position the most upwards, to stop from percussion Lock or crossbeam 10054 that component 10052 extends fall in the lock groove being limited in staple cartridge channel.Due to During lock 10054 will not fall into lock groove in such cases, so when firing member 10052 advances, Lock 10054 may will not adjoin the distally sidewall of lock groove.When firing member 10052 is by sliding part 10050 when promoting towards distally, firing member 10052 can owing to leaning against the support nose on support lugn and It is supported on its upwards firing position.When firing member 10052 is as mentioned above relative to sliding part 10050 During retraction, do not rely on the support lugn of sliding part 10050 owing to supporting nose, firing member 10052 upwards can fall position from it.In at least one such embodiment, surgical stapling device can wrap Include the spring that may be structured to that firing member 10052 can be biased to its down position and/or any its His suitable biasing element.Once firing member 10052 is fully retracted, and it just can not be again towards distally It is advanced through the nail bin 10000 exhausted.More specifically, when sliding part 10050 being somebody's turn to do in the sequence of operation When moment is left at the distal end of nail bin 10000, firing member 10052 just can not be by sliding part 10050 are maintained at its upper position.Therefore, if as it has been described above, in the case of not replacing nail bin Again being advanced by firing member 10052, lock crossbeam 10054 will contact the sidewall 10057 of lock groove, Prevention firing member 10052 is advanced in nail bin 10000 by again towards distally.In other words, once Replace the nail bin 10000 exhausted with new nail bin, owing to new nail bin has the sliding part proximally positioned 10050, firing member 10052 can be maintained at its upper position and allow firing member 10052 again Advance towards distally.

As it has been described above, sliding part 10050 may be structured to make staple drivers 10040 not hit first Send out and move between position and the second firing position, in order to nail 10030 is penetrated from support section 10010. In various embodiments, at nail 10030 after support section 10010 penetrates, staple drivers 10040 Can be contained in nail chamber 10012.In certain embodiments, support section 10010 can include may be structured to One or more holding features knot that staple drivers 10040 penetrates from nail chamber 10012 or drops out can be stoped Structure.In other embodiments various, sliding part 10050 may be structured to can be by staple drivers 10040 Penetrate from the support section 10010 with nail 10030.In at least one such embodiment, example As, staple drivers 10040 (such as can be gathered by bioabsorbable material and/or biocompatible materials Etherimide) constitute.In certain embodiments, staple drivers could attach to follow closely 10030.At least one In individual such embodiment, staple drivers moldable above the base portion of each nail 10030 and/or week Enclose so that this staple drivers is one-body molded with nail.It is entitled that JIUYUE in 2006 is submitted on the 29th “SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME " U.S. Patent Application Serial Number 11/541,123 is incorporated by reference in its entirety herein accordingly.

In all cases, as to supplementing above, compressible tissue thickness compensating part can be relative to Rigid support componental movement, distortion and/or deflection below nail bin.In various embodiments, support Any other suitably part of part and/or nail bin can include that being configured to limit tissue thickness mends Repay one or more feature structures of relative motion between part and support section.As it has been described above, nail 10030 The platform surface 10011 that may extend into support section 10010 at least partially above, wherein at some In the case of, the cross force being applied to tissue thickness's compensating part can be prolonged from support section 10010 by (such as) Nail 10030 and/or the anti-skid stud 10013 stretched are kept out.In all cases, tissue kept out by nail 10030 During the transverse movement of thickness compensation part can the tilted and/or bending in nail chamber 10012, wherein in various realities Executing in example, the size of nail chamber 10012 and nail 10030 can be configured to and be configured to keep nail The lower limb 10032 of 10030 and relative anvil block 10060 shape the relative alignment between pit so that nail 10000 correctly shape during nail forming process.In various embodiments, nail 10030 and/or anti-skid stud 10013 may be structured to stop or at least limit the horizontal torsion in tissue thickness's compensating part 10020 Bent.In at least one such embodiment, nail 10030 and/or anti-skid stud 10013 such as can be constructed For strengthening or limit the first surface of tissue thickness's compensating part or tissue contacting surface relative to the second table The laterally and/or longitudinally motion of the i.e. lower surface in face.In various embodiments, nail bin and/or wherein position The staple cartridge channel having nail bin can include at least one minimizing twisting component, and this minimizing twisting component can be to Upper extension is to limit laterally and/or longitudinally motion or the distortion of tissue thickness's compensating part.As it has been described above, extremely Partially the wrappage around tissue thickness's compensating part also can stop, or at least limits tissue thickness's compensation The laterally and/or longitudinally motion of part or distortion.

In various embodiments, nail bin can include that multiple nail chamber, the receiving of each nail chamber are positioned in Nail, wherein nail chamber can be arranged to multiple row, and the anvil block being wherein positioned in nail bin opposite can include The multiple nails corresponding with the nail chamber in nail bin shape pit.In other words, anvil block can include that multiple shaping is recessed Pit row, the most each shaping pit can be positioned on the opposite, nail chamber in nail bin.In various embodiments, often Individual shaping pit can include two the shaping cup-shapeds being configured to receive the nail lower limb 10032 of nail 10030 Thing, the most each shaping cup is configured to receive nail lower limb 10032, and makes nail lower limb 10032 example As shaped towards another nail lower limb 10032 or crimp.In all cases, nail lower limb 10032 may not enter Entering to shape cup or do not properly enter shaping cup, therefore nail lower limb 10032 may be in percussion sequence Deform during row.In various embodiments described herein, anvil block can include each being configured to Enough receive and formed the array shaping pit or the grid of nail lower limb.In at least one such embodiment, The array shaping pit can include a certain amount of shaping pit, and these quantity shaping pit exceed in nail bin The quantity of the nail accommodated.In at least one embodiment, nail bin can include the nail of such as six lengthwise rows Chamber, wherein anvil block can include that six row alignd with six row nail chambeies shape pit, and shapes pit quilt in addition It is positioned at the centre shaping pit row.Such as, on the side of anvil block, anvil block can include can be positioned on The first shaping pit row on one nail chamber row, can be positioned on neighbouring first nail chamber row the second nail chamber row it On the second shaping pit row and be positioned at the first shaping pit row and second and shape in the middle of pit row Shape pit row.

In various embodiments, as it has been described above, such as, anvil block can move to close position from open position Put, in order to against tissue thickness's compensating part (such as tissue thickness's compensating part 10020) the compression group of nail bin Knit.In all cases, before tissue thickness's compensating part is relative to tissue positioned, tissue thickness compensates Part can be adjacent to the support section location of nail bin.In certain embodiments, tissue thickness's compensating part 10020 can Being in such position: in this position, before anvil block moves to its make position, tissue thickness compensates Part 10020 adjoins support section 10018.In some other embodiment, tissue thickness's compensating part 10020 can be at such position: in this position, tissue thickness's compensating part 10020 and support section Gap is there is between 10018.In at least one such embodiment, anvil block can make tissue and tissue thickness Degree compensating part 10020 shifts downwards, until tissue thickness's compensating part 10020 adjoins support section 10018, the most now anvil block is moveable to its make position and produces compression in tissue.If surgery The location being organized between anvil block and nail bin is felt dissatisfied by doctor, can open anvil block, adjust anvil block and The position of nail bin, closes anvil block the most again.Owing to nail bin can carry out this type of location and weight relative to tissue New definition, so in all cases, such as, the distal end of tissue thickness's compensating part 10020 can be with Support section 10010 separates.Under some these type of situations, the distal end portion of tissue thickness's compensating part 10020 Portion can contact tissue, and peel off from support section 10010 or roll relative to support section 10010.? In various embodiments, as being described in more below, nail bin can include being configured to tissue thickness to be mended Repay part and releasably hold one or more feature structures of support section below nail bin.

In various embodiments, referring now to Figure 55, nail bin 10300 can include support section 10310, The tissue thickness's compensating part 10320 supported by support section 10310, and include the remote of nose 10303 Side end 10302, this nose 10303 is configured to can be by the distally of tissue thickness's compensating part 10320 End 10325 is releasably held in appropriate location.In at least one embodiment, nose 10303 can Including being configured to receive the slit of the distal end 10325 of tissue thickness's compensating part 10320 10305.In various embodiments, distal end 10325 can be compressed or is wedged in slit 10305 In so that when nail bin 10300 is relative to tissue positioned, distal end 10325 can be held in place. In at least one such embodiment, slit 10305 can be along being parallel to or at least substantially parallel to propping up Support part divides the direction of the platform surface 10311 of 10310 to be orientated.In various embodiments, slit 10305 Can be level relative to platform surface 10311.In other embodiments various, referring now to Figure 56, Tissue thickness's compensating part 10420 that nail bin 10400 can include support section, be supported by support section, with And include that the distal end 10402 of nose 10403, this nose 10403 are configured to can tissue thickness The distal end 10425 of degree compensating part 10420 is releasably held in appropriate location.Real at least one Executing in example, distal end 10425 can include the protuberance extended from it, and nose 10403 can include It is configured to receive the vertical slit 10405 of the protuberance of distal end 10425.In various enforcements In example, distal end 10425 and/or can be compressed from its protuberance extended or be wedged in slit 10405 In so that when nail bin 10400 is relative to tissue positioned, distal end 10425 can be held in place. In certain embodiments, such as, tissue thickness's compensating part 10420 can include slit (such as slit 10429), this slit may be structured to can receive at least some of of nose 10403 wherein.? In at least one embodiment, slit 10405 along being perpendicular to or can be at least substantially orthogonal to support section The direction orientation of platform surface 10411.In various embodiments, referring now to Figure 57, nail bin 10500 The tissue thickness's compensating part 10520 can include support section, being supported by support section, and include nose Distal end 10502, this nose is configured to can be by the distal end portion of tissue thickness's compensating part 10520 Portion 10525 is releasably held in appropriate location.In at least one embodiment, nose can include vertically Slit 10505, this vertical slit is configured to receive the distal end portion of tissue thickness's compensating part 10520 Portion 10525.In various embodiments, distal end 10525 can be compressed or is wedged in slit 10505 In so that when nail bin 10500 is relative to tissue positioned, distal end 10525 can be held in place.

In various embodiments, referring again to Figure 55, tissue thickness's compensating part 10320 can include top Surface 10324, this top surface 10324 can be positioned on the top surface 10304 of nose 10303 Side.Figure 44 illustrate that the top surface of tissue thickness's compensating part is positioned at above nail bin nose another show The top surface 10721 of example embodiment, the most such as tissue thickness's compensating part 10720 is positioned at nose Above the top surface 10004 of 10003.In use, referring again to Figure 55, tissue can be at nose Slide on the top surface 10304 of 10303, and in some cases, tissue can contact tissue thickness The distal end 10325 of degree compensating part 10320, and tissue thickness's compensating part can be exerted a force to 10320, so that tissue thickness's compensating part 10320 is prone to peel off from support section 10310.Herein In described embodiment, this peeling force can be wedged the part in nose 10303 by distal end 10325 Keep out.Under any circumstance, once organizing and appropriately position relative to nail bin 13000, anvil block can be revolved Forward make position to against support section 10310 compression tissue and tissue thickness's compensating part 10320.? In at least one such embodiment, anvil block can be rotated to such position: in this position, anvil block connects Touch the top surface 10304 of nose 10303, anvil block therefore can be stoped to further rotate.In various situations Under, owing to the top surface 10324 of tissue thickness's compensating part 10320 is just being positioned at the top of nose 10303 Above surface, portion 10304, so when anvil block is just closed, top surface 10324 can be towards support section 10310 are pushed down, and in some cases, such as, top surface 10324 can be pushed to Below the top surface 10304 of nose 10303.As described herein, in being contained in nail bin 10300 After nail has been deployed and tissue thickness's compensating part 10320 is cut into, support section 10310 and nose 10303 is movable away from tissue thickness's compensating part 10320 so that tissue thickness's compensating part 10320 remote End 10325 can skid off slit 10305.

As it has been described above, anvil block (such as anvil block 10060) such as can be rotated to make position, close at this Closing position, anvil block 10060 contacts the top nose surface 10004 of nail bin (such as nail bin 10000). Once anvil block has arrived its make position, tissue thickness's compensating part (such as tissue thickness's compensating part 10020) amount compressed will depend upon which inter alia tissue thickness's compensating part uncompressed thickness or Highly and tissue thickness.Referring now to Figure 42 and Figure 43, tissue thickness's compensating part 10920 can Including the top surface flushing with the top surface 10004 of nose 10003 or at least substantially flushing.? In this type of embodiment, the top surface of tissue thickness's compensating part 10920 can be pushed to nose 10003 Below top surface 10004.Referring now to Figure 47 and Figure 48, tissue thickness's compensating part (is such as organized Thickness compensation part 10820) such as can include top surface 10821.At tissue thickness's compensating part 10820 Before being compressed by tissue T and anvil block 10060, this top surface 10821 is positioned at top nose surface Below 10004.In the case of tissue T relative thin, as shown in Figure 45 and 46, tissue thickness compensates Part 10920 can stand relatively small compression.Referring now to Figure 47 and Figure 48, when tissue T is relatively thick Time, tissue thickness's compensating part 10820 can stand bigger compression.Also thickness is had at the existing thinner part of tissue T Part in the case of, as shown in Figure 47 and Figure 48, such as, tissue thickness's compensating part 10820 can be Compressed larger quantities when it is positioned below thicker tissue T, and be positioned below relatively thin tissue T at it Time compressed less amount.As it has been described above, by this way, tissue thickness's compensating part can compensate for different Tissue thickness.

In various embodiments, referring now to Figure 58 and Figure 59, surgery suturing appliance can include 1) by structure Make the storehouse passage 16670 for being able to receive that nail bin 16600, and 2) being pivotally coupled to The anvil block 16660 of storehouse passage 16670.Nail bin 16600 can include support section 16610 and tissue thickness Compensating part 16620, wherein the distal end 16625 of tissue thickness's compensating part 16620 can be by nail bin Nose 16603 at 16600 distal end 16602 releasably holds support section 16610.? In at least one embodiment, nose 16603 can include slit 16605, and can be made up of flexible material. In use, referring primarily to Figure 58, nose 16603 can bend downwards, in order to expands slit 16605 Opening.In certain embodiments, nose 16603 can include notch or cut out 16606, this recess or cut Mouth 16606 may be structured to make nose 16603 bend downwards.In any case, in various situations Under, this enlarged openings of slit 16605 can be conducive to the distal end of tissue thickness's compensating part 16620 16625 insert in slit 16605.Once tissue thickness's compensating part 16620 the most suitably positions, can be by nose Portion 16603 discharges.Owing to the material of composition nose 16603 has resilience, nose 16603 can return to Or at least substantially return its non-deflected, and trap tissue thickness's compensation against platform surface 16611 The distal end 16625 of part 16620, as shown in Figure 59.In use, similarly as described above, when When support section 16610 is away from the histokinesis sewed up, distal end 16625 can be pulled out slit 16605.In all cases, separate with support section 16610 when tissue thickness's compensating part 16620 Time, flexible nose 16603 may be structured to deflect.In various embodiments, figure is referred again to 59, tissue thickness's compensating part 16620 can include that the top surface 16604 with nose 16603 aligns or extremely The top surface 16621 of few substantial alignment.

In various embodiments, referring now to Figure 60 to Figure 61, nail bin (such as nail bin 11400) example As the tissue thickness's compensating part 11420 being removably attached to support section 11410 can be included.At least In one embodiment, nail bin 11400 can include being configured to can be by tissue thickness's compensating part 11420 Longitudinal side remains to one or more keeper bars 11413 of platform surface 11411.At at least one this In the embodiment of sample, each keeper bar 11413 can include relative arm 11418, and this relative arm can Limit passage 11416 between which.In this type of embodiment, one in arm 11418 can be constructed For extending above at tissue thickness's compensating part 11420, and another arm 11418 may be structured to Can extend below the antelabium 11419 that support section 11410 extends.Referring primarily to Figure 60, each The size of the passage 11416 of keeper bar 11413 can be set and be configured to can use nail bin Longitudinal side of tissue thickness's compensating part 11420 is applied compressive force to before 11400.During use, main Figure 61 to be seen, nail bin 11400 can be positioned in staple cartridge channel, and once nail bin 11400 is the most fixed Position, anvil block (such as anvil block 11460) is the most such as moveable to its compressible tissue thickness compensating part The position of 11420.Similarly as described above, when tissue thickness's compensating part 11420 is compressed, can be horizontal To or outward expansion, therefore make keeper bar 11413 separate with nail bin 11400.At some, other are implemented In example, anvil block 11460 is closed and keeper bar 11413 may will not be made to separate with nail bin, or may not Keeper bar 11413 can be made to be kept completely separate with nail bin.In at least one such embodiment, as above institute Stating propelling trigger shaft can make nail 10030 dispose from support section 11410 through nail bin 11400, squeezes simultaneously Anvil seat 11460 and nail bin 11400 make them closer to each other, in order to apply compressive force to tissue thick Degree compensating part 11420, this compression stress be enough to make tissue thickness's compensating part 11420 extending transversely and make holding Device bar 11413 separates with nail bin 11400.Once keeper bar 11413 separates with nail bin 11400, Support section 11410 can move and from Surgery displacement away from the tissue thickness's compensating part 11420 implanted Remove.

In various embodiments, as to above supplement, nail bin can include multiple securing member, and these are many Individual securing member is configured to be releasably held by tissue thickness's compensating part the support section of nail bin. In certain embodiments, such as, support section can include the multiple holes being limited in platform surface.Wherein Securing member can extend across tissue thickness's compensating part and can be releasably retained the hole at support section In.In use, when nail gradually penetrates from support section, securing member gradually can be released from support section Put.In at least one such embodiment, securing member can be implanted with tissue thickness's compensating part, and And at least one embodiment, such as, securing member can be by least one bioabsorbable material structure Become.In certain embodiments, after tissue thickness's compensating part is the most implanted, and work as support section extremely Time partially away from the tissue thickness's compensating part motion implanted, securing member can separate with support section.? In various embodiments, referring now to Figure 130 to Figure 131, nail bin (such as nail bin 11600) such as may be used Including the tissue thickness's compensating part being releasably attached to support section 11610 by multiple securing members 11613 11620.In each securing member 11613 can include embedding tissue thickness compensating part 11620 and/or with tissue The second end that the first end 11618 that thickness compensation part engages engages with support section 11610 11618, and first end 11618 is connected to the adapter 11616 of the second end 11618.Respectively Planting in embodiment, securing member 11613 can extend across the cutter slit being limited in support section 11610 11615.In use, firing member 10052 can make blade move across in support section 11610 Cutter slit 11615 also cuts securing member 11613, in order to discharges tissue thickness from support section 11610 and mends Repay part 11620.In at least one such embodiment, trigger shaft 10052 can be from nail bin 11600 Proximal end is advanced to the distal end of nail bin 11600, in order to 1) as mentioned above by sliding part 10050 court Distally advances and gradually fires nail 10030；2) gradually cut securing member 11613 and/or make securing member 11613 disconnect, so that tissue thickness's compensating part 11620 gradually discharges from support section 11610.At certain In a little embodiments, similarly as described above, tissue thickness's compensating part 11620 can include multiple separable district Section.These multiple separable sections such as can remain to prop up each via one or more securing members 11613 Support part divides 11610.If firing member 10052 stops at proximal end and the distal end portion of nail bin 11600 In the middle of portion, as illustrated in graph 130, then securing member 11613 can help to open at anvil block 11660 and Support section 11610 away from tissue T move after by the non-implant part of tissue thickness's compensating part 11620 Remain to support section 11610, as shown in Figure 131.In various embodiments, as to benefit above Fill, the cutting edge 10053 of firing member 10052 may be structured to cut securing member 11613 and/or Securing member 11613 is made to disconnect.

In various embodiments, referring now to Figure 132, nail bin such as can include tissue thickness's compensating part (such as tissue thickness's compensating part 15120), this tissue thickness's compensating part can include having different-thickness Some.In at least one embodiment, tissue thickness's compensating part 15120 can include having first The Part I of thickness or interior section 15122a, can each have from Part I 15122a extension The Part II of the second thickness or mid portion 15122b, and from Part II 15122b extend can Each there is Part III or the exterior section 15122c of the 3rd thickness.In at least one such embodiment In, such as, the 3rd thickness is thick than the second thickness, and the second thickness is thick than the first thickness.But In other embodiments various, any suitable thickness can be used.In various embodiments, tissue thickness The part 15122a to 15122c of compensating part 15120 can include the step with different-thickness.At least In one embodiment, similarly as described above, nail bin can include multiple nail row 10030 and have Bu Tong height Multiple staple drivers of degree, these staple drivers can make nail 10030 be deformed into different forming heights.Also Similarly as described above, nail bin can include the first staple drivers 15140a, this first staple drivers 15140a can drive nail 10030 to the first forming height being supported on；Second staple drivers 15140b, this second staple drivers 15140b can drive the nail 10030 to the second being supported on to shape Highly；And the 3rd staple drivers 15140c, the 3rd staple drivers 15140c can drive and be supported on it On nail 10030 to the 3rd forming height.In nail bin, such as, the first forming height can be shorter than second Forming height, the second forming height can be shorter than the 3rd forming height.In various embodiments, such as Figure 132 Shown in, each nail 10030 can include that identical or substantially the same unshaped does not i.e. fire height.? In some other embodiment, referring now to Figure 133, the first driver 15140a, the second driver 15140b and/or the 3rd driver 15140c can support the nail with different unshaped height.At least one In individual such embodiment, the first staple drivers 15140a can support the nail with the first unshaped height 15130a, the second staple drivers 15140b can support the nail 15130b with the second unshaped height, and And the 3rd staple drivers 15140c can support the nail 15130c with the 3rd unshaped height.Wherein, example As, the first unshaped height can be shorter than the second unshaped height, and the second unshaped height can be shorter than the 3rd not Forming height.In various embodiments, refer again to Figure 133, nail 15130a, 15130b and/or The top of 15130c can be located at or is at least substantially positioned in identical plane, and in other embodiments, The top of nail 15130a, 15130b and/or 15130c can not be positioned in identical plane.

In certain embodiments, referring now to Figure 154, nail bin can include that the tissue with some is thick Degree compensating part 15220, the plurality of part has different thickness.This tissue thickness's compensating part 15220 can Implant against tissue T as described above by nail 15130a, 15130b and 15130c.Real at least one Executing in example, referring now to Figure 155, nail 15130a, 15130b and/or 15130c can be deformed to different Forming height.Wherein the first nail 15130a can be configured to the first forming height, and the second nail 15130b can become Shape is the second forming height, and the 3rd nail 15130c can be configured to the 3rd forming height, and wherein, Such as, the first forming height can be shorter than the second forming height, and the second forming height can be shorter than the three one-tenth Shape height.Contemplate other embodiments, wherein follow closely 15130a, 15130b and 15130c and can be configured to appoint What suitable forming height and/or any relative forming height.

As mentioned above and see Figure 134, such as, nail bin (such as nail bin 10000) can include supporting part Points 10010 and tissue thickness's compensating part 10020.Plurality of nail 10030 can be stored at least partly in In support section 10010, and may extend into tissue thickness when following closely 10030 and being in its non-firing position In compensating part 10020.In various embodiments, when following closely 10030 and being in its non-firing position, nail The top of 10030 is not from tissue thickness's compensating part 10020 projection.When staple drivers 10040 is described above Making nail 10030 when its non-firing position moves to its firing position, the top of nail 10030 can penetrate group Knit thickness compensation part 10020 and/or penetrate upper layer or crust 10022.In some embodiment selected else In, when following closely 10030 and being in its non-firing position, the top of nail 10030 can Tu Chuan tissue thickness compensate The top surface of part 10020 and/or crust 10022.In either case, when nail 10030 is by portion When extending upward support section 10010 before administration, nail 10030 can be also as described above relative to supporting part Divide to tilt and/or deflection.

In various embodiments, referring now to Figure 140, such as, nail bin can include tissue thickness's compensating part 13620 and crust or top layer 13621.In at least one such embodiment, such as, one Or multiple absorbent cotton or keeper 13622 can embed in crust 13621.In certain embodiments, each Keeper 13622 can include being defined in one or more hole 13629, when nail 13030 is in it During non-firing position, the one or more hole 13629 may be structured to can accommodate nail wherein The nail lower limb 13032 of 13030, as shown in Figure 140.In use, as to above supplement, work as nail 13030 when its non-firing position moves to its firing position, and nail lower limb 10032 can be slid through hole 13629, until the base portion 13031 contact tissue thickness compensation part 13620 of (such as) nail 13030 is also Against the lower surface of absorbent cotton 13622 by least some of boil down to of tissue thickness's compensating part 13620 Only.In various embodiments, referring now to Figure 135, such as, nail bin can include tissue thickness's compensating part 13120 and crust or top layer 13122.In at least one such embodiment, such as, tissue Thickness compensation part 13120 can include can from the top surface 13121 of tissue thickness's compensating part 13120 upwards Taper lug, protuberance and/or the projection 13128 extended.When nail 13030 is in its non-firing position Time, protuberance 13128 may be structured to receive and encapsulate the top of the nail lower limb 13032 of nail 13030 End, as shown in Figure 135.Top layer 13122 may also include and can align or the most basic with protuberance 13128 The taper lug of upper alignment, protuberance and/or projection 13129.In use, nail lower limb 10032 can be worn Protuberance 13128 and 13129 thoroughly, and expose from tissue thickness's compensating part 13120.In various embodiments In, referring now to Figure 139, such as, nail bin can include tissue thickness's compensating part 13520 and crust Or top layer 13522.In at least one such embodiment, such as, can include can be from for crust 13522 The top surface 13521 upwardly extending taper lug of tissue thickness's compensating part 13520, protuberance and/ Or projection 13529.Similarly as described above, when following closely 13030 and being in its non-firing position, protuberance 13529 may be structured to receive and encapsulate the top of the nail lower limb 13032 of nail 13030, such as Figure 139 Shown in.In use, nail lower limb 10032 can penetrate protuberance 13529 and expose from crust 13522.

In various embodiments, referring now to Figure 136, such as, nail bin can include tissue thickness's compensating part 13220 and crust or top layer 13222.In at least one such embodiment, such as, tissue Thickness compensation part 13220 can include the top surface that can extend downwardly into tissue thickness's compensating part 13220 Taper scrobicula in 13221 and/or groove 13128.In various embodiments, it is in it when nail 13030 During non-firing position, the top of nail lower limb 13032 can extend across groove 13128, as shown in Figure 136. In at least one embodiment, top layer 13222 may also include and can align or the most basic with groove 13228 The taper scrobicula of upper alignment and/or groove 13229.In various embodiments, referring now to Figure 137, example As, nail bin can include tissue thickness's compensating part 13320 and crust or top layer 13322.At least one In individual such embodiment, crust 13320 can include extending downwardly into tissue thickness's compensating part 13320 Top surface 13321 in thick part 13329.In all cases, it is in it when nail 13030 During non-firing position, thick part 13329 may be structured to accommodate wherein the nail lower limb of nail 13030 13032 at least some of, as shown in Figure 137.In this type of embodiment, thick part 13329 can Nail lower limb 13032 is held in place, makes nail lower limb 13032 and be positioned at tissue thickness's compensating part 13320 opposite Anvil block nail shape pit alignment or at least substantially align.In various embodiments, referring now to figure 138, such as, nail bin can include tissue thickness's compensating part 13420 and crust or top layer 13422.? In at least one such embodiment, crust 13422 can include can be from tissue thickness's compensating part 13420 The part 13429 of the upwardly extending thickness of top surface 13421.In all cases, when following closely at 13030 When its non-firing position, thick part 13429 may be structured to can accommodate nail 13030 wherein Follow closely at least some of, as shown in Figure 138 of lower limb 13032.In this type of embodiment, thick part Nail lower limb 13032 can be held in place by 13429, makes nail lower limb 13032 and is positioned at tissue thickness's compensating part The nail of the anvil block on 13420 opposites shapes pit alignment or at least substantially aligns.

In various embodiments, referring now to Figure 141 and Figure 142, such as, nail bin can include that tissue is thick Degree compensating part 13720 and and crust or top layer 13721.In at least one such embodiment, Such as, can include can be from the top surface of tissue thickness's compensating part 13720 for tissue thickness's compensating part 13720 13721 upwardly extending pyramids and/or staged lug, protuberance and/or projection 13728.When When nail 13030 is in its non-firing position, protuberance 13728 may be structured to receive and encapsulate nail The top of the nail lower limb 13032 of 13030, as shown in Figure 142.Similarly, can include can for top layer 13721 The pyramid alignd with protuberance 13728 or at least substantially align and/or staged lug, prominent Portion and/or projection 13729.In various embodiments, crust 13721 may also include from protuberance 13729 upwardly extending one or more tusks 13727, these tusks may be structured to connect Close against top layer 13721 location tissue, and stop or at least limit tissue, top layer 13721 and/or Nail lower limb 13032 top between relative to laterally and/or longitudinally motion.In use, when nail 13030 from When its non-firing position moves to its firing position, nail lower limb 13032 can penetrate protuberance 13728 He 13729, and expose from tissue thickness's compensating part 13720.In various embodiments, referring now to Figure 143 And Figure 144, such as, nail bin can include tissue thickness's compensating part 13820 and crust or top layer 13821.In at least one such embodiment, such as, tissue thickness's compensating part 13820 can include Can be from the upwardly extending pyramid of top surface 13821 of tissue thickness's compensating part 13820 and/or ladder Formula lug, protuberance and/or projection 13828.When following closely 13030 and being in its non-firing position, prominent Portion 13828 may be structured to receive and encapsulate the top of the nail lower limb 13032 of nail 13030, such as figure Shown in 144.Similarly, top layer 13821 can include can aliging with protuberance 13828 or at least substantially The pyramid of alignment and/or staged lug, protuberance and/or projection 13829.In various enforcements In example, top layer 13821 may also include extended downwardly in tissue thickness's compensating part 13820 or many Individual tusk 13827, such as, these tusks may be structured to stop or at least limit top layer Relatively transverse and/or lengthwise movement between 13821 and tissue thickness's compensating part 13820.In use, When following closely 13030 and moving to its firing position from its non-firing position, nail lower limb 10032 can penetrate protuberance 13828 and 13829, and expose from tissue thickness's compensating part 13820.

In various embodiments, referring now to Figure 145, such as, nail bin can include tissue thickness's compensating part (such as tissue thickness's compensating part 13920), this tissue thickness's compensating part can include being defined in ridge therein 13923 and paddy 13924, at least one embodiment, paddy 13924 can be limited at ridge 13923 it Between.In various embodiments, each ridge 13923 can have identical height, substantially the same height Degree or different height.Similarly, each paddy 13924 can include the identical degree of depth, substantially the same The degree of depth or the different degree of depth.In various embodiments, multiple nails 13030 can store at least in part In tissue thickness's compensating part 13920 so that the top of nail 13030 can be positioned in ridge 13923.? In at least one such embodiment, such as, when following closely 13030 and being stored in its non-firing position, nail The nail lower limb 13032 of 13030 can not from tissue thickness's compensating part 13920 and/or be attached to tissue thickness compensate The crust of part 13920 or top layer 13921 projection.In various embodiments, ridge 13923 and/or paddy 13924 can be across nail bin horizontal expansion.In at least one such embodiment, nail bin can include longitudinal knife Slit.Its median ridge 13923 and paddy 13924 can transverse to and/or be perpendicular to the direction of cutter slit and extend. In all cases, ridge 13923 may be structured to be held in place, directly on the top of nail lower limb 13032 To nail 13030 from its non-firing position moves to its firing position.In various embodiments, now Seeing Figure 146, the outer micromicro of tissue thickness's compensating part and/or covering tissue thickness compensating part includes longitudinal ridge And/or paddy.In at least one such embodiment, such as, tissue thickness's compensating part can include by ridge 14023 and paddy 14024 limit top surface, its two-story valley 14024 can be limited at ridge 14023 it Between.In various embodiments, tissue thickness's compensating part can include crust 14021, and this crust 14021 can Including being defined in multiple hole 14029 therein, each hole each may be structured to accommodate nail lower limb 13032.In certain embodiments, hole 14029 can be limited in ridge 14023, wherein nail lower limb 13032 Top can be positioned on below the summit 14028 of ridge 14029, be positioned to flush with summit 14028, and/ Or be positioned at above summit 14028.In certain embodiments, in addition to the above or replace above Described, such as, hole 14029 can be limited in paddy 14024.In certain embodiments, such as, each Hole can embossed around or at least partly surround, this embossing can strengthen the crust around hole and/or tissue Thickness compensation part.Under any circumstance, as to above supplement, such as, crust 14021 can with appoint What suitably mode is attached to tissue thickness's compensating part, including using at least one binding agent.

In various embodiments, referring now to Figure 148, such as, disposable loading unit 15900 can wrap Including anvil block 15960 and staple cartridge channel 15970, wherein staple cartridge channel 15970 can be relative to anvil block 15960 Rotate.In at least one such embodiment, anvil block 15960 may not rotate.Real at some Executing in example, tissue can be positioned between anvil block 15960 and staple cartridge channel 15970, staple cartridge channel subsequently 15970 can rotate towards tissue with against anvil block clamping tissue.In at least one such embodiment, one Secondary property loading unit 15900 may also include that may be structured to can tissue thickness's compensating part of contact tissue 15920。

In various embodiments, referring now to Figure 149 to Figure 151, disposable loading unit 12900 can Including charging assembly, this charging assembly includes the bottom that can be removably attached to support section 12610 Part 12922, the top section 12990 of anvil block 12560 can be removably attached to, and the end of by The flexible joint 12991 that portion's part 12922 and top section 12990 couple together.It is similar to institute above State, longitudinally keep guide rail 12825 can extend downwardly into from base section 12922 and be limited to support section In cutter slit 12615 in 12610 so that base section 12922 can be releasably retained and prop up Support part divides 12610.Similarly, guide rail 12995 is longitudinally kept can to upwardly extend from top section 12990 In the cutter slit being limited in anvil block 12560 so that top section 12990 can be protected releasedly Hold anvil block 12560.As shown in Figure 150 and Figure 151, tissue thickness's compensating part 12620 can be mounted To the base section 12922 of charging assembly, wherein in order to carry out position tissue relative to support section 12610 Thickness compensation part 12620, clinician can make top section 12990 and base section 12922 towards each other Flexure, is positioned at charging assembly between anvil block 12560 and support section 12610, then discharges flexure Charging assembly so that charging assembly can against anvil block 12560 come resilient expansion and biasing top section 12990, and come resilient expansion and biasing base section 12922 against support section 12610.

In various embodiments, referring now to Figure 152, such as, nail bin (such as nail bin 14900) can Including support section 14910, in addition, also include that the tissue against support section 14910 location is thick Degree compensating part 14920.Similarly as described above, such as, support section 14910 can include can be by nail portion The staple drivers that administration's sliding part is upwards lifted away from, in order to be lifted away from nail (such as following closely 10030).These nail towards Anvil block (such as, being such as positioned at the anvil block 10060 on nail bin 14900 opposite) is positioned at least partially at In support section 14910.In certain embodiments, such as, support section 14910 can include six row nails Chamber, the two row nail chambeies in such as outside, two row of inner side are followed closely chambeies and are positioned in inner row and outer row Between middle two rows nail chamber.Wherein anvil block 10060 can include and follow closely what alignd or at least substantially alignd in chamber Six row shape pit 10062.In various embodiments, inner row nail chamber can include the nail being positioned in Driver 14940a, center row nail chamber can include the staple drivers 14940b that is positioned in, and outward Skidding nail chamber can include the staple drivers 14940c being positioned in.Wherein in staple drivers 14940a Each can include being configured to can the support 14949a, staple drivers 14940b of support nail 10030 In each can include being configured to can the support 14949b of support nail 10030, staple drivers Each in 14940c can include being configured to can the support 14949c of support nail 10030.At nail At the non-firing position of driver, i.e. extending to when staple drivers 14940a to 14940c rests upon When support part is divided on 14910 driver support members 14926 below, compared to staple drivers 14940b's The support 14949c of support 14949b and staple drivers 14940c, the support of staple drivers 14940a 14949a can position closer to anvil block 10060.In such position, the first forming distance can be limited at Support 14949a and being positioned between the shaping pit 10062 above support 14949a；Second shape away from From can be limited at support 14949b and be positioned the shaping pit 10062 above support 14949b it Between；3rd forming distance can be limited at support 14949c and be positioned the shaping above support 14949c Between pit 10062.The most in various embodiments, such as, the first forming distance can be shorter than the second one-tenth Shape distance, and the second forming distance can be shorter than the 3rd forming distance.When staple drivers 14940a extremely 14940c is when their non-firing position (Figure 152) moves to their firing position, and each nail drives Dynamic device 14940a to 14940c can be disposed sliding part by nail and move upward towards anvil block 10060 equal or extremely The distance being substantially identical less so that the first driver 14940a is by its accordingly nail 10030 driving the One forming height, its corresponding nail 10030 is driven the second forming heights by the second driver 14940b, It is followed closely 10030 driving the 3rd forming heights by the 3rd driver 14940c accordingly.Wherein, such as, First forming height can be shorter than the second forming height, and the second forming height can be shorter than the 3rd shaping height Degree.Contemplate other embodiments various, wherein the first staple drivers 14940a by upward displacement first away from From, the second staple drivers 14940b is by upward displacement second distance, and the 3rd staple drivers 14940c By upward displacement the 3rd distance.Wherein one or more in the first distance, second distance and the 3rd distance Can be different.

In various embodiments, refer again to Figure 152, relative to the tissue contacting surface of anvil block 10060 10061, the platform surface 14911 of support section 14910 can in height be varied from.Real at some Executing in example, this height change can produce in the horizontal, and at least one embodiment, such as, encloses The height of the platform surface 14911 around inner row nail chamber can be higher than the platform surface around outer row nail chamber The height of 14911.In various embodiments, the lower surface 14922 of tissue thickness's compensating part 14920 It is configured to be parallel to or at least substantially parallel to the platform surface of support section 14910 14911.As to above supplement, tissue thickness's compensating part 14920 also can become on thickness Change.The most at least one embodiment, top surface or the tissue of tissue thickness's compensating part 14920 connects Touch surface 14921 to slope inwardly from its outward flange i.e. transverse edge.In at least one such embodiment In, due to mentioned above, such as, tissue thickness's compensating part 14920 can be positioned inner row nail chamber it On region in relatively thin, and be positioned outer row nail chamber on region in thicker.In various enforcements In example, referring now to Figure 153, such as, the platform surface of support section 15010 can include that staged is put down Platform surface.Wherein, such as, the highest step of this stepped surface can follow closely chamber around inner row, and should The minimum step of stepped surface can follow closely chamber around outer row.In at least one such embodiment, tool The step having intermediate altitude can follow closely chamber around center row.In certain embodiments, such as, tissue thickness is mended Repaying part (such as tissue thickness's compensating part 15020) and can include lower surface, this lower surface can be parallel to The platform surface of support section 15010 also adjoins with this platform surface.In at least one embodiment, example As, top surface or the tissue contacting surface 15021 of tissue thickness's compensating part can include arch, parabolic Line and/or curved surface, at least one such embodiment, this surface can from tissue thickness First cross side of degree compensating part 15020 extends to the second cross side of tissue thickness's compensating part 15020, Such as, the center alignment of summit and nail bin 15000 or at least substantially align.

In various embodiments, as to supplementing above, the nail of nail bin 10000 percussion sliding part 10050 can under the effect of firing member (as other places illustrate) from the proximal end of nail bin 10000 towards The distal end 10002 of this nail bin is moved, as shown in Figure 161 and Figure 162.When sliding part 10050 quilt During propelling, sliding part 10050 can contact stud driver 10040 at the warehouse being defined in nail bin 10000 In nail chamber 10012 in 10010, staple drivers 10040 is lifted up.In at least one embodiment In, sliding part 10050 and staple drivers 10040 can each include one or more slope or nauropemeter Face, these one or more slopes or inclined surface can cooperate so that staple drivers 10040 and being supported on Nail move upward from their non-firing position.Nail bin 10000 may also include dish 10027, such as, This dish can accommodate the nail in warehouse 10010 bottom at least partly about warehouse 10010 and at least in part Driver 10040.Warehouse 10010 may also include and is defined in longitudinal slit 10016 therein, and this is longitudinally Slit 10016 is configured to can receive percussion at least in part when firing member is through nail bin 10000 Component.

Turning now to Figure 163, the nail accommodated in staple cartridge body 10010 can be in the proximal end of nail bin 10000 In succession fire between 10001 and distal end 10002.In various embodiments, such as, nail bin 10000 can include staple drivers 10040a, 10040b and 10040c, and these staple drivers can use pre- The mode first determined is to fire nail.Such as, nail bin 10000 can include being positioned at longitudinal slit 10016 Nearside driver 10040c on first side, and it is positioned at the second side of longitudinal slit 10016 the most relatively The second nearside driver 10040c on side.Each driver 10040c is configured to fire simultaneously Two nails, i.e. the nail of two recent sides.This type of nail is positioned in the nail chamber being labeled as 10012c.Thing In reality, the every side subscript at longitudinal slit 10016 is designated as in two nail chambeies of 10012c, this type of nail Chamber 10012c can include the nail chamber, distally being labeled as 10013c and be labeled as the nearside nail chamber of 10014c.Read Person is it is to be understood that nail chamber 10013c is positioned in the nail row different from following closely chamber 10014c.It is true that nail Chamber 10013c and 10014c can be located at two inner sides and follow closely in row, and the 3rd outermost nail row will not driven The nail of dynamic device 10040c percussion.Additionally, nail bin 10000 can include being positioned at longitudinal slit 10016 Medium drive 10040b on first side, and it is positioned at the second side of longitudinal slit 10016 the most relatively The second medium drive 10040b on side.Each driver 10040b is configured to fire simultaneously Three nails.This type of nail is positioned in the nail chamber being labeled as 10012b.It is true that at longitudinal slit 10016 Every side subscript be designated as in three of 10012b nail chambeies, this type of nail chamber 10012b can include being labeled as The nail chamber, distally of 10013b, be labeled as 10014b in the middle of nail chamber and be labeled as the distally nail of 10015b Chamber.Reader is it is to be understood that three nail chambeies 10013b, 10014b and 10015b are all positioned at different In nail row.It addition, nail bin 10000 can include the distally being positioned on the first side of longitudinal slit 10015 Driver 10040a, and it is positioned at the second distally on the second side i.e. opposite side of longitudinal slit 10015 Driver 10040a.Each driver 10040a is configured to can fire four nails simultaneously.This type of nail It is positioned in the nail chamber being labeled as 10012a.It is true that at every side subscript of longitudinal slit 10016 Being designated as in four nail chambeies of 10012a, this type of nail chamber 10012a can include being labeled as two of 10013a far Nail chamber, side, be labeled as 10014a in the middle of nail chamber and be labeled as the nail chamber, distally of 10015a.Reader will Understanding, nail chamber 10013a, 10014a and 10015a are all positioned at and extend across longitudinal slit 10,016 1 In the array of all three nail row on side.It is true that the farthest side nail chamber being positioned in warehouse 10010 Farthest side nail in 10013a is positioned in inner side nail row and outside nail row, and relative to being in and being positioned in In the middle of between side nail chamber row and nail chamber, outside row, the farthest side nail chamber 10014a in the row of nail chamber prolongs towards distally Stretch.Although the most only discuss several staple drivers 10040a, 10040b and 10040c, but nail bin 10000 can include any appropriate number of staple drivers for following closely from the injection of nail chamber.This type of staple drivers Two, three, four and/or more nail can be penetrated simultaneously.Referring specifically to Figure 18, nail bin can include Such as can support one or more staple drivers 41040a of two nails thereon, such as be configured to Enough one or more staple drivers 41040b supporting three nails the most thereon, and/or be configured to can be One or more staple drivers 41040c of four nails are supported on it.In various embodiments, it is contained in nail More last staple drivers or farthest side staple drivers in storehouse can include staple drivers 41040c, and these drive Dynamic device 41040c can include two distally that more last nails are maintained in staple line being supported support 41041c.Such as, driver 41040a to 41040c supports the nail in six staple lines, and driver 41040c supports the more last nails in four staple lines of those staple lines.This type of nail can be along being perpendicular to cutting The axis alignment in path (this cutting path extends along a longitudinal axis), or at least substantially align.Due to This type of nail has above-mentioned arrangement, and they can provide various hemostasis beneficial effect.In two other staple line More last nails can be supported by support 41041b.

In various embodiments, the nail bin for surgical stapling device can include that the nail being such as arranged in nail bin is put down Layer on platform, such as tissue thickness's compensating part and/or buttress material.In use, fired when nail Time, described layer and patient tissue can be by these nail captures.Subsequently, described layer can divide with surgical stapling device Open, can be retained in the patient when stiching instrument removes from patient.In certain embodiments, described layer Distal end could attach to nail bin, so that described layer just positions relative to patient tissue when nail bin and this layer Time, stable relative to nail bin.

Distal end at described layer is attached in some embodiment of nail bin, and this nail bin can include towards distally The cutting blade arranged, the distal end that described layer is attached to nail bin is cut away by this cutting blade.Figure 81 A Illustrating nail bin groupware 2300 to Figure 83, this nail bin groupware 2300 includes nail bin 2330 and is arranged in nail bin Distal incision blade 2324 in the distal chamber 2332 of 2330.As being described in more below, distal incision Blade 2324 never deployed position can move to deployed position in distal chamber 2332.In deployed position, Cutting blade 2324 extends distal chamber 2332 to cut off the distal end portion of the layer 2306 being arranged on nail bin Portion 2316.

Seeing Figure 82 and Figure 83, in various embodiments, the distal part 2316 of layer 2306 can be passed through Being trapped in and be attached to nail bin 2300 between nail bin 2300 and panel 2310, this panel 2310 is from nail The nose 2308 of storehouse assembly 2300 proximally extends.In certain embodiments, layer 2306 can be by pressure Shrink in and be captured between nail bin 2330 and panel 2310.In other words, nail bin 2330 and panel Gap between 2310 is smaller than positioning the thickness of the distal part 2316 of layer 2306 in the gap, Distal part 2316 is compressed between nail bin 2330 and panel 2310.In some embodiment In, seeing Figure 82 and Figure 83, the distal part 2316 of layer 2306 can include one or more hole 2320.One or more bolts 2318 can extend across hole 2320 from panel 2308, with trapping layer The distal part 2316 of 2306.In certain embodiments, such as, the distal part 2316 of layer 2306 Nail bin 2330 can be attached to by binding agent, welding and/or hot riveting.

The distal incision blade that the remainder of the distal part 2316 of layer 2306 with layer 2306 is cut off In 2324 distal chamber 2332 that may be arranged at nail bin 2330.Distal chamber 2332 and distal incision blade 2324 can be oriented so that distal incision blade 2324 can be attached to nail relative to distal part 2316 The distal part 2316 of layer 2306 is cut off by the position of the position in storehouse 2330 more nearside.Such as, Seeing Figure 82 and Figure 83, distal incision blade 2324 can be attached to relative to by distal part 2316 The bolt 2318 of nail bin 2330 and the position of hole 2320 more nearside are by the distal part 2316 of layer 2306 Cut off.Therefore, when the distal part 2316 of layer 2306 is cut off by distal incision blade 2324, layer The remainder of 2306 can discharge from nail bin.

Distal incision blade 2324 can include cam 2322, and this cam 2322 can be by distal incision cutter Sheet 2324 releases distal chamber 2332.Guide rail in the engageable distal chamber of cam 2,322 2332 and/or passage 2334, this guide rail and/or passage 2334 can be when blade 2324 extends distal chamber 2332 by cams 2322 and the movement limit of distal incision blade 2324 at specific direction.Guide rail and/or passage 2334 exist Figure 82 and Figure 83 is illustrated as being perpendicular to the nail platform 2302 of nail bin 2330.In this arrangement, when Distal incision blade 2324 never deployed position (Figure 82 illustrates) moves to deployed position, and (Figure 83 shows Go out) time, can distally extend along the direction following closely platform 2302 being perpendicular to nail bin 2330 in chamber 2332. In various embodiments, guide rail and/or passage 2334 can be arranged to the nail platform relative to nail bin 2330 2302 one-tenth any proper angle.Such as, guide rail and/or passage 2334 can be arranged to relative to nail bin The nail platform 2302 of 2330 becomes 30 ° of angles so that distal incision blade 2324 is along relative to nail bin 2330 Nail platform 2302 becomes the distal direction part at 30 ° of angles to extend distal chamber 2322.

In order to dispose distal incision blade, cam 2322 can be promoted by firing member 2326.Such as, hit Send out component 2326 to may be arranged in the slit (such as cutter slit 2304) in nail bin 2330.Firing member 2326 can include can engaging with cam 2322 so that cam 2322 and distal incision blade 2324 towards The cam face 2328 and 2329 of layer 2306 displacement.Firing member 2326 can be relative to cam 2322 He Distal incision blade 2324 from unactuated position towards distal movement to actuated position, to dispose cutting blade 2324 and the distal part 2316 of layer 2306 is cut off.Figure 82 illustrates the percussion being in unactuated position Component 2326, in this unactuated position, cam face 2328 and 2329 not yet connects with cam 2322 Close.In various embodiments, when firing member 2326 is in unactuated position, firing member 2326 Cam face 2328 and 2329 in one or two can with cam contact, if distal incision blade 2324 are not pushed out distal chamber 2332.When firing member 2326 is towards distal movement to shown in Figure 83 Actuated position time, the cam face 2328 of firing member 2326 engages with cam 2322, with by convex Wheel 2322 and distal incision blade 2324 are gradually pushed to deployed position so that distal incision blade 2324 The distal part 2316 of layer 2306 is cut off.

As it has been described above, the guide rail in the engageable distal chamber of cam 2,322 2332 and/or passage 2334.This Outward, guide rail and/or passage 2334 can be arranged to become one jiao relative to the nail platform 2302 of nail bin 2330 Degree.In various embodiments, guide rail and/or passage 2334 can be arranged to into such angle, this angle Degree makes when distally distal incision blade 2324 is disposed in chamber 2332, cam 2322 and blade 2324 Towards distal movement.In all cases, arrange that guide rail can reduce actuating in the following manner at this angle The size of the power needed for firing member 2326: along firing member 2326 move along longitudinal axis by convex The component motion alignment of wheel 2322 and blade 2324.Arrange that guide rail also can reduce cam with such angle Between 2322 and firing member 2326 and/or cam 2322 and the guide rail in distal chamber 2332 and/or passage The probability sticked together between 2324.

In various embodiments, firing member 2326 can pass through cutting blade 2312 and/or staple drivers 2340 from unactuated position towards distal movement to actuated position.In various embodiments, firing member 2326 can be integral with tissue cutting blade 2312 and/or staple drivers 2340 so that percussion structure Part 2326 together with tissue cutting blade 2312 and/or staple drivers 2340 along the longitudinal direction of nail bin 2330 Axis travels across nail bin 2330.In other embodiments various, firing member 2326 can be cut with tissue Cutting blade 2312 and/or staple drivers 2340 are separately.In this type of embodiment, organize cutting blade 2312 and/or staple drivers 2340 firing member 2326 can be forced through nail bin 2330.As another Plant and select, separate with tissue cutting blade 2312 and/or staple drivers 2340 at firing member 2326 In this type of embodiment, firing member 2326 can be positioned at the distal end of nail bin 2330, now fires Component 2326 is in unactuated position, as shown in fig.82.When cutting blade 2312 and/or staple drivers During the distal end that 2340 arrive nail bin 2330, this cutting blade 2312 and/or staple drivers 2340 can Travel across nail bin 2330, shift firing member 2326 onto actuated position subsequently, as shown in Figure 83.? In all these embodiments, tissue cutting blade 2312 and/or staple drivers 2340 are along nail bin 2330 The side of longitudinal axis move upward can by distal incision blade 2324 along be different from tissue cutting blade and/ Or the direction deployment of staple drivers 2340.

In various embodiments, until organizing cutting blade 2312 and/or the percussion of staple drivers 2340 Stroke has completed or has the most completed, and just disposes distal incision blade 2324 by the extremity of layer 2306 Divide 2316 cut-outs.In this type of embodiment, the distal part 2316 of layer 2306 can remain attached to nail Storehouse 2330, thus makes layer 2306 stable relative to nail bin 2330, until most of even all of nails are Fired by staple drivers 2340 and/or until patient tissue and layer 2306 are by tissue cutting blade 2312 Cut off.In other embodiments various, distal incision blade 2324 can be deployed at tissue cutter Sheet 2312 and/or staple drivers 2340 start they percussion stroke before by the distal part of layer 2306 2316 cut off.Such as, firing member 2326 can be by the first cause of the percussion trigger of surgical stapling device Action moves to the actuated position shown in Figure 83 with from the unactuated position shown in Figure 82.Percussion trigger Follow-up actuating tissue cutting blade 2312 and/or staple drivers 2340 can be made to move.Therefore, layer The distal part 2316 of 2306 can be before tissue cutting blade 2312 cut off patient tissue and/or can be Nail bin 2330 is departed from before nail trapping layer 2306 and patient tissue.As another example, firing member 2326 by the first trigger-actuated of surgical instruments, and can organize cutting blade 2312 and/or nail to drive Device 2340 can be by the second trigger-actuated.

As it has been described above, the nose 2308 of nail bin groupware 2300 can include panel 2310, this panel 2310 Proximally extend from nose 2308 and the distal part 2316 of cover layer 2306 at least in part.Panel 2310 can include towards interior surface 2309, should can facing layer 2306 remote towards interior surface 2309 Side part 2316.In certain embodiments, distal part 2316 is cut off at distal incision blade 2324 Time, the inner surface 2309 of panel 2310 can support the distal part 2316 of layer 2306.In various feelings Under condition, when distal incision blade 2324 is deployed, distal incision blade 2324 finally can with towards interior Surface 2309 contact, thus that the distal part 2316 of layer 2306 is complete with the remainder of layer 2306 Full cut-out.

Panel 2310 also can protect patient tissue so that it is injures from distal incision blade 2324.Respectively In the case of Zhong, do not cut off by tissue cutting blade 2312 and/or do not closed by the stapling from nail bin 2330 Uninfluenced patient tissue can cross the exterior surface 2311 of panel 2310.In such cases, panel 2310 can protect these uninfluenced tissues so that it is injure from distal incision blade 2324.Such as, As shown in Figure 83, panel 2310 can be positioned on the distal incision blade 2324 extending distal chamber 2332 And between the patient tissue of the exterior surface 2311 of panel 2310 so that these patient tissues are the most sudden and the most violent It is exposed to distal incision blade 2324.

Referring now to Figure 77 to Figure 79, nail bin 20000 can include warehouse 20010 and releasedly It is attached to tissue thickness's compensating part 20020 of warehouse 20010.Nail bin 20000 can include nail, nail chamber and/ Or any suitably-arranged of staple drivers.Staple drivers is after being fired by sliding part or firing member, towards far Side through nail bin 20000 with by least some of of tissue thickness's compensating part 20020 and patient tissue extremely Few part capture is in nail, as described elsewhere herein.For brevity, at this not to reader repeat with Follow closely, follow closely the explanation that chamber is relevant with staple drivers.Referring now primarily to Figure 77 and Figure 77 A, nail bin 20000 Can include sliding part 20060, this sliding part 20060 is advanced towards distally by firing member 20050.Hitting Sending out certain point during component 20050 and sliding part 20060 are distally advanced, sliding part 20060 is such as May be structured to make tissue thickness's compensating part 20020 discharge from warehouse 20010, such as Figure 78 and Tu Shown in 79.Such as, the distal end 20022 of tissue thickness's compensating part 20020 can be by flexible clamp 20013 and retaining pin 20072 releasably hold the distal end of warehouse 20010, wherein sliding part The 20060 holding effects that can overcome retaining pin 20072, or recall from retaining pin.Flexible clamp 20013 may be structured to can be against the platform 20015 of warehouse 20010 by tissue thickness's compensating part 20020 firmly fix.In such cases, flexible clamp 20013 can be to tissue thickness's compensating part 20020 provide enough clamping forces, to be held in place by by tissue thickness's compensating part 20020.Protect Hold pin 20072 and also tissue thickness's compensating part 20020 can be securely held to warehouse 20010.Such as, Seeing Figure 77 and Figure 77 A, the distal end 20022 of tissue thickness's compensating part 20020 can include limiting In hole 20023 therein, this hole 20023 is able to receive that retaining pin 20072, and owing to retaining pin Interaction between 20072 and the sidewall in hole 20023, retaining pin 20072 can prevent tissue thickness from mending Repay part 20020 to skid off between clamp 20013 and storehouse platform 20015.Additionally, retaining pin 20072 He Clamp 20013 can cooperate and limit the motion of tissue thickness's compensating part 20020, and in all cases, The top of retaining pin 20072 can adjoin clamp 20013, or can be positioned so that the most adjacent with clamp.

In use, as to above supplement, the position of retaining pin 20072 can be due to sliding part 20060 recall and decline, as shown in Figure 78 and Figure 79.More specifically, retaining pin 20072 can be from convex Wheel 20070 extension.Its cam 20070 can dispose or rest upon from the dish being attached to warehouse 20010 On the 20011 elastic component i.e. springs 20012 extended；And when sliding part 20060 engages cam When 20070, this sliding part 20060 can push down on cam 20070 and retaining pin 20072, thus presses Contracting spring 20012.Warehouse 20010 can include being defined in guide 20018 therein, and this guide limits Cam 20070 processed, along substantially vertical path, is i.e. perpendicular to the path motion of storehouse platform 20015.? In various embodiments, sliding part 20060 can include cam actuator 20062, this cam actuator 20062 are lifted away from surface 20063 towards distal extension relative to staple drivers.Once the position of pin 20072 is Fully declining, tissue thickness's compensating part 20020 can slide and from clamp relative to storehouse platform 20015 20013 skid off.In all cases, pin 20072 can decline enough amounts, but still from storehouse platform 20015 projections at least in part.In other cases, pin 20072 can drop to storehouse platform 20015 times Side.In either case, cam actuator 20062 and the staple drivers of sliding part 20060 is lifted away from table Face 20063 enables to the retaining pin 20072 nail at last nail or farthest side by sliding part 20060 Fully decline while percussion.In other cases, cam actuator 20062 He of sliding part 20060 Staple drivers is lifted away from surface 20063 and may be structured to can make at last nail or the nail quilt of farthest side Before sliding part 20060 percussion, retaining pin 20072 fully declines.In the case of other other, sliding The cam actuator 20062 of moving part 20060 and staple drivers are lifted away from surface 20063 can make retaining pin 20072 the most fully decline after the nail of last nail or farthest side is fired by sliding part 20060.Although Cam 20070 is described herein as having a retaining pin 20072, but multiple retaining pin 20072 Can extend from cam 20070, these retaining pins each can be by releasable for tissue thickness's compensating part 20020 Remain to warehouse 20010.Therefore, tissue thickness's compensating part 20020 can include being able to receive that retaining pin The appropriate number of hole 20023 of 20072.

Referring now to Figure 80 and Figure 81, such as, nail bin 21000 can include warehouse 21010, releasable Be fixed to tissue thickness's compensating part 21020 of warehouse 21010 and can discharge from warehouse 21010 The sliding part 21060 of tissue thickness's compensating part 21020.Similar mentioned above, sliding part 21060 can wrap Include staple drivers and be lifted away from surface 21063.Staple drivers is lifted away from surface 21063 and is configured to be driven by nail Dynamic device and the nail being supported on lift towards the anvil block being positioned at tissue thickness's compensating part 21020 opposite. Also being similar to mentioned above, sliding part 21060 may also include cam actuator 21062.Cam actuator 21062 can act on clamp 21013, allow clamp 21013 no longer by tissue thickness's compensating part 21020 Distal end 21022 remain to the platform surface 21015 of warehouse 21010.More specifically, clamp 21013 can include the cam 21072 extending downwardly in warehouse 21010.Wherein when sliding part 21060 When being advanced through nail bin 21000 towards distally, cam 21072 can be engaged by cam actuator 21062.When When cam actuator 21062 engages cam 21072, cam actuator 21062 can by cam 21072 to On lift and make clamp 21013 to bend away from the distal end 21022 of tissue thickness's compensating part 21020, As shown in Figure 81.Now, warehouse 21010 can move away from tissue thickness's compensating part 21020.Change sentence Talking about, tissue thickness's compensating part 21020 is before discharging from warehouse 21010, the most by one or more nails Implant patient tissue.In this case, after tissue thickness's compensating part 21020 is discharged, warehouse 21010 can move away from the tissue thickness's compensating part 21020 implanted and remove from operative site.

As to above supplement, the cam actuator 21062 of sliding part 21060 and staple drivers are lifted away from Surface 21063 enables to the cam 20072 nail at last nail or farthest side by sliding part 20060 Sufficiently raise while percussion to be enough to reduce the clamping force applied by clamp 21013.In other situations Under, the cam actuator 21062 of sliding part 21060 and staple drivers are lifted away from surface 21063 and can be constructed For enabling to last nail or before the nail of farthest side fired by sliding part 21060, cam 21072 Sufficiently raise to be enough to reduce the clamping force applied by clamp 21013.In the case of other other, The cam actuator 21062 of sliding part 21060 and staple drivers are lifted away from surface 21063 and enable to cam 20072 sufficiently raise with foot after the nail of last nail or farthest side is fired by sliding part 21060 The clamping force applied by clamp 21013 with reduction.Have although clamp 21013 is described herein as One cam 21072 extended from it, but multiple cam 21072 can extend from clamp 21013, these Cam each can be lifted away from clamp 21013 so that tissue thickness's compensating part 20020 is released from warehouse 20010 Put.

As to above supplement, sliding part or firing member through nail bin can be at sliding part towards distally At the end of motion or close at the end of, and/or at the end of the percussion stroke of firing member, will tissue thickness Degree compensating part discharges from warehouse.In other words, tissue thickness's compensating part can be at the nail of all or almost all Discharge from warehouse while nail bin percussion is complete.In other embodiments various, tissue thickness's compensating part Can the nail of first i.e. recent side of nail from nail bin fire while or before from warehouse discharge.One so Exemplary embodiment draw in Figure 90 to Figure 92, the figures illustrate nail bin 22000.It is similar to Mentioned above, nail bin 22000 can include warehouse 22010 and be releasably secured to warehouse 22010 Tissue thickness's compensating part 22020.Although nail bin 22000 may also include nail percussion as above and slides Part, but this sliding part may will not discharge tissue thickness's compensating part 22020；On the contrary, nail bin 22000 is also Actuator 22011 can be included, this actuator 22011 can when the percussion stroke of firing member starts, by Firing member advances towards distally.Other embodiments various announced herein disclose for advancing cause towards distally The device of dynamic device.But for brevity, the most not to reader repeat relevant with this embodiment these other Embodiment.Under any circumstance, actuator 22011 can include the cam support extended from it 22012, this cam support 22012 can work as support when actuator 22011 is in its unactuated position Cam 22070, as shown in Figure 90.Additionally, nail bin 22000 may also include biasing member i.e. spring 22074.This biasing member i.e. spring 22074 can similarly be in shown in Figure 90 at actuator 22011 Its unactuated position time, keep against cam support 22012 or offset cam 22070.Work as cam 22070 when being in such position, and the retaining pin 22072 extended from cam 22070 can be with tissue thickness The hole 22023 limited in the distal end 22022 of compensating part 22020 engages and extends through this hole 22023 so that similarly as described above, retaining pin 22072, and/or with extend from warehouse 22010 Tissue thickness's compensating part 22020 can be maintained at suitable position by the retaining pin 22072 of clamp 22013 cooperation Put.

When actuator 22011 is advanced towards distally by firing member, referring now to Figure 91, cam support Part 22012 can advance towards distally so that cam support 22012 is it is possible to no longer supporting cam wheel 22070.In such cases, spring 22074 can be by cam 22070 biased downward so that retaining pin 22072 are biased to no longer engage with tissue thickness compensating part 22020, or at least local with tissue thickness Degree compensating part 22020 engages.In the case of at least one, spring 22074 can be by downward for cam 22070 Biasing so that retaining pin 22072 is positioned in below the platform 22015 of nail bin 22010.In any feelings Under condition, actuator 22011 advances towards distally and tissue thickness's compensating part 22020 all can be made from warehouse 22010 Release.In other words, although retaining pin 22072 position declines, clamp 22013 still can be to tissue thickness Compensating part 22020 provides chucking power so that tissue thickness's compensating part 22020 remains held against nail platform On 22015；But, once apply enough between tissue thickness's compensating part 22020 and warehouse 22010 Relative to force, tissue thickness's compensating part 22020 can skid off below clamp 22013.As to above Supplementing, tissue thickness's compensating part 22020 can be at the nail of recent side from nail bin from warehouse 22010 release Occur to occur with this percussion before 22000 percussions simultaneously, and/or occur immediately after this percussion.At this In the case of class, even if the tissue thickness of release in advance compensating part 22020 makes tissue thickness's compensating part 22020 (such as) also can discharge from warehouse 22010 in the case of nail bin 22000 only part percussion.

Referring now to Figure 84 to Figure 87, end effector assembly 5000 can include first shown in other places Jaw and the second jaw 5002.In various embodiments, the second jaw 5002 can include storehouse assembly.Should Storehouse assembly includes securing member warehouse 5050 and is releasably secured to the tissue of securing member warehouse 5050 Thickness compensation part 5058.Referring primarily to Figure 84, securing member warehouse 5050 can have storehouse platform 5052 He The securing member chamber 5054 being limited in storehouse platform 5052.It addition, the second jaw 5002 can such as include tightly Firmware (such as surgical staples), these securing members can be removably positioned in securing member chamber 5054. Such as, these securing members can be can be positioned at each securing member chamber of warehouse 5050 in the way of penetrating In 5054.In certain embodiments, warehouse 5050 can include slit 5056, and this slit 5056 can be from The portions of proximal 5004 of the second jaw 5002 extends towards the distal part 5006 of the second jaw 5002. In various embodiments, percussion assembly 5030 can translate along the slit 5056 of warehouse 5050.Example As, percussion assembly 5030 can translate during percussion stroke in slit 5056, and can be at percussion stroke Securing member is penetrated by period from securing member chamber 5054.

Referring primarily to Figure 84, Figure 86 and Figure 87, percussion assembly 5030 can include trigger shaft (figure 84), cutting edge 5036, cross bar 5038 and leg 5044 (Figure 86 and Figure 87).When percussion assembly 5030 when firing during stroke by percussion through the second jaw 5002, and tissue can be cut by cutting edge 5036 Cut and/or tissue thickness's compensating part 5058 is cut.Such as, cross bar 5038 can by the first jaw relative to Warehouse 5050 keeps, and percussion assembly 5030 can be kept by leg 5044 relative to warehouse 5050. In various embodiments, cross bar 5038 and leg 5044 can such as cutting element 5036 be remained with The platform 5052 of fastener cartridge 5050 is vertical.Referring primarily to Figure 29 A and Figure 29 B, fire assembly 5030 can engage the sliding part 5034 in warehouse 5050 during percussion stroke.Percussion assembly 5030 can Such as sliding part 5034 is promoted towards distally, thus by securing member from securing member chamber during percussion stroke 5054 injections.

Referring primarily to Figure 84, tissue thickness's compensating part 5058 can pass through at least one adapter 5080a, 5080b is releasably secured to warehouse 5050.In certain embodiments, multiple adapters Tissue thickness's compensating part 5058 can be fixed to warehouse 5050 by 5080a, 5080b.Such as, nearside connects Device 5080a can be by solid for tissue thickness's compensating part 5058 at the portions of proximal 5004 of the second jaw 5002 Surely arrive warehouse 5050, and distal connector 5080b can be in the distal part 5006 of the second jaw 5002 Tissue thickness's compensating part 5058 is fixed to warehouse 5050 by place.In certain embodiments, connection additionally Tissue thickness's compensating part 5058 can be fixed to warehouse 5050 by device.In this type of embodiment, such as, separately Outer adapter can separating at least partially along warehouse 5050 length, and can be positioned on proximal connector Between 5080a and distal connector 5080b.

Can be by tissue thickness's compensating part 5058 phase referring still primarily to Figure 84, adapter 5080a and 5080b Warehouse 5050 is kept.When adapter 5080a and 5080b split, be cut, shift or because of During other reasons no longer onset, tissue thickness's compensating part 5058 can discharge from warehouse 5050.Real at some Executing in example, percussion assembly 5030 slit 5056 along fastener cartridge 5050 during percussion stroke is flat During shifting, adapter 5080a and 5080b can be overcome.During firing stroke at this, fire assembly 5030 Not only can cut the tissue being clamped between the first jaw and the second jaw 5002, and also can be by securing member Move to the tissue being clamped from securing member chamber 5054.In various embodiments, percussion assembly 5030 During percussion stroke, sliding part 5034 (Figure 86 and Figure 87) can be promoted towards distally.Sliding part 5034 Can have can the cam face of driver in jointing fastener chamber 5054 or slope 5042.Work as slope During 5042 joint driver, driver can be promoted by slope towards platform 5052, so that securing member is from fastening Part chamber 5054 is penetrated.It addition, percussion assembly 5030 can be by tissue thickness's compensating part during percussion stroke 5058 and adapter 5080a, 5080b cut.

Referring primarily to Figure 84, the cutting edge 5036 of percussion assembly 5030 can such as start at percussion stroke Time or start the most afterwards by proximal connector 5080a, and can such as percussion stroke at the end of or will At the end of Yaoing, distal connector 5080b is cut.In certain embodiments, sliding part 5034 (Figure 86 And Figure 87) can be after proximal connector 5080a is cut by cutting edge 5036, and at cutting edge 5036 Before being cut by distal connector 5080b, securing member is made to penetrate from securing member chamber 5054.Real at this type of Execute in example, if percussion assembly 5030 is not fully complete percussion stroke, then the cutting edge of percussion assembly 5030 5036 may stop arriving before distal connector 5080b, and tissue thickness's compensating part 5058 can be Warehouse 5050 is remained fixed at the distal part 5006 of the second jaw 5002.In certain embodiments, Tissue thickness's compensating part 5058 can remain fixed to warehouse 5050, until operator is by distal connector 5080b cuts or otherwise overcomes distal connector.Such as, operator can be by surgical operation Surgical instruments that middle introducing is other and/or step, overcome distal connector 5080b.

Referring also to Figure 84 to Figure 87, in various embodiments, the second jaw 5002 can be at percussion stroke During beginning or start overcome adapter 5080a and 5080b the most afterwards.In other words, the second jaw The element of 5002 can fire stroke start time or start a little while after, overcome proximal connector 5080a, Any other adapter between distal connector 5080b and the two adapter.Such as, the second pincers Mouth 5002 and/or storehouse assembly can include actuator 5010, and this actuator 5010 can be at securing member from fastening The injection of part chamber overcame distal connector 5080b in the past.Actuator 5010 can overcome distal connector 5080b, even and if fire stroke premature end, say, that such as percussion assembly 5030 arrives Before the distal part 5006 of the second jaw 5002, tissue thickness's compensating part 5358 also can be from warehouse 5050 releases.In various embodiments, actuator 5010 can include that (Figure 85 A is to figure in bottom side 5016 85C) with sidewall 5018 (Figure 84 and Figure 85 D).Sidewall 5018 can extend from bottom side 5016, and At least some of extension around warehouse 5050.Bottom side 5016 and/or sidewall 5018 may extend past fixed Position securing member in securing member chamber 5054, or extend around the securing member being positioned in securing member chamber. It addition, actuator 5010 can be kept movingly relative to warehouse 5050.Such as, actuator 5010 Can move to actuated position (Figure 85 B and Figure 85 D) from pre-actuated position (Figure 85 A).Real at some Execute in example, the slit in the engageable warehouse of sidewall 5,018 5050 of actuator 5010 so that actuator 5010 move, to slide relative to warehouse 5050 in slit.When actuator 5010 is relative to warehouse During 5050 motion, actuator 5010 can be relative in the securing member chamber 5054 being positioned at warehouse 5050 Securing member slides.Such as, actuator 5010 can slide through the securing member in securing member chamber 5054, and/ Or slide around these securing members.

Referring primarily to Figure 85 A to Figure 85 C, actuator 5010 can include slit 5012, this slit 5012 Can extend towards distal part 5006 from the portions of proximal 5004 of the second jaw 5002.In actuator 5010 Slit 5012 can such as corresponding with the slit 5056 (Figure 84) in warehouse 5050 and/or alignment.Separately Outward, percussion assembly 5030 translate along the slit 5056 in warehouse 5050 during percussion stroke and/or In slit 5056 during translation, it is possible to translate and/or narrow along the slit 5012 in actuator 5010 Translation in groove 5012.In various embodiments, fire the engageable actuator of assembly 5,030 5010, with Fire when stroke starts or start to make actuator 5010 towards distal movement the most afterwards.In this type of embodiment In, percussion assembly 5030 can be by actuator 5010 at the portions of proximal 5004 of the second jaw 5002 Activate.Such as, when actuator 5010 activated and during towards distal movement, the distal end portion of actuator 5010 Distal connector 5080b can be cut by portion, or otherwise overcomes distal connector 5080b.Change sentence Talking about, actuator 5010 proximally activates and can realize tissue thickness's compensating part 5058 from warehouse 5050 court The release in distally.In various embodiments, actuator 5010 only can be towards distally displacement to overcome distally even Meet device 5080b.In at least one embodiment, actuator 5010 can overcome distal connector 5080b Before, about 1mm is such as shifted.In certain embodiments, actuator 5010 can connect overcoming distally Before device 5080b, such as, shift about 0.5mm to about 5mm.

Referring primarily to Figure 85 A and Figure 85 B, not during percussion assembly 5030 fires stroke at one section Between firing position and part firing position during motion, actuator 5010 can be from pre-actuated position (figure 85A) move to actuated position (Figure 85 B).In various embodiments, actuator 5010 can such as wrap Include release stop part, such as positioner tab 5022.Percussion element is relative to the row of actuator 5010 Enter and can suspend owing to encountering positioner tab 5022.In other words, positioner tab 5022 can Percussion assembly 5030 is allowed to temporarily cease relative to the traveling of actuator 5010.Such as, at actuator 5010 From pre-actuated position to actuated position move time, positioner tab 5022 can engaging slide part 5034 And/or percussion assembly 5030, thus percussion assembly 5030 is kept relative to actuator 5010 so that Actuator 5010 moves together with percussion assembly 5030.Such as, referring primarily to Figure 86 and Figure 87, cause The bottom side 5016 of dynamic device 5010 can include positioner tab 5022, and sliding part 5034 is permissible Including groove or groove 5040.In various embodiments, it is positioned at the second jaw when sliding part 5034 Time in the portions of proximal 5004 of 5002, groove 5040 can receive tab 5022.Such as, percussion is worked as Assembly 5030 never firing position moves to firing position, and therefore actuator is correspondingly from pre-actuated position When (Figure 85 A) is pulled to actuated position (Figure 85 B), groove 5040 can align with tab 5022. In various embodiments, at least one tab 5022 can be positioned on slit 5012 (figure in actuator 5010 85A to Figure 85 C) either side, and the engageable sliding part of each tab 5,022 5034.

Referring primarily to Figure 85 A, when percussion assembly 5030 and sliding part 5034 during percussion stroke along During slit 5056 (Figure 84) translation, sliding part 5034 can engage positioner tab 5022.Example As, positioner tab 5022 can be when firing stroke and starting or start to engage sliding part the most afterwards 5034 connect.In certain embodiments, positioner tab 5022 can be located at the proximal end of actuator 5010 Near portion, and when firing stroke and starting, sliding part 4034 engageable positioner tab 5022. When trigger shaft 5032 is towards the groove in distal movement and positioner tab 5022 and sliding part 5034 During 5040 joint (Figure 86 and Figure 87), actuator 5010 can be driven towards distally and/or be moved towards distally Position.In certain embodiments, referring primarily to Figure 85 B, actuator 5010 can such as towards distal movement, Until it arrives the hard stop part 5060 being defined in warehouse 5050.Hard stop part 5060 can such as position At the distal part 5006 of the second jaw 5002, and can prevent actuator 5010 further towards far Lateral movement.In various embodiments, assembly 5030 is being fired by securing member from the securing member of warehouse 5050 Before the injection of chamber 5054 (Figure 84), actuator 5010 can adjoin with hard stop part 5060.At some In embodiment, when percussion assembly 5030 penetrates at least one securing member from securing member chamber 5054, and/or At percussion assembly 5030 after at least one securing member is penetrated in securing member chamber 5054, actuator 5010 Just adjoin with hard stop part 5060.

Referring primarily to Figure 85 D, when actuator 5010 is by sliding part 5034 and/or percussion assembly 5030 court When distally promotes, actuator 5010 can cut distal connector 5080b, or otherwise overcome distally Adapter 5080b, to compensate tissue thickness for 5058 at the distal part 5006 of the second jaw 5002 Discharge from warehouse 5050.In certain embodiments, actuator 5010 can include recess 5024, is used for connecing Receive distal connector 5080b, and distal connector is fixed.Stop to hard towards distally at actuator 5010 When block piece 5060 shifts, distal connector 5080b can be fixed by recess 5024.It addition, actuator 5010 can such as include the cutting edge 5020 along recess 5024.In certain embodiments, actuator 5010 when moving towards hard stop part 5060, can cutting at hard stop part 5060 and actuator 5010 Cut promotion distal connector 5080b between sword 5020.In various embodiments, when cutting edge 5020 quilt Pushing and/or during towards hard stop part 5060, distal connector 5080b can be cut by cutting edge 5020. In this type of embodiment, when firing stroke and starting or after beginning a little while, and at securing member from securing member Before the percussion of chamber 5054 (Figure 84), distal connector 5080b can be by the cutting edge of actuator 5010 5020 cuttings.In certain embodiments, at least one is penetrated at percussion assembly 5030 from securing member chamber 5054 During individual securing member, and/or penetrate at least one securing member from securing member chamber 5054 at percussion assembly 5030 After, distal connector 5080b can be cut by cutting edge 5020.In various embodiments, actuator 5010 can overcome distal connector 5080b on the premise of not cutting distal connector 5080b.Example As, actuator 5010 can make distal connector 5080b separate or be stretched by distal connector so that remote Tissue thickness's compensating part 5058 is no longer fixed by side-connector 5080b relative to warehouse 5050.

In various embodiments, proximal connector 5080a can be cut by the nearside cutting edge of actuator 5010 Cut.Similarly, along warehouse 5050 length arrange other adapter can fire stroke start time or Cut by actuator 5010 after starting a little while, or otherwise overcome effect.In addition or separately Selection of land, the cutting edge 5036 of percussion assembly 5030 can be by proximal connector 5080a and/or other connection Device cuts, and maybe can adopt and overcome proximal connector 5080a and/or other adapter in other ways.Example As, at securing member before the securing member chamber 5054 (Figure 84) of warehouse 5050 is penetrated, fire assembly Proximal connector 5080a can be cut by the cutting edge 5036 of 5030, the cutting edge of actuator 5010 Distal connector 5080b can be cut by 5020.

Actuator 5010 can be overcome referring primarily to Figure 87, sliding part 5034 and/or percussion assembly 5030 The obstruction of middle positioner tab 5022.When sliding part 5034 and/or percussion assembly 5030 overcome screens During the obstruction of device tab 5022, percussion assembly 5030 and sliding part 5034 can be relative to actuators 5010 motions.Such as, sliding part 5034 can be promoted by percussion assembly 5030 towards distally, so that actuator 5010 towards distal movement, until hard stop part 5060 stops actuator 5010 further towards distal movement (Figure 85 A, Figure 85 C and Figure 85 D).Referring also to Figure 87, when the further distally of actuator 5010 When motion is prevented from, percussion assembly 5030 can try hard to recommend dynamic sliding part 5034 with sufficiently large, so that screens Device tab 5022 deforms, deflect and/or groove 5040 from sliding part 5034 separates.Example As, each tab 5022 may comprise cantilever, is being applied with sufficiently large longitudinal force to sliding part 5034 Afterwards, this cantilever can bend downwards, thus departs from groove 5040.Promote sliding at percussion assembly 5030 Moving part 5034, when making sliding part 5034 depart from positioner tab 5022, fires assembly 5030 and slides Moving part 5034 can move relative to actuator 5010.In various embodiments, positioner tab 5022 Can be sufficiently rigid to disconnect, with when actuator 5010 shifts towards distally to hard stop part 5060, Bear the power that this percussion assembly 5030 applies；And when actuator 5010 arrives hard stop part 5060 Time, ratchet tab 5022 can be sufficiently flexible, just applies excessive power need not motor and/or operator Deflectable.In all cases, exceeded predetermined in the power putting on positioner tab 5022 Power after, positioner tab can allow trigger shaft 5032 through warehouse 5050.

Referring now to Figure 29 A and Figure 29 B, end effector assembly 5100 can include the first jaw (as Other places illustrate) and the second jaw 5102.In various embodiments, the second jaw 5102 and/or can position Fastener cartridge assembly wherein can include actuator 5110.Actuator 5110 can be such as relative to fastening The securing member warehouse of part storehouse assembly such as securing member warehouse 5050 (Figure 84) slides or shifts.It addition, In certain embodiments, actuator 5110 can include at least partly surrounding warehouse 5050 location Diapire 5116 and sidewall 5118.When fixing actuator 5110 is by during relative to warehouse 5050, diapire 5116 and/or sidewall 5118 may extend past the fastening being positioned in securing member chamber 5054 (Figure 84) Part, or extend around the securing member being positioned in securing member chamber.In various embodiments, actuator 5110 can include slit 5112, and this slit 5112 is along at least some of extension of diapire 5116.Separately Outward, sidewall 5118 can include antelabium 5122 and/or antelabium 5124, and this antelabium can slidably engage Warehouse 5050.Such as, antelabium 5122 can extend around warehouse 5050 and extend to warehouse 5050 In slit in platform 5052 (Figure 84).It addition, antelabium 5124 can be such as along the side of warehouse 5050 Face extends in slit.In various embodiments, move relative to warehouse 5050 when actuator 5110 Time, antelabium 5122,5124 can slide in slit.In this type of embodiment, antelabium can such as retrain And/or limit the relative motion between actuator 5110 and warehouse 5050.When actuator 5110 relative to When warehouse 5050 moves, actuator 5110 can be relative to the securing member chamber 5054 being positioned at warehouse 5050 In securing member slide.Such as, the fastening during actuator 5110 can slide through securing member chamber 5054 Part, or slide around this securing member.

Referring also to Figure 29 A and Figure 29 B, actuator 5110 can be such as in the proximal portion of the second jaw 5102 Divide and include at 5104 discharging stop part, such as positioner 5114.Referring primarily to Figure 29 A, screens fills Putting 5114 and can include positioner arm 5120, this positioner arm 5120 can operationally keep warehouse The sliding part 5134 of 5050 (Figure 84).Such as, sliding part 5134 can include groove 5144, and blocks The position engageable groove of devices arms 5,120 5144 is to keep sliding part 5134 relative to actuator 5110. In various embodiments, positioner 5114 can have multiple positioner arm 5120, this positioner Arm 5120 can be maintained in the groove 5144 of sliding part 5134.Positioner arm 5120 can be such as Extend from the opposite side of actuator 5110, and sliding part 5134 can such as be positioned at positioner arm In the middle of 5120.In certain embodiments, it is maintained at the ditch of sliding part 5134 when positioner arm 5120 Time in groove 5144 (Figure 29 A), percussion assembly 5030 can promote against sliding part 5134, and can make Actuator 5110 shifts towards distally.Positioner arm 5120 can be sufficiently rigid, with at actuator 5110 by percussion assembly 5030 promote towards distally time, sliding part 5134 is protected relative to actuator 5110 Hold.Then, actuator 5110 can such as adjoin hard stop part, and such as (Figure 84 is extremely for hard stop part 5060 Figure 85 B, and Figure 85 D), this hard stop part can prevent actuator 5110 further towards distal movement.

Referring primarily to Figure 29 B, when actuator 5010 adjoin hard stop part 5060 (Figure 84 to Figure 85 B, With Figure 85 D) time, percussion assembly 5030 can promote sliding part 5134 through positioner 5114.Change sentence Words are said, percussion assembly 5030 can promote sliding part 5134 to overcome positioner arm 5120.Implement at this type of In example, positioner arm 5120 may be sufficiently flexible, with flexure thus with the groove of sliding part 5134 5144 depart from, and can allow to fire assembly 5030 along the slit 5112 in actuator 5110 from screens Pass through between devices arms 5120.Being similar to actuator 5010, actuator 5110 can include sword, and this sword can example As when actuator 5110 is shifted towards distally by percussion assembly 5030, by distal connector, it is similar to remote Side-connector 5080b (Figure 84 and Figure 85 D) cuts, or otherwise overcomes distal connector.So After, percussion assembly 5030 and sliding part 5134 can such as translate along slit 5112, and can make fastening Part penetrates from the securing member chamber 5054 of warehouse.In various embodiments, actuator 5110 can first overcome far Side-connector and/or other adapter, then securing member just fires from fastener cartridge 5050.At some In embodiment, at securing member before fastener cartridge 5050 fires, actuator 5110 can overcome distally even Connect device and/or other adapter.

Referring now to Figure 87 A and Figure 87 B, end effector assembly 5200 can include the first jaw (as Other places illustrate) and the second jaw 5202.In various embodiments, the second jaw 5202 and/or securing member Storehouse assembly can such as include actuator 5210, and this actuator 5210 can be the tightest relative to securing member warehouse Firmware warehouse 5050 (Figure 84) slides.It addition, in certain embodiments, actuator 5210 can include Diapire 5216 and sidewall.Sidewall can for example, at least position partially around warehouse 5050.Actuator 5210 Can include slit 5212, this slit 5212 is along at least some of extension of diapire 5216.It addition, activate Device 5210 can be kept movingly relative to warehouse 5050.When actuator 5210 is relative to warehouse During 5050 motion, actuator 5210 can be relative in the securing member chamber 5054 being positioned at warehouse 5050 Securing member moves.Such as, actuator 5210 can slide through the fastening being positioned in securing member chamber 5054 Part, or slide around this securing member.

In various embodiments, percussion assembly 5030 can be flat along slit 5212 during percussion stroke Move and/or translate in slit 5212.Being similar to actuator 5010 and 5110, actuator 5210 can wrap Include release stop part 5214.In various embodiments, release stop part 5214 can include frangible portion 5220, this frangible portion can be for example the bridgeware across slit 5212.Referring primarily to Figure 87 A, percussion Assembly 5030 can adjoin release stop part 5214, to be promoted towards distally by actuator 5210.Then, cause Dynamic device 5210 can adjoin hard stop part, such as hard stop part 5060 (Figure 84 to Figure 85 B, and figure 85D), this hard stop part can prevent actuator 5210 further towards distal movement.Referring primarily to figure 87B, when firing assembly 5030 and arriving hard stop part 5060, can make the frangible of release stop part 5214 Part 5220 disconnects, and percussion assembly 5030 can continue towards far along slit 5212 during percussion stroke Lateral movement.Frangible portion 5220 can be sufficiently rigid, with at actuator 5210 towards distally to hard backstop During part 5060 (Figure 85 D) displacement, bear the power that this percussion assembly 5030 applies；And can be enough Frangible, with when actuator 5210 arrives hard stop part 5060, it is not necessary to motor and/or operator execute Add excessive power just can disconnect.In various embodiments, it is fired at securing member from fastener cartridge 5050 Before, actuator 5210 can overcome distal connector 5080b and/or other adapter.Implement at some In example, actuator 5210 can be when at least one securing member fires from securing member chamber, and/or at least one Individual securing member after securing member chamber fires, just overcomes distal connector and/or other adapter.

Referring now to Figure 88 and Figure 89, end effector assembly 5300 can include that the first jaw is not (as Place illustrates) and the second jaw 5302.In various embodiments, the second jaw 5302 can include warehouse 5350 and be releasably secured to tissue thickness's compensating part 5358 of warehouse 5350.It is similar to second Jaw 5002, the second jaw 5302 can such as include securing member such as surgical staples, and this securing member can It is positioned at removing in the securing member chamber of warehouse 5350.Such as, securing member can be in the way of can penetrating It is positioned in each securing member chamber.In certain embodiments, warehouse 5350 can include slit 5356 (figure 88), this slit 5356 can prolong towards distal part 5306 from the portions of proximal 5304 of the second jaw 5302 Stretch.In various embodiments, percussion assembly 5030 can translate along the slit 5356 of warehouse 5350. Percussion assembly 5030 can such as translate during percussion stroke in the slit of fastener cartridge 5350, and can Such as during percussion stroke, securing member is penetrated from securing member chamber.Percussion assembly 5030 can such as hit The sliding part 5334 (Figure 89) in warehouse 5350 is engaged during distribution journey, and can be such as at percussion stroke Sliding part 5334 is promoted by period towards distally.Additionally, percussion assembly 5030 and/or actuator 5310 can Tissue thickness's compensating part 5358 is made to discharge from warehouse 5350 during percussion stroke.

Referring also to Figure 88 and Figure 89, tissue thickness's compensating part 5358 can include main body 5360, from main body The 5360 nearside installed parts 5362 extended and the distally installed part 5364 extended from main body 5360.Main Figure 89 to be seen, such as, pin 5366 can extend across nearside installed part 5362 and enters in warehouse 5350 Opening 5356a so that pin 5366 at the portions of proximal 5304 of the second jaw 5302 by tissue thickness Compensating part 5358 releasably holds relative to warehouse 5350.Pin 5366 can such as frictional fit and/or It is snapped in opening 5356a.In certain embodiments, one or more binding agents can such as be used Pin 5366 is maintained in opening 5456a.In certain embodiments, can such as by warehouse 5350 extremely A few part and/or pin 5366 weld.In various embodiments, tissue thickness's compensating part 5358 can Including multiple nearside installed parts 5362, these nearside installed parts (can be schemed by slit 5356 in warehouse 5350 88) either side or both sides are releasably secured to warehouse 5350.In certain embodiments, Distally installed part 5364 such as can be fixed to warehouse at the distal part 5306 of the second jaw 5302 5350.Distally installed part 5364 can such as via between distally installed part 5364 and warehouse 5350 extremely Few a kind of binding agent is fixed to warehouse 5350.Or alternatively, distally installed part 5364 can example in addition As being fixed to warehouse 5350 by least one pin and/or other securing member.

Referring primarily to Figure 89, actuator 5310 can be looped around on distally installed part 5364, and can prolong Reach the sliding part 5334 in the second jaw 5302.In various embodiments, actuator 5310 can be such as Including extending through warehouse 5350 and/or limit in the second jaw 5302 and/or sliding part 5334 The cable of fixed passage 5346 or rope.In various embodiments, sliding part 5334 can towards distal movement With tractive actuator 5310, to penetrate the distally installed part 5364 of tissue thickness's compensating part 5358.Example It is fixed to the first end 5316 of sliding part 5334 as, actuator 5310 can have, is fixed on warehouse The second end 5318 in 5350 and between first end 5316 and the second end 5318 Ring 5320.Ring 5320 can such as be looped around on distally installed part 5364.In various embodiments, ring 5320 part and the tissue thickness's compensating parts 5358 that can be fixed to warehouse 5350 at distally installed part 5364 Main body 5360 between be wrapped on distally installed part 5364.In certain embodiments, the second end 5318 can be securely fixed in warehouse 5350 so that when first end 5316 moves, ring 5320 Tighten around distally installed part 5364.In various embodiments, the second jaw 5302 and/or warehouse 5350 can such as include button, pin and/or castor, such as the first button 5312 and the second button 5314.Actuator 5310 can such as be wound around the first button 5312 and the second button 5314.Button 5312, The position of 5314 and actuator 5310 make the ring of actuator 5310 around the orientation of button 5312,5314 5320 when sliding part 5334 and percussion assembly 5330 are in time firing during stroke towards distal movement, can be around Distally installed part 5364 is tightened.It addition, ring 5320 around distally installed part 5364 tighten time, ring 5320 can penetrate distally installed part 5364, so that the main body 5360 of tissue thickness's compensating part 5358 is Discharge from warehouse 5350 at the distal part 5306 of two jaws 5302.Therefore, in view of said circumstances, Distally installed part 5364 can start period disengaging warehouse at percussion stroke.

In various embodiments, when the distally installed part 5364 of tissue thickness's compensating part 5358 is from warehouse During 5350 release, the nearside installed part 5362 of tissue thickness's compensating part 5358 is fixed to warehouse 5350 Pin 5366 can discharge from the opening 5356 of warehouse 5350.Such as, fire stroke start time or open After beginning a little while, pin 5366 can discharge from opening 5356.Pin 5366 can be such as by percussion assembly 5030 Cutting edge 5036 cut off and/or cut off, and/or can by percussion assembly 5030 element release and/ Or displace opening 5356.In this type of embodiment, when nearside installed part 5362 and distally installed part 5364 Both from warehouse 5350 discharge after, tissue thickness's compensating part 5358 can fire stroke start time or beginning After a little while, discharge from warehouse 5350.In other words, actuator 5310 percussion assembly 5030 and/ Or sliding part 5334 by securing member from warehouse 5350 securing member chamber injection before, can be by tissue thickness Compensating part 5358 discharges from warehouse 5350.In certain embodiments, will tissue thickness at actuator 5310 Degree compensating part 5358 before warehouse 5350 discharges and/or when, percussion assembly 5030 and/or sliding part 5334 can penetrate at least one securing member from securing member chamber.

Fastener cartridge assembly can include warehouse, and this warehouse includes slit and multiple securing member chamber.This securing member Storehouse assembly may also include multiple securing member, and the most each securing member is removably positioned in securing member chamber. This fastener cartridge assembly may also include can along the percussion element that slit moves, be releasably secured to warehouse Tissue thickness's compensating part and installed part, wherein tissue thickness's compensating part is fixed to storehouse by installed part Body, and certain the securing member distally during wherein installed part is positioned at multiple securing member.This fastener cartridge group Part may also include the cable being positioned between percussion element and installed part, and wherein cable is configured to work as percussion Installed part is made to disconnect when element is along slit towards distal movement.When cable makes installed part disconnect, tissue thickness Compensating part can discharge from warehouse.By securing member before securing member chamber removes, cable make installed part break Open.This fastener cartridge assembly may also include passage, and wherein cable extends through this passage.

Referring now to Figure 93 A to Figure 93 D, end effector assembly 5600 can include the first jaw (as Other places illustrate) and the second jaw 5602.In various embodiments, the second jaw 5602 can include fastening Part warehouse 5650 and be releasably secured to the second jaw 5602 and/or securing member warehouse 5650 Tissue thickness's compensating part 5658.In certain embodiments, securing member warehouse 5650 and solid releasedly Surely the tissue thickness's compensating part 5658 arriving securing member warehouse 5650 may make up fastener cartridge assembly.Main ginseng See that Figure 93 A, warehouse 5650 can have storehouse platform 5652 and be defined in the fastening in storehouse platform 5652 Part chamber 5654.It addition, the second jaw 5602 can such as include securing member (such as surgical staples), this is tight Firmware can be removably positioned in securing member chamber 5654.Such as, single fastener can be penetrating The mode gone out is positioned in each securing member chamber 5654 of warehouse 5650.Referring still primarily to Figure 93 A, storehouse Body 5650 can include the ridge 5648 extended from storehouse platform 5652.Ridge 5648 can be such as around securing member chamber At least some of extension of 5654.In various embodiments, it is positioned at securing member chamber 5654 when securing member Time middle, the top of securing member can highlight from securing member chamber 5654.In this type of embodiment, work as securing member When penetrating from securing member chamber 5654, the ridge 5648 at least partly surrounding location, securing member chamber 5654 can To support the top of securing member, and/or guide the top of securing member.In certain embodiments, referring also to Figure 93 A, warehouse 5650 can include slit 5656, and this slit 5656 can near from the second jaw 5602 Side part 5604 extends towards the distal part 5606 of the second jaw 5602.In various embodiments, Percussion assembly 5630 can translate along the slit 5656 of warehouse 5650.Such as, percussion assembly 5630 can Percussion stroke during translate along slit 5656, and can percussion stroke during by securing member from fastening Part chamber 5654 is penetrated.

Referring also to Figure 93 A to Figure 93 D, percussion assembly 5630 can include trigger shaft 5632, cutting edge 5636, cross bar 5638 and leg 5644.When percussion assembly 5630 percussion stroke during by percussion through During the second jaw 5602, cutting edge 5636 can be by tissue cutting and/or by tissue thickness's compensating part 5658 Cutting.Slit in the engageable first jaw anvil block of cross bar 5638, with will percussion assembly 5630 relative to First jaw keeps；And leg 5644 can such as engage slit (the such as storehouse in the second jaw 5602 Slit 5656 in body 5650), so that the first jaw is kept relative to warehouse 5650.In various enforcements In example, the cutting edge 5636 of percussion assembly 6530 can such as be kept by cross bar 5638 and/or leg 5644 Vertical for the platform 5652 with fastener cartridge 5650.Referring primarily to Figure 93 A and Figure 93 D, fire assembly 5630 can engage the sliding part 5634 in warehouse 5650 during percussion stroke.Percussion assembly 5630 can Such as percussion stroke during by sliding part 5634 towards distally promote, with by securing member from securing member chamber 5654 injections.In various embodiments, sliding part 5634 can such as have engageable securing member chamber 5654 In driver and/or the cam face of securing member or slope 5642.When slope 5642 engages driver Time, driver can be promoted by slope 5642 towards platform 5652, so that the securing member of correspondence is from securing member chamber 5654 injections.It addition, in various embodiments, percussion assembly 5630 can cut during percussion stroke Tissue thickness's compensating part 5658.

Referring primarily to Figure 93 A and Figure 93 B, tissue thickness's compensating part 5658 can include storehouse contact surface 5662 (Figure 93 A) and tissue contacting surface 5664 (Figure 93 B).Storehouse contact surface 5662 can be such as When tissue thickness's compensating part 5658 is fixed to warehouse 5650 (Figure 93 B), fixed against storehouse platform 5652 Position.It addition, such as when tissue is clamped between the first jaw and the second jaw 5602, tissue connects Touching surface 5664 can be against tissue positioned.Referring primarily to Figure 93 A, tissue thickness's compensating part 5658 can wrap Include installed part 5660.In various embodiments, installed part 5660 can be such as can to compensate from tissue thickness The rectangle of part 5658 extension or the fin of triangle.Mend it addition, installed part 5660 can be tissue thickness Repaying the cut out portion of part 5658, this cut out portion leaves in tissue thickness's compensating part 5658 and installs The space 5666 that the shape of part 5660 is corresponding.When tissue thickness's compensating part 5658 is relative to warehouse 5650 During location, installed part 5660 can such as align with the slit 5656 of warehouse 5650.It addition, when tissue The storehouse contact surface 5662 of thickness compensation part 5658 is positioned to adjacent with the platform 5652 of warehouse 5650 Time, installed part 5660 may extend in slit 5656.In various embodiments, compensate when tissue thickness When part 5658 is fixed to warehouse 5650, installed part 5660 can be friction fit in slit 5656.Peace At least some of of tissue thickness's compensating part 5658 can be kept by piece installing 5660 relative to warehouse 5650. Such as, when installed part 5660 is friction fit into slit 5656, storehouse contact surface 5662 just can be against The platform 5652 of warehouse 5650 positions.

In various embodiments, can include can be with the slit of warehouse 5650 for tissue thickness's compensating part 5658 Multiple installed parts 5660 of 5656 alignment.Such as, at least one installed part 5660 can be positioned on the second pincers In the portions of proximal 5604 of mouth 5602, and at least one installed part 5660 can be positioned on the second jaw In the distal part 5606 of 5602.In various embodiments, installed part 5660 can compensate along tissue thickness Separating at least partially of part 5658 length.Such as, slit 5656 can be from the second jaw 5602 Portions of proximal the 5604 to the second jaw 5602 distal part 5606 extend longitudinal slit.Install Part 5660 can such as be friction fit in longitudinal slit 5656, and can make tissue thickness's compensating part 5658 It is fixed to warehouse 5650.

Referring primarily to Figure 93 A and Figure 93 D, sliding part 5634 can include tongue 5640, this tongue 5640 can highlight from sliding part 5634 towards the distal part 5606 of the second jaw 5602.When percussion assembly 5630 when firing promotion sliding part 5634 during stroke, and tongue 5640 can be along warehouse 5650 Slit 5656 moves.Referring primarily to Figure 93 D, tongue 5640 can adjacent tissue's thickness compensation part 5658 Storehouse contact surface 5664 move along slit 5656.It addition, tongue 5640 can be against being positioned at Installed part 5660 in slit 5656 and move.In various embodiments, installed part 5660 can be can Deflection.When tongue 5640 pushes installed part 5660, tongue 5640 can make installed part 5660 It is deflected to align with the main body of tissue thickness compensating part 5658, or at least substantially aligns.Such as, when When tongue 5640 moves in warehouse 5650, installed part 5660 can in succession deflect into tissue thickness and mend Repay in the corresponding space 5666 limited in part 5658.When installed part 5660 deflects away from slit 5656 Time, tissue thickness's compensating part 5658 can no longer be fixed to warehouse 5650 and/or discharge from warehouse 5650. In various embodiments, another element of sliding part 5634 and/or percussion assembly 5630 can make installed part 5660 deflect away from slit 5656, so that tissue thickness's compensating part 5658 is no longer fixed to warehouse 5650 And/or discharge from warehouse 5650.

Referring now to Figure 94, being similar to end effector assembly 5600, end effector assembly 5700 can Including the first jaw (as other places illustrate) and the second jaw 5702.In various embodiments, the second pincers Mouth 5702 can include securing member warehouse 5750 and be releasably secured to warehouse 5750 and/or second Tissue thickness's compensating part 5758 of jaw 5702.In certain embodiments, securing member warehouse 5750 and can The tissue thickness's compensating part 5758 being fixed to release warehouse 5750 can such as constitute fastener cartridge assembly. Being similar to warehouse 5650, warehouse 5750 can have storehouse platform 5752, be limited in storehouse platform 5752 use In keeping the securing member chamber 5754 of securing member, at least partly surrounding the ridge 5748 in securing member chamber 5754, And/or prolong from the portions of proximal 5704 of the second jaw 5702 towards the distal part 5706 of the second jaw 5702 The slit 5756 stretched.In various embodiments, warehouse 5750 can include traversing slit 5756 or across slit 5756 bridgewares 5780 extended.Bridgeware 5780 can be the most frangible and/or separable bridge joint Part.In certain embodiments, bridgeware 5780 can be the thinnest can breaking part, and can be solid The absorbable material of form, such as PGA, PCL, PGA/PCL, PLA/PCL and/or TMC.Bridge Fitting 5780 can have hole 5782, and this hole 5782 can extend through bridgeware at least in part 5780。

Referring also to Figure 94, in various embodiments, percussion assembly 5630 can narrow along warehouse 5750 Groove 5756 translates.Such as, percussion assembly 5630 can be flat along slit 5756 during percussion stroke Move, and during percussion stroke, securing member can be penetrated from securing member chamber 5754.Percussion assembly 5630 can Including trigger shaft 5632, cutting edge 5636, cross bar 5638 and leg 5644.When percussion assembly 5630 When being fired through the second jaw 5702 during percussion stroke, cutting edge 5636 can tissue and/or group Knit thickness compensation part 5758 to cut.Slit in the engageable first jaw anvil block of cross bar 5638, with by One jaw keeps relative to warehouse 5750, and leg 5644 can such as engage in the second jaw 5702 Slit (slit 5756 in such as warehouse 5750), with will percussion assembly 5630 relative to second pincers Mouth 5702 keeps.In various embodiments, cross bar 5638 and/or leg 5644 can be such as by cutting edges 5636 remain vertical with the platform 5752 of fastener cartridge 5750.

Referring also to Figure 94, tissue thickness's compensating part 5758 can include that storehouse contact surface 5762 and tissue connect Touch surface.Storehouse contact surface 5762 such as can be fixed to warehouse 5750 when tissue thickness's compensating part 5758 And/or during the second jaw 5702, position against storehouse platform 5752.It addition, tissue contacting surface can be such as When tissue is clamped between the first jaw and the second jaw 5702, against tissue positioned.Various In embodiment, tissue thickness's compensating part 5758 can include installed part 5760.Installed part 5760 can be such as The projection that can extend from the storehouse contact surface 5762 of tissue thickness's compensating part 5758, pin, tab and/ Or post.Installed part 5760 can such as position relative to warehouse 5750 when tissue thickness's compensating part 5758 Time, align with the hole 5782 of bridgeware 5780 or at least substantially align.It addition, work as tissue thickness When the storehouse contact surface 5762 of compensating part 5758 is positioned to adjacent with the platform 5752 of warehouse 5750, peace Piece installing 5760 can extend at least partly in hole 5782.In various embodiments, mend when tissue thickness Repaying part 5758 when being fixed to warehouse 5750, installed part 5760 can be friction fit in hole 5782.Peace Tissue thickness's compensating part 5758 can be protected by piece installing 5760 relative to warehouse 5750 and/or the second jaw 5702 Hold and/or fixing.Such as, in installed part 5760 is friction fit into the hole 5782 of bridgeware 5780 Time, storehouse contact surface 5762 can position against the platform 5752 of warehouse 5750.

In various embodiments, fastener cartridge 5750 can include extending across the slit 5756 of warehouse 5750 Multiple bridgewares 5780.Bridgeware 5780 can such as along slit 5756 length at least some of every Open.Such as, slit 5756 can be portions of proximal the 5704 to the second jaw from the second jaw 5702 Longitudinal slit that the distal part 5706 of 5702 extends.It addition, in various embodiments, tissue thickness Compensating part 5758 can include the multiple installed parts 5760 that can align with the bridgeware 5780 of warehouse 5750. Such as, when tissue thickness's compensating part 5758 positions relative to warehouse 5750, at least one installed part In 5760 portions of proximal 5704 that can be positioned on the second jaw 5702, and at least one installed part In 5760 distal part 5706 that can be positioned on the second jaw 5702.In various embodiments, installed part 5760 can separating along tissue thickness's compensating part 5758 length at least partially.Installed part 5760 can be such as It is friction fit in slit 5756, and tissue thickness's compensating part 5758 can be made to be fixed to warehouse 5750 And/or second jaw 5702.

Referring also to Figure 94, when percussion assembly 5630 moves along slit 5756 during percussion stroke Time, the cutting edge 5636 of percussion assembly 5630 can cut tissue thickness's compensating part 5758 and/or be clamped in Tissue between the first jaw of end effector assembly 5700 and the second jaw 5702.It addition, when percussion Assembly 5630 through slit 5756 move time, percussion assembly 5630 can make bridgeware 5780 separate.Example As, when firing assembly 5630 and moving through slit 5756, the cutting edge 5636 of percussion assembly 5630 Bridgeware 5780 can be made to rupture, or bridgeware is cut.In various embodiments, when percussion assembly 5630 when firing motion in slit 5756 during stroke, and cutting edge 5636 can be by each bridgeware 5780 cut in succession.Once bridgeware 5780 is cut sword 5636 and cuts or act at cutting edge 5636 Under rupture, tissue thickness's compensating part 5758 can no longer be fixed to warehouse 5750 and/or release from warehouse 5750 Put.In certain embodiments, cutting edge 5636 can make the installed part aligned during percussion stroke 5760 rupture, and are maybe cut by the installed part 5760 aligned.In various embodiments, sliding part And/or another element of percussion assembly 5630 can make bridgeware 5780 rupture or be cut by bridgeware 5780 Cut, so that tissue thickness's compensating part 5758 is discharged from warehouse 5750.

Referring now to Figure 95 and Figure 96, it is similar to end effector assembly 5600, end effector assembly 5800 can include the first jaw (as other places illustrate) and the second jaw 5802.In various embodiments, Second jaw 5802 can include securing member warehouse 5850 and be releasably secured to warehouse 5850 and/ Or the second tissue thickness's compensating part 5858 of jaw 5802.In certain embodiments, securing member warehouse 5850 and be releasably secured to tissue thickness's compensating part 5858 of securing member warehouse 5850 and may be constructed Fastener cartridge assembly.Being similar to warehouse 5650, warehouse 5850 can have storehouse platform 5852, be limited to storehouse Platform 5852 is configured to receive the securing member chamber 5854 of securing member, around securing member chamber 5854 The ridge 5848 of at least some of location, and/or can be from portions of proximal 5804 court of the second jaw 5802 The slit 5856 that the distal part 5806 of the second jaw 5802 extends.In various embodiments, warehouse 5850 can include traversing slit 5856 or the bridgeware extended at least in part across slit 5856 5880.Bridgeware 5880 can be the most frangible and/or separable bridgeware.In some embodiment In, bridgeware 5880 can include the first supporting leg 5884 and the second supporting leg 5886.Referring primarily to Figure 96, First supporting leg 5884 can such as extend to slit 5856 from the first side of warehouse 5850, the second supporting leg 5886 can such as extend to slit 5856 from the second side of warehouse 5850.First supporting leg 5884 and Two supporting legs 5886 can be angularly oriented relative to the axis of slit 5856, and the first supporting leg 5884 can Such as become about 90 degree of orientations relative to the second supporting leg 5886.In certain embodiments, the first supporting leg 5884 and/or second supporting leg 5886 can deflect.In various embodiments, bridgeware 5880 can include Such as gap between the first supporting leg 5884 and the second supporting leg 5886.

Referring also to Figure 95 and Figure 96, in various embodiments, percussion assembly 5630 can be along warehouse 5850 Slit 5856 translate.Such as, percussion assembly 5630 can be along slit 5856 during percussion stroke Translation, and during percussion stroke, securing member can be penetrated from securing member chamber 5854.Percussion assembly 5630 Trigger shaft 5632, cutting edge 5636, cross bar 5638 and leg 5644 can be included.When percussion assembly 5630 when firing during stroke by percussion through the second jaw 5802, cutting edge 5636 can by tissue and / or tissue thickness's compensating part 5858 cut.Slit in the engageable first jaw anvil block of cross bar 5638, with Keep the first jaw relative to warehouse 5850, and leg 5644 can such as engage the second jaw 5802 In slit (slit 5856 in such as warehouse 5850), with relative to second jaw 5802 keep hit Send out assembly 5630.In various embodiments, cross bar 5638 and/or leg 5644 can be such as by cutting edges 5636 remain vertical with the platform 5852 of fastener cartridge 5850.

Referring also to Figure 95 and Figure 96, tissue thickness's compensating part 5858 can include storehouse contact surface 5862 He Tissue contacting surface.Such as it is fixed to warehouse 5850 and/or the second jaw when tissue thickness's compensating part 5858 When 5802, storehouse contact surface 5862 can position against storehouse platform 5852.It addition, such as pressed from both sides when tissue When holding between the first jaw and the second jaw 5802, tissue contacting surface can be against tissue positioned.? In various embodiments, tissue thickness's compensating part 5858 can include installed part 5860.It is similar to installed part 5760, installed part 5860 can be for example can be from the storehouse contact surface 5862 of tissue thickness's compensating part 5858 Projection, pin, tab and/or the post extended.Such as when tissue thickness's compensating part 5858 is relative to warehouse 5850 location time, installed part 5860 can and the supporting leg 5884 and 5886 of bridgeware 5880 between gap Alignment.It addition, when the storehouse contact surface 5862 of tissue thickness's compensating part 5858 is positioned to and warehouse 5850 Platform 5852 adjacent time, the supporting leg 5884 and 5886 that installed part 5860 can be bridged part 5880 is solid Fixed.In various embodiments, when tissue thickness's compensating part 5858 is fixed to warehouse 5850, install Part 5860 can be friction fit in the gap between supporting leg 5884 and 5886.Second jaw 5802 is pacified Piece installing engages with bridgeware and can keep tissue thickness's compensating part 5858 relative to warehouse 5850.Such as, one Denier installed part 5860 is friction fit between the supporting leg 5884 and 5886 of bridgeware 5880, can be connect in storehouse Touch surface 5862 fixing against the platform 5852 of warehouse 5850.

In various embodiments, referring primarily to Figure 95, fastener cartridge 5850 can include across warehouse 5850 Slit 5856 extend multiple bridgewares 5880.Bridgeware 5880 can be such as along slit 5856 length Separate at least partially.Such as, slit 5856 can be the portions of proximal from the second jaw 5802 Longitudinal slit that the distal part 5806 of the 5804 to the second jaw 5802 extends.It addition, in various enforcements In example, tissue thickness's compensating part 5858 can include aliging many with the bridgeware 5880 of warehouse 5850 Individual installed part 5860.Such as, when tissue thickness's compensating part 5858 is relative to warehouse 5850 and/or second When jaw 5802 positions, at least one installed part 5860 can be positioned on the proximal portion of the second jaw 5802 Divide in 5804, and at least one installed part 5860 can be positioned on the distal part of the second jaw 5802 In 5806.In various embodiments, installed part 5860 can along tissue thickness's compensating part 5858 length extremely A few part separates.Installed part 5860 can such as be friction fit in bridgeware 5880, and can make group Knit thickness compensation part 5858 and be fixed to warehouse 5850.

Referring also to Figure 95 and Figure 96, percussion assembly 5630 is transported along slit 5856 during percussion stroke Time dynamic, the cutting edge 5636 of percussion assembly 5630 can cut tissue thickness's compensating part 5858 and/or clamping Tissue between first jaw and the second jaw 5802 of end effector assembly 5800.It addition, work as Percussion assembly 5630, when moving through slit 5856, can make bridgeware 5880 separate.Such as, when Percussion assembly 5630 is when moving through slit 5856, and the cutting edge 5636 of percussion assembly 5630 is permissible The supporting leg 5884 and 5886 of deflection bridgeware 5880, and/or make the supporting leg of bridgeware separate.Various In embodiment, when firing assembly 5630 motion in slit 5856 during percussion stroke, cutting edge 5636 supporting legs 5884 and 5886 that can in succession deflect each bridgeware 5880, so that each bridgeware 5880 separate.Once the supporting leg 5884 and 5886 of bridgeware 5880 is cut sword 5636 and deflects, bridge joint The corresponding installed part 5860 of tissue thickness's compensating part 5858 can be discharged by part 5880.Along warehouse The length of 5850 by each installed part 5860 after each bridgeware 5880 discharges, tissue thickness's compensating part 5858 can no longer be fixed to warehouse 5850 and/or discharge from warehouse.In certain embodiments, cutting edge The installed part 5860 aligned can be cut during percussion stroke by 5636, or makes the peace aligned Piece installing 5860 ruptures.In various embodiments, sliding part and/or another element of percussion assembly 5630 Bridgeware 5880 can be made to separate, to be discharged from warehouse 5850 by tissue thickness's compensating part 5858.

Referring now to Figure 97 to Figure 100, it is similar to end effector assembly 5600, end effector group Part 5900 can include the first jaw i.e. anvil block 5910 (Figure 99 and Figure 100) and the second jaw 5902.? In various embodiments, the second jaw 5902 can include securing member warehouse 5950 and fix releasedly To securing member warehouse 5950 and/or tissue thickness's compensating part 5958 of the second jaw 5902.Real at some Execute in example, securing member warehouse 5950 and be releasably secured to tissue thickness's compensating part of warehouse 5950 5958 can such as constitute fastener cartridge assembly.Referring primarily to Figure 98, securing member warehouse 5950 can have storehouse Platform 5952 and the securing member chamber being limited in storehouse platform 5962.Installation cavity 5948 and/or securing member chamber 5954 can such as be limited in storehouse platform 5952.In various embodiments, installation cavity 5948 and securing member Chamber 5954 can have same or similar structure and/or geometry.Second jaw 5902 can such as include Securing member (such as surgical staples), this securing member can be removably positioned in securing member chamber 5954. In certain embodiments, warehouse 5950 can include slit 5956, and this slit 5956 can be from the second jaw The portions of proximal 5904 of 5902 extends towards the distal part 5906 of the second jaw 5902.

Referring also to Figure 97 to Figure 100, in various embodiments, percussion assembly 5630 can be at percussion stroke Period translates along the slit 5956 of warehouse 5950, and can percussion stroke during by securing member from fastening Part chamber 5954 is penetrated.When percussion assembly 5630 is fired through end effector group during percussion stroke During part 5900, tissue and/or tissue thickness's compensating part 5958 can be cut by cutting edge 5636.Cross bar Slit 5912 (Figure 99 and Figure 100) in 5638 engageable anvil blocks 5910, with relative to warehouse 5950 keep the first jaw, and the slit that leg 5644 can such as engage in the second jaw 5902 is (all Slit 5956 as in warehouse 5950), to keep percussion assembly relative to the second jaw 5902 5630.In various embodiments, cutting edge 5636 can such as be protected by cross bar 5638 and/or leg 5644 Hold as the platform 5952 with fastener cartridge 5950 vertical.

Referring also to Figure 97 to Figure 100, tissue thickness's compensating part 5958 can include storehouse contact surface 5962 (Figure 97) with tissue contacting surface 5964 (Figure 98 and Figure 99).Such as when tissue thickness's compensating part 5958 when being fixed to warehouse 5950 and/or the second jaw 5902, and storehouse contact surface 5962 can be put down against storehouse Platform 5952 positions.It addition, be such as clamped between anvil block 5910 and the second jaw 5902 when tissue Time, tissue contacting surface 5964 can be against tissue positioned.In various embodiments, tissue thickness compensates Part 5958 can include installed part 5960.It is similar to installed part 5760 and/or installed part 5860, such as, Installed part 5960 can be can to extend from the storehouse contact surface 5962 of tissue thickness's compensating part 5958 Projection, pin, tab and/or post.In certain embodiments, tissue thickness's compensating part 5958 can be such as Including groove 5970 that can be adjacent with installed part 5960.Groove 5970 can such as erect with installed part 5970 Straight alignment.Referring primarily to Figure 99, groove 5970 can be limited at the tissue of tissue thickness's compensating part 5958 In contact surface 5964, and can extend towards installed part 5960.In various embodiments, tissue thickness is mended The thin slice repaying part 5958 can such as be positioned between groove 5970 and installed part 5960.

Such as when tissue thickness's compensating part 5958 positions relative to warehouse 5950, installed part 5960 can Align with the installation cavity 5948 in storehouse platform 5952.It addition, when the storehouse of tissue thickness's compensating part 5958 When contact surface 5962 is positioned to adjacent with the platform 5952 of warehouse 5950, installed part 5960 can position In installation cavity 5948.In various embodiments, it is fixed to warehouse when tissue thickness's compensating part 5958 When 5950, installed part 5960 can be friction fit in installation cavity 5948.Installed part 5960 and installation cavity 5948 are bonded together with a friction fit, can keep tissue thickness's compensating part relative to warehouse 5950 5958 at least some of.Such as, when installed part 5960 is friction fit in installation cavity 5948, can Storehouse contact surface 5962 is fixed against the platform 5952 of warehouse 5950.

Referring primarily to Figure 97 and Figure 98, fastener cartridge 5950 can include being limited in storehouse platform 5952 Multiple installation cavitys 5948.In certain embodiments, corresponding installation cavity 5948 can appointing at slit 5956 Side is defined in storehouse platform 5952.First installation cavity 5948 can such as be limited to the of warehouse 5950 One longitudinal side, and the second installation cavity 5948 of correspondence can such as be limited to the second of warehouse 5950 longitudinally Side.Such as, the first portions of proximal that corresponding installation cavity 5948 be can be positioned on the second jaw 5902 In 5904, and/or second can be positioned on the remote of the second jaw 5902 to corresponding installation cavity 5948 In side part 5906.In various embodiments, securing member chamber 5954 can be positioned on corresponding mounted in pairs Between chamber 5948, say, that from slit 5956 closer to；And it is near to can be positioned on the second jaw 5902 Paired at mounted in pairs chamber 5948 at side part 5904 and the second jaw 5902 distal part 5906 Between installation cavity 5948, say, that be positioned in the mid portion of warehouse 5950.It addition, various In embodiment, tissue thickness's compensating part 5958 can include aliging with the installation cavity 5948 of warehouse 5950 Multiple installed parts 5960.Such as, at least one installed part 5960 can be positioned on the second jaw 5902 In portions of proximal 5904；And at least one installed part 5960 can be positioned on the remote of the second jaw 5902 In side part 5906.In various embodiments, a pair installed part 5960 can be positioned on the second jaw 5902 Portions of proximal 5904 in；And a pair installed part 5960 can be positioned on the distally of the second jaw 5902 In part 5906.Installed part 5960 can such as be friction fit in installation cavity 5948, and can make group That knits thickness compensation part 5958 is fixed to warehouse 5950 at least partially.

Referring primarily to Figure 99 and Figure 100, installed part 5960 can be from installation cavity 5948 during percussion stroke Remove.In various embodiments, the driver 5920 being movably positioned in installation cavity 5948 can hit During distribution journey, installed part 5960 is penetrated from installation cavity 5948.Such as, driver 5920 can position In each installation cavity 5948.During percussion stroke, the second jaw 5902 fires assembly 5630 And/or the element of sliding part can such as engage with driver 5920, so that driver 5920 is towards storehouse platform 5952 and/or move towards tissue thickness's compensating part 5958.Driver 5920, can be such as when motion Will be located into the installed part 5960 in installation cavity 5948 towards platform 5952 and/or tissue thickness's compensating part 5958 promote.In various embodiments, the peace being defined in tissue thickness's compensating part 5958 and be pushed out The groove 5970 of piece installing 5960 correspondence can receive the installed part 5960 being pushed out.Such as, driver Installed part 5960 can be pushed in groove 5970 by 5920.Installed part 5960 can such as be squeezed into groove In 5970, deform into groove, and/or be compressed into groove 5970.Once installed part 5960 is in percussion Remove and be pushed into the groove 5970 of correspondence from installation cavity 5960 during stroke, tissue thickness's compensating part 5958 just can no longer be fixed to warehouse 5950 and/or discharge from warehouse 5950.

In various embodiments, referring now to Figure 62 to Figure 66, nail bin 13000 can include warehouse 1310, tissue thickness's compensating part 13020 and multiple fire adapter, these can fire adapter by structure Make as tissue thickness's compensating part 13020 being releasably held warehouse 13010, as hereafter entered one Step more detailed description.Warehouse 13010 can include proximal end 13011, distal end 13012 and platform 13015, this platform 13015 is configured to can supporting tissue thickness compensation part 13020 thereon.Warehouse 13010 can include the one or more proximal stop 13013 extended from it, and this proximal stop can quilt It is configured to stop or stop tissue thickness's compensating part 13020 proximally to move.Similarly, warehouse 13010 can include one or more distally stop part 13014, and this distally stop part may be structured to can Stop or stop tissue thickness's compensating part 13020 towards distal movement.Referring primarily to Figure 63, warehouse 13010 may also include and are defined in multiple nail chamber 13016 therein.In various embodiments, nail bin 13000 Can include multiple adapter 13030 and 13040, these adapters are configured to tissue thickness to be mended Repay part 13020 to releasably hold on warehouse 13010.Such as, each adapter 13030 can include The multiple chambeies plug 13031 following closely in chamber 13016 can be positioned, and between chamber plug 13031 and at tissue The connecting rod 13032 that thickness compensation part 13020 extends above.In at least one embodiment, chamber plug 13031 can be closely adhered to follow closely in chamber 13016.In certain embodiments, chamber plug 13031 can Pressure coordinates and/or is snapped to follow closely in chamber 13016.Such as, each adapter 13040 can include chamber Plug 13031 and the head 13042 extended from it, wherein head 13042 can be at least in part in tissue thickness Degree compensating part 13020 extends above.Referring again to Figure 63, tissue thickness's compensating part 13020 can such as wrap Include: the one group of nearside recess being defined in the proximal end 13021 of tissue thickness's compensating part 13020 13023, this nearside recess is able to receive that the chamber plug 13031 that proximally adapter 13030 extends；Middle concave Mouth 13024, each intermediate recesses 13024 is able to receive that from the chamber plug that intermediate connector 13040 extends 13031；And the one group of distally being defined in the distal end 13022 of tissue thickness's compensating part 13020 Recess 13025, this distally recess is configured to receive the chamber plug that distally adapter 13030 extends 13031。

In use, sliding part or firing member can be advanced through nail bin 13000 towards distally, positioning Nail injection in nail chamber 13016.In various embodiments, wherein location has the nail chamber 13016 of nail can To clog without chamber plug 13031.In certain embodiments, wherein location have chamber plug 13031 nail chamber can Will not can position nail wherein.Although not shown, but in certain embodiments, nail chamber can include fastening Part and the chamber plug 13031 being positioned in.Referring again to Figure 65 and Figure 66, nail bin 13000 also can example As included multiple staple drivers 13050, nail is supported on not firing of they by these staple drivers 13050 Position.Such as, when firing member is advanced through nail bin towards distally, can be by staple drivers 13050 and nail It is lifted up (that is, towards the platform 13015 of warehouse 13010 and towards being positioned at tissue thickness's compensating part The anvil block on 13020 opposites lifts).Similarly, at least some in staple drivers 13050 can contact It is positioned at the chamber plug 13031 in some nail chambeies 13016, and these chambeies is filled in 13031 towards anvil block upwards Lift.When nail is lifted up by staple drivers 13050, the nail lower limb of these nails may pass through tissue thickness and mends Repay part 13020, through the tissue being positioned at tissue thickness's compensating part 13020 and anvil block, and with It is positioned at the anvil block contact of tissue opposite side.Then staple drivers 13050 can drive nail against anvil block, makes Deformation must be followed closely, tissue thickness's compensating part 13020 and tissue to be trapped in wherein.When 13031 quilts are filled in chamber When staple drivers 13050 is lifted up, anvil block can stop chamber plug 13031 to move upward.In this type of situation Under, referring primarily to Figure 63, chamber plug 13031 may deformation, deflection and/or disconnection.Implement at some In example, chamber plug 13031 can such as include one or more recess, and this recess may cause chamber plug 13031 Ad-hoc location wherein deforms, deflects and/or disconnect.In all cases, whole chamber plug 13031 Or the most whole chamber plug 13031 can penetrate from nail chamber 13016 under the driving of staple drivers 13050 Go out.Now, tissue thickness's compensating part 13020 can be no longer connected to by adapter 13030 and/or 13040 Warehouse 13010, therefore, warehouse 13010 can be away from the tissue thickness's compensating part implanted against tissue 13020 motions.

In use, as to above supplement, firing member can be from the proximal end of nail bin 13000 13011 advance towards the distal end 13012 of nail bin 13000.Warehouse 13010 can include longitudinal slit 13019, this longitudinal direction slit 13019 is configured to can receive firing member slidably therein extremely A few part.Firing member, when advancing towards distally, can will be located in the nail 13016 of recent side Follow closely injection, fire the adapter 13030 of recent side subsequently.The percussion of recent side adapter 13030 can The proximal end 13021 of tissue thickness's compensating part 13020 is discharged from warehouse 13010.Implement at other In example, firing member can be before firing any nail, the adapter of percussion recent side.In any situation Under, firing member can be pushed further into towards distally, to be penetrated from nail chamber 13016 by nail, fires the most again Intermediate connector 13040.Now, can only retain tissue thickness's compensating part 13020 is remained to warehouse The farthest side adapter 13030 of 13010.Once the adapter 13030 of farthest side is hit by firing member Sending out, tissue thickness's compensating part 13020 can be no longer attached to warehouse 13010.Above-mentioned percussion sequence describes It is that nail bin is fired completely or thoroughly.Be likely to occur in nail bin that the nail accommodated do not fired completely its His situation.In such cases, tissue thickness's compensating part 13020 is remained to the connection of warehouse 13010 Some in device can not be fired.When the part completing nail bin 13000 uses, anvil block can be opened, and And warehouse 13010 is pulled away from tissue thickness's compensating part 13020 that part is implanted.In such cases, not The adapter of percussion is configured to skid off nail chamber 13016, even if they do not fired also be as This.Under any circumstance, such as, adapter 13030 and 13040 can be by any suitable bio-compatible Property and/or bioabsorbable material constitute.

As to above supplement, firing member can such as include cut portion (such as cutter), this cutting Part may be structured to can be when firing member be advanced through nail bin 13000 towards distally, by tissue thickness Compensating part 13020 and tissue cross.In such cases, cut portion is also structured to will connect The connecting rod 13032 of device 13030 is crosscutting.

In various embodiments, referring now to Figure 101 and Figure 102, can such as use nail bin application device The nail bin 10800 including support section 10810 and tissue thickness's compensating part 10820 is loaded into by 10880 In staple cartridge channel.Similarly as described above, nail bin application device 10880 such as can also be configured to can Top is organized thickness compensation part 10890 position relative to anvil block (such as anvil block 10060) so that when When anvil block 10060 closes, anvil block 10060 can contact tissue thickness compensation part 10890 and tissue thickness Compensating part engages.In at least one embodiment, tissue thickness's compensating part 10890 can include from tissue thickness Multiple holding lower limbs 10895 that the top surface 10891 of degree compensating part 10890 extends, this holding lower limb is by structure Make as anvil block 10060 can be engaged and tissue thickness's compensating part 10890 is releasably held anvil block. In at least one such embodiment, lower limb 10895 can be arranged to lengthwise rows, the most each lower limb 10895 can include at least one foot, and this at least one foot can enter the cutter being defined in anvil block 10060 Slit 10065 also engages with this cutter slit 10065.In certain embodiments, some feet of lower limb 10895 Can extend in one direction, and other feet can extend in another direction.In at least one embodiment, one A little feet can extend in opposite direction.

Under any circumstance, once anvil block 10060 engages, now with tissue thickness compensating part 10890 Seeing Figure 102 and Figure 103, anvil block 10060 just can be again turned on, and then clinician can make nail bin execute Move away from tissue thickness's compensating part 10820 and 10890 with device 10880.Then, figure is seen 104, top tissue thickness compensation part 10890 can be positioned on the first side of target tissue, and organizes thickness Degree compensating part 10820 can be positioned on (can include bottom tissue thickness compensating part) the second side of this tissue On.After tissue thickness's compensating part 10820 and 10890 suitably positions, referring now to figure 105, Such as, the blade (such as blade 10053) of firing member can be advanced through above-mentioned target tissue and tissue thickness Degree compensating part.

In various embodiments, referring now to Figure 106, nail bin application device (such as application device 12280) such as can include being detachably mounted to tissue thickness thereon compensating part 12290, this tissue Thickness compensation part can be similar to mentioned above being inserted in staple cartridge channel (as shown in Figure 106 A), and When anvil block 10060 moves to make position, engage with anvil block 10060.Application device 12280 can wrap Include shank 10084, be used for positioning tissue thickness's compensating part 12290 relative to nail bin.It addition, use Device 10084 can include multiple lower limb 10081, and tissue thickness's compensating part 12290 can be fixed to nail by this lower limb Storehouse.In at least one such embodiment, tissue thickness's compensating part 12290 can include from its top table The upwardly extending multiple holding components 12295 in face 12291.The most each holding component 12295 can include Multiple flexible legs 12296, this flexible leg is configured to the cutter slit that can insert in anvil block 10060 In 10065.Referring primarily to Figure 107 and Figure 108, the flexible leg 12296 of each holding component 12295 Can be separated by gap 12298 so that flexible leg 12296 is in inserting cutter slit 10065, and flexible leg can Inward deflection, and the foot of the once expansion of lower limb 12296 is through cutter slit 10065, lower limb 12296 is subsequently Just can outwards return elastically.In various embodiments, the foot of the expansion of flexible leg 12296 can be defined Relative holding antelabium 12297 flexure below in anvil block 10060, and due to lower limb 12296 and lip Edge 12297 interacts, and tissue thickness's compensating part 12290 can be held anvil block 10060.Then, Nail bin application device 12280 can move away from tissue thickness's compensating part 12290, as shown in 106B. In use, once tissue thickness's compensating part 12290 is leaned on by the nail disposed from nail bin 10000 the most Tissue to implant, anvil block 10060 just can be opened again, and when anvil block 10060 moves away from implanting Tissue thickness's compensating part 12290 time, keep component 12995 lower limb 12296 just can inward deflection, make Obtain this lower limb to be pulled out from cutter slit 10065.

As outlined above, end effector assembly can include nail bin, anvil block, and is positioned at nail bin and anvil The most a piece of buttress material in the middle of seat.In at least one embodiment, referring now to Figure 109 to figure 111, a piece of buttress material (such as buttress material 336) is configured to be snapped to nail In at least one in storehouse 322 and/or anvil block (not shown), so that this sheet buttress material is releasable Be maintained in end effector.Seeing Figure 110 and Figure 111, nail bin 322 can include the first side wall 302 and second sidewall 304, wherein at least one sidewall in the first side wall 302 and the second sidewall 304 Can include from its outward extending antelabium 306.In various embodiments, buttress material 336 can include First edge or the 308, second edge, the first side or the second side 310 and at least in part along the first limit At least one antelabium 312 that the length at edge 308 and the second edge 310 extends.In at least one embodiment In, seeing Figure 111, antelabium 312 is configured to connect with antelabium 306 in snap-fit fashion Close, so that buttress material 336 is releasably held nail bin 322.

As to above supplement, see Figure 111, buttress material 336 can include surface 316, should Surface 316 is configured to can be with platform 328 adjacent positioned of nail bin 322, or against nail bin 322 Platform 328 position.In at least one embodiment, lateral edges 308 and 310 can include sidewall, should Sidewall can extend along apparent surface 316 direction perpendicularly or transversely.In this type of embodiment, antelabium 312 can extend from these sidewalls so that antelabium 312 can at the antelabium 306 of nail bin 322 below and antelabium 306 lock mutually.In various embodiments, when disposing nail from nail bin 322, buttress material 336 Antelabium 312 can depart from from the antelabium 306 of nail bin 322.More specifically, when disposing nail, this nail can Contact with buttress material 336, apply power upwards to buttress material 336, and make supporter material Material 336 separates with nail bin 322.It is therefore advantageous that when disposing nail from nail bin 322 as mentioned above And/or when opening end effector, buttress material 336 can separate with nail bin 322 automatically.

In various embodiments, seeing Figure 110 and Figure 111, a piece of buttress material can include prolonging from it At least one component stretched, this component may be structured to buttress material to be releasably held nail One in storehouse and/or anvil block.In at least one embodiment, component 318 can be from buttress material 336 Extend along the direction perpendicular or transverse to surface 316.In various embodiments, component 318 is permissible The mode that frictional fit or pressure coordinate engages with the one in nail chamber 320 and/or anvil block pit, to incite somebody to action This sheet buttress material releasably holds the one in nail bin and anvil block.Similarly as described above, In various embodiments, the nail disposed from nail chamber 320 can apply power upwards to buttress material 336, and And make component 318 separate with nail chamber 320.In various embodiments, nail can be pierced component 318 and/or props up Support thing material 336, so that this buttress material is fixed to tissue, as outlined above.

As shown in Figure 110, a piece of buttress material can include from its more than one component extended (the most prominent Go out portion), for this sheet buttress material is remained to the one in nail bin and anvil block.In various embodiments In, referring now to Figure 112 and Figure 113, more than one component 318 ' can be such as from this sheet buttress material 336 ' extend.In at least one embodiment, component 318 ' can be pressure fitted into the nail chamber of nail bin 322 ' In 320 ', and/or in the anvil block pit of anvil block (not shown) so that component 318 ' is by this sheet supporter material Material strip remains in nail bin and/or anvil block with friction, as outlined above.As retouched in further detail herein State, except the nail chamber of nail bin and anvil block for receive extend from a piece of buttress material protuberance (or Keep component) anvil block pit outside, nail bin and/or anvil block also can include slit or hole wherein.

In certain embodiments, as being described in more below, support section can include keeping feature structure, This holding feature structure nail gradually fire from nail bin time, be configured to can by tissue thickness's compensating part by Gradually discharge from support section.Referring now to Figure 114, nail bin (such as nail bin 11200) such as can include Support section 11210, this support section 11210 includes may be structured to can be by tissue thickness's compensating part 11220 (Figure 115) releasably hold holding feature structure 11213 thereon.In various embodiments In, keep feature structure 11213 can such as be positioned in the end in each nail chamber 11212, the most often Individual holding feature structure 11213 can include being defined in guide groove 11216 therein, this guide groove quilt It is configured to the nail lower limb 10032 slideably received within nail 10030.In this type of embodiment, follow closely lower limb 10032 and keep both feature structures 11213 may be structured to can be by tissue thickness's compensating part 11220 Releasably hold support section 11210.

In use, referring now to Figure 115, it is contained in the staple drivers in support section 11210 10040 can be driven upward as described above by sliding part 10050.Wherein staple drivers 10040 can be constructed For holding feature structure 11213 can be contacted, make holding feature structure 11213 and support section 11210 It is at least partially separated, and makes holding feature structure 11213 be outwardly and away from nail 10030 and nail chamber 11212 displacements.Feature structure 11213 is kept to separate and/or outward displacement with support section 11210 Time, keep feature structure 11213 can be no longer able to tissue thickness's compensating part 11220 is remained to supporting part Dividing 11210, therefore, tissue thickness's compensating part 11220 can discharge from support section 11210.It is similar to Mentioned above, tissue thickness's compensating part 11220 such as can follow closely 10030 from nail bin towards anvil block (such as anvil Seat 11260) when gradually penetrating, gradually discharge from support section 11210.In various embodiments, example Platform surface 11211 copline such as top surface and support section 11210 when staple drivers 10040 Or at least substantially copline time, staple drivers 10040 can with keep feature structure 11213 contact.? In this type of embodiment, nail 10030 be shaped as they be fully formed or completely percussion configuration while And/or before, tissue thickness's compensating part 11220 can discharge from support section 11210.

In at least one such embodiment, referring primarily to Figure 116, driver 10040 can be by excessively Drive so that be pulled to so that nail 10030 is fully formed above platform surface 11211, and driver 10040 be overdriven period, holding feature structure 11213 can be made to disconnect and away from support section 11210.In various embodiments, referring again to Figure 115, holding feature structure 11213 can be from nail chamber 11212 separate or before outward displacement, extend or dangle in nail chamber so that driver on nail chamber 10040 when reaching exactly to platform surface 11211, can contact with keeping feature structure 11213.In office In the case of He, once tissue thickness's compensating part 11220 discharges from support section 11210, referring now to Figure 116, support section 11210 just can move away from the tissue thickness's compensating part 11220 implanted.

Referring now to Figure 117, the fastener cartridge assembly 6002 being used together with end effector assembly can Including warehouse 6050 and tissue thickness's compensating part 6058 of being releasably secured to warehouse 6050.Class Being similar to warehouse 5650, such as, warehouse 6050 can include the slit 6056 that percussion assembly can be guided to advance And/or the securing member chamber 6054 securing member can being removably retained in warehouse 6050.In various realities Executing in example, warehouse 6050 can such as include protuberance 6048, such as post, installed part, tab and/or Ridge.When tissue thickness's compensating part 6058 positions relative to storehouse platform, protuberance 6048 can be from warehouse The storehouse platform of 6050 extends and enters in tissue thickness's compensating part 6058.In various embodiments, storehouse Body 6050 can include the multiple protuberances 6048 extended from storehouse platform.Protuberance 6048 can be such as along warehouse The length location of 6050, and can such as be positioned between adjacent securing member chamber 6054.

Referring also to Figure 117, in various embodiments, tissue thickness's compensating part 6058 can be around tissue thickness Protuberance 6048 thermoforming of degree compensating part 6058.Such as, tissue thickness's compensating part 6058 can be relative Platform location, storehouse in warehouse 6050.Tissue thickness's compensating part 6058 once positions, so that it may be heated to Sufficiently high temperature so that tissue thickness's compensating part 6058 deforms, with conform to include to extend from it The shape of the storehouse platform of protuberance 6048 shape.Tissue thickness's compensating part 6058 can such as locally be added Heat, and can such as be heated to approximation and/or the glass close to the material constituting tissue thickness's compensating part 6058 Glass transition temperature.Tissue thickness's compensating part can such as be heated to about 90 DEG C to about 120 DEG C.At some In embodiment, tissue thickness's compensating part can such as be heated to about 75 DEG C to about 150 DEG C.Once organize thickness Degree compensating part 6058 has deformed and has fitted around protuberance 6048, so that it may removes thermal source or alleviates thermal source Heat supply, and tissue thickness's compensating part 6058 can cool down.Can such as make tissue thickness's compensating part 6058 warp The temperature raised about 2 seconds to about 5 seconds, so that it fully deforms around protuberance 6048.At other In the case of, can such as make tissue thickness's compensating part 6058 stand the temperature about 1 second to about 10 seconds raised, So that it fully deforms around protuberance 6048.Tissue thickness's compensating part 6058 after the cooling period, can be such as It is punctured into closer to protuberance 6048 and/or more tightly around protuberance 6048.In various embodiments, Tissue thickness's compensating part 6058 of thermoforming can prevent and/or limit tissue thickness's compensating part 6058 along warehouse The length of 6050 and between securing member chamber 6054 transverse shift and/or flexing.

In addition or alternatively, tissue thickness's compensating part 6058 can be tight around being removably positioned in At least some of thermoforming of the securing member in firmware chamber 6054.Such as, tissue thickness's compensating part 6058 The lower limb thermoforming above the platform of storehouse can be extended to around nail.Referring also to Figure 117, in various embodiments, Fastener cartridge assembly 6002 can include at least one of lid around warehouse 6050 or shell 6060.Outward Shell 6060 can be such as around bottom, side and/or the extension of storehouse platform of warehouse 6050.Shell 6060 Such as can be fixed to warehouse 6050 by pin 6062.It addition, in various embodiments, shell 6060 can example As comprised metal material, such as rustless steel 300 series, rustless steel 400 series, titanium and/or medical grade Aluminum.Metal shell 6060 can such as be conducive to the heat transfer in warehouse 6050 and/or protuberance 6048, To improve thermoforming effect.

Referring now to Figure 118, the fastener cartridge assembly 6102 being used together with end effector assembly can Including warehouse 6150 and tissue thickness's compensating part 6158 of being releasably secured to warehouse 6050.Class Be similar to warehouse 5650, warehouse 6150 can include such as can guiding slit 6156 that percussion assembly advances, And the securing member chamber 6154 such as securing member can being removably retained in warehouse 6150.Warehouse 6150 may also include the ridge 6146 (being similar to ridge 5648) extended from storehouse platform 6152.Ridge 6146 can Such as around at least some of extension in securing member chamber 6154.In various embodiments, fixed when securing member When position is in securing member chamber 6154, the top of this securing member can be from securing member chamber 6148 projection.At this type of In embodiment, when securing member penetrates from securing member chamber 6154, at least partly surround securing member chamber The ridge 6146 of 6154 location can support the top of securing member, and/or guides the top of securing member.Respectively Planting in embodiment, warehouse 6150 can include multiple ridges at least partly about securing member chamber 6154 6146.Such as, spine 6146 can be at least about the proximal end in each securing member chamber 6154 and/or distally End extends.

Referring also to Figure 118, in various embodiments, fastener cartridge assembly 6102 can such as include around The lid positioning and being similar to shell 6060 at least partially of warehouse 6150 or shell 6160.Shell 6160 such as around bottom and/or the side extension of warehouse 6150, and can such as can be fixed by pin 6162 To warehouse 6150.In various embodiments, shell 6160 can such as include protuberance 6148, such as Post, installed part, tab and/or ridge.Protuberance 6148 can extend over the storehouse platform of warehouse 6150 6152.In various embodiments, when relative to storehouse platform position tissue thickness compensation part 6158, prominent Go out portion 6148 to may extend in tissue thickness's compensating part 6158.In various embodiments, shell 6160 The multiple protuberances 6148 extended from it can be included.Protuberance 6148 can be such as along the length of shell 6160 Location, and can be such as around the periphery location of warehouse 6150.

Similar with tissue thickness compensating part 6058, tissue thickness's compensating part 6158 can be around shell 6160 Protuberance 6148 thermoforming.In various embodiments, tissue thickness's compensating part 6158 can compare shell 6160 is wide so that a part for tissue thickness's compensating part 6158 extends beyond the periphery of warehouse 6150.? In this type of embodiment, tissue thickness's compensating part 6158 can such as be thermally formed to the periphery around warehouse 6150 Protuberance 6148.Or alternatively, tissue thickness's compensating part 6158 can such as be thermally formed in addition Ridge 6146 and/or the nail lower limb extended from securing member chamber 6154.In various embodiments, shell 6160 can Such as comprise metal material, such as rustless steel 300 series, rustless steel 400 series, titanium and/or medical grade Aluminum, in order to be conducive to heat transfer and improve thermoforming effect.

Referring now to Figure 119 and Figure 120, end effector assembly 6200 can include the first jaw or anvil Seat 6210 and the second jaw 6202.Second jaw 6202 can include warehouse 6250, and solid releasedly Surely tissue thickness's compensating part 6258 of warehouse 6250 is arrived.Being similar to warehouse 5650, warehouse 6250 can example As (all in included securing member chamber 6254 and the securing member can being removably positioned in securing member chamber 6254 Such as surgical staples).In various embodiments, surgical staples 6290 can be positioned in securing member chamber 6254 and drive On dynamic device 6220.Referring primarily to Figure 119, when driver 6220 is in pre-firing position, follow closely 6290 A part can be positioned in securing member chamber 6254.In various embodiments, nail 6290 can include base portion 6292 and from base portion 6292 extend lower limb 6294a and 6294b.First lower limb 6294a can be such as from base The first end in portion 6292 extends, and the second lower limb 6294b can be such as from the second end of base portion 6292 Extend.In various embodiments, when driver 6220 be in pre-firing position and follow closely 6290 be in pre- During the configuration shaped, the base portion 6292 of nail 6290 can be positioned in securing member chamber 6254, and follows closely Leg 6294a and 6294b of 6290 can extend to tissue thickness's compensating part 6258 from securing member chamber 6254 In.

In various embodiments, referring also to Figure 119 and Figure 120, each nail lower limb 6294a, 6294b can be Base portion 6292 and each nail lower limb 6294a, include barb between the top 6299a of 6294b.Barb can be The sharpest and/or sharp-pointed projection, such as spine.In various embodiments, the line footpath of nail can be E.g., from about 0.18mm, about 0.20mm and/or about 0.23mm (about 0.0069 inch, about 0.0079 Inch and/or about 0.0089 inch).The line footpath of barb can be e.g., from about 0.03mm (about 0.001 English Very little).In some cases, the line footpath of barb can such as between about 0.01mm to about 0.08mm (about 0.0005 inch to about 0.003 inch) between.In certain embodiments, the first lower barb 6296a Can be positioned on the first nail lower limb 6294a, and the second lower barb 6296b can be positioned on the second nail lower limb On 6294b.Lower barb 6296a, 6296b can be positioned on base portion 6292 and nail lower limb 6294a, 6294b's Top 6299a, between 6299b.It addition, the first upper barb 6298a can be positioned on the first nail lower limb On 6294a, and the second upper barb 6298b can be positioned on the second nail lower limb 6294b.Upper barb 6298a, 6298b can be positioned lower barb 6296a, 6296b at corresponding nail lower limb 6294a on 6294b With top 6299a, between 6299b.When driver 6220 is in pre-firing position and follows closely 6290 and is in During preformed configuration, at least one barb 6296a of nail 6290,6296b, 6298a, 6298b can determine Position is in tissue thickness's compensating part 6258.In this type of embodiment, barb 6296a, 6296b, 6298a, Tissue thickness's compensating part 6258 such as can be caught relative to warehouse 6250 and/or keep by 6298b.Embed The barb 6296a of tissue thickness's compensating part 6258,6296b, 6298a, 6298b can such as prevent and/or limit Tissue thickness processed compensating part 6258 is relative to storehouse platform transverse movement, and/or can such as prevent tissue thickness Compensating part 6258 is away from the lifting of storehouse platform.In addition or alternatively, in various embodiments, fall Hook can be positioned on the top 6299a of nail lower limb 6294a.6294b, at 6299b.

Referring primarily to Figure 120, when driver 6220 moves to firing position, nail 6290 can be from fastening Part chamber 6254 removes and/or penetrates.It addition, tissue thickness's compensating part 6258 and tissue T can be held Between the anvil block 6210 and warehouse 6250 of end effector assembly 6200.Nail in anvil block 6210 becomes Shape pit 6214 can such as make nail 6290 be configured to B shape.It addition, at least one barb of nail 6290 6296a, 6296b, 6298a, 6298b can such as engage the tissue being clamped in nail 6290.Barb 6296a, 6296b, 6298a, 6298b can catch and/or remain trapped in the tissue T in nail 6290.

Referring now to Figure 121 to Figure 124, securing member 6390 can in securing member chamber 6350 by and end The lock driver 6320 (Figure 123 and Figure 124) that actuator assembly is used together releasably holds.? In various embodiments, securing member 6390 can include base portion 6392 and the lower limb extended from base portion 6392 6394a and 6294b.First lower limb 6394a can such as extend from the first end of base portion 6392, and the Two lower limb 6394b can such as extend from the second end of base portion 6392.In certain embodiments, lock drives Device 6320 can releasably hold the base portion 6392 of securing member 6390.In various embodiments, lock drives Dynamic device 6320 can include snap close 6340, and this snap close 6340 can hook releasedly and/or keep base portion 6392.Snap close 6340 can be for example, flexible, and can such as bend with the base portion of release fasteners 6390 6392.In various embodiments, lock driver 6320 and/or snap close 6340 can such as such as be gathered by plastics Etherimide is constituted, and has glass filler or without glass filler so that snap close 6340 can be sufficiently flexible Deformation and/or plastic deformation.

Referring primarily to Figure 123 and Figure 124, lock driver 6320 can be movably positioned in and be defined in In securing member chamber 6354 in the storehouse platform 6352 of warehouse 6350.Lock driver 6320 can be at securing member Chamber moves to unlocked position (Figure 124) from latched position (Figure 123).Slip in warehouse 6350 Part and/or driver can engage lock driver 6320 during percussion stroke so that lock driver 6320 from Latched position moves to unlocked position.In various embodiments, securing member 6390 can work as lock driver 6320 be fixed to when being in the locked position lock driver 6320, and can work as lock driver 6320 move to solution Discharge from lock driver 6320 during lock position.When lock driver 6320 moves to solve lock-bit from latched position Postponing, securing member 6390 can penetrate from securing member chamber 6354.The key adjacent with securing member chamber 6354 6353 can such as allow securing member 6390 discharge from lock driver 6320.Key 6353 can be the most urgent solid The antelabium extended internally at least partially at edge, part chamber 6354.In various embodiments, key 6353 can There is cam face 6355.In lock driver 6320 after latched position moves to unlocked position, snap close The flange 6344 of 6340 can adjoin with the cam face 6355 of key 6353.In this type of embodiment, when Snap close 6340 against cam face 6355 move time, cam face 6355 can make snap close 6340 bend, The base portion 6392 of securing member 6390 is discharged by hook 6342.In various embodiments, hook 6342 can Rotate up, to discharge base portion 6392.Such as, hook 6342 can rotate up so that its opening upwards Point to tissue thickness compensating part 6358, and make base portion 6392 may pass through this opening upwards motion Eventually away from lock driver 6320.

Referring also to Figure 123 and Figure 124, tissue thickness's compensating part 6358 can releasably be consolidated Surely the storehouse platform 6352 of warehouse 6350 is arrived.When lock driver 6320 is in the locked position (Figure 123) Time, nail lower limb 6394a and 6394b can extend to tissue thickness's compensating part 6358 from securing member chamber 6354 In.Nail lower limb 6394a and 6394b such as can keep tissue thickness's compensating part relative to storehouse platform 6352 6358, and can such as prevent and/or limit tissue thickness's compensating part 6358 and occur relative to storehouse platform 6352 Transverse movement.It addition, when lock driver 6320 moves to unlocked position and securing member 6390 from securing member When chamber 6354 is penetrated (Figure 124), snap close 6340 can with the base portion 6392 of release fasteners 6390, Make securing member 6390 can depart from lock driver 6320 and warehouse 6350.Fastening it is positioned when removedly Securing member 6390 in part chamber 6354 penetrates from they corresponding securing member chambeies 6354 and departs from warehouse When 6350, tissue thickness's compensating part 6858 can no longer be fixed to warehouse 6350 and/or release from warehouse 6350 Put.

Referring now to Figure 125 to Figure 129, end effector assembly 6400 can include the first jaw and/or Anvil block 6410 (Figure 127 to Figure 129) and the second jaw 6402.Second jaw 6402 can include Securing member warehouse 6450 and be releasably secured to the second jaw 6402 and/or tissue thickness's compensating part Tissue thickness's compensating part 6458 of 6458.In certain embodiments, securing member warehouse 6450 is with releasable Be fixed to tissue thickness's compensating part 6458 of warehouse 6450 and can such as constitute fastener cartridge assembly.Respectively Planting in embodiment, warehouse 6450 can include storehouse platform 6452 and extend through at least the one of warehouse 6450 The slit 6456 of part.Chamber can be limited in storehouse platform 6452, and enters in warehouse 6450.Such as, Securing member chamber 6454 can be limited in storehouse platform 6452, and can receive securing member 6490 (figure wherein 126A to Figure 129).Securing member 6490 can be removably positioned in securing member chamber 6454.Example As, single fastener 6490 can be removably positioned in each securing member chamber 6454, and can hit Penetrate from securing member chamber 6454 during distribution journey.It addition, lock chamber 6448 can be defined in storehouse platform 6452 In, and lock 6440 can be received wherein.Such as, single lock 6440 can be movably positioned in each In lock chamber 6448, and can move to solve from latched position (Figure 127 and Figure 128) during percussion stroke Lock position (Figure 129).

Referring primarily to Figure 126, lock 6440 can include base portion 6444 and hook 6442, and this hook can be relative to base Portion 6444 positions movingly.Such as, hook 6442 can be at least some of shape through base portion 6444 Move in the hole become.Hook 6442 can such as receive and/or keep adapter 6480.Hook 6442 can be such as It is made up of liquid crystal polymer (LCP), nylon, Polyetherimide, Merlon and/or ABS.Adapter 6480 can for example, stitching thread.In certain embodiments, adapter can such as by PDS, PGA/PCL, PLLA/PCL, TMC/PCL, PGA and/or PCL are constituted.In various embodiments In, hook 6442 is after being embedded or partially embedded in base portion 6444, and hook 6442 can retrain adapter 6480.Adapter 6480 can such as be maintained between hook 6442 and base portion 6444.When hook 6442 quilt Lift-off or during by part lift-off base portion 6444, adapter 6480 just can the most no longer be restrainted by hook 6442 Tie up, and can such as move to depart from lock 6440.In various embodiments, when hook 6442 is by least portion After dividing ground lift-off base portion 6444, adapter 6480 is slidably to depart from lock 6440.

Referring primarily to Figure 126 A, adapter 6480 can extend from tissue thickness's compensating part 6458.Tissue Thickness compensation part 6458 can such as with adapter 6480 frictional fit, and/or together with adapter 6480 Thermoforming.In various embodiments, when locking 6440 and being in the unlocked position, adapter 6480 can be worn Cross the hook 6442 of lock 6440.When by adapter 6480 through hook 6442, tissue thickness's compensating part 6458 can move to appropriate location relative to warehouse 6450.Such as, tissue thickness's compensating part 6458 can be determined Position is on the storehouse platform 6452 of warehouse 6450.Referring primarily to Figure 127, once tissue thickness's compensating part 6458 position relative to warehouse 6450, and lock 6440 just can move to latched position from unlocked position.Example As, the hook 6442 of lock 6440 can be embedded or partially embedded in base portion 6444 so that lock 6440 surrounds connection Device 6480 and/or constraint adapter 6480.In various embodiments, lock 6440 and/or driver 6420 Can such as include spring, lock 6440 can be biased to unlocked position by this spring.When lock 6440 is in locking During position, tissue thickness's compensating part 6458 such as can be fixed to warehouse by adapter and the joint of lock 6450。

Referring primarily to Figure 128 and Figure 129, key can during percussion stroke along warehouse 6450 at least Part motion.This key can for example, sliding part 6434 and/or percussion assembly element.In various enforcements In example, sliding part 6434 can engage with the driver in the chamber in warehouse 6450 during percussion stroke. Driver can be pushed away towards storehouse platform 6452 and/or towards tissue thickness's compensating part 6458 by sliding part 6434 Dynamic, securing member is penetrated and/or to be made lock 6440 move to unlock from latched position from securing member chamber 6454 Position.Referring primarily to Figure 128, sliding part 6434 can during percussion stroke with driving in lock chamber 6448 Dynamic device 6420 engages.Sliding part 6434 can make driver 6420 towards storehouse platform 6452 and/or towards group Knit thickness compensation part 6458 to move.It addition, referring primarily to Figure 129, driver 6420 can make lock 6440 Unlocked position is moved to from latched position.Such as, hook 6442 can be released base portion by driver 6420 6444.When hook 6442 is subsequently lifted base portion 6444, adapter just can be no longer by lock 6440 constraint. In this type of embodiment, tissue thickness's compensating part 6458 can such as be not affixed to warehouse 6450 and/or from storehouse Body 6450 discharges.

Referring now to Figure 67, tissue thickness's compensating part 17050 such as can include Part I 17052, with And the Part II 17054 that Part I 17052 extends relatively.Tissue thickness's compensating part 17050 can structure Become the part of nail bin groupware.In some cases, tissue thickness's compensating part 17050 can be attached to nail bin The warehouse of assembly.In some cases, tissue thickness's compensating part 17050 can be assembled into surgical stapling device The anvil block of tool.Under any circumstance, the Part I 17052 of tissue thickness's compensating part 17050 can be can Compression.In use, Part I 17052 can be trapped in the nail of nail bin injection, and can be to Also the tissue being trapped in nail applies compression stress.The Part II of tissue thickness's compensating part 17050 17054 can extend across Part I 17052, and wherein Part II 17054 can include from Part I 17052 proximal end 17053 extended and distal end 17055.As being described in more below, second Part 17054 can be pliable and tough and/or more more rigid than Part I 17052 not as good as Part I 17052.Existing Seeing Figure 68, nail bin groupware 17000 can include warehouse 17010, and this warehouse includes being defined in therein Multiple nail chambeies and the multiple nails being stored at least partly in nail intracavity.As shown in Figure 68, tissue thickness is mended Repay part 17050 and may be mounted to warehouse 17010.

Nail bin groupware 17000 can include nearside installed part 17060 and distally installed part 17070, this nearside The proximal end 17053 of Part II 17054 can be releasably held warehouse by installed part 17060 17010, the distal end 17055 of Part II 17054 can be released by this distally installed part 17070 Remain to Part II 17054 with putting.Nearside installed part 17060 can include single parts, or more than one Individual parts.As shown in Figure 68, nearside installed part 17060 can include the first installed part part 17060a and Second installed part part 17060b, these installed part parts can capture Part II at least in part 17054 and Part II 17054 is kept against warehouse 17010.Turning now to Figure 69, each installation Part part 17060a and 17060b can include key 17062, and this key 17062 can be releasably It is fixed in the keyway 17012 being defined in warehouse 17010.Each key 17062 and each keyway The size of 17012 all can be configured to allow the sidewall of keyway 17012 apply to keep to key 17062 Power, thus resisting bond 17062 is from the removal of keyway 17012.In all cases, key 17062 can Pressure coordinates and/or snap fit is in keyway 17012 releasedly.In the case of at least one, key 17062 can such as include the end 17063 expanded, and this end can be clamped in keyway releasedly Between the sidewall of 17012.As shown in Figure 68 and Figure 69, each installed part part 17060a and 17060b can include window 17064, and this window can receive the near of Part II 17054 at least in part Side end 17053.In such cases, the sidewall of window 17064 can engage tissue thickness's compensating part 17030, and tissue thickness's compensating part 17030 is pressed to the platform 17014 of warehouse 17010.Additionally, the Can being accommodated at least partially in installed part part 17060a and 17060b of two parts 17054.

Referring again to Figure 68 and Figure 69, similarly as described above, distally installed part 17070 can include window Mouth 17074, the big I of this window 17074 is configured to and is able to receive that the remote of Part II 17054 Side end 17055 at least some of.Being also similarly to mentioned above, the sidewall of window 17074 can Engage tissue thickness's compensating part 17030, and tissue thickness's compensating part 17030 is pressed to warehouse 17010 Platform 17014.Additionally, Part II 17054 can be accommodated in installed part part at least partially In 17070.Distally installed part part 17070 can include the one or more pins 17072 extended from it, This pin can be releasably secured to the one or more pin-and-holes being defined in warehouse 17010 In 17011.The size of each pin 17070 and each pin-and-hole 17011 can be configured to and enable to The sidewall of pin-and-hole 17011 applies retentivity to pin 17072, thus resists pin 17072 from pin-and-hole 17011 Removal.In all cases, each pin 17072 can coordinate and/or by snap fit by pressure releasedly It is combined in pin-and-hole 17011.

Nail bin 17000 to be assembled, in the case of at least one, can be first by tissue thickness's compensating part 17030 Platform 17014 against warehouse 17010 positions, and can nearside installed part 17060 and distally be installed Part 17070 is assembled into warehouse 17010.Nearside installed part 17060 and distally installed part 17070 are assembled To warehouse 17010, to capture or to trap tissue thickness's compensating part against warehouse 17010 as mentioned above 17050.Nearside installed part 17060 and distally installed part 17070 can capture second also as described above Divide the end of 17074, and this end is releasably held warehouse 17010.In some cases, Nearside installed part 17060 and/or distally installed part 17070 may be structured to can be by Part I 17052 Be trapped in wherein at least partially.Although tissue thickness's compensating part 17050 that Figure 67 to Figure 69 describes Only include two parts, but it can also be envisaged that tissue thickness's compensating part includes the various alternatives of many more than two part Form.Such as, tissue thickness's compensating part can include compressible Part I 17052 and extend through Cross the Part II 17054 of two or more rigidity therein.It addition, such as, tissue thickness compensates Part can include two with any suitable arrangement (being such as arranged to two-layer or more layers) or More compressible portions.

Once nail bin 17000 assembles complete, so that it may be assembled into surgical stapling device.In at least one feelings Under condition, the passage in the available end effector being limited to surgical stapling device keeps nail bin removedly 17000, the most again by operative site inserted into the patient for nail bin 17000.Inserted at nail bin 17000 Enter in operative site and/or when being manipulated by operative site, nearside installed part 17060 and/or distally peace Piece installing 17070 may be structured to tissue thickness's compensating part 17050 to be remained to warehouse 17010.Group The Part II 17054 knitting thickness compensation part 17050 can make tissue thickness's compensating part 17050 the most firm Property so that tissue thickness's compensating part 17050 does not become to depart from from warehouse 17010, until nearside installed part 17060 and/or distally installed part 17070 in one or more are cut open and/or depart from warehouse 17010, As being described in more below.Owing to Part II 17054 is rigidity, so in all cases, main Want or uniquely the attribute of the Part I 17052 of tissue thickness's compensating part 17050 made one's options, with Tissue thickness's compensating part 17050 is made to have desired tissue compensation characteristic.In use, tissue thickness is mended The Part II 17054 repaying part 17050 can be resisted between proximal end 17053 and distal end 17055 Relative motion, and in all cases, opposing proximal end 17053 and distal end 17055 court Move each other.

In all cases, once nail bin 17000 is properly positioned, so that it may advance firing member 17030 pass through nail bin 17000, are removably positioned in the nail in nail bin 17000 to dispose.Nail Storehouse 17000 can include movable member 17034, and this movable member 17034 can be by firing member 17030 advance from the proximal end of nail bin 17000 towards the distal end of nail bin 17000.As to upper Supplementing of literary composition, movable member 17034 may be structured to can be between non-firing position and firing position The nail being stored in removedly in warehouse 17010 is lifted.Firing member 17030 also can such as include cutting Cutting part (such as cutter 17032), this cut portion may be structured to can be in firing member 17030 court When distally is advanced through nail bin 17000, the tissue cross that will be just sewn.Cutter 17032 also can be constructed For can be when firing member 17030 be advanced through nail bin 17000 towards distally, by tissue thickness's compensating part 17050 is crosscutting.Referring primarily to Figure 67 and Figure 68, the proximal end 17053 of Part II 17054 can Cut off by cutter 17032.In at least one such embodiment, tissue thickness's compensating part 17050 can edge The longitudinal axis limited by the recess 17057 being defined in Part II 17054 at least in part is by least It is partially cut off, or is completely severed.As shown in Figure 68, recess 17057 can with extend through warehouse The longitudinal knife slit 17015 of 17010 aligns or at least substantially aligns.Once cutter 17032 is by second The proximal end 17053 of part 17054 is the most crosscutting, and Part II 17054 just can be proximally Installed part 17060a, 17060b discharge at least in part, or release.In such cases, tissue thickness Compensating part 17050 can become to separate with warehouse 17010.Such as, firing member 17030 can be by least portion Ground is divided to advance or be fully advanced through nail bin 17000, with by tissue thickness's compensating part 17050 at least portion Divide or fully implanted tissue, and due to tissue thickness's compensating part 17050, particularly Part II 17054 by the most crosscutting, and tissue thickness's compensating part 17050 can be sufficiently flexible to skid off nearside peace Piece installing part 17060a, 17060b and distally installed part 17070.In use, in various situations Under, fire the most at least in part and tissue thickness's compensating part 17050 the most at least portion at firing member 17030 After dividing ground to implant, firing member 17030 can retract to its nearside or starting position, wherein warehouse 17010 Tissue thickness's compensating part 17050 of implantation can be pulled away from subsequently.Such as, if along longitudinal axis by warehouse 17010 are pulled away from tissue thickness's compensating part 17050, then, such as thick by the most crosscutting tissue Degree compensating part 17050 can buckling, and the proximal end of this tissue thickness's compensating part 17050 and Distal end can move towards one another.

Referring now to Figure 70 to Figure 72, tissue thickness's compensating part 17150 can include compressible portion 17152 and extend through compressible portion 17152 and/or from compressible portion 17152 extend peace Piece installing part 17154.Compressible portion 17152 can include proximal end 17153, this proximal end The thickness of 17153 is smaller than the thickness of the main part 17156 of tissue thickness's compensating part 17150.Extremely In few such embodiment, proximal end 17153 can such as include tapered portion.Refer again to figure 70 to Figure 72, nail bin groupware (such as nail bin 17100) such as can include nearside installed part 17160, should Nearside installed part 17160 is configured to can be releasably by tissue thickness's compensating part 17150 Installed part part 17154 is fixed to warehouse 17010.Nearside installed part 17160 can include extending from it One or more locks 17162, these locks 17162 can be received in be defined in warehouse 17110 Or in multiple keyhole 10112.In at least one such embodiment, each lock 17162 can include lower limb With the foot extended from lower limb, wherein lower limb may be structured to can lock 17162 insertion keyhole 17112 time horizontal Flexure, resilience subsequently or at least substantially recoil to it and do not bend configuration so that foot can connect releasedly Close keyhole 17112 sidewall or move to keyhole sidewall rear.Similarly as described above, nearside installed part 17160 may also include chamber 17164, and this chamber 17164 is configured to receive tissue thickness's compensating part The nearside installed part part 17154 of 17150.Chamber 17164 may be structured to can nearly side installed part portion Divide 17154 platforms pressing to warehouse 17110, and the proximal end of tissue thickness's compensating part 17150 is protected Hold in position.In all cases, firing member such as firing member 17030 such as can be constructed For nearside peace can be cut when firing member 17030 advances to cut tissue thickness's compensating part 17150 Piece installing 17160.At at least one under such circumstances, incision nearside installed part 17160 can be by tissue thickness Degree compensating part 17150 discharges from warehouse 17110.Refer again to Figure 68 describe embodiment, such as, Firing member 17030 may be structured to can through be defined in nearside installed part part 17060a and Slit between 17060b, and at least some cases, it is possible to through nearside installed part part 17060a, 17060b and do not cut wherein.

Referring now to Figure 73 to Figure 76, as to supplementing, for releasedly by tissue thickness above Compensating part remains to the nearside installed part of warehouse can include Part I 17260a and Part II 17260b, this Part I 17260a and Part II 17260b can limit longitudinal direction after being assembled into warehouse Gap i.e. slit 17267, the gap of this longitudinal direction or the big I of slit 17267 are configured to permit Permitted firing member 17030 to pass through between Part I 17260a and Part II 17260b.It is similar to Literary composition is described, and each in Part I 17260a and Part II 17260b may comprise chamber 17264, this chamber 17264 is configured to can receive tissue thickness's compensating part at least in part and be protected Hold in position.It is also similarly to mentioned above, Part I 17260a and Part II 17260b In each may comprise the lock 17262 extended from it, this lock 17262 may be structured to can be with storehouse Body engages.

As it has been described above, nail bin groupware can include installed part or the attachment part of nearside, and the installed part in distally Or attachment part, wherein be configured to can be by tissue thickness's compensating part for the installed part of nearside or attachment part Proximal end remain to the proximal end of warehouse, and the installed part in distally or attachment part are configured to The distal end of tissue thickness's compensating part can be remained to the distal end of warehouse.At some, other are implemented In example, nail bin groupware may be used for only with at least one nearside installed part or at least one distally installed part Tissue thickness's compensating part is remained to warehouse.Turning now to Figure 147, storehouse assembly 17300 can include warehouse 17310 and tissue thickness's compensating part 17350, wherein the distal end of tissue thickness's compensating part 17350 can Including being configured to be releasably attached to the distal end 17355 of warehouse 17310.At least one In individual such embodiment, the distal end of warehouse 17310 can include lockhole 17011, this lockhole 17011 are configured to receive at least one distally installed part and be attached to warehouse 17310.Read Person is not it will be appreciated that at least for this embodiment, storehouse assembly 17300 comprises additionally in for by thick for tissue The proximal end of degree compensating part 17350 is installed to the nearside installed part of warehouse 17310.In various situations Under, distal end 17355 can be with main part 17,356 1 bodily form of tissue thickness compensating part 17350 Become, or alternatively, this main part 17356 can be attached to.

In various embodiments, referring now to Figure 156 and Figure 157, nail bin groupware such as nail bin 10400 Such as can include warehouse 10410, this warehouse includes may be structured to can be by tissue thickness's compensating part 10450 distal end releasably holding appropriate location or nose 10419.It is similar to institute above Stating, tissue thickness's compensating part 10450 can include the Part I being installed to Part II 10454 10452, wherein Part II 10454 can include being configured to be protected releasedly by nose 10419 The distal end 10455 held.In all cases, the nose 10419 of warehouse 10410 and platform 10414 can limit a slit 10418 between which, and this slit 10418 is configured to can receive far Side end 10455.Nose 10419 can be made up of elastomeric material, and the size of this elastomeric material can be set Become and be configured to allow nose 10419 bias to engage with distal end 10455.Using In, see Figure 157, after tissue thickness's compensating part 10450 is implanted the most at least in part, warehouse 10410 when moving away from tissue thickness's compensating part 10450, and nose 10419 can be sufficiently flexible, with Tissue thickness's compensating part 10450 is allowed to skid off below nose 10419.Turning now to Figure 158, as To supplementing above, ground floor 10452 can be made up of compressible foam, and may be mounted to the second layer 10454.In all cases, can utilize one or more binding agents that ground floor 10452 is installed to Two layer 10454.Ground floor 10452 is installed to the second layer 10454 so that distal end 10455 He The recess 10457 being defined in distal end 10455 is still exposed.It addition, ground floor 10452 is pacified Install to the second layer 10454 so that ground floor 10452 is relative in the longitudinal direction limited by the second layer 10454 Mandrel 10459 is laterally centered.

As it has been described above, nail bin groupware can include being stored in movable percussion structure therein at least in part Part, this movable firing member may be structured to will to deposit between non-firing position and firing position Storage nail in nail bin groupware lifts.Turning now to Figure 159 and Figure 160, nail bin groupware 10500 can wrap Include warehouse 10510, tissue thickness's compensating part 10550 and be stored therein slidably movable Firing member or sliding part 10034.Sliding part 10034 can include being defined in thereon one or more Slope 10035, these one or more slopes in use may be structured to can be by nail not hitting from them Send out position and be lifted up firing position.Before use, sliding part 10034 can be releasably locked at Appropriate location.In at least one such embodiment, before sliding part 10034 advances towards distally, Sliding part 10034 can be releasably held in proximal position by tissue thickness's compensating part 10550, to incite somebody to action Nail penetrates and cuts tissue thickness's compensating part 10550 from nail bin groupware 10500.Tissue thickness's compensating part 10550 can include one or more tabs or the positioner 10557 extended from it, this tab or screens Device 10557 can be releasably engaged sliding part 10034.Such as, sliding part 10034 can include one Individual or multiple grooves 10037, positioner 10557 can be positioned in this groove 10037, until sliding Part 10034 is applied in sufficiently large power so that sliding part 10034 overcomes by positioner 10557 to it The retentivity applied.In use, may be structured to can be by sliding part 10034 for positioner 10557 It is held in place by, exceedes until the longitudinal percussion force being applied to sliding part 10034 towards distal direction Till threshold force, wherein when percussion force exceedes threshold force, sliding part 10034 can slide towards distally, and And positioner 10557 can fully bend or deform so that sliding part 10034 can slide whereby.Extremely In a few embodiment, positioner 10557 can be positioned on the nail chamber nearside being defined in warehouse 10510 And/or it being positioned at the nail nearside being stored in warehouse 10510 so that sliding part 10034 can be by releasably Be maintained at nail nearside non-firing position.Sliding part 10034 advances towards distally the most, sliding part 10034 just can advance towards nail.

As to above supplement, refer again to Figure 159 and Figure 160, warehouse 10510 can include one Or multiple holding slit 10517, these keep slits 10517 may be structured to can receiving card position device 10557 at least some of.More specifically, the most in the illustrated embodiment, when sliding part 10034 When being in the non-firing position of its nearside, the holding slit 10517 being defined in warehouse 10510 side can be with limit Align due to the groove 10037 of sliding part 10034 respective side so that positioner 10557 can synchronize fixed Position is in the holding slit 10517 and groove 10037 of alignment.In at least one such embodiment, The sidewall keeping slit 10517 being defined in warehouse 10510 can support positioner 10557, and At least suppression positioner 10557 separates with groove 10037 too early.As it has been described above, sliding part 10034 Can advance towards distally, make groove 10037 no longer align with ratchet 10557；But, at least illustrating In embodiment, after sliding part 10034 advances the most at least in part, ratchet 10557 can be still narrow with holding Groove 10517 aligns and/or is positioned within slit 10517.Referring primarily to Figure 159, fill including screens Putting 10557, slider groove 10037 and storehouse keeps the first layout of slit 10517 to may be arranged at slip First side of part 10034, including the second positioner 10557, and the second slider groove 10037 The second layout keeping slit 10517 with the second storehouse may be arranged at second side or relative of sliding part 10034 Side.

Some embodiment of nail bin can such as include flexible layer (the such as tissue thickness's benefit being positioned on nail platform Repay part and/or buttress material), the top that wherein can be arranged to nail make not fire nail extends to this layer In.In some other embodiment, flexible layer may make up compressible and/or squeezable nail bin, this nail Storehouse is implantable in the patient, and deformation and/or compression when being trapped in nail.If surgeon, Nurse, technician or other user (one or more user) are unintentionally by thumb or other finger Being pressed against on this flexible layer or implantable nail bin, this flexible layer and/or implantable nail bin also can such as become Shape and/or compression.This type of deformation and/or compression make nail bin not use again.

Generally assembling keeper in nail bin, this can help user that nail bin is successfully loaded into surgery seam In clutch.This keeper also can covering nail platform and any flexible layer, thus avoid user unintentionally Compress, extrude this flexible layer and/or make this flexible layer deform.But, user is sometimes at nail bin not Before being fully attached in the end effector of surgical stapling device, prematurely nail bin keeper is removed. In the case of removing nail bin keeper too early, the flexible layer person of being likely to be used damages.

Figure 164 to Figure 167 shows the embodiment of the keeper 10000 that can be attached to nail bin 10010. Seeing Figure 166 and Figure 167, nail bin 10010 can include the flexible layer being arranged on its storehouse platform 10011 10020 (such as tissue thickness's compensating part and/or buttress material).As shown in Figure 167, follow closely 10030 Can extend to the flexible layer 10020 exposed from nail bin 10010.If keeper 10000 is moved too early Removing, user can press unintentionally flexible layer 10020, nail bin 10010 is pushed end effector simultaneously Staple cartridge channel in, thus layer 10020 is compressed and/or makes layer 10020 deform.

Figure 168 to Figure 173 illustrates the embodiment of keeper 2600, and this keeper 2600 can be locked into Nail bin 2650, and cannot unlock from nail bin 2650 and remove, until nail bin 2650 is fully inserted into end In the staple cartridge channel 2670 of portion executor.As Figure 168 is clearly shown that, the nearside of keeper 2600 End sections 2604 can include movable cam portion 2616, and these movable cam portions 2616 have The lock tabs 2626 extended from it.Lock tabs 2626 extends to the slit 2652 of nail bin 2650 In (such as cutter slit), and engage with slit 2652.Lock tabs 2626 is bonded on slit 2652 In, keeper 2600 and nail bin 2650 are releasably held together.As being described in more below, In cam portion 2616 and the keyed engagement in staple cartridge channel 2670 of keeper 2616, cause cam part Points 2616 inward towards after flex relative to each other, and lock tabs only departs from from slit 2652 so that keeper 2600 Can discharge from nail bin 2650 and remove.Additionally, in various embodiments, if nail bin 2650 is suitably Resting upon in staple cartridge channel 2670, cam portion 2616 can only be engaged by the keys.

As it has been described above, in certain embodiments, the proximal end part 2604 of keeper 2600 can include Cam portion 2616, each cam portion 2616 is attached to the master of keeper 2600 by cervical region 2624 Body 2606.Cam portion 2616 can be separated from each other by gap 2622.Cam portion 2616 when by In compression stress time can be along the direction inward deflection of arrow I (shown in Figure 172), it addition, also can edge The direction of arrow O (shown in Figure 170) is around cervical region 2624 flexiblely flex outward.Locking is prominent Sheet 2626 can extend from each cam portion 2618.As being described in more below, when lock tabs 2626 When being arranged on nail bin 2650, may extend in the slit 2652 (such as cutter slit) of nail bin 2650, And be releasably engaged with this slit 2652.Referring primarily to Figure 170 and Figure 171, cam portion can bias In flex outward position so that the antelabium 2628 extended from lock tabs 2626 can be with nail bin 2650 Ridge 2654 in slit 2652 engages.Cam portion 2616, can when being offset to flex outward position Promote to engage with the ridge 2654 in slit 2652 by the antelabium 2628 of lock tabs 2626 so that When there is not the inside compression stress of the key from staple cartridge channel 2670, keeper 2600 locks onto nail bin 2650。

Referring primarily to Figure 170 to Figure 173, in various embodiments, the key of staple cartridge channel 2670 can wrap Including the inwall of staple cartridge channel 2670, this inwall provides the inward compression power being incremented by cam portion 2616, Cam portion 2616 can be inserted in staple cartridge channel 2670 at keeper 2600 and nail bin 2650 Time, along the direction inward deflection of arrow I (shown in Figure 172).Such as, staple cartridge channel 2670 can wrap Including the first inwall 2672 limiting the first width, this first width is suitable for being in the biasing of flex outward The cam portion 2616 of position.Staple cartridge channel 2670 can include the second inwall limiting the second width 2676, this second width is suitable for being in the cam portion of the inward deflection position as shown in Figure 172 2616.Staple cartridge channel 2670 can include being positioned in the middle of the first inwall 2672 and the second inwall 2676 Intermediate inner wall 2674, this intermediate inner wall 2674 can be transitioned into the second width from the first width.Using In, nail bin 2650 and keeper 2600 along relative to staple cartridge channel 2670 proximal direction and towards Staple cartridge channel moves, in order to insert in staple cartridge channel 2670, such as the arrow P in Figure 170 and Figure 172 Instruction.Referring primarily to Figure 170 and Figure 171, at nail bin 2650 and keeper 2600 towards staple cartridge channel During 2670 motion, the rounding end 2620 of cam portion 2616 and exterior surface 2618 can be led to nail bin First wall 2672 in road 2670 engages.As it has been described above, in certain embodiments, the first wall 2672 limits Fixed width is suitable for being in the cam portion 2616 of the offset position of flex outward.In other realities various Executing in example, the width that the first wall 2672 limits is suitable for being in the cam portion of inward portion deflected position 2616, wherein the amount of inward portion flexure be enough to make the antelabium 2628 of lock tabs 2626 not from nail bin The ridge 2654 of 2650 departs from, and makes keeper 2600 unlock from nail bin 2650.Referring now to Figure 172, And Figure 173, continue the direction along arrow P proximally towards nail bin at nail bin 2650 and keeper 2600 When passage 2670 moves, rounding end 2620 and exterior surface 2618 engage with midfeather 2674, so Engage with the second wall 2676 afterwards.Midfeather 2674 and the second wall 2676 can provide incremental power, make convex Wheel part 2616 gradually inward deflection.Finally, cam portion 2616, by inward deflection a certain amount, makes The antelabium 2628 of lock tabs 2626 can depart from the ridge 2654 in the slit 2652 of nail bin 2650. Once lock tabs 2626 departs from ridge 2654, and keeper 2600 just unlocks from nail bin 2650 so that protect Holder 2600 can remove from nail bin 2650.In various embodiments, cam portion 2616 is inwardly scratched Song, make lock tabs 2626 only when nail bin 2650 is fully inserted into staple cartridge channel 2670 just from ridge 2654 depart from.

In certain embodiments, lockable keeper (all as explained above with Figure 168 to Figure 173 describe Keeper 2600) still prevent the nail bin of specific dimensions and be inserted into and be intended to and the nail bin of different specific dimensions In the end effector being used together.Such as, nail bin 2650 can include reference surface 2632, this benchmark Surface 2632 can engage with the reference surface 2674 of staple cartridge channel 2670.Master meter from nail bin 2650 Face 2632 predefines distance to the first of cam portion 2616 and may correspond to the base of staple cartridge channel 2670 Between quasi-surface 2674 and the wall 2672,2674 and 2676 including key of staple cartridge channel 2670 second Predetermined distance.The keeper of specific dimensions, nail bin and being intended to is used together with specific dimensions nail bin The first of staple cartridge channel predefines distance and predefines distance with second to may differ from other size different First the predefining distance and second and predefine distance of keeper, nail bin and staple cartridge channel.Change sentence Talking about, the first of the nail bin of every kind of size, keeper and staple cartridge channel predefines distance and second in advance Determine distance likely differ from the nail bin of other sizes, keeper and staple cartridge channel first predetermined away from Distance is predefined from second.Therefore, attempt that nail bin and keeper are inserted off size nail bin to lead to Road may cause the cam portion of keeper cannot engage the wall of staple cartridge channel, and/or the master meter of nail bin Face cannot engage the reference surface of staple cartridge channel.Such as, nail bin 2650 and keeper 2600 may be disposed to When being inserted into the staple cartridge channel that size is consistent, make the cam portion 2616 can only be with staple cartridge channel 2670 Second wall 2676 engages so that when reference surface 2632 and 2674 is engaged with each other, lock tabs 2626 slits 2652 from nail bin 2650 depart from.Such as, if nail bin 2650 and keeper 2600 Staple cartridge channel 2670 relatively is too short, then, cam portion 2616 may not arrive the second wall 2676, makes When proper reference surface 2632 and 2674 engages, the lock tabs 2626 slit from nail bin 2650 2552 depart from.Therefore, keeper 2600 will not unlock, and can not remove from nail bin 2650.Phase Instead, such as, if nail bin 2650 staple cartridge channel 2670 relative with keeper 2600 is long, then, The cam portion 2616 engaged with the second wall 2676 of staple cartridge channel 2670 can hinder nail bin 2650 respectively Reference surface 2632 engage with the reference surface 2674 of staple cartridge channel 2670.Therefore, nail bin 2650 Can not rest upon completely in staple cartridge channel 2670.

Keeper 2600 not only includes the lock tabs 2626 extended from cam portion 2616, also can wrap Include a pair nearside tab 2612 being arranged near the proximal end 2602 of keeper 2600, and arrange A pair distally tab 2610 near the distal end 2604 of keeper 2600.Nearside tab 2608 Can extend from main body 2606 with distally tab 2610, and can engage and by nail bin with nail bin 2650 2650 releasably hold.In certain embodiments, nearside tab 2612 and distally tab 2610 can be with Nail bin 2650 engages and is kept by nail bin 2650, until nail bin 2650 rests upon completely in staple cartridge channel In 2670.In other words, nearside tab 2612 and/or distally tab 2610 may act as another kind of lock, This lock prevents keeper 2600 from nail bin before nail bin 2650 rests upon completely in staple cartridge channel 2670 2650 remove.

Referring primarily to Figure 168, each nearside tab 2612 can include proximal lip 2614, and each Distally tab 2610 can include distal lip 2610.Each proximal lip 2614 can include towards interior angulation The surface 2615 of degree, and each distal lip 2610 can include towards interior angled surface 2611. Proximal lip 2614 and the side of the engageable nail bin of distal lip 2,610 2650, and releasably hold The side of nail bin 2650.When nail bin 2650 and keeper 2600 are inserted in staple cartridge channel 2670, Can be with the edge 2672 and 2678 of staple cartridge channel 2670 towards interior angled surface 2611 and 2615 Engage.The edge 2672 and 2678 of staple cartridge channel 2670 can make nearside tab 2612 and/or distally tab 2610 flex outward so that proximal lip 2614 and distal lip 2610 are de-from the side of nail bin 2650 From.When proximal lip 2614 and distal lip 2610 depart from from the side of nail bin 2650, releasably It is also removed by keeper 2600 from nail bin 2650.

Seeing Figure 174 to Figure 180, such as, the end effector 12 of surgical instruments is able to receive that end Executor's insert 28010.In various embodiments, end effector insert 28010 can include mending Repay part main body 28012 and at least one fixture 28014a, 28014b.In various embodiments, end is held Row device insert 28010 can such as include the nearside folder being positioned at the proximal end of compensating part main body 28012 Have 28014b and be positioned at the distally fixture 28014a at the distal end of compensating part main body 28012. Referring primarily to Figure 177, can by distally fixture 28014a at the distal end of anvil block 25060 or near solid Surely the anvil block 25060 of end effector 12 is arrived.Such as, distally fixture 28014a can be with anvil block 25060 Longitudinal slit 25062 substantial alignment and/or longitudinal slit of anvil block 25060 can be partially located in In 25062.Referring primarily to Figure 178, nearside fixture 28014b can be fixed to end effector 12 Nail bin 25000 (Figure 179) in lower jaw 25070.Can be by nearside fixture 28014b at nail bin At the proximal end of 25000 or near be fixed to nail bin 25000.Such as, nearside fixture 28014b can be with Longitudinal slit 25004 substantial alignment in nail bin 25000 and/or can be positioned in nail bin 25000 vertical In slit 25004.

Referring now to Figure 179 and Figure 180, end effector insert 28010 can be inserted surgical instruments End effector 12 in.In various embodiments, at least the one of end effector insert 28010 Partly (such as compensating part main body 28012, distally fixture 28014a and/or nearside fixture 28014b) can The most deformable and/or resilient.Hold when end effector insert 28010 is inserted end Time in row device 12, distally fixture 28014a and/or nearside fixture 28014b is flexible or bends.Once Fixture 28014a and 28014b bends, and such as, fixture 28014a and 28014b just can such as have return The trend of its initial not deformed configuration, and producible resilience force or restoring force.In various embodiments, When end effector insert 28010 is when being positioned in end effector 12, end effector inserts Part 28010 can apply spring-load to end effector 12.In certain embodiments, end effector Insert 28010 can be solid or the most solid so that end effector is being inserted by operator Enter part 28010 and time nail bin 25000 inserts end effector 12, insert 28010 can be firmly grasped.

In certain embodiments, after the cutting and/or tightening operation of end effector 12, end is held Row device insert 28010 can remove from end effector 12.In other embodiments, end effector Insert 28010 can remain positioned in end effector 12 during cutting and/or percussion operation.Example As, when firing in nail nail chamber 25002 (Figure 178) from nail bin 25000, can be by cutting element 25052 crosscut end executor's inserts 28010.In various embodiments, end effector insert 28010 can comprise and compensate with at least one the similar tissue thickness in tissue thickness described herein compensating part Material.Such as, end effector insert 28010 can comprise polymer composition, such as can biological inhale The biocompatible elastomers polymer received.End effector insert 28010 also can comprise can biological be inhaled The polymer received, such as lyophilizing polysaccharide, glycoprotein, elastin laminin, Dan Baiduotang proteoglycan PG, gelatin, collagen And/or oxidized regenerated cellulose (ORC).In certain embodiments, end effector insert 28010 can Comprise at least one therapeutic agent, such as pharmaceutically active agents or medicine.

Referring also to Figure 174 to Figure 180, end effector insert 28010 can be releasably attached to The anvil block 25060 of end effector 12 and/or end effector 12 and/or nail bin 25000.Nearside fixture 28014b can such as be releasably secured to nail bin 25000 (Figure 178), and distally folder Tool 28014a can such as be releasably secured to anvil block 25060 (Figure 177).In various realities Executing in example, nearside fixture 28014b can align with the slit 25004 of nail bin 25000 and/or be positively retained at In this slit 25004.It addition, in certain embodiments, distally fixture 28014a can be with anvil block 25060 Slit 25062 align and/or be positively retained in this slit 25062.Referring primarily to Figure 179, at some In embodiment, nail bin 25000 is being positioned in lower jaw 25070 before (Figure 179), it is possible to Nearside fixture 28014b is fixed to nail bin 25000 by releasable mode.Such as, nail bin 25000 He The end effector insert 28010 of attachment moves towards end effector 12 and/or lower jaw 25070 And/or when moving in end effector 12 and/or lower jaw 25070, distally fixture 28014a can transport Dynamic to align with the slit 25062 in anvil block 25060.In various embodiments, when nail bin 25000 He When end effector insert 28010 is positioned in end effector 12 (Figure 180), distally fixture 28014a can be releasably engaged anvil block 25060.Distally fixture 28014a can such as slide into anvil block In the slit 25062 of 25060.In various embodiments, make distally fixture 28014a relative to anvil block Before or while 25060 location, nearside fixture 28014b is made to position relative to nail bin 25000.

When end effector insert 28010 is such as by nearside fixture 28014b and distally fixture 28014a When being releasably fixed at as described in end effector 12, end effector insert 28010 can keep tightening in end effector 12.In other words, the nail in relative lower jaw 25070 The fixing nearside fixture 28014b in storehouse 25000 can such as along end effector insert 28010 to phase Traction force is applied for the fixing distally fixture 28014a of anvil block 25060.In various embodiments, closely Tension force between side fixture 28014b and distally fixture 28014a can help end effector insert 28010 It is maintained in end effector 12.

In various embodiments, it is positioned at end when nail bin 25000 and end effector insert 28010 Time in executor 12, nearside fixture 28014b can be positioned on the sliding part 25056 (figure not fired 178) middle with nail bin 25000.Such as, the sliding part 25056 not fired can be at nearside fixture 28013b nearside.In certain embodiments, sliding part 25056 can such as percussion stroke during towards distally Move across nearside fixture 28014b, and nearside fixture 28014b can be made to deflect.In various embodiments In, after sliding part 25056 makes nearside fixture 28014b deflection during percussion stroke, nearside fixture 28014b just can discharge by the slit 25004 from nail bin 25000.In certain embodiments, sliding part 25056 and/or the element (as other places illustrate) of trigger shaft 25050 can be by nearside fixture 28014b from nail Storehouse 25000 discharges.It addition, at nearside fixture 28014b after nail bin 25000 discharges, end performs Tension force in device insert 28010 can be alleviated at least in part.Distally fixture is put on not existing During traction force on 28014a, distally fixture 28014a can discharge from anvil block 25060.Therefore, end Executor's insert 28010 can discharge from end effector 12, and such as, can be at end effector 12 after removing in the patient, stays in the tissue of patient.

In certain embodiments, the layer that anvil block can be attached such as tissue thickness's compensating part and/or supporter material The proximal end of material such as can be releasably attached to the proximal end of nail bin, is used for and end effector In can be inserted into the anvil block of nail bin and align and be attached on this anvil block.In general, the layer that anvil block can be attached can Arrange towards the side of anvil block relative to nail bin.Such as, the layer that anvil block can be attached may be arranged at the nail of nail bin On platform and/or may be arranged at nail podium level on.The proximal end of the layer that anvil block can be attached could attach to nail The proximal end in storehouse, or the proximal end of nail podium level.Hold in the end that nail bin is inserted surgical stapling device After row device, the layer Guan Bi that the anvil block of surgical stapling device just can be able to be attached against anvil block so that anvil block can be attached Layer be attached to anvil block.When being again turned on anvil block, the layer that the anvil block of current attachment to anvil block can be attached can be with Anvil block moves away from nail bin together.In all cases, attachment layer, when moving together with anvil block, can be enclosed The proximal end being attached to nail bin and/or nail bin layer around this attachment layer pivots.Various in the case of other, Attachment layer is when moving together with anvil block, and the proximal end of this layer can depart from from nail bin.Now, wherein anvil The layer that seat can be attached is attached to the surgical stapling device of anvil block and can cut and sew up patient tissue.Anvil block can be attached Layer also can be cut by this surgical stapling device, and captured by nail.The layer can being attached at anvil block and patient's group Knit after being captured by nail, can be by this surgical stapling device from taking out in the patient.The layer can being attached at anvil block is the most attached Receive in the various embodiments of nail bin, this surgical stapling device can be pulled away from from this layer, thus make this layer and nail Attachment between storehouse disconnects.

Figure 181 and Figure 182 illustrates the enforcement of the nail bin groupware 2400 of the layer 2414 including that anvil block can be attached Example.The layer 2414 that anvil block can be attached can such as include tissue thickness's compensating part and/or buttress material.Anvil The proximal end 2416 of the layer 2414 that seat can be attached could attach to the proximal end of staple cartridge body 2402 2418.In various embodiments, nail bin groupware 2400 can include the nail being such as arranged in staple cartridge body 2402 Nail bin layer 2412 on platform, such as tissue thickness's compensating part and/or buttress material.Storehouse dish 2404 can For example, at least partially around staple cartridge body 2402 and can be made up of metal material.Staple cartridge body 2402 is near at it Surface 2406 and the groove 2408 being defined in this surface 2406 can be included at side end 2418.See Figure 181, in order to the layer 2414 can being attached by anvil block is attached to staple cartridge body 2402, can be able to be attached anvil block The proximal end part 2416 of layer 2414 be positioned above groove 2408.It follows that such as Figure 182 Shown in, such as, tab 2410 deformable extended from storehouse dish 2404 so that they stretch into groove 2408 In, the proximal end part 2416 of the layer 2414 that anvil block can be attached is trapped in groove in groove 2408 Sidewall and tab 2410 between.The layer 2414 that anvil block can be attached also can such as be captured by tab 2410 Between the bottom of groove 2408 and tab 2410.

In use, the end that the nail bin groupware 2400 shown in Figure 182 can insert surgical stapling device is held In the staple cartridge channel of row device.It follows that the layer anvil block of end effector can be able to being attached against anvil block 2414 Guan Bis.The layer 2414 that anvil block can be attached makes to work as nail bin groupware at the arrangement of staple cartridge body 2402 2400 are inserted into staple cartridge channel 2400, and when anvil block closes subsequently, the layer 2414 that this anvil block can be attached can be with Anvil block suitably aligns.In various embodiments, the surface towards anvil block of the layer 2414 that anvil block can be attached 2415 can include the binding agent that can adhere to anvil faces and/or engage anvil block can be attached by anvil block Layer 2414 is attached to one or more attachment features structures of anvil block.Such as, towards the surface of anvil block 2415 can include the one or more projections extended from it, and these one or more projections can be narrow with the cutter of anvil block Groove engages.After the layer 2414 can being attached at anvil block is attached to anvil block, can by anvil block be attached on it The layer 2414 that can be attached of anvil block return open position together.The layer 2414 that anvil block can be attached is attached to anvil The part of seat can be attached to the proximal end 2416 of staple cartridge body 2402 around this layer 2414 and pivot, so that Layer 2414 can move together with anvil block.Now, this surgical stapling device may be included on staple cartridge body 2402 The nail bin layer 2412 of alignment and be attached to anvil block and layer that the anvil block that aligns with anvil block can be attached 2414。

When nail bin layer 2412 aligns with staple cartridge body 2402, and the layer 2414 that anvil block can be attached is attached to Anvil block when aliging with anvil block, can cut and sew up patient tissue by standby surgical stapling device.Staple cartridge body 2402 and nail bin layer 2412 can be positioned on patient tissue side, and the layer that anvil block and anvil block can be attached 2414 can be positioned on the opposite side of patient tissue.When against patient tissue location slit clutch, anvil block can The layer 2414 that the layer 2414 of attachment is attached to anvil block and staple cartridge body 2402 can make anvil block to be attached relative to Anvil block is stable.When relative to patient tissue suitable mapping surgical stiching instrument, anvil block can be closed, thus Tissue capture is being positioned at the staple cartridge body 2402 of tissue side and nail bin layer 2412 and is being positioned at tissue the second phase Between the layer 2414 that the anvil block of offside and anvil block can be attached.

After being closed by anvil block, now patient tissue is trapped in the staple cartridge body 2402 being positioned at tissue side And nail bin layer 2412 and between the layer 2414 that the tissue anvil block of opposite side and anvil block can be attached, can be by This surgical stapling device fires.Such as, staple drivers can be advanced through in staple cartridge body 2402 along distal direction Staple drivers slit 2422, also make these nails shape with the nail that is stored in nail bin of percussion.Fired And the nail shaped can capture nail bin layer 2412, anvil block can be attached layer 2414 and the patient's group between both Knit.It addition, the cutter slit 2420 that can be advanced through in warehouse 2402 along distal direction of cutting blade and anvil Cutter slit in Zuo.Cutting blade advance time, layer nail bin layer 2412, anvil block can be able to being attached 2414 and patient tissue between both cut off.In various embodiments, staple drivers and cutting blade can Simultaneously advance.In all cases, the bootable cutting blade of staple drivers, by patient tissue, nail bin Before the layer 2414 that layer 2412 and anvil block can be attached cuts off so that nail is fired and shapes.

Capture quilt is followed closely at nail bin layer, layer 2414 that anvil block can be attached and the patient tissue between both After cutting blade cutting, can again anvil block be opened.When anvil block is again turned on, it is attached by nail this moment The layer 2414 can being attached with the anvil block of patient tissue to nail bin layer 2412 can separate with anvil block.Such as, exist When opening anvil block and/or in time taking out surgical stapling device in the patient, the layer 2414 can being attached due to anvil block Can be held in place by by nail and patient tissue so that layer 2414 can be pulled away from and such as be remained to The binding agent of anvil block and/or attachment features structure.Additionally, the proximal end of layer 2414 that anvil block can be attached 2416 can be pulled away from staple cartridge body 2402, thus separate with the proximal end 2416 of staple cartridge body 2402.Example As, in all cases, the proximal end 2416 of the layer 2414 that anvil block can be attached is trapped in warehouse The part between groove 2408 and the tab 2410 of storehouse dish 2404 in 2402 can be from tab 2410 and ditch It is drawn out between groove 2408.Various in the case of other, the layer 2414 that anvil block can be attached can be caught from it The part obtained between the tab 2410 of groove 2408 and storehouse dish 2404 removes.Such as, anvil block can be attached The layer 2414 connect is trapped in the part between groove 2408 and tab 2410 can be crushed on layer 2414 Tab 2410 in this part is bottled up, and thus can reduce the power needed for the remainder of tear-off layer 2414 And/or the position that confining layers 2414 is torn.Such as, the tab of the layer 2414 that anvil block can be attached is stretched into 2410 can partly delineate, cut and/or bore a hole in this layer 2414.Nail is departed from nail bin layer 2412 Warehouse 2402, and after the layer 2414 that can be attached of anvil block departs from staple cartridge body 2402 and anvil block, this surgery stitches Clutch is from taking out in the patient, but the layer 2412 and 2414 implanted can be stayed in the patient.Such as, layer Rows of staple can be followed closely on 2412 and 2414, and/or different-thickness, mesh can be compressed into by different nails Be the compression at least applying minimum to the patient tissue captured by nail.

Referring also to Figure 181 and Figure 182, in various embodiments, the layer 2414 that anvil block can be attached can be It is attached to anvil block and after anvil block is again turned on, separates from staple cartridge body 2402.As it has been described above, will follow closely Storehouse assembly 2400 inserts staple cartridge channel and is pressed to by anvil block after the layer 2414 that anvil block can be attached closes, layer 2414 can utilize it to be attached to anvil towards the binding agent on the surface 2415 of anvil block and/or attachment features structure Seat.When being again turned on anvil block, the layer 2414 that anvil block can be attached can move away from staple cartridge body together with anvil block 2402.In all cases, the layer 2414 that anvil block can be attached moves away from staple cartridge body together with anvil block Layer 2414 can be captured at the tab 2410 of storehouse dish 2404 and the groove 2408 in warehouse 2402 by 2402 Between part between tab 2410 and groove 2408 pull out so that the proximal end of layer 2414 2416 also can move together with anvil block.

Figure 183 and Figure 184 illustrates another embodiment 2450 of nail bin groupware, this nail bin groupware 2450 The layer 2464 can being attached including the anvil block that could attach to staple cartridge body 2452.In this embodiment, anvil block can The proximal end 2466 of the layer 2464 of attachment is in the attachment that can extend from the surface 2456 of warehouse 2452 Divide and be attached to surface 2472 on 2470.The proximal end 2466 of the layer 2464 that anvil block can be attached can be such as Binding agent, ultra-sonic welded, hot weld and/or hot riveting is utilized to be attached to surface 2472.In various embodiments In, nail bin groupware 2450 can include the nail bin layer 2462 being arranged on staple cartridge body 2462.Implement at this type of In example, attachment part 2470 can extend from the surface 2456 of warehouse 2452, so that surface 2472 and nail The surface 2467 towards anvil block of clad 2462 is substantially flush.Therefore, the layer 2464 that anvil block can be attached Can substantially flat be positioned at the surface 2467 towards anvil block and the surface 2472 of nail bin layer 2462 On.In all cases, it is similar to, above in association with the embodiment described by Figure 181 and Figure 182, inciting somebody to action After nail bin groupware 2450 inserts the staple cartridge channel of end effector, the anvil block of end effector can be closed Close, so that the side 2465 towards anvil block of layer 2464 that anvil block can be attached with anvil block contacts.Anvil block can be attached Binding agent on the side 2465 towards anvil block of the layer 2464 connect and/or attachment features structure can by anvil block The layer 2464 of attachment is attached on anvil block.It follows that be again turned on anvil block, now anvil block can be attached Layer 2464 can pivot around the proximal end 2466 being attached to surface 2472.It is similar to above in association with figure Embodiment described by 181 and Figure 182, layer 2464 and nail bin layer 2462, anvil block can be able to being attached Patient tissue cutting between Zhe Liangzhe, and stitch together.Then, the anvil of surgical stapling device it is again turned on Seat and/or by surgical stapling device from taking out in the patient, the layer 2464 that anvil block can be attached can divide with anvil block From, nail bin layer 2462 can separate with staple cartridge body 2452.It addition, the layer 2464 that can be attached of anvil block is near Side end 2466 can make with binding agent and/or be attached to other attachment features structures on surface 2472 and separate The layer 2464 that can be attached of anvil block can implanted in the patient.

Referring also to Figure 183 and Figure 184, in various embodiments, the layer 2464 can being attached when anvil block is attached When being again turned on anvil block after receiving anvil block, the portions of proximal 2466 of the layer 2464 that anvil block can be attached can be with table Face 2472 separates.Such as, the proximal end 2466 of the layer 2464 that anvil block can be attached also could attach to anvil Seat.The layer 2464 can being attached at the anvil block of anvil block and attachment is along away from staple cartridge body 2452 and/or nail bin layer Time moving in the direction of 2462, the proximal end 2466 of layer 2464 can be pulled up from surface 2472 and and table Face 2472 separates.In this type of embodiment, the layer 2464 can being attached at nail bin layer 2462, anvil block and this Before patient tissue between the two is cut and sews up, the layer 2464 that anvil block can be attached can first divide from nail bin From.

Figure 185 and Figure 186 illustrates another embodiment 2500 of nail bin groupware, this nail bin groupware 2500 The layer 2510 can being attached including nail bin layer 2506 and anvil block.In the embodiment shown in Figure 185 and Figure 186 In, the layer 2510 that anvil block can be attached is attached to nail bin layer 2506, rather than staple cartridge body 2502.Such as, nail The layer 2510 that clad 2506 and anvil block can be attached each can include tissue thickness's compensating part and/or supporter material Material.The layer 2510 that anvil block can be attached can include from the proximal end 2508 of layer 2510 extend first near Side tab portion 2512.First nearside tab portion 2512 could attach to the proximal end of nail bin layer 2506 Surface 2516.Such as, the first nearside tab portion 2512 is glue-bondable, weld and/or be overmolded into nail On the proximal end surface 2516 of clad 2506.In certain embodiments, the layer 2510 that anvil block can be attached The the second nearside tab portion 2514 extended from the first nearside tab portion 2512 can be included.Second nearside Tab portion 2514 can such as utilize gluing, weld and/or be coated with molding is attached to the end of nail bin layer 2506 Surface, portion 2518.

It is similar to, above in association with the embodiment described in Figure 181 to Figure 184, inserted by nail bin groupware 2500 After entering in the staple cartridge channel of surgical stapler end effector, when can at anvil block by the anvil block of end effector On the layer 2510 of attachment during Guan Bi, the surface 2511 towards anvil block of the layer 2510 that anvil block can be attached is just Anvil block can be attached to by binding agent and/or attachment features structure.When being again turned on anvil block, anvil block can be attached Layer 2510 can move away from nail bin layer 2506 and staple cartridge body 2502 together with anvil block.In various situations Under, when anvil block is again turned on, the layer 2510 that anvil block can be attached can be around the first tab portion 2512 pivot Turn.After the layer 2510 can being attached at anvil block is attached to anvil block, end effector can close on patient tissue Close so that staple cartridge body 2502 and nail bin layer 2506 are positioned at the first side of patient tissue, anvil block and anvil block The layer 2510 that can be attached is positioned at the second opposite side of patient tissue.As explained above with Figure 181 and Figure 182 Described, cutting blade can be advanced through the cutter slit 2520 in warehouse 2502, and staple drivers can push away Enter through the staple drivers slit 2422 in warehouse 2502.Referring primarily to Figure 185, in some embodiment In, the first tab portion 2512 of the layer that anvil block can be attached and the second tab portion 2514 can be with cutter slits 2512 alignment.Cutting blade is when being advanced through cutter slit 2520, and cutting blade can be by the first projection piece Points 2512 and second tab portion 2514 cut.In all cases, dashed forward first by cutting blade Sheet part 2512 and the second tab portion 2514 are cut off and can be made the first tab portion 2512 and the second tab Part 2514 separates from nail bin layer 2506.Advance at cutting blade and staple drivers, nail bin layer 2506, after the layer 2510 that anvil block can be attached and the patient tissue between both have been cut and have sewed up, can Being again turned on anvil block, the layer 2510 making anvil block to be attached separates with anvil block, nail bin layer 2506 and staple cartridge body 2502 separate.As it has been described above, the layer 2510 that the anvil block in the embodiment of Figure 185 and Figure 186 can be attached It is attached to nail bin layer 2506, and is not attached to staple cartridge body 2502.Therefore, there is no need to take measures by The layer 2510 that anvil block can be attached separates with staple cartridge body 2502.Additionally, the layer 2510 that can be attached of anvil block First tab portion 2512 and/or the second tab portion 2514 can remain attached to nail bin layer 2506, because of All captured by nail for the two layer and implantable in the patient.Such as, if cutting blade is not dashed forward first Sheet part 2512 and the second tab portion 2514 separate from nail bin layer 2506, then, nail bin layer 2506 The layer 2510 can being attached with anvil block will by the first tab portion 2512 and the second tab portion 2514, with And the nail shaped is being attached to one another in the patient.

Referring also to Figure 185 and Figure 186, in various embodiments, nail has been inserted at nail bin groupware 2500 Storehouse passage, and after the layer 2510 that can be attached of anvil block is attached to anvil block, the first tab portion 2512 and Two tab portion 2514 can move away from the layer 2510 that anvil block is again turned on and anvil block and anvil block can be attached During nail bin layer 2506, separate from nail bin layer 2506.Such as, anvil block and the anvil block being attached to anvil block can be attached First tab portion 2512 and the second tab portion 2514 can be drawn by the layer 2510 connect from nail bin layer 2506 Open so that the first tab portion 2512 and the second tab portion 2514 separate from nail bin layer 2506.

Figure 187 and Figure 188 illustrates another of the layer that the anvil block being used together with surgical stapling device can be attached Embodiment 2550.As explained below, the proximal end part of the layer 2550 that anvil block can be attached The 2554 proximal end parts that could attach to nail bin, for insertion into the end effector of surgical stapling device In, and align with the anvil block of end effector and be attached to this anvil block.Stroke at cutting blade starts Time, the main body 2552 of the layer 2550 that anvil block can be attached can be come and nail by the cutting blade of surgical stapling device Storehouse separates.Such as, the cutting blade 2570 shown in Figure 188 can cut before any patient tissue, And before any part of the main body 2552 of the layer 2550 that anvil block can be attached is followed closely capture, make the anvil block can The layer 2550 of attachment departs from from nail bin.

Referring primarily to Figure 187, the layer 2550 that anvil block can be attached can include main body 2552 and proximal end portion Divide 2554.Proximal end part 2554 includes the attachment features that could attach to the proximal end part of nail bin Structure 2556.Such as, attachment features structure 2556 can include binding agent, pad and/or hot riveting Point.Attachment features structure 2556 also can such as include being trapped in the slit of nail bin and storehouse dish tab it Between part, as explained above with described in Figure 181 and Figure 182.The layer 2550 that anvil block can be attached can be attached Aliging to nail bin and with nail bin, aligns with the main body 2552 of layer 2550 in the nail chamber of this type of nail bin.In other words Say, when nail fires from nail bin, follow closely the main body 2552 of the layer 2550 can being attached by capture anvil block.Similar In above in association with the embodiment described in Figure 181 to Figure 186, can will include that the anvil block being attached to nail bin can be attached The nail bin groupware of the layer 2550 connect inserts in the staple cartridge channel of surgical stapler end effector.Then, Close on the surface 2553 towards anvil block of the layer 2550 anvil block of end effector can be able to being attached at anvil block Close.Surface 2553 towards anvil block can include binding agent and/or attachment features structure, this binding agent and/or Attachment features structure when anvil block presses to close towards the surface 2553 of anvil block, the layer that anvil block can be attached 2550 are releasably attached to anvil block.It follows that be again turned on anvil block, the layer that now anvil block can be attached 2550 can pivot around attachment features structure 2556 together with anvil block.It is similar to above in association with Figure 181 extremely Embodiment described in Figure 186, nail bin can such as include nail bin layer, such as tissue thickness's compensating part and/or Buttress material.

The layer 2550 that anvil block can be attached can include the first side 2566 and the second side 2568.First side Face 2566 and the second side 2568 can therebetween limit center line 2564.In certain embodiments, anvil block can The layer 2550 of attachment could attach to the anvil block of end effector aligned so that center line 2564 and anvil Cutter slit in Zuo and the alignment of the cutter slit in nail bin.The main body 2552 of the layer 2550 that anvil block can be attached can Including the first lateral slit 2558, near this proximally positioned end of the first lateral slit and from the first side Face 2566 extends and through crossing the centre line 2564.The main body 2552 of the layer 2550 that anvil block can be attached may also include Second lateral slit 2560, this second lateral slit 2560 is relative to the first lateral slit 2558 proximally Location also extends from the second side 2568 and through crossing the centre line 2564.First lateral slit 2558 and second is horizontal Can therebetween limit coupling part 2562 to slit 2560, anvil block can be attached by this coupling part 2562 The main body 2552 of layer 2550 be connected to the proximal end part 2554 of layer 2550.

Referring primarily to Figure 188, the layer 2550 can being attached at anvil block is releasably attached to end effector Anvil block after, this end effector can be closed on patient tissue, make the layer that anvil block and anvil block can be attached 2550 are positioned at tissue side, nail bin and/or nail bin layer is positioned at the opposite side of tissue.It follows that cutter The cutter slit that sheet 2570 can such as be advanced through in nail bin is (such as shown in Figure 181 to Figure 185 Cutter slit 2418) and anvil block in cutter slit.The center line 2564 of the layer 2550 that anvil block can be attached can be with cutter Slit aligns so that cutting blade 2570 cuts, along this center line, the layer 2550 that anvil block can be attached progressively. Cutting blade 2570 is advanced through, in the distal direction indicated along arrow D, the layer 2550 that anvil block can be attached Time, first its cutting edge 2572 cuts the proximal end part 2554 of this layer 2550, then by connecting portion 2562 are divided to cut open, thus by the proximal end part 2554 of the main body 2552 of layer 2550 with layer 2550 Separately.The main body 2552 of the layer 2550 that cutting blade 2570 anvil block the most at last can be attached cuts open.Cutting After cutting blade 2570 is advanced through the layer 2550 that anvil block can be attached, layer 2550 is divided into four.Anvil block The main body 2552 of the layer 2550 that can be attached separates from the portions of proximal 2554 of layer 2550.Additionally, anvil block The main body 2552 of the layer 2550 that can be attached is divided into two panels, 2580 and 2582；The layer that anvil block can be attached The portions of proximal 2554 of 2550 is divided into two panels, 2586 and 2588.

In all cases, this stiching instrument may will not be hit by surgeon completely that use surgical stapling device Send out.For example, with reference to Figure 188, cutting blade 2570 and staple drivers may be only advanced to by surgeon The position of main body 2552 half of the layer 2550 that anvil block can be attached.Continue with this example, at cutting blade When the cutting stroke of 2570 starts, when the coupling part 2560 of layer 2550 is cut off by blade 2570, The main body 2552 of the layer 2550 that anvil block can be attached discharges from nail bin.It is then cut out blade 2570 and continues edge Center line 2564 advances, until about half position of main body 2552 length of layer 2550 that can be attached of anvil block Put.During said process, staple drivers also can advance, at the layer 2550 that cut blade 2570 cuts open The half of main body 2552 and patient tissue in percussion nail make nail shape.The layer 2550 that anvil block can be attached Second half of main body 2552 is not cut open, and is not captured by nail.Then can be by cutting blade 2570 He Staple drivers is retracted, and is again turned on anvil block.When being again turned on anvil block, the layer that anvil block can be attached The main body 2552 of 2550 is captured by nail and is attached to the part of patient tissue and can depart from from anvil block.As above Described, before any nail is fired, and cutting blade 2570 cuts off any patient tissue or layer Before any part of the main body 2552 of 2550, the main body 2552 of the layer 2550 can being attached by anvil block is even The coupling part 2560 receiving proximal end part 2554 can be cut off.Therefore, the main body of layer 2550 2552 discharge from nail bin.When taking out surgical stapling device in the patient, the layer 2550 that anvil block can be attached Main body 2552 in the part that captured by patient tissue the remainder of main body 2552 can be pulled away from anvil block. As described in this example, the layer 2550 that anvil block can be attached is suitable for the incomplete percussion of surgical stapling device, because Before any nail from nail bin is fired and shapes in the main body 2552 of layer 2550, anvil block can be attached The coupling part 2560 of the layer 2550 connect can be cut by cutting blade 2570.

The embodiment described in conjunction with Figure 181 to Figure 186 is also suitable for not exclusively firing of surgical stapling device. In each case, it is not necessary to the cutting blade of surgical stapling device, the layer that anvil block can be attached is divided with nail bin Open.In combining the embodiment that Figure 181 to Figure 184 describes, after part percussion surgical instruments, can draw The layer can being attached from anvil block so that it is no longer with the attachment of staple cartridge body.Describe combining Figure 185 and Figure 186 Embodiment in, the layer that anvil block can be attached is attached to nail bin layer, and is not attached to nail bin.As it has been described above, The layer that nail bin layer and anvil block can be attached is simultaneously implanted in the patient.Therefore, surgical instruments fires the most completely Separate with by the layer that the anvil block combined in embodiment described in Figure 181 to Figure 186 can be attached and have no association.

In all cases, surgeon can use the second surgical instruments extremely will scheme above in association with Figure 181 The layer that anvil block described in 184 can be attached separates.Such as, in all cases, if surgeon is to easily Damaging tissue (such as lung tissue) and use this surgical stapling device, he may want to avoid firmly draw tissue This surgical stapling device just can be pulled away from the layer that anvil block can be attached.In such cases, surgeon is from trouble When taking out surgical stapling device in person's body, another kind of surgical instruments such as gripping tool can be introduced, so that sewing up Patient tissue and the layer that can be attached of anvil block keep transfixion.Retouching above in association with Figure 185 to Figure 188 In the various embodiments of the layer that the anvil block stated can be attached, surgeon can be no longer necessary to introduce the second surgery work The layer that anvil block can be attached by tool separates from surgical stapling device.Refer again to combine Figure 185 and Figure 186 institute The embodiment stated, the layer 2510 that anvil block can be attached is attached to nail bin layer 2506, and this nail bin layer is the most implanted In the patient.The layer that anvil block can be attached is not attached to the nail bin in surgical stapling device.Therefore, when from trouble When taking out stiching instrument in person's body, it is not necessary to firmly pull or tractive patient tissue is with the layer can being attached by anvil block Separate with nail bin.Refer again to the embodiment combined described in Figure 187 and Figure 188, at cutting blade 2570 Stroke when starting, the main body 2552 of the layer 2550 can being attached by anvil block is stitched from surgery by cutting blade Clutch mechanical separation.Equally, after cutting with surgical stapling device and sewed up patient tissue, prepare from trouble When taking out this surgical stapling device in person's body, the main body 2552 of the layer 2550 that anvil block can be attached and surgical stapling Attachment is the most there is not between the nail bin of device.Therefore, in time taking out stiching instrument in the patient, it is not necessary to use Power pulls or the main body 2552 of the layer 2550 that anvil block can be attached just can be divided by tractive patient tissue with nail bin Open.

Referring primarily to Figure 189 to Figure 190, the compensating part 27120 for sleeve 27110 can include main body 27122, this main body 27122 has the longitudinal projection 27124 extended at least partially along it.Longitudinal projection 27124 longitudinal paths that can such as limit the center line along main body 27122.In various embodiments, set is worked as When cylinder 27110 is positioned on anvil block, longitudinal projection 27124 can be by the longitudinal slot acceptance in anvil block.Main Figure 191 to be seen, longitudinal projection 27124 can include rounding protuberance.Such as, longitudinal projection 27124 Cross section can form arc and/or partial circle.In other embodiments, longitudinal projection 27124 can be wrapped Include angular and/or stepped protuberance.Compensating part 27120 also can such as include edge 27126, should Edge 27126 can be straight, bending, reeded, corrugated and/or flexuose. In various embodiments, edge 27126 can include gap 27128, and these gaps 27128 can be in group When the sleeve 27110 installed is positioned on anvil block, receive the snap close extension extended from anvil block.

As outlined herein, layer such as tissue thickness's compensating part such as can by nail bin penetrate one or more In securing member implanting tissue.The most as outlined herein, in all cases, whole staple line can be by this layer Capture in tissue at least partially.Such as, the nail of the recent side in staple line can capture this layer wherein At least partially, the farthest side nail and in this staple line also can capture at least some of of this layer wherein.? In some cases, the portions of proximal of this layer can be followed closely relative to the recent side in staple line and proximally be extended, and / or this layer distal part can relative in staple line farthest side follow closely towards distal extension.In use, Implantable series of layers.At at least one under such circumstances, these layers can be implanted in succession along line of cut. In some cases, layer can implanted make one layer overlapping with another layer segment ground.Such as, first implant The distal end of layer can be overlapping with the proximal end of the second implant layer.Similarly, the distally of the second implant layer End can be overlapping with the proximal end of the 3rd implant layer, by that analogy.Therefore, some securing member can be at it The part of middle two or more layers of capture.Can increase at nail two or more layers of IT and put on The pressure of nail interior institute capture tissue and/or augmenting tissue rigidity, especially catch when several adjacent nails When obtaining more than one layer.Referring now to Figure 192 to Figure 194, as being described in more below, tissue thickness, Compensating part 11050 can include proximal end 11053 and distal end 11055, wherein proximal end 11053 and/or distal end 11055 can include one or more strain relief part, this strain relief Divide the rigidity that can reduce tissue thickness's compensating part 11050 and the rigidity of the tissue being just sewn.

Referring again to Figure 192 to Figure 194, the distal end 11055 of tissue thickness's compensating part 11050 can Including being defined in one or more slit 11058.Slit 11058 can such as include being defined in group Knit the otch in thickness compensation part 11050 and/or recess.Slit 11058 can limit protuberance or tab 11056, this protuberance or tab 11056 may be structured to can relative to each other and/or tissue thickness mend The main part repaying part 11050 is moved at least in part and/or bends.In other words, slit 11058 can Strain in local elimination tissue thickness compensating part 11050 and below tissue.In some cases, The tab 11056 of one tissue thickness's compensating part 11050 can near with minor microstructure thickness compensation part 11050 Side end 11053 is overlapping.In all cases, slit 11058 can allow first tissue thickness's compensating part 11050 and minor microstructure thickness compensation part 11050 pivot relative to each other.In some cases, mainly join Seeing Figure 194, the tab 11056 of first tissue thickness's compensating part 11050 can be with minor microstructure thickness compensation The tab 11056 of part 11050 is overlapping.In all cases, in two stacked distal end 11055 Slit 11058 also can reduce the rigidity in inferior tissue.Although showing of tissue thickness's compensating part 11050 Go out embodiment and only include tab 11057 and the layout of slit 11058 on one end, but this tissue thickness Compensating part such as can include tab 11057 and the layout of slit 11058 on its two ends.

In certain embodiments, as to above supplement, each tab 11056 can include tapered wheel Wide.Such as, each tab 11056 can include the free end of base portion and end corresponding thereto, Qi Zhongji Portion is attached to the main body of tissue thickness's compensating part 11050 and has base widths, and this free end has end Portion's width, wherein base widths may be wider than end portion width.In certain embodiments, end portion width is comparable Base widths width.Referring primarily to Figure 194, end 11055 can include multiple tab 11056, this tab There is different configurations.Such as, tab 11056 can have different length.As shown in Figure 194, example As, the tab 10056a of least significant end can have the first length, and the second tab 10056b can have ratio first Second length of length length, the 3rd tab 10056c can have threeth length longer than the second length, the Four tab 10056d can have fourth length longer than the 3rd length, and the 5th tab 10056e can have ratio 5th length of the 4th length length, it is long that the 6th tab 10056f can have sixth longer than the 5th length Degree.In such embodiments, from tissue thickness's compensating part 10050 distal end more close to tab 10056 can become the shortest.In other embodiments, tab 10056 length can be suitable with any other Arrangement is arranged.

In all cases, as to above supplement, layer can include the edge of confining layers periphery.At certain In the case of Xie, these edges can be straight, substantially straight, wire and/or substantially Wire.In some such cases, layer edge can be in close contact and/or otherwise affect around Tissue.It addition, in some such cases, these edges are probably rigidity, and can be with rigidity Ground supporting tissue.It practice, some of tissue is adjacent by other parts of this layer of rigid support with organize Part can not be supported by this layer, the most there is not transition.Refer again to Figure 192 to Figure 194, tissue The periphery of thickness compensation part 11050 can include wavy configuration, and this wavy configuration can organize downwards offer tool There is the region of gradual change rigidity.The periphery of tissue thickness's compensating part 11050 can include being defined in therein multiple Recess or groove 11059, this recess or groove 11059 can limit tab 11057.It is similar to institute above Stating, tab 11057 can extend from the main body of tissue thickness's compensating part 11050, and can transport relative to main body Dynamic.Being also similarly to mentioned above, each tab 11057 can include base portion end and free end, should Base portion end is attached to the main body of tissue thickness's compensating part 11050, and this free end can be relative to base portion Move in end.In some cases, the width comparable tab that the free end of tab 11057 has The narrow width of the base portion end of 11057, and in the case of other, the free end of tab 11057 has Width may be wider than the width of the base portion end of tab 11057.Tab 11057 can such as include any conjunction The configuration of suitable configuration, such as semi-circular configuration, or arch at least in part.In view of mentioned above, group Knit the tissue below the main part of thickness compensation part 11050 and/or be fastened to tissue thickness's compensating part The tissue of main part can be supported rigidly by main part, tissue below contact pin 11057 and/or tight The tissue being affixed to contact pin is provided less rigid support by contact pin 11057, and adjacent with tab 11057 But the tissue not being disposed below can not be supported by tissue thickness's compensating part 11050.

Referring now to Figure 195 and Figure 196, nail bin groupware 11100 can include warehouse 11110 and be attached to Tissue thickness's compensating part 11150 of warehouse 11110.Nail bin groupware 11100 may also include one or more Attachment members 11160, this attachment members 11160 can by tissue thickness's compensating part 11150 releasedly It is maintained on warehouse 11110.In the case of at least one, each attachment members can include band, this Band extends around warehouse 11110 and tissue thickness's compensating part 11150.In use, as to above Supplementing, firing member 10030 can be advanced through nail bin 11100 with incision tissue thickness compensating part 11150, the nail percussion being stored at least partly in warehouse 11110 subsequently, and by attachment members 11160 cut off.Tissue thickness's compensating part 11150 can include first end or proximal end 11157, with And the second end or distal end 11155.Distal end 11155 can include the protuberance of elongation 11156, this protuberance 11156 extends from the main part 11153 of tissue thickness's compensating part 11150. As shown in Figure 195, the protuberance 11156 of this elongation can be relative to attachment members 11160 court of farthest side Distal extension.The most in the illustrated embodiment, warehouse 11110 can include platform 11113, warehouse The nail chamber of 11110 can be limited in this platform.In all cases, tissue thickness's compensating part 11150 Main body 11153 may be structured to and to be arranged such that its covering is defined in warehouse 11110 Platform 11113 and nail chamber.In at least some cases, equally as shown in Figure 195, the protuberance of elongation 11156 can be from platform 11113 towards distal extension, and relative to the nail chamber court being limited in platform 11113 Distal extension.

In use, as to above supplement, tissue thickness's compensating part 11150 can as described herein tightly It is affixed to tissue, and tissue thickness's compensation characteristic can be provided.Similarly as described above, mend in tissue thickness Repay the tissue below part 11150 to be propped up by tissue thickness's compensating part 11150 and the nail rigidity fixing this tissue Support, and the tissue around tissue thickness's compensating part 11150 can not be by tissue thickness's compensating part 11150 Support, and can be flexible.In such cases, unsupported flexible tissue and tissue thickness compensate Tissue (i.e. transition tissue) between the tissue being rigidly supported below part 11150 is likely to occur undesirably The strain of degree.Transition tissue may be adversely affected by this type of strain.Such as, when by tissue thickness When compensating part is fixed to such as lung tissue, close around tissue (the i.e. periphery of tissue thickness's compensating part periphery Tissue) may tear in some cases, especially neighbouring and/or remote around tissue thickness's compensating part Perienchyma's (i.e. end periphery tissue) of side end.But, tissue thickness's compensating part 11150 remote Side protuberance 11156 can supporting base end portion perienchyma.In other words, distal projections 11156 can be for end Perienchyma of portion provides transition to support.The support of this type of transition is smaller than tissue thickness's compensating part 11150 The support that main body provides, and quilt below unsupported tissue and tissue thickness's compensating part 11150 can be relaxed The fully strain between supporting tissue changes.In all cases, distal projections 11156 can provide expansion Region, power can not sewed up tissue and sewed up transmission between tissue in this enlarged area.Distal projections 11156 may be structured to can bend and together with unsupported tissue and tissue thickness's compensating part 11150 Motion.In all cases, distal projections 11156 can be relative to tissue thickness's compensating part 11150 Main part and/or unsupported histokinesis.

Referring again to Figure 195 and Figure 196, tissue thickness's compensating part 11150 may also include that to be defined in it near Recess 11157 in side end 11153.Recess 11157 can be limited to two prominent towards distal extension Between portion 11158.Recess 11157 can such as have any suitable shape, such as parabolic shape. Similarly as described above, the protuberance 11158 towards distal extension can provide by proximad end periphery tissue Cross support.This type of transition supports and is smaller than the support that tissue thickness's compensating part 11150 main body provides, and The strain being adequately supported between tissue below unsupported tissue and tissue thickness's compensating part 11150 can be relaxed Change.In all cases, proximal projections 11158 can provide enlarged area, and power can be in this expansion district Territory is not being sewed up tissue and sewed up transmission between tissue.Proximal projections 11158 may be structured to can Flexure is also moved together with unsupported tissue and tissue thickness's compensating part 11150.In all cases, Two proximal projections 11158 can relative to the main part of tissue thickness's compensating part 11150, each other, And/or unsupported histokinesis.Also contemplate the proximal end from tissue thickness's compensating part and/or distally The embodiment of the various alternatives of the many more than two protuberance that end extends.

As shown in Figure 196, two or more tissues can be implanted along certain path in end to end mode thick Degree compensating part 11150.In such cases, the distal end of first tissue thickness's compensating part 11150 11155 can be overlapping with the proximal end 11153 of minor microstructure thickness compensation part 11150.Similarly, The distal end 11155 of two tissue thickness's compensating parts 11150 can be with the 3rd tissue thickness's compensating part 11150 Proximal end 11153 overlapping.In all cases, the distally of first tissue thickness's compensating part 11150 Protuberance 11156 can align with the groove 11157 of minor microstructure thickness compensation part 11150 or at least base Align in basis.It addition, in various embodiments, distal projections 11156 and proximal flutes 11158 Size can be set to and be configured to make them have substantially the same size and/or shape Shape.In all cases, distal projections 11156 may be structured to be positioned at adjacent tissue thickness In the proximal flutes 11157 of compensating part 11150.

Turning now to Figure 29 3 and Figure 29 4, the end effector of surgery suturing appliance can include the first jaw With the second jaw, this first jaw includes the storehouse passage being configured to can receive nail bin 11300 wherein 11390, this second jaw includes anvil block 11391.Similar mentioned above, nail bin 11300 can include warehouse 11310 and tissue thickness's compensating part 11350.Nail bin 11300 may also include and is attached to tissue thereon neighbour Connection member 11355.In all cases, tissue adjoining members 13555 can be removably attached to storehouse Body 11310.Except or substitute be removably attached to warehouse 11310 in addition to, organize adjoining members 11355 Tissue thickness's compensating part 11350 can also be attached to.In at least one such embodiment, tissue neighbour Connection member 11355 can be releasably secured to tissue thickness's compensating part 11350.Using In, similarly as described above, securing member can be disposed from warehouse 11310, with by tissue thickness's compensating part 11350 are fixed to the tissue T being trapped between tissue thickness's compensating part 11350 and anvil block 11391.Respectively In the case of Zhong, securing member can not penetrate through tissue adjoining members 11355.In some other cases, fastening Part can penetrate tissue adjoining members 11355, and catching tissue adjoining members 11355 at least partially Obtain wherein, and tissue adjoining members 11355 has been fixed to tissue T.In either case, class Being similar to mentioned above, may be structured at least partially of tissue adjoining members 11355 can be by propping up By providing transition between the tissue of securing member rigid support below support tissue and tissue thickness's compensating part 11350 Support.Tissue adjoining members 11355 can such as have any suitable shape, such as ligule.At least In one embodiment, tissue adjoining members 11355 can include one or more recess 11358, this recess Tab 11356 can be limited between which.Once tissue thickness's compensating part 11350 positions against tissue T And it being fixed to tissue T, tissue adjoining members 11355 may be structured to compensate relative to tissue thickness Part 11350 bends, and provides the tissue adjacent with the distal end of tissue thickness compensating part 11350 Support.In all cases, such as, tissue adjoining members 11355 can be relative to tissue thickness's compensating part 11350 flexure, it addition, tab 11356 can relative to each other, tissue adjoining members 11355 master Body and/or tissue thickness's compensating part 11350 bend.

Refer again to Figure 29 3 and Figure 29 4, tissue adjoining members 11355 at least partially can be with tissue Thickness compensation part 11350 is overlapping.In all cases, this part of tissue adjoining members 11355 can example As being attached to tissue thickness's compensating part 11350 by one or more binding agents.In some cases, tissue Can weighing with one or more nail chambeies of restriction in warehouse 11310 at least partially of adjoining members 11355 Folded so that can being trapped in tissue adjoining members 11355 at least partially from the nail of these nail chamber injections Wherein, and by tissue adjoining members 11355 it is fixed to tissue.Tissue adjoining members 11355 is at least A part can be overlapping with the nose 11311 of warehouse 11310.In all cases, tissue adjoining members This part of 11355 such as can be attached to nose 11311 by one or more binding agents.In other feelings Under condition, this part of tissue adjoining members 11355 can be not attached to nose 11311.Referring primarily to figure 294, tissue adjoining members 11355 at least partially can be with the distal part 11312 of nose 11311 Overlapping.In all cases, this part of tissue adjoining members 11355 can be not attached to nose The distal part 11312 of 11311.In at least some cases, can between tissue adjoining members 11355 Define gap.Tissue adjoining members 11355 at least partially can be from the nose of warehouse 11310 11311 freely extend.In this type of embodiment, tissue adjoining members 11355 can include cantilever.

In use, as to above supplement, nail bin 11300 can be positioned on the first side of tissue T, And anvil block 11391 can be positioned on the second side.Anvil block 11391 subsequently can be around the axle of surgery suturing appliance The pivot 11392 limited in 11393 pivots towards nail bin 11300.Once anvil block 11391 and nail bin 11300 the most suitably position, and are contained in the nail in warehouse 11310 and just can therefrom penetrate, penetrate tissue thickness Compensating part 11350, and tissue thickness's compensating part 11350 is fixed to tissue T.Hereafter, can open Anvil block 11391, and end effector can move away from tissue T.In such cases, can be by warehouse 11310 are pulled away from tissue thickness's compensating part 11350, so that tissue thickness's compensating part 11350 stays tissue In T.Meanwhile, tissue adjoining members 11355 can be from nail bin together with tissue thickness compensating part 11350 11300 depart from.The meaning that tissue adjoining members 11355 is attached to tissue thickness's compensating part 11350 is existed In, tissue thickness's compensating part 11350 can keep tissue adjoining members 11355 against tissue.In various feelings Under condition, tissue adjoining members 11355 can be biased against tissue T by tissue thickness's compensating part 11350. Such as, when histokinesis, stretch and/or bend time, tissue adjoining members 11355 can support flexibly The tissue T of lower section, and the pressure of tissue, stress and/or strain are distributed in bigger region.

Referring again to Figure 29 3 and Figure 29 4, the end effector of surgical instruments can include organizing adjacent structure Part, all such as (e.g.) the tissue adjoining members 11395 being attached to anvil block 11391.In various situations Under, tissue adjoining members 11395 can or at least substantially phase identical with tissue adjoining members 11355 With.In the case of at least one, tissue adjoining members 11395 can include being defined between tab 11396 Recess 11398.In use, tissue adjoining members 11395 can such as utilize one or more to bond Agent is attached to anvil block 11391, wherein when anvil block 11391 relative to tissue T location and closes therewith, Tissue adjoining members 11395 can position against tissue T.At nail after nail bin fires, it is again turned on anvil block When 11391, tissue adjoining members 11395 can separate from anvil block 11391 and remain attached to tissue T.In all cases, tissue adjoining members 11395 can such as be trapped in from storehouse at least partially In the nail of body 11310 injection.In at least some in the case of this type of, tissue adjoining members 11395 can be with anvil The nail chamber limited in seat 11391 is the most overlapping, or extends above in these nail chambeies.In some feelings Under condition, one or more binding agents (such as activatable adhesive) such as can be located at tissue adjoining members In the tissue contacting surface of 11395 so that tissue adjoining members 11395 adheres to tissue T.Any In the case of, can referring primarily to Figure 29 4, tissue adjoining members 11355 and/or tissue adjoining members 11395 It is used to supporting tissue T flexibly.Utilizing tissue adjoining members 11355 and tissue adjoining members In embodiment both 11395, tissue adjoining members 11355 with 11395 can by identical material or Different materials is constituted.Tissue adjoining members 11355 and 11395 can be of similar shape and configuration, Or different shapes and configuration.Tissue adjoining members 11355 and 11395 also can have same thickness or not Same thickness.This class feature of optional tissue adjoining members 11355 and 11395, in order to being positioned at Tissue between them provides desired support profiles (profile).Such as, this class feature optional, make Obtain in tissue thickness's compensating part 11355 and 11395 bigger than another rigidity.Meanwhile, may be used Select these characteristics so that soft than another of in tissue thickness's compensating part 11355 and 11395 Property is bigger.

In all cases, tissue thickness's compensating part can include multiple layer.Such as, tissue thickness's compensating part Ground floor and the second layer can be included.This type of layer can be made up of identical material or different materials.Some layers May be structured to provide different qualities for tissue thickness's compensating part.Such as, tissue thickness's compensating part can Including the compressible ground floor and sustainable ground floor that tissue thickness compensation characteristic is provided rigidity more The big second layer.Referring primarily to Figure 197 and Figure 198, tissue thickness's compensating part 11250 can include first Layer 11251 and the second layer 11252.The second layer 11252 is compressible, and tissue thickness can be provided to compensate Characteristic.Ground floor 11251 can be rigidity, and the sustainable second layer 11252.The second layer 11252 such as can position and/or be attached to warehouse 11210 against warehouse 11210.In some cases, Ground floor 11251 can include the vertical passage 11253 extended along a length thereof, this vertical passage 11253 Size can be configured to and be configured to be releasably held in be defined in warehouse 11210 vertical In cutter slit 11215.In all cases, the second layer 11252 can be fixed to ground floor 11251 also It is held in place by by ground floor 11251.

Referring again to Figure 197 and Figure 198, compensating part 11250 can include multiple layer.It addition, the second layer The neighboring 11218 of 11252 can extend beyond the neighboring of ground floor 11251 at least in part 11220.Additionally, ground floor 11251 and the second layer 11252 can include rigidity in various degree.Example As, the second layer 11252 is more soft than ground floor 11251.This layout can make tissue thickness's compensating part 11250 have sufficiently rigid interior zone and sufficiently flexible perimeter, and this interior zone is by first Layer 11251 and the second layer 11252 are constituted, and can be suitable for fully supporting to nail 11260 offer, this outside area Territory is made up of the second layer 11252, can be adapted to provide for enough flexibilities, in order to such as at tissue T and tissue Thickness compensation part 11250 during nail 11260 capture and/or is alleviated afterwards is applied to the negative of tissue T Load.Ground floor 11251 and the second layer 11252 can be such as bound up by binding agent.Also in the disclosure In the range of contemplate other attachment arrangements for ground floor 11251 being attached to the second layer 11252.

As to supplementing above, ground floor 11251 can include interior section 11254 and at least in part Around the exterior section 11256 of interior section 11254, its outer portion 11256 is than interior section 11254 is more soft.Such as, exterior section 11254 can include multiple slit 11210, this slit 11210 The flexibility of exterior section 11254 can be increased.Additionally, as it has been described above, the second layer 11252 may be structured to Can be more soft than ground floor 11251.This layout can make tissue thickness's compensating part 11250 have difference Three regions of rigidity, including the first interior zone, zone line and the 3rd i.e. perimeter, region.The One interior zone has the rigidity of maximum, and interior zone is by interior section 11254 structure of ground floor 11251 Become；Zone line has intermediate rigidity, and zone line is by exterior section 11256 He of ground floor 11251 The second layer 11252 is constituted；3rd region has the rigidity of minimum, and the 3rd region is only by the second layer 11252 Constitute.

The second layer 11252 of tissue thickness's compensating part 11250 can have fabric construction, and this fabric construction can Including plurality of fibers, this plurality of fibers can be woven into this fabric construction.Fabric construction can provide to be had enough The flexible second layer 11252, such as to be followed closely 11260 in tissue T and tissue thickness's compensating part 11250 During capture and/or alleviate the burden being applied to tissue T afterwards.Additionally, neighboring 11218 can be by fibre Dimension is constituted, and this fiber can provide hurtless measure tissue contacting surface, to make as mentioned above to be applied in tissue T Burden minimize.Above-mentioned fabrics structure and fiber can be made up of biocompatible materials.Additionally, it is above-mentioned Fabric construction and/or fiber can such as by bioabsorbable material such as PLLA, PGA, PCL and/ Or combinations thereof is constituted.

Seeing Figure 199 to Figure 20 1, staple cartridge channel may be structured to receive nail bin 1060, wherein follows closely Storehouse 1060 can include warehouse 1062, storehouse platform 1064 and support member 1065.It addition, tissue thickness is mended Repay part (such as tissue thickness's compensating part 1100) can be located against removedly storehouse platform 1064 or Adjacent with storehouse platform 1064, as shown in Figure 199.

Referring again to Figure 199 to Figure 20 1, tissue thickness's compensating part is after implantation within a patient, it is possible to quilt Tissue resorption.This absorption process initially can make tissue thickness's compensating part resolve into less sheet, and this sheet includes Roughen Edges, surrounding tissue T can be had undesirable effect by Roughen Edges.In order to alleviate these bad shadows Ring, tissue thickness compensating part 1100 can be assembled by multiple 1140 at least in part, each in this sheet Individual have hurtless measure neighboring, and the formation single structure that can be bound up, as shown in Figure 20 1.Sheet 1140 bind modes forming tissue thickness's compensating part 1100 make absorption process first make tissue thickness mend Repay part 1100 and resolve into several 1140, thus allow the probability that Roughen Edges occurs minimize.Example As, sheet 1140 can have circular contour, and available thermal bond pattern is bound up and forms tissue thickness Degree compensating part 1100.In the scope of the present disclosure, also contemplate other profiles of sheet 1140 and by sheet 1140 Other modes being bound up.In one example, by binding agent 1143, sheet 1140 is bound up on (see Figure 200) together.Compared with sheet 1140, binding agent 1143 faster can be absorbed by organizing, with Make sheet 1140 can be separated from each other in the starting stage of absorption process.As shown in Figure 200, multiple 1140 Can be arranged to a kind of stacked array, the end sections of one of them sheet 1140 can be with another sheet 1140 End sections overlapping so that can such as can by two end sections of multiple 1140 by binding agent It is attached to one another together to release.In some cases, another kind of folding can be arranged to for multiple 1140 Putting array, wherein one in sheet 1140 can be positioned on above multiple 1140 and is releasably attached to These sheets 1140, as shown in Figure 20 1.

Seeing Figure 20 2 to Figure 20 4, as described above, tissue thickness's compensating part can implant patient Be absorbed by tissue after internal, and absorption process that tissue thickness's compensating part initially can be made to resolve into is random little Sheet.Start as it has been described above, there are the outer peripheral small pieces of hurtless measure by utilization, can realize absorption process Guiding with produce there are the outer peripheral small pieces of hurtless measure.Another kind of method can include compensating tissue thickness Part is transformed in the following manner: just can split in the starting stage of absorption process and have hurtless measure periphery relatively Little several.Such as, as shown in diagram 202, tissue thickness's compensating part 1200 can such as include that pattern is all Such as pattern 1212, this pattern can be molded into or be carved in tissue thickness's compensating part 1200, to produce (such as) multiple circular portion 1210.This part 1210 can be by the girth along circular portion 1210 1214 thickness reducing tissue thickness compensating parts 1200 and define, as shown in profile 202A.Cause This, in tissue thickness's compensating part 1200, those parts along circular portion 1210 girth 1214 can be by group Knitting and faster absorb, this can make circular portion 1210 just be separated from each other in the starting stage of absorption process.Also Contemplate in the scope of the present disclosure and include that there is other geometries and the some of hurtless measure neighboring Other patterns.Such as, as shown in Figure 20 3, tissue thickness's compensating part 1200 ' can have pattern 1216, this pattern 1216 includes some 1218, and the profile of the plurality of part can be mended along tissue thickness Repay the length of part 1200 ' with waveform curve longitudinal extension.In another example, such as Figure 20 4 institute Show, tissue thickness's compensating part 1200 " pattern 1220 can be included, this pattern 1220 can include multiple six limits The part 1222 of shape.

See Figure 20 5, as it has been described above, tissue thickness's compensating part such as tissue thickness's compensating part 1250 can Such as followed closely such as nail 1002 capture along tissue T, and may be structured to can be such as implanted patient After internal, just resolve into several hurtless measure sheet such as sheet 1226 in the starting stage of absorption process.These Sheet 1226 once separates, so that it may moves relative to each other and/or slides, and this can affect surrounding tissue T.For Make the relative motion between this sheet 1226 minimize, can make the nail 1002 of percussion be spatially arranged On tissue thickness's compensating part 1250 so that nail 1002 can capture multiple 1226, as shown in Figure 20 5. This layout can also aid in tissue thickness's compensating part 1250 and keeps the structure of substantially one, even if many Individual sheet 1226 was separated from each other in the starting stage of absorption process.Therefore, at sheet 1226 in absorption process Starting stage in be separated from each other after, tissue thickness's compensating part 1250 can continue to nail 1002 capture groups Knit T and support is provided.

As to above supplement, referring now to Figure 20 6, can use another method guide tissue thickness The absorption process of compensating part produces has outer peripheral of hurtless measure.Such as, as shown in Figure 20 6, tissue Thickness compensation part such as tissue thickness's compensating part 1300 can include multiple slit 1310, these slits 1310 Strategically positioned, to strengthen the flexibility of tissue thickness's compensating part 1300 as described above.Separately Outward, tissue thickness's compensating part 1300 can be partly divided into some 1312 by slit 1310, the plurality of Part just can be separated from each other in the starting stage of absorption process.Slit 1312 can be along the periphery of part 1312 Limit 1314 reduces the width of tissue thickness's compensating part 1300, as shown in Figure 20 6.The reduction of width may Causing some 1312 circumferentially limits 1314 faster to be absorbed, it can make tissue thickness's compensating part 1300 resolve into separate part 1312 in the starting stage of absorption process.

Seeing Figure 20 7A and Figure 20 7B, the end effector of surgery suturing appliance can include the first jaw With the second jaw, wherein may be structured to can phase at least one jaw in the first jaw and the second jaw Another jaw is moved.In certain embodiments, this end effector can include band staple cartridge channel First jaw of 1010 and the second jaw of band anvil block 1012 (Figure 20 7B), wherein anvil block 1012 Can such as pivot towards staple cartridge channel 1010 and/or away from staple cartridge channel 1010.Staple cartridge channel 1010 can Being configured to receive nail bin 1020, this nail bin 1020 such as can be removably retained in nail bin and lead to In road 1010.Other embodiments can include the nail bin being difficult to remove from staple cartridge channel 1010.Nail bin 1020 Warehouse 1022, storehouse platform 1024 and layer 1000 can be included, wherein as shown in Figure 20 7A, layer 1000 energy Enough storehouse platforms 1024 or adjacent with storehouse platform 1024 of being positioned against removedly.

It is similar to other embodiments as herein described, refers again to Figure 20 7A and Figure 20 7B, warehouse 1022 can include multiple nail chamber 1026 and the nail 1002 being positioned in each nail chamber 1026.Additionally it is similar to In other embodiments as herein described, nail 1002 can be by the staple drivers 1028 being positioned in warehouse 1022 Support.Wherein sliding part and/or firing member such as can be advanced through nail bin 1020, to be driven by nail Device 1028 is lifted up in nail chamber 1026, and is penetrated from nail chamber 1026 by nail 1002, such as figure Shown in 207B.When nail 1002 penetrates from nail chamber 1026, tissue T and/or layer 1000 can be followed closely 1002 captures, as shown in Figure 20 7B.

Layer 1000 can be made up of biocompatible materials.It addition, layer 1000 can be such as by bioabsorbable Material such as PLLA, PGA, PCL and/or combinations thereof constitute.In at least one embodiment In, layer 1000 can include tissue thickness's compensating part, and this tissue thickness's compensating part can include that internal compression is special Levying structure, it is described above that internal compression feature structure is designed to be followed closely 1002 at layer 1000 and tissue T During capture, the thickness to tissue T compensates.

Referring again to Figure 20 7B, layer 1000 can include tissue contacting surface 1003, this contact tissue table Face 1003 may be structured to reduce layer 1000 and against between the tissue T of this layer 1000 location Sliding.The pressure applied against the tissue T contacted with tissue contacting surface 1003 can depend in part on group Knit the contact area between T and tissue contacting surface 1003.Owing to this pressure is inversely proportional to area, Therefore, reduce contact area and can produce the higher pressure against tissue T, and then can produce preferably Sliding protection.Tissue contacting surface 1003 can include multiple anti-skid stud 1030, these anti-skid studs 1030 Including less contact area, wherein anti-skid stud 1030 can reduce layer 1000 and determine against this layer 1000 Sliding between the tissue T of position.Such as can be made by compression molding technology and there is anti-skid stud 1030 Layer 1000.Alternatively, can first make layer 1000, more such as by swashing of multiple raised structures can be produced Light and/or chemical etch technique, form anti-skid stud 1030 in tissue contacting surface 1003.Additionally, it is anti- The micron orders that sliding nail 1030 can include using such as photoetching technique to be formed in tissue contacting surface 1003 with/ Or nanoscale structures.Photoetching technique typically can use prefabricated photomask as motherboard, this motherboard can obtain To micron order and/or the final pattern of nanoscale anti-skid stud.Also contemplate in the scope of the present disclosure for Form micron order and/or the other technologies of nanoscale anti-skid stud 1030, these technology can be used to make needs Anti-skid stud 1030.In one example, available el art makes anti-skid stud 1030.

Referring now to Figure 20 7C to Figure 22 4, anti-skid stud 1030 can include multiple shape.Such as, such as figure Shown in 207C, tissue contacting surface 1003 can include cylindricality anti-skid stud 1038, these cylindricality anti-skid studs 1038 base portions that can include square and/or rectangle, and be typically remote from tissue contacting surface 1003 and extend Generallyperpendicular side.It addition, cylindricality anti-skid stud 1038 may terminate at the narrowest top Divide or top 1040, as shown in profile 208.Additionally, tissue contacting surface 1003 can include circular cone Shape anti-skid stud 1032 (as shown in Figure 21 8), pyramid anti-skid stud 1034 are (such as Figure 21 9 institute Show) and/or cheese anti-skid stud 1042 (as shown in Figure 21 1).Pyramid anti-skid stud 1034 can Including square and/or the base portion of triangle and the side tilted, generally may be used in these sides tilted Extend away from tissue contacting surface 1003 and terminate at top section 1036, such as profile 220 institute Show.

Anti-skid stud 1030 spatially can be arranged in tissue contacting surface with predetermined pattern or array On 1003.Such as, anti-skid stud 1030 can spatially along surface 1003 length longitudinal extension and be put down each other Multiple row of row are disposed in tissue contacting surface 1003.Anti-skid stud 1030 also can be spatially in ring Shape is arranged.Such as, anti-skid stud 1030 can be with arranged in concentric circles.Alternatively, anti-skid stud 1030 can be with It is positioned in tissue contacting surface 1003 machine.

As to above supplement, the anti-skid stud 1030 that tissue contacting surface 1003 has can include multiple Shape, multiple height and/or multiple space arrangement, with each region along tissue contacting surface 1003 Avoid above-mentioned sliding to some extent.Such as, tissue contacting surface 1003 is followed closely 1002 to be configured to Can penetrate at the region of also capture tissue T and/or surrounding, it may be necessary to avoid sliding to a greater degree Move.

Seeing Figure 20 9, Figure 21 0 and Figure 21 5 to Figure 21 7, layer 1000 can include wire projection 1044, this wire projection may be provided in tissue contacting surface 1003.Wire projection 1044 can longitudinally be prolonged Stretch.Such as, wire projection 1044 can extend parallel to each other along the length of layer 1000, such as Figure 20 9 institute Show.Alternatively, wire projection 1044 can extend along the width of layer 1000, as shown in Figure 21 5.This Outward, in length and breadth and horizontal wire projection 1044 can become cross path.Such as, as shown in Figure 21 7, First pattern 1046 of wire projection 1044 can be parallel with first direction in tissue contacting surface 1003 Extend, and the second pattern 1048 of wire projection 1044 can be with the in tissue contacting surface 1003 Two directions extend in parallel, and wherein first direction may be perpendicular or substantially perpendicular to second direction.Additionally, Wire projection 1044 can have shown in substantially consistent hatch region 210.Alternatively, wire projection 1044 can have different hatch region (not shown).In some cases, the first pattern 1046 He Second pattern 1048 can be continuous print or interruption.

As to above supplement, layer 1000 can include non-linear shape projection, in tissue contacting surface 1003 This non-linear shape projection can be provided only with, or be combined setting with wire projection 1044.Additionally, and anti-skid stud The combination of 1030, can arrange wire projection 1044 in tissue contacting surface 1003 and/or non-linear shape is dashed forward Rise to avoid sliding in desired limit.

Seeing Figure 21 3 and Figure 21 4, layer 1000 can include multiple depression 1050, and the plurality of depression can be carved Enter in tissue contacting surface 1003, as shown in Figure 22 3.Depression 1050 can include substantially consistent holding Nest shape, as shown in Figure 22 4.Alternatively, depression 1050 can include the different degree of depth, and it can be along group Sliding is avoided in the multiple regions knitting contact surface 1003 to some extent.In general, the most individually Depression can make its residing district more soft and make this type of district more easy disintegrating.Additionally, combine anti-skid stud 1030 As described above, cave in the 1050 multiple shapes that can include and/or space arrangements.It addition, layer 1000 may be included in the depression 1050 and anti-skid stud being spatially arranged in tissue contacting surface 1003 The combination of 1030.In some cases, anti-skid stud 1030 and depression 1050 can be arranged with alternating pattern.

Referring again to Figure 22 3 and Figure 24 4, layer 1000 can include being similar to wire projection 1044 (as above Described) wire depression 1052, this wire depression can such as along the length longitudinal extension of layer 1000 and that This is parallel, as shown in Figure 22 3.The most such as come with alternating pattern additionally, layer 1000 may be included in The wire depression 1052 being arranged in tissue contacting surface 1003 and the combination of wire projection 1044.This Outward, referring now to Figure 22 1 and Figure 22 2, the combination of wire depression 1052 and wire projection 1044 is permissible Wave pattern 1054 is arranged, as shown in Figure 22 1.

Referring now to Figure 24 4 to Figure 24 6, tissue thickness's compensating part such as compensating part 22320 such as can wrap Include multiple first chamber 22322a and multiple second chamber 22322b, the first chamber 22322a and the second chamber 22322b can shape pit 22062a and 22062b with nail respectively and align.Referring primarily to Figure 24 5, follow closely into Shape pit 22062a and 22062b can be defined in the separate stepped surface on anvil block 22060.More Specifically, such as, nail shaping pit 22062a can be defined in the first surface 22069a of anvil block 22060 In, and follow closely shaping pit 22062b can be defined in the second surface 22069b of anvil block 22060, its Middle first surface 22069a can be positioned so that relative to second surface 22069b skew or higher.Tissue First chamber 22322a of thickness compensation part 22320 is big than the second chamber 22322b, wherein at least one In this type of embodiment, the first chamber 22322a is extensible must be higher than the second chamber 22322b.In view of institute above Stating, the first chamber 22322a can extend up to the first nail and shape in pit 22062a, and the second chamber simultaneously 22322b can extend up to the second nail and shape in pit 22062b.First chamber 22322a and/or second Chamber 22322b may be structured to accommodate medicine.

As to above supplement, the first chamber 22322a may be disposed to some row, and the second chamber 22322b can It is arranged to different row.First chamber 22322a and/or the second chamber 22322b may be structured to can distinguish tightly Thickly it is fitted in nail to shape in pit 22062a and/or nail shaping pit 22062b.Additionally, tissue thickness Compensating part 22320 can be assembled into anvil block 22060 so that the second layer 22327 of compensating part 22320 supports Second surface 22069b by anvil block 22060 positions.Referring now to Figure 24 7 and Figure 24 8, compensating part, 22320 can be positioned so that adjacent with anvil block 22060 so that when anvil block 22060 shifts towards nail bin 22000 And when compressing the tissue T of both, compensating part 22320 can adjoin with anvil block 22060.

Referring now to Figure 22 4A and Figure 22 4B, similarly as described above, layer 1000 also may be positioned to Anvil block 1012 is adjacent so that shifts towards nail bin 1020 when anvil block 1012 and compresses the group of both When knitting T, layer 1000 can adjoin with anvil block 1012.It is also similarly to mentioned above, at nail 1002 quilts Staple drivers 1028 drives and after the injection of nail chamber 1026, layer 1000 can be by nail 1002 capture.Specifically Ground, as shown in Figure 22 4A and Figure 22 4B, nail 1002 can include base portion the 1060, first deformable member 1062 and second deformable member 1064.First deformable member 1062 includes the first top 1063, the Two deformable members 1064 include the second top 1065, driven by staple drivers 1028 at nail 1002 and When penetrating from nail chamber 1026, the second top 1065 can be arrived by penetrated bed 1000 together with the first top 1063 The corresponding nail reaching them shapes pit 1066 and 1068.It addition, when top 1063 and 1065 is distinguished When nail shaping pit 1066 and 1068 are left in guiding on the return path, top 1063 and 1065 can be each From penetrated bed 1000 again.

Referring again to Figure 22 4A, layer 1000 can include that some 1070, the plurality of part can include The thickness reduced relative to the remainder of layer 1000.Such as, as shown in Figure 22 4A, layer 1000 can Including substantially consistent thickness " A ", and part 1070 can include the thickness less than thickness " A " Degree.It addition, layer 1000 can align with nail bin 1020 so that once nail 1002 is fired, follow closely 1002 Top 1063 and 1065 just can be on the top 1063 and 1065 of deformable member 1062 and 1064 Towards respective dimple 1066 and 1068 advance time, penetrate the whole thickness " A " of tissue T and layer 1000, And can be when being left nail shaping pit 1066 and 1068 by guiding respectively, being somebody's turn to do of penetrating component 1070 The thickness reduced.The thickness of the reduction of part 1070 can promote that top 1063 and 1065 is respectively from pit 1066 and 1068 thrust in tissue T on the return path on top 1063 and 1065 again.

Referring now to Figure 22 4B, layer 1000 can include multiple projection 1080, and the plurality of projection can include The thickness increased relative to the remainder of layer 1000.Such as, as shown in Figure 22 4B, layer 1000 can Including substantially consistent thickness " A ", and projection 1080 can include the thickness bigger than thickness " A " “A+B”.Layer 1000 can align with nail bin 1020 so that is once fired by nail 1002, follows closely 1002 Top 1063 and 1065 just can be on the top 1063 and 1065 of deformable member 1062 and 1064 Towards respective dimple 1066 and 1068 advance time, penetrate the thickness " A " of tissue T and layer 1000.Separately Outward, pit 1066 and 1068 can be left guiding respectively in the top 1063 and 1065 of nail 1002 Time, the thickness " A " of penetrated bed 1000, thus at least partly surround projection 1080 and wrap up or substantially Upper parcel deformable member 1062 and 1064.In other words, tissue T and projection 1080 can be captured Between each component and the base portion 1060 of nail 1002 in deformable member 1062 and 1064.As To supplementing above, projection 1080 may be disposed to row, and may be structured to be closely adhered to anvil The nail of seat 1020 shapes in pit.Such as, as shown in Figure 22 4B, projection 1080 can have bending Profile, the profile of this bending can shape pit 1066 and 1068 pairing and engage with nail.

As it has been described above, some embodiment of surgical stapling device can include the anvil block table being arranged in end effector Layer on face, such as buttress material and/or tissue thickness's compensating part.This layer may easily be moved and/or Misalignment affects.Such as, if should when surgical stapling device was positioned before sewing up tissue by surgeon Layer pulls across tissue, and this layer will move relative to anvil block.In certain embodiments, this layer can include using Feature structure is releasably kept so that before surgical stapling device is fired always in attach it to anvil block This layer is maintained at the position alignd with anvil block.In certain embodiments, releasable holding feature structure can Implantation within a patient.

In certain embodiments, referring now to Figure 22 5 to Figure 22 7, the layer 33420 that anvil block can be attached (such as buttress material and/or tissue thickness's compensating part) can include shell 33426, be defined in shell Chamber 33424 in 33426 and the core 33425 being positioned in chamber 33424.Such at least one In embodiment, such as, shell 33426 can include the film main body formed by continuous extrusion profile, and core 33425 can include threadiness drug core (such as ORC).In at least one embodiment, shell 33426 can include one or more flexible leg 33423, and these one or more flexible legs may be structured to can In being configured to the cutter slit 22063 that can extend to be defined in anvil block 22060 and anvil block can be attached Layer 33420 releasably hold anvil block 22060.

In some other embodiment, see Figure 24 4 to Figure 24 8, the layer 22320 that anvil block can be attached (such as buttress material and/or tissue thickness's compensating part) could attach to anvil block 22060.At at least one In embodiment, the layer 22320 that anvil block can be attached can include chamber 22322a and/or chamber 22322b, and this chamber can It is configured to can be closely adhered to nail respectively shape in pit 22062a and/or 22062b.Closely patch Conjunction can releasably hold, relative to anvil block 22060, the layer 22320 that anvil block can be attached.In some embodiment In, the layer 22320 that anvil block can be attached can be assembled into anvil block 22060 so that the layer that anvil block can be attached The second layer 22327 of 22320 positions against the second surface 22069b of anvil block 22060.At some other In embodiment, referring now to Figure 24 7 and Figure 24 8, the layer 22320 that anvil block can be attached can be positioned so that with Anvil block 22060 is adjacent so that shifts towards nail bin 22000 when anvil block 22060 and compresses both During tissue T, the layer 22320 that anvil block can be attached can adjoin with anvil block 22060.

Seeing Figure 22 8 to Figure 23 4, available keeper makes the anvil of layer that anvil block can be attached and end effector Seat alignment and the layer making anvil block to be attached are attached to the anvil block of end effector.Referring primarily to Figure 22 9 and figure 230, the layer 2030 that anvil block can be attached can include main body 2034 and the projection extended from main body 2034 2036.Seeing Figure 23 1 to Figure 23 4, projection 2036 can be with the slit in end effector anvil block 2042 2048 such as cutter slits engage.In certain embodiments, projection 2036 is wide than slit 2048 so that Projection 2036 is compressed when inserting slit 2048.In certain embodiments, projection 2036 deformable For making it heave outwardly, and extrude the surface of slit 2048.Projection 2036 and slit 2048 it Between compression stress the layer 2030 that can be attached by anvil block can be provided relative to the fixing retentivity of anvil block 2042.

The layer 2030 that anvil block can be attached can be releasably attached to keeper 2000.Keeper 2000 The layer 2030 that anvil block can be made to be attached aligns with anvil block 2042 and the layer 2030 that makes anvil block to be attached is attached To anvil block 2042.The embodiment of keeper 2000 can include the tab covering 2006 and extending from lid 2006 2008 and 2010 (tab 2010 is shown in Figure 22 8 to Figure 23 0).Such as Figure 22 9 and Figure 23 0 institute Show, tab be configured to can jointing nail storehouse 2020, and nail bin 2020 is releasably held holding Device 2000.Keeper may also include the grip portion 2002 from lid 2006 extension, and user catches grasping The layer 2030 that keeper 2000, nail bin 2020 and anvil block can be attached can be inserted end and hold by part 2002 In the staple cartridge channel 2040 of row device.

Keeper 2000 may also include the tab 2014 from lid 2006 extension.In certain embodiments, Keeper 2000 can include that two tabs 2014, a tab 2014 prolong from each side of lid 2006 Stretch.From Figure 22 8 it is clear that each tab 2014 can include towards interior groove 2016 dough-making powder The most angularly surface 2018.See Figure 22 9 and Figure 23 0, the side of the layer 2030 that anvil block can be attached Can engage with the groove 2016 in tab 2014 to edge.In various embodiments, can be attached when anvil block Layer 2030 when being bonded in the slit 2016 of keeper 2000, layer 2030 that anvil block can be attached and protecting The lid 2006 of holder 2000 can limit gap between them.The layer 2030 that anvil block can be attached may be arranged at On keeper 2000 so that the projection 2036 of this layer 2030 extends away from keeper 2000.From figure 228 and Figure 23 1 it is clear that keeper 2000 may also include the projection from lid 2006 extension Ridge 2022.From Figure 23 1 it is clear that the protruding ridge 2022 of keeper 2000 can with anvil block The projection 2036 of the layer 2030 of attachment is directed at.

In use, nail bin 2020 can be inserted by surgeon, nurse, clinician or other user Enter the staple cartridge channel 2040 of end effector, anvil block is closed on keeper, so that anvil block can be attached Layer from keeper release and layer is attached to anvil block, take off keeper from end effector the most again.Main Figure 23 1 to Figure 23 4 to be seen, user can firmly grasp keeper 2000 (by catching grip portion 2002), nail bin 2020 is inserted in the staple cartridge channel 2040 of end effector.By nail bin 2020 When inserting in the staple cartridge channel 2040 of end effector, the tab 2008 of keeper 2000 can be with nail bin Passage 2040 engages.Figure 23 1 illustrates the nail bin 2020, Qi Zhongbao being loaded in staple cartridge channel 2040 The layer 2030 that holder 2000 and anvil block can be attached is positioned at nail bin 2020 top.Figure 23 1 is it also shows that hold The anvil block 2042 of portion executor is positioned at above layer 2030 and keeper 2000 that anvil block can be attached.Existing Seeing Figure 23 2, anvil block 2042 can move towards the layer 2030 that keeper 2000 and anvil block can be attached.Anvil Seat 2042 motion time, the main body of the layer 2030 that the surface 2044 of anvil block 2042 can be able to be attached with anvil block 2034 contacts.Additionally, the slit 2046 (such as cutter slit) of anvil block 2042 can be able to be attached with anvil block The ridge 2036 of layer 2030 engages.It addition, when anvil block 2042 moves towards nail bin 2020, anvil block The lateral edge 2050 of 2042 can keep connecing towards interior angled surface 2018 of tab 2014 with film Close, tab 2014 is pushed out so that can move away from, to internal channel 2016, the layer that anvil block can be attached The lateral edge of 2030.

Anvil block 2042 continues the layer 2030 can being attached by anvil block towards layer 2030 motion that anvil block can be attached Push the lid 2006 of keeper 2000 to.It addition, when anvil block 2042 continues to move towards nail bin 2020, The protruding ridge 2022 of keeper 2000 can engage anvil in the projection 2036 of the layer 2034 that anvil block can be attached Seat 2042 slit 2046 time by this projection 2036 of support.As it has been described above, the projection of keeper 2000 Ridge 2022 projection 2036 of layer 2030 that anvil block can be attached can be made to deform so that anvil block can be attached The overall dimensions of the projection 2036 of layer 2030 stretches out.In other words, the layer can being attached at anvil block When the projection 2036 of 2030 enters the slit 2046 of anvil block 2042, the protruding ridge of keeper 2000 2022 can be pressed into the layer 2030 that anvil block can be attached below projection 2036, cause projection 2036 bloat and/ Or expand in the slit 2046 of anvil block 2042.The projection 2036 expanded contacts with slit 2046 can be by The ridge 2036 of the layer 2030 that anvil block can be attached is maintained in slit 2046.Slit 2046 can include antelabium 2048, antelabium 2048 can capture at least some of of projection 2036, projection 2036 is more securely protected Hold in the slit 2046 of anvil block 2042.

Referring now to Figure 23 3, when anvil block 2042 moves away from keeper 2000, anvil block 2042 carries Layer 2030 that anvil block can be attached together away from keeper 2000.As shown in Figure 23 4, at anvil block 2042 After the layer 2030 can being attached with anvil block moves away from keeper 2000, can be by keeper 2000 from end Executor takes off, and allows layer 2030 that anvil block can be attached and nail bin 2020 stay in end effector.

Refer again to Figure 22 9 and Figure 23 0, in certain embodiments, the layer 2030 that anvil block can be attached Proximal end 2032 could attach to nail bin 2020.Such as, the available bonding of layer 2030 that anvil block can be attached Agent, spot welding and/or hot riveting are attached to nail bin 2020.In various embodiments, anvil block can be attached Layer 2030 is attached to anvil block 2042, and after being again turned on anvil block 2042, the layer that anvil block can be attached 2030 can depart from from nail bin 2020.In other embodiments various, the nail in nail bin fired and with The layer 2030 that can be attached of the anvil block of appearance be trapped in the nail of percussion before, the layer that anvil block can be attached 2030 can remain attached to nail bin 2020.

Figure 23 5 illustrates the layer 2030 that anvil block separate with keeper 2000 can be attached.Figure 23 6 and figure 237 other embodiments illustrating the layer that anvil block can be attached.Figure 23 6 illustrates and includes main body 2064 and prolong from it The layer embodiment 2060 that the anvil block of the discrete projections 2062 stretched can be attached.Figure 23 7 illustrates and includes main body 2074 and the layer embodiment 2070 that can be attached of another anvil block from its discrete projections 2072 extended.Example As, each discrete projections 2072 can include the bolt 2073 that the main body of the layer 2070 can being attached from anvil block extends With the cap 2075 extended from bolt 2073.In certain embodiments, cap 2075 can have and compares bolt 2073 bigger sizes so that when projection 2072 is inserted into slit 2046, cap can be at anvil block Extend in lateral edge 2048 in 2042 slits 2046.

Referring now to Figure 23 8 to Figure 24 3, the various embodiments of the layer that anvil block can be attached can include one or Multiple disposing attachment features structure, these can dispose attachment features structure can be formed at what anvil block can be attached In the main body of layer.Figure 23 8 to Figure 24 0 illustrates layer 2080 embodiment that anvil block can be attached, and this anvil block can The layer 2080 of attachment includes that main body 2082 and a series of deployment theing be formed in main body 2082 are attached spy Levy structure 2084.By forming hole 2085 in main body 2082, each dispose attachment features structure 2084 can be formed in main body 2082.Each attachment features structure 2084 of disposing can include being attached to master The longitudinal component 2086 of body 2082 and be attached to the lateral part 2088 of this longitudinal component 2086. In various embodiments, longitudinal component 2086 can be attached to main body 2082 by articulated section 2087.Cincture Each hole 2085 disposing attachment features structure 2084 and articulated section 2087 can permit license deployment to be attached Feature structure 2084 is not being disposed configuration and is being disposed motion between configuration, as being described in more below. In other embodiments various, articulated section 2087 can not be there is.In this type of embodiment, can dispose attached Connect feature structure 2084 can such as bend around longitudinal component 2086, not dispose configuration and to dispose structure Move between type.

Figure 23 8 illustrates and is in the attachment features the disposed structure 2084 not disposing configuration, the most each can Dispose attachment features structure 2084 and be located substantially on the main body of the layer 2084 can being attached by the anvil block limited In 2082 planes.Figure 23 9 illustrates and is in the attachment features the disposed structure 2084 disposing configuration, its In each attachment features structure 2084 of disposing extend the main body 2082 of the layer 2080 can being attached by anvil block The plane limited.Such as, attachment features structure 2084 can be disposed can rotate around articulated section 2087, to prolong Stretch out the plane limited by main body 2082.As shown in Figure 24 0, can dispose attachment features structure 2084 can It is deployed in the slit 2046 of anvil block 2042.Attachment features structure 2084 can be disposed when deployed, its Longitudinal component 2086 may extend in the slit 2046 of anvil block 2042, and lateral part 2088 can be entered One step extends in slit 2046.In all cases, the horizontal of attachment features structure 2084 can be disposed Part 2088 can engage with the antelabium 2048 in slit 2046, with the layer 2080 providing anvil block to be attached And retentivity higher between anvil block 2042.Additionally, the transverse part of attachment features structure 2084 can be disposed Points 2088 engage with the antelabium 2048 in slit 2046 and can prevent disposing attachment features structure 2084 and return Return to non-deployed position.In certain embodiments, each longitudinal direction disposing attachment features structure 2084 Part 2086 may be shorter than the narrow 2047 of slit 2046.In this type of embodiment, laterally When part 2088 engages with the antelabium 2048 in slit 2046, can apply to open to longitudinal component 2086 Power.The main body 2082 of the layer 2080 that anvil block can be attached can closely be supported by the tension force in lateral part 2088 Keep by anvil block 2042.

Main body 2082 and attachment features structure 2084 can be disposed can be formed by single main body.Then, may be used By the way of such as cutting hole 2085 in main body 2082, main body 2082 forms hole 2085. Available stamping tool, cutting blade, laser or any other suitable device cutting hole 2085.Respectively Planting in other embodiments, layer 2080 and hole 2085 that anvil block can be attached can be formed in a mold.At some In embodiment, hole 2085 can be between main body 2082 and can disposing includes between attachment features structure 2084 Gap.In some other embodiment, hole 2085 not main body 2082 with can dispose attachment features structure Gap is provided between 2084.In various embodiments, such as, can be by between main body 2082 and longitudinal part The layer 2080 that anvil block between points 2086 can be attached is thinning or indentation, is consequently formed articulated section 2087. In other embodiments various, main body 2082 need not be changed and the vertical of attachment features structure 2084 can be disposed Thickness between part 2086, so that it may form articulated section.

Figure 23 8 to Figure 24 0 described hereinabove shows layer 2080 embodiment that anvil block can be attached, Wherein can dispose attachment features structure 2084 and all include the lateral part 2088 of circle.Lateral part 2088 Can have other suitable shapes, include but not limited to triangle, ellipse and polygon.Such as, figure 241 to Figure 24 3 illustrates layer 2090 embodiment that anvil block can be attached, and wherein can dispose attachment features structure 2094 each include the lateral part 2098 with rectangular cross section.Each dispose attachment features structure 2094 can be attached to main body 2092 by articulated section 2097.

In certain embodiments, the main body of the layer that anvil block can be attached and attachment features structure can be disposed can comprise Flexibility and/or elastomeric material.Such as, refer again to Figure 23 8 to Figure 24 0, the layer that anvil block can be attached The main body 2082 of 2080 and attachment features structure 2084 can be disposed can comprise flexibility and/or elastomeric material. As another example, see Figure 24 1 to Figure 24 3, main body 2092 He of the layer 2090 that anvil block can be attached Attachment features structure 2094 can be disposed and can comprise flexibility and/or elastomeric material.See Figure 23 8 to Figure 24 0 The layer 2080 that can be attached of anvil block, when each attachment features structure 2084 of disposing is deployed to anvil block 2042 Slit 2046 (such as cutter slit) in time, lateral part 2088 can bend and/or deform to pass The narrow 2047 of slit 2046.Then, slit 2046 is extended past in lateral part 2088 Antelabium 2048 and time in entering the broad 2049 of slit 2046, lateral part 2088 can be recovered Do not bend and/or undeformed shape.Recover in lateral part 2088 not bend and/or the not deformed shape phase Between, lateral part 2088 can extend transverse in the broad 2049 of slit 2046.At transverse part After dividing in 2088 broads 2049 extending transverse to slit 2046, the narrow of slit 2046 2047 are provided that interference fit, suppression lateral part 2088 are pulled out slit 2046 easily.In other words Saying, to lateral part 2088 pulls out slit 2046, lateral part 2088 is necessary for the most suitably scratching Song and/or deformation, with the narrow 2047 through slit 2046.In various embodiments, can be by horizontal stroke To being sized such that of the narrow 2047 of part 2088 and/or slit 2046: can dispose Attachment features structure 2084 pull out slit needed for pulling force can sufficiently large with at anvil block 2042 relative to patient During tissue positioned so that the layer 2080 that anvil block can be attached does not shifts from anvil block 2042.But, at anvil block After the layer 2080 that can be attached is captured by nail, pulling force can be small enough so that layer 2080 that anvil block can be attached can be from Anvil block is pulled away from.

In various embodiments, the cutting blade of surgical stapling device can disposing layer that anvil block can be attached Attachment features structure is cut off.Seeing Figure 24 0, cutting blade can travel across the slit of anvil block 2042 2046.Each attachment features structure 2084 of disposing substantially can be cut in half by cutting blade.To follow closely After percussion when anvil block 2042 removes the layer 2080 that anvil block can be attached, it is easy to dispose attachment spy by each Levy the half block pull-out slit 2046 of structure 2084.

Just include disposing layer such as Figure 23 8 to Figure 24 3 disclosure that the anvil block of attachment features structure can be attached The layer that can be attached of anvil block for, the layer that available keeper makes anvil block to be attached aligns with anvil block and make can portion Administration's attachment features structural portion is deployed in the slit of anvil block.Figure 25 1 to Figure 25 4 illustrates keeper 19700, But first nail bin 19690 is installed in staple cartridge channel 19740 by this keeper, then can be attached by anvil block Layer 2056 press to anvil block 19720.Keeper 19700 includes Part I 2052 and Part II 2054, the direction that wherein Part I 2052 can indicate along arrow Q and S relative to Part II 2054 (respectively as shown in Figure 25 3 and Figure 25 4) moves.Part I 2052 can include cam, this cam Including inverse salient angle 19646 and 19647, and salient angle 19642 and 19643.Part II can include with The cam projection 19614 and 19616 that the cam of Part I 2052 engages.Such as Figure 25 1 and Figure 25 2 institute Show, when keeper 19700 being inserted end effector middle, cam projection 19614 and 19616 with The inverse salient angle 16646 and 16647 of the cam of Part I 2052 engages.Referring now to Figure 25 3 and figure, 254, after being rested upon in the staple cartridge channel 19740 of end effector by nail bin, Part I 2052 can Move relative to Part II 2054 in direction along arrow Q.Part I 2052 is along the side of arrow Q The cam lobe 19642 of cam projection 19614 and 19616 and Part I 2052 is caused to motion Engage with 19643.Cam projection 19614 and 19616 is pushed open by salient angle 19642 and 19643, thus Promote the layer 2056 that anvil block can be attached to contact with anvil block 19720.

Referring now to Figure 25 5 to Figure 25 8, in certain embodiments, nail bin can be installed to nail by keeper In the passage of storehouse, the layer that anvil block can be attached is arranged on anvil block, and the layer that anvil block can be attached can portion Administration's attachment features structure is deployed as the configuration engaged with anvil block.See Figure 25 6 and Figure 25 7, keeper 2110 embodiments can include grip portion 2112, towards nail bin part 2114 with towards anvil portion 2118.Towards nail bin part 2114 and can be spaced apart by support member 2116 towards anvil portion 2118, And may be disposed to the most at an angle.From Figure 25 8 it is clear that towards nail bin part 2114 Can be similar to fully open when anvil block 2150 is in the angle can being arranged to towards anvil portion 2118 Angle during position, between staple cartridge channel 2160 and anvil block 2150.Can wrap towards nail bin part 2114 Include the first fixture 2124 and from the second fixture 2126 extended towards nail bin part 2114.First fixture 2114 can engage with nail bin 2140, and nail bin 2140 is releasably held keeper 2110, such as figure Shown in 255.Second fixture 2126 can engage with the staple cartridge channel 2160 of end effector so that will protect Holder 2110 releasably holds staple cartridge channel 2160.Fixture can be included towards anvil portion 2118 2120, this fixture 2120 keeps the layer that anvil block can be attached, such as Figure 23 8 relative to anvil faces 2118 The layer 2080 can being attached to the anvil block shown in Figure 24 0.May also include discrete prominent towards anvil portion 2118 Play 2122, the attachment features the disposed structure on layer 2080 that this discrete projections can be attached relative to anvil block The location positioning of 2084.As shown in Figure 25 5, when the layer 2080 can being attached by anvil block is loaded into keeper 2110 towards time on anvil portion 2118, the layer 2080 that anvil block can be attached can first be shelved on discrete projections 2122 tops.

See Figure 25 8, in certain embodiments, keeper 2110 is inserted end effector and When being rested upon in staple cartridge channel 2160 by nail bin 2140, the layer 2080 that anvil block can be attached can be with anvil block 2150 contacts.The layer 2080 that once anvil block can be attached contacts with anvil block 2150, keeper 2110 and nail Storehouse 2140 may continue to move relative to anvil block 2150, until resting upon nail bin 2140 in nail bin completely In passage 2160.In this type of embodiment, keeper 2110 can be towards anvil towards anvil portion 2118 The layer 2080 that can be attached of seat moves and the layer 2080 that can be attached against anvil block promotes so that from keeper The discrete projections 2122 extended towards anvil portion 2118 of 2110 can be attached by disposing in layer 2080 Connect feature structure 2084 to be pushed up playing the structure of deployment as explained above with described in Figure 23 8 to Figure 24 3 Type.In various embodiments, each discrete projections towards anvil portion 2118 of keeper 2110 2122 can include inclined plane 2123, and this inclined plane 2123 can connect with disposing attachment features structure 2084 Close.When keeper 2110 continues to move relative to the layer 2080 that anvil block 2150 and anvil block can be attached, Inclined plane 2123 can with can dispose the progressive joint of attachment features structure 2084, until attachment features can be disposed Structure 2084 is in rotating around articulated section 2087 and being deployed to the slit 2152 of anvil block 2150.As Shown in Figure 25 8, the inclined plane 2123 of discrete projections 2122 can support simultaneously each disposes attachment features The longitudinal component 2086 of structure and lateral part 2088 so that longitudinal component 2086 and lateral part It is deployed to both 2088 in the slit 2152 of anvil block 2150.

In some other embodiment, use keeper 2110 can rest upon nail bin 2140 at nail bin completely In passage 2160, and the layer 2080 not making anvil block to be attached contacts with anvil block 2150.Implement at this type of In example, after nail bin 2140 rests upon completely in staple cartridge channel 2160, anvil block 2150 can be made from completely Open position moves towards make position so that the layer 2080 that anvil block 2150 can be attached with anvil block contacts, And discrete projections 2122 is deployed to the slit of anvil block 2050 by disposing attachment features structure 2084 In 2052.

Figure 25 9 to Figure 26 2 illustrates another keeper embodiment 2170.Keeper 2170 can include face To nail bin part 2174 with towards anvil portion 2178, the two part is spaced apart by support member 2190, And it is arranged to the most at an angle.The most releasable towards the engageable nail bin of nail bin part 2,174 2140 Ground keeps nail bin 2140.Staple cartridge channel 2160 towards the most engageable end effector of nail bin part 2174 And releasably hold staple cartridge channel 2160.Anvil block can be disposed with on anvil portion 2178 can be attached Layer, all layers 2080 that can be attached of anvil block described as explained above with Figure 23 8 to Figure 24 0.Such as Figure 26 1 Illustrating in greater detail with Figure 26 2, can include hole 2182 towards anvil portion 2178, this Kong Keyu arranges The attachment features disposed structure 2084 at the layer 2080 can being attached towards the anvil block on anvil portion 2178 Alignment.Each hole 2182 can include the cam 2202 being arranged therein.Each cam 2202 can be by flexibility Component 2204 is attached to towards anvil portion 2178 so that cam 2202 can be around flexible member 2204 It is rotated away from hole 2182, and contacts with attachment features structure 2084 can be disposed.Each cam 2202 can Including curved surface 2203, this curved surface can be disposed disposing attachment features structure 2084 progressively In slit 2152 in anvil block 2150.See Figure 26 1, start to move from hole 2182 at cam 2202 Go out and with can dispose attachment features structure 2084 contact time, the curved surface 2203 of cam 2202 is first Can contact with the lateral part 2088 that can dispose attachment features structure 2084 so that lateral part 2088 It is deployed in the slit 2152 of anvil block 2150.Referring now to Figure 26 2, along with cam 2202 continues to move out Hole 2182, the curved surface 2203 of cam 2202 can be with the longitudinal direction that can dispose attachment features structure 2086 Part 2086 contacts so that longitudinal component 2086 is deployed in the slit 2152 of anvil block 2150.

Can include admittedly towards nail bin part 2174 and towards the support member 2190 between anvil portion 2178 Determine part 2194 and moveable portion 2196.Moveable portion 2196 can be operably linked to button 2192, user presses the button 2192, makes moveable portion 2196 transport relative to standing part 2194 Dynamic.The moveable portion 2196 of support member 2190 can include a series of cam face 2206, this CAM table Face can engage with cam portion 2202, with by cam portion 2202 introduction hole 2182.Work as moveable portion 2196 when proximally moving relative to standing part 2194, and cam face 2206 can allow cam 2202 such as The upper described hole 2182 that removes, and the attachment features the disposed knot of the layer 2080 can being attached with anvil block Structure 2084 contacts.

In certain embodiments, the moveable portion 2196 of support member 2190 can be biased in relative to fixing The distal position of part 2194, as shown in Figure 25 9.Such as, can be at standing part 2194 and movable Spring or the like is arranged between part 2196.Spring can be by the moveable portion 2196 of support member 2190 It is biased in the distal position relative to standing part 2194.In various embodiments, bias force can be enough Greatly so that nail bin 2140 rests upon power required in staple cartridge channel 2160 will not overcome bias force.Cause This, rest upon nail bin 2140 in staple cartridge channel 2160 completely being applied with to button 2192 unintentionally In the case of required power, attachment features structure 2084 can be disposed unlikely by cam 2202 portion Administration.

The layer can being attached at anvil block releasably holds in the various embodiments of surgical stapler anvil, anvil Layer that the layer that can be attached of seat can include making patient tissue can be attached relative to anvil block and stable other of anvil block Feature structure.Referring now to Figure 24 9 and Figure 25 0, it is shown that the layer 22320a that can be attached of anvil block and 22320b is between anvil block 22060 and patient tissue T.The layer 22320a that anvil block can be attached and The embodiment of 22320b can include the projection 2078 from main body extension towards the side of patient tissue T. Projection 2078 can push or thrust tissue T, thus provides the layer that tissue T and anvil block can be attached Grip between 22320a and 22320b.This grip can prevent the layer that tissue can be attached relative to anvil block 22320a and 22320b slides.

In various embodiments, after the surgical stapling device being provided with the layer that anvil block can be attached is fired, Above-mentioned holding feature structure can be separated with the layer that anvil block can be attached.In this type of embodiment, can be by above-mentioned guarantor Hold feature structure and be attached to one or more tie-down.Tie-down can be attached to surgical stapling device, or suffers from Another object that person is external so that after stiching instrument fires, just can be from the patient by pullling tie-down Take out these and keep feature structure.

In various embodiments, tissue thickness's compensating part can comprise polymer composition.This combination of polymers Thing can comprise one or more synthetic polymers and/or one or more non-synthetic polymer.Synthesized polymer Thing can include absorbable polymer and/or the non-absorbable polymer of synthesis of synthesis.In various embodiments In, this polymer composition can be including (for example) biocompatible foam.This biocompatible foam can Open celled foam and/or the closed-cell foam of porous including (such as) porous.This biocompatible foam can There is uniform pore morphology, maybe can have gradient pore form (that is, at the whole depth of foam in a direction On, orifice size is gradually increased into macropore).In various embodiments, this polymer composition can comprise Porous support, porous matrix, gel-type vehicle, hydrogel matrix, solution substrate, thread substrate, tubulose One in substrate, composite interstitial substance, membrane matrix, Biostatic polymer and biodegradable polymers or Multiple, and combinations thereof.Such as, tissue thickness's compensating part can include by thread matrix enhancement Foam, maybe can include the foam with additional hydrogel layer, and this additional hydrogel layer exists at body fluid Lower stretching, extension, to further provide for compression organizationally.In various embodiments, tissue thickness's compensating part is also Can be made up of the coating in material and/or the second layer or third layer, this coating stretches in the presence of body fluid, To further provide for compression organizationally.This type of layer can be hydrogel, and such as, this hydrogel can be synthesis Material and/or natural origin material, and can be biological durable material and/or Biodegradable material.At certain In a little embodiments, can use and such as be provided that the fiber of additional flexibility, rigidity and/or intensity is non-and knit Producing material material or fiber mesh type element strengthen tissue thickness's compensating part.In various embodiments, tissue Thickness compensation part has porous form, and this porous form shows gradient-structure, such as, such as at one It is aperture on surface, and is bigger hole on another surface.This form for tissue in-growth or Can be more preferable for hemostasis behavior.Additionally, this gradient also can be with the bio-absorbable section combination of change.Short Phase absorption profile may be more suitable for realizing hemostasis, and Long-term absorption section can realize more preferable organization healing Again will not seepage.

The example of non-synthetic polymer includes but not limited to lyophilizing polysaccharide, glycoprotein, elastin laminin, egg White polysaccharide, gelatin, collagen and oxidized regenerated cellulose (ORC).The example of the absorbable polymer of synthesis Include but not limited to poly-(lactic acid) (PLA), PLLA (PLLA), polycaprolactone (PCL), PVOH Acid (PGA), PTMC (TMC), polyethylene terephthalate (PET), polyhydroxy Copolymer (PGCL), Acetic acid, hydroxy-, bimol. cyclic ester and the trimethylene of phenylalkanoic acid ester (PHA), Acetic acid, hydroxy-, bimol. cyclic ester and 6-caprolactone The copolymer of carbonic ester, poly-(decanedioic acid glyceride) (PGS), PPDO, poly-(ortho esters), Condensing model, polysaccharide, poly-(ester-acid amide), tyrosine-based polyarylate, the poly-imido-carbonic ester of tyrosine-based, cheese Propylhomoserin base Merlon, poly-(D, L-lactide-carbamate), poly-(B-hydroxybutyric acid), poly-(E-is in oneself Ester), Polyethylene Glycol (PEG), poly-[two (carboxyphenoxy) phosphonitrile], poly-(aminoacid), intend poly-(amino Acid), absorbable polyurethane, and combinations thereof.

In various embodiments, this polymer composition can be including (for example) the most about 50% To the polymer composition of the PLLA of about 90%, and the most about 50% to about 10% The polymer composition of PCL.In at least one embodiment, this polymer composition can comprise (example As) PLLA of the most about 70%, and the PCL of the most about 30%.In various enforcements In example, this polymer composition can be including (for example) the most about 55% to about 85% The polymer composition of PGA, and the polymer composition of the PCL of by weight 15% to 45%.? In at least one embodiment, this polymer composition can be including (for example) the most about 65% PGA, and the PCL of the most about 35%.In various embodiments, this polymer composition can wrap The polymer composition of the PGA containing (such as) the most about 90% to about 95%, and by weight The polymer composition of the PLA of gauge about 5% to about 10%.

In various embodiments, the absorbable polymer of synthesis can include bioabsorbable biocompatibility Elastomer copolymer.The most bioabsorbable biocompatible elastomers copolymer includes but not limited to (6-caprolactone is preferably about 30:70 with the mol ratio of Acetic acid, hydroxy-, bimol. cyclic ester to the copolymer of 6-caprolactone and Acetic acid, hydroxy-, bimol. cyclic ester To about 70:30, it is therefore preferable to 35:65 is to about 65:35, and more preferably 45:55 to 35:65)； 6-caprolactone and lactide (include L-lactide, D-lactide, their blend or lactic acid copolymerization Thing) elastomer copolymer (mol ratio of 6-caprolactone and lactide is preferably about 35:65 to about 65:35, and more preferably 45:55 to 30:70)；To dioxanone (1,4-dioxa hexamethylene Alkane-2-ketone) and the elastomer copolymer of lactide (including L-lactide, D-lactide and lactic acid) (mol ratio of dioxanone Yu lactide is preferably about 40:60 to about 60:40)；ε-own interior Ester and elastomer copolymer (6-caprolactone and the mol ratio to dioxanone to dioxanone It is preferably about 30:70 to about 70:30)；To dioxanone and the elasticity of trimethylene carbonate Precursor copolymer (is preferably from about 30:70 to about to the mol ratio of dioxanone Yu trimethylene carbonate 70:30)；Elastomer copolymer (trimethylene carbonate and the second of trimethylene carbonate and Acetic acid, hydroxy-, bimol. cyclic ester The mol ratio of lactide is preferably from about 30:70 to about 70:30)；Trimethylene carbonate and lactide (bag Include L-lactide, D-lactide, their blend or lactic acid copolymer) elastomer copolymer (trimethylene carbonate is preferably from about 30:70 to about 70:30 with the mol ratio of lactide)；And it Blend.In one embodiment, this elastomer copolymer is the copolymerization of Acetic acid, hydroxy-, bimol. cyclic ester and 6-caprolactone Thing.In another embodiment, this elastomer copolymer is the copolymer of lactide and 6-caprolactone.

It is published in entitled " the ELASTOMERIC MEDICAL on 21 days November nineteen ninety-five DEVICE " United States Patent (USP) 5,468,253 and be published in the entitled of calendar year 2001 December 4 days The United States Patent (USP) 6,325,810 of " FOAM BUTTRESS FOR STAPLING APPARATUS " Disclosure be the most each incorporated by reference in its entirety herein.

In various embodiments, the absorbable polymer of synthesis can include that (such as) can be with brand name VICRYL (polyglactic 910) from Ethicon, Inc. commercially available 90/10 poly-(Acetic acid, hydroxy-, bimol. cyclic ester-L-third hands over Ester) copolymer, can be with brand name DEXON from commercially available poly-of American Cyanamid Co. Acetic acid, hydroxy-, bimol. cyclic ester, can with brand name PDS from the commercially available PPDO of Ethicon, Inc., can With brand name MAXON from poly-(Acetic acid, hydroxy-, bimol. cyclic ester-three methylene commercially available for American Cyanamid Co. Base carbonic ester) statistic copolymer, can be commercially available from Ethicon with brand name MONOCRYL 75/25 poly-(glycolide-s-caprolactone) copolymer (poliglecaprolactone 25) in one or many Kind.

The example of the non-absorbable polymer of synthesis includes but not limited to polyurethane foam plastics, polypropylene (PP), polyethylene (PE), Merlon, polyamide such as nylon, polrvinyl chloride (PVC), poly-methyl Acrylic acid methyl ester. (PMMA), polystyrene (PS), polyester, polyether-ether-ketone (PEEK), politef (PTFE), polytrifluorochloroethylene (PTFCE), polyvinyl fluoride (PVF), PEP (FEP), poly- Acetal, polysulfones, and combinations thereof.The non-absorbable polymer of synthesis may include but be not limited to elasticity Body foam plastics and porous elastomers, such as silicone, polyisoprene and rubber.In various embodiments In, described synthetic polymer can include can be with brand name GORE-TEX Soft Tissue Patch from W. The expanded PTFE (ePTFE) that L.Gore Associates, Inc. are commercially available, and can be with trade (brand) name Claim NASOPORE from copolyether ester polyurethane foam commercially available for Polyganics.

The feature of the polymer composition of tissue thickness's compensating part may be in (such as) void fraction percent, hole Size and/or hardness.In various embodiments, this polymer composition can have (such as) by body The void fraction percent of long-pending meter about 30% to about 99%.In certain embodiments, this polymer composition Can have the void fraction percent of (such as) the most about 60% to about 98%.In various embodiments In, this polymer composition can have the hole hundred of (such as) the most about 85% to about 97% Divide rate.In at least one embodiment, this polymer composition can be including (for example) the most about The PLLA and the PCL of the most about 30% of 70%, and it is the biggest to have (such as) The porosity of about 90%.In at least one such embodiment, therefore, this polymer composition will bag Containing the copolymer of the most about 10%.In at least one embodiment, this polymer composition can wrap PGA and the PCL of the most about 35% containing (such as) the most about 65%, and can There is the void fraction percent of (such as) the most about 93% to about 95%.In various embodiments In, this polymer composition can have the porosity being more than 85% by volume.This polymer composition can There is the hole dimension of (such as) about 5 microns to about 2000 microns.In various embodiments, should Polymer composition can have (such as) hole chi between about 10 microns to about 100 microns Very little.In at least one such embodiment, this polymer composition can including (for example) PGA and The copolymer of PCL.In certain embodiments, this polymer composition can have (such as) between about Hole dimension between 100 microns to about 1000 microns.In at least one such embodiment, this gathers Polymer composition can be including (for example) the copolymer of PLLA and PCL.According to some aspect, polymer The hardness of compositions can represent by Shore hardness, and Shore hardness can be defined as with durometer (such as Xiao Family name's durometer) material that the records resistance to residual indentation.In order to assess the durometer value of given material, According to entitled " Standard Test Method for Rubber Property-Durometer Hardness " ASTM program D2240-00 (its be incorporated by reference in its entirety herein), use penetrator foot Press to material.Penetrator foot press can be entered material, keep the sufficiently long time (such as 15 Second), read reading by suitable scale the most subsequently.According to scale type used, when pressure head foot is complete During full penetrable material, can obtain be 0 reading；And when pressure head foot does not penetrates material, can obtain for The reading of 100.This reading dimensionless.In various embodiments, can adopt according to ASTM D2240-00 Hardness is determined by any suitable scale such as A class and/or OO class scale.In various embodiments In, the polymer composition of tissue thickness's compensating part can have (such as) about 4A to about 16A's Shore A Hardness value, this hardness number is of about 45OO to about 65OO in the range of Shore OO.? In at least one such embodiment, this polymer composition can be including (for example) PLLA/PCL copolymerization Thing or PGA/PCL copolymer.In various embodiments, the polymer composition of tissue thickness's compensating part Can have the Shore A Hardness value less than 15A.In various embodiments, tissue thickness's compensating part is poly- Polymer composition can have the Shore A Hardness value less than 10A.In various embodiments, tissue thickness The polymer composition of compensating part can have the Shore A Hardness value less than 5A.In certain embodiments, Polymeric material can have the Shore OO compositions value of (such as) about 35OO to about 75OO.

In various embodiments, at least two during this polymer composition can have the above-mentioned characteristic identified Kind.In various embodiments, at least three during this polymer composition can have the above-mentioned characteristic identified Kind.This polymer composition can have (such as) by volume 85% to 97% porosity, 5 microns To the hole dimensions of 2000 microns and the Shore A Hardness value of 4A to 16A and 45OO to 65OO Shore OO hardness value.In at least one embodiment, such as, this polymer composition can comprise by The polymer composition of the PLLA of weight meter 70% and the combination of polymers of the PCL of by weight 30% Thing, and there is the porosity of by volume 90%, the hole dimension of 100 microns to 1000 microns and 4A Shore A Hardness value and the Shore OO hardness value of 45OO to 65OO to 16A.At least one In individual embodiment, such as, this polymer composition can comprise the polymer of PGA of by weight 65% Compositions and the polymer composition of PCL of by weight 35%, and have by volume 93% to The porosity of 95%, the hole dimension of 10 microns to 100 microns and the Xiao A hardness of 4A to 16A Value and the Shore OO hardness value of 45OO to 65OO.

In various embodiments, available flowable attachment part is by the most attached for tissue thickness's compensating part Receive nail bin and/or anvil block.This flowable attachment part can operationally with nail bin and/or anvil block phase Association.In various embodiments, can arrange between tissue thickness's compensating part and nail bin and/or anvil block can Flowing attachment part.In various embodiments, can the wrapping at least partially of tissue thickness's compensating part outer surface Include flowable attachment part.In various embodiments, adhesive phase zoarium can include tissue thickness's compensating part With flowable attachment part.This adhesive phase zoarium can include basic unit and be positioned at least one of substrate surface Adhesive phase on Fen, this basic unit includes tissue thickness's compensating part, and this adhesive phase includes flowable attachment Part.This adhesive phase zoarium can include tissue contacting surface and relative surface, this tissue contacting surface Including tissue thickness's compensating part, this relative surface includes flowable attachment part.This adhesive phase is fit Nail bin and/or anvil block can be releasably attached to.

In various embodiments, flowable attachment part can such as comprise flowable polymer compositions, all Such as contact adhesive (" PSA ").The contact adhesive paint tissue thickness of effective dose can be compensated Part, these contact adhesives can provide enough cohesive strengths, to produce the bonding of desired adhesion characteristic To nail bin and/or anvil block.Contact adhesive may possess one or more in following characteristic: (1) is strong And lasting cohesiveness；(2) with finger gently once pressing and can adhere to；(3) enough it is maintained on adherend Ability；(4) enough cohesive strengths are thoroughly to remove from adherend.In various embodiments, when to can When flowing attachment part applies pressure, heat and/or stress, flowable attachment part is the most flowable.This type of Pressure and/or stress can such as directly apply, accordingly by hands and/or by equipment (such as plant equipment) Ground, and can be manual processes and/or automated procedure.

In various embodiments, variations in temperature and/or pressure change may be made by flowable attachment part Accordingly.In various embodiments, when applying heat and/or pressure to flowable attachment part, flowable Attachment part can flow to the second position from primary importance.In various embodiments, flowable attachment part exists Under body temperature (37 DEG C) and/or flowable under room temperature (25 DEG C).In various embodiments, flowable attached Connect part flowable under body temperature (37 DEG C), but be not under room temperature (25 DEG C).In various embodiments In, variations in temperature may be made accordingly by flowable attachment part so that when tissue thickness's compensating part is During one temperature, flowable attachment part is positioned at primary importance, and is the second temperature at tissue thickness's compensating part When spending, flowable attachment part is positioned at the second position.In various embodiments, the second temperature is than first Temperature is high.In various embodiments, the first temperature can be room temperature, and the second temperature is body temperature.Respectively Planting in embodiment, pressure change may be made corresponding by flowable attachment part so that mend in tissue thickness When repaying part by the first pressure, flowable attachment part is positioned at primary importance, and compensates in tissue thickness When part is by the second pressure, flowable attachment part is positioned at the second position.In various embodiments, second Pressure is big than the first pressure.In various embodiments, the first pressure can be atmospheric pressure, and second Pressure can be finger pressure.In various embodiments, flowable attachment part can from when be in room temperature and/ Or primary importance during atmospheric pressure flows to the second position when being in body temperature and/or finger pressure.? In various embodiments, when applying pressure and/or stress to flowable attachment part, flowable attachment Divide and can flow to the second position from first (unstressed) position.

In various embodiments, in the space during flowable attachment part can flow to nail bin and/or anvil block. In various embodiments, when applying heat and/or pressure to flowable attachment part, flowable attachment Divide flowable, and at least one without flowable attachment part of the surface of nail bin and/or anvil block Divide upper extension, and/or fill the space (such as, such as slit and/or nail chamber) in nail bin and/or anvil block At least some of.In various embodiments, flowable attachment part can flow in vivo, to fill nail Space in storehouse and/or anvil block at least some of.In various embodiments, flowable attachment part can Flowing makes flowable attachment part include at least some of complementation with the space in nail bin and/or anvil block Shape.In various embodiments, flowable polymer compositions flowable with fill in anvil block slit and / or follow closely at least some of of chamber.In various embodiments, when applying pressure to flowable attachment part Time, flowable attachment part can flow in space, and the shape in space.Be not intended to by any specifically Theoretical constraint, it is believed that by flowable attachment part by least one of the space in nail bin and/or anvil block Point filling can augmenting tissue thickness compensation part and nail bin and/or the attachment intensity of anvil block.

In various embodiments, flowable attachment part such as contact adhesive may to variations in temperature and/ Or pressure change makes corresponding, to take turns with the second position and/or second in primary importance and/or the first profile Move between exterior feature.In various embodiments, flowable attachment part can have and between nail bin and/or anvil block The primary importance separated.In various embodiments, when flowable attachment part is positioned at the second position, can Flowing attachment part may be structured to penetrate into the space in nail bin and/or anvil block, and/or by nail bin and/ Or at least some of filling in this space of anvil block.As described herein, flowable attachment part can be in space Shape so that when specify flowable attachment part be the second profile time, flowable attachment part include with The profile that space is complementary.In various embodiments, primary importance and/or the first profile can with nail bin and/or Anvil block separates, and the second position and/or the second profile can contact with nail bin and/or anvil block.In various realities Executing in example, primary importance and/or the first profile can include the neutrality when being in room temperature and/or atmospheric pressure (original) profile, and the second position and/or the second profile can include when being in body temperature and/or finger pressure During power, the profile complementary with the space in nail bin and/or anvil block.The profile of flowable attachment part can flow Dynamic, to reach the shape complementary with the space in nail bin and/or anvil block and/or size.

In various embodiments, tissue thickness's compensating part is bonded to substrate (such as nail bin and/or anvil Seat) method offer tissue thickness compensating part is substantially provided, flowable attachment part (is such as pressed Sensitive adhesive) such as paint tissue thickness compensating part surface is at least some of, and make flowable attached Connect part and substrate contact.In various embodiments, method tissue thickness's compensating part being bonded to substrate Can include pressure is applied at least one in tissue thickness's compensating part and substrate.Flowable attachment part Primary importance from tissue thickness's compensating part outer surface can flow to also to include the outer surface of substrate and/or interior The second position on surface.Flowable attachment part can make tissue thickness's compensating part adhere to substrate contact Substrate.In various embodiments, tissue thickness's compensating part can be bonded to substrate by flowable attachment part. In various embodiments, such as slit during flowable attachment part can flow at least one space in substrate And/or nail chamber.In various embodiments, flowable attachment part when in the second position, can be by base At least some of filling at least one space at the end.

In various embodiments, tissue thickness's compensating part is attached to substrate (such as nail bin and/or anvil Seat) method can generally include: by flowable polymer compositions (such as contact adhesive) at least One discrete globule and/or discrete bands are applied to the surface of tissue thickness's compensating part, make substrate and can flow At least one discrete globule of dynamic polymer composition and/or discrete bands contact, and by flowable poly- It is flowable poly-that the substrate of polymer composition and at least one discrete globule and/or discrete bands press to another The discrete globule of at least one of polymer composition and/or discrete bands, with by tissue thickness's compensating part with can The mode of release is attached to substrate.In various embodiments, tissue thickness's compensating part is attached to substrate Method can include applying at least one discrete globule and/or the discrete bands of flowable polymer compositions To substrate at the desired location of substrate on tissue thickness's compensating part periphery and/or central shaft.Respectively Planting in embodiment, the method that tissue thickness's compensating part is attached to substrate can include flowable polymer group The discrete globule of at least one of compound and/or discrete bands are along the longitudinal direction and/or horizontal direction is applied to group Knit on thickness compensation part.

In various embodiments, the method that tissue thickness's compensating part is attached to substrate can include with at least portion The pattern and/or the amount applying that are pre-selected based on painting amount desired on tissue thickness's compensating part with dividing can be flowed At least one discrete globule and/or discrete bands of dynamic polymer composition.Optional applying is flowable poly- The pattern of polymer composition and amount, with bear handle medical treatment device with clinician and be associated stress (as Shear stress).In view of clinician is easy to handle and/or the preservation of flowable polymer compositions, excellent The pattern and amount that apply flowable polymer compositions are chosen as making in flowable polymer compositions by selection of land Amount balance.It addition, when selecting to apply the pattern of flowable polymer compositions and amount, it is contemplated that can The composition of flowing copolymer compositions.

In various embodiments, tissue thickness's compensating part can be partly attached to nail by flowable attachment part Storehouse and/or anvil block, and/or tissue thickness's compensating part fully can be attached to nail bin and/or anvil block.Completely Tissue thickness's compensating part of attachment can include the flowable polymer group between tissue thickness's compensating part and substrate The unbroken layer of compound (such as, such as contact adhesive).In other words, the tissue thickness adhered to completely is mended Repaying part can be that tissue thickness's compensating part does not has any part to be not coated with the tissue of flowable polymer compositions Thickness compensation part.Tissue thickness's compensating part of part attachment can include between tissue thickness's compensating part and substrate The flowable polymer compositions of effective dose, it includes that tissue thickness's compensating part is without flowable polymer Compositions at least some of.Tissue thickness's compensating part of part attachment can be to flowable polymer compositions Apply the shear stress bigger than the tissue thickness's compensating part adhered to completely.Therefore, flowable polymer group The shear property of compound and/or the pattern of flowable polymer compositions and amount can be selected as bearing by facing Bed doctor handles medical treatment device by way of expectations.

In various embodiments, can be by flowable polymer compositions with in continuous pattern and discontinuous pattern The form of a kind of pattern be applied to tissue thickness's compensating part.In various embodiments, flowable polymer The continuous pattern of compositions can include being applied to tissue thickness's compensating part at least some of on flowable poly- The discrete bands of polymer composition.In various embodiments, the continuous pattern of flowable polymer compositions Can include mending along the most longitudinally disposed of tissue thickness's compensating part central shaft and/or along tissue thickness Repay the continuous globule of at least some of flowable polymer compositions arranged of part periphery.Flowable polymerization Compositions can use other patterns various and configuration to put in substrate, such as cruciform pattern or other Pattern of diagonal lines, the most in blocks or continuous one layer, or any other of desired adhesion characteristic can be reached Design.In various embodiments, the continuous pattern of flowable polymer compositions can compensate along tissue thickness The inner rim of part and/or neighboring apply.In various embodiments, the company of flowable polymer compositions Continuous pattern can apply along the inner rim of tissue thickness's compensating part so that is being attached to by tissue thickness's compensating part During substrate, flowable polymer compositions positions along the central longitudinal axis of substrate.In various embodiments In, the continuous pattern of flowable polymer compositions can apply along the inner rim of tissue thickness's compensating part, makes Must be when tissue thickness's compensating part be attached to substrate, in flowable polymer compositions and substrate at least One space (such as slit and/or nail chamber) alignment.In various embodiments, flowable polymer group The continuous pattern of compound can apply along the neighboring of tissue thickness's compensating part so that tissue thickness is being compensated When part is attached to substrate, flowable polymer compositions positions along the neighboring of substrate.In various embodiments In, flowable polymer compositions is applied to tissue thickness's compensating part so that the interior section of substrate and / or peripheral border without flowable polymer compositions.

In various embodiments, the discontinuous pattern of flowable polymer compositions may be included in substrate that The multiple discrete globule of this spaced apart flowable polymer compositions and/or discrete bands.In various realities Executing in example, multiple globules and/or can the working as at least partially of band of flowable polymer compositions, executed When plus-pressure and/or stress pinched together.In various embodiments, flowable polymer compositions quilt Multiple globules pinched together and/or band can form the continuous pattern of flowable polymer compositions. In various embodiments, tissue thickness's compensating part of part attachment can include flowable polymerization in its surface The multiple discrete globule being spaced apart from each other of compositions and/or discrete bands so that tissue thickness compensates Part is when being under pressure, and at least some of of its surface is the freely sky without flowable polymer compositions Between.This free space can include the globule not having flowable polymer compositions of tissue thickness's compensating part And/or in the part that band contacts with each other, and/or tissue thickness's compensating part, do not apply flowable polymer group The globule of compound and/or the part of band.In various embodiments, free space can be the interior of substrate Portion's part and/or peripheral border.

In various embodiments, the method that tissue thickness's compensating part is attached to substrate can include flowable At least one discrete bands of polymer composition is applied on tissue thickness's compensating part.In various embodiments In, the discrete bands of flowable polymer compositions can be along the central longitudinal axis of tissue thickness's compensating part A part extends.In at least one embodiment, the discrete bands of flowable polymer compositions can be along group Knit align on thickness compensation part with at least one space in substrate (such as slit and/or nail chamber) Part applies.In various embodiments, tissue thickness's compensating part is attached to the method for substrate can include by The multiple parallel discrete bands of flowable polymer compositions is applied on tissue thickness's compensating part.Respectively Planting in embodiment, two discrete bands of flowable polymer compositions can be along the phase of tissue thickness's compensating part Offside edge longitudinal extension.In at least one embodiment, such as, the two of flowable polymer compositions Each band in individual discrete bands can along tissue thickness's compensating part with at least one space in substrate The part applying that (such as slit and/or nail chamber) aligns.In various embodiments, can select in advance Select the distance between band and/or between lateral edges so that tissue thickness's compensating part is being attached to substrate Time, flowable polymer compositions can flow at least one space (such as at least the one of anvil block in substrate Individual nail chamber) in.

In various embodiments, flowable polymer compositions multiple parallel discrete can be pre-selected The distance between distance and/or lateral edges between band, so that tissue thickness's compensating part can be the most attached Substrate, or be partially attached to substrate.In various embodiments, the width of above-mentioned band can the most extremely It is 1mm less.In various embodiments, the width of band can be such as between about 0.5mm and about 1.5mm Between.In various embodiments, the width of band can such as between about 1.0mm and about 1.25mm it Between.In various embodiments, the gap width between adhesive strings and/or between lateral edges can be such as At least 1mm.In various embodiments, can be pre-selected between band and/or between lateral edges Distance, so that tissue thickness's compensating part is partly attached to substrate, pre-based on tissue thickness's compensating part Phase applied amounts is pre-selected the ratio of binding agent and adhesive-free space.In various embodiments, binding agent with The ratio in adhesive-free space can be 1:10 to 10:1, such as 1:1,1:2,1:3,1:4,1:5 and 2:3。

In various embodiments, example, it may require be: the flowable minima of contact adhesive is 0.25mm.In various embodiments, such as, the thickness that contact adhesive base material includes may be between about Between 1.25mm and about 1.50mm.In certain embodiments, such as, contact adhesive base material includes Thickness may be between about 0.5mm and about 0.75mm.

As described herein, in various embodiments, flowable attachment part can include flowable polymer group Compound.Flowable polymer compositions can include contact adhesive.Flowable attachment part can include pressure-sensitive Adhesive phase is fit.In various embodiments, flowable attachment part can include that adhesive phase is fit, should Adhesive phase zoarium includes tissue thickness's compensating part and flowable polymer compositions.Polymer composition can Comprise one or more synthetic polymers and/or one or more natural polymers.Polymer composition can Being bioabsorbable, biocompatibility and/or biodegradable.The example of natural polymer Include but not limited to lyophilizing polysaccharide, glycoprotein, elastin laminin, Dan Baiduotang proteoglycan PG, gelatin, collagen, fibre Fibrillarin, fibronectin, Fibrinogen, elastin laminin, serum albumin, hemoglobin, egg white Albumen, oxidized regenerated cellulose (ORC) and combinations thereof.The example of polysaccharide includes but not limited to transparent Matter acid, chondroitin sulfate, hetastarch, hydroxyethyl cellulose, hydroxypropyl cellulose, carboxymethyl fibre Dimension element, chitin/chitosan, agarose, alginate, and combinations thereof.Synthetic polymer Example includes but not limited to poly-(lactic acid) (PLA), PLLA (PLLA), polycaprolactone (PCL), gathers Glycolic (PGA), poly-(hydroxyacetic acid), poly-(hydroxybutyric acid), poly-(phosphine nitrile), polyester, poly-(trimethylene Carbonic ester) (TMC), polyethylene terephthalate (PET), polyhydroxy-alkanoates (PHA), second The copolymer of copolymer, Acetic acid, hydroxy-, bimol. cyclic ester and the trimethylene carbonate of lactide and 6-caprolactone (PGCL), poly- (decanedioic acid glyceride) (PGS), PPDO, poly-(ortho esters), condensing model, polyacrylamide Amine, polysaccharide, poly-(ester-acid amide), tyrosine-based polyarylate, the poly-imido-carbonic ester of tyrosine-based, tyrosine Base Merlon, poly-(D, L-lactide-carbamate), poly-(B-hydroxybutyric acid), poly-(E-caprolactone), Polyethylene Glycol (PEG), poly(ethylene oxide), poly-[two (carboxyphenoxy) phosphonitrile], poly-(aminoacid), plan are gathered (aminoacid), absorbable polyurethane, poly hydroxy ethyl acrylate, polyvinyl pyrrolidone, poly-second Enol, polyacrylic acid, poly-acetas, polycaprolactone, polypropylene, nylon, and combinations thereof.

In various embodiments, flowable polymer compositions can comprise the copolymerization of 6-caprolactone and Acetic acid, hydroxy-, bimol. cyclic ester Thing (PCL/PGA).In various embodiments, flowable polymer compositions can be including (for example) by weight The polymer composition of the PGA of gauge about 50% to about 90%, and by weight about 50% to about 10% The polymer composition of PCL.In various embodiments, flowable polymer compositions can comprise (such as) the by weight about polymer composition of the PGA of 50% to about 75%, and by weight about The polymer composition of the PCL of 50% to about 25%.In various embodiments, flowable polymer combination Thing including (for example) the polymer composition of the PGA of by weight about 50% to about 60%, and can be pressed The polymer composition of the PCL of weight meter about 50% to about 40%.In at least one embodiment, may be used Flowing copolymer compositions can be including (for example) the combination of polymers of PGA of by weight about 70% Thing, and the polymer composition of the PCL of by weight about 30%.In at least one embodiment, may be used Flowing copolymer compositions can be including (for example) the combination of polymers of PGA of by weight about 64% Thing, and the polymer composition of the PCL of by weight about 36%.

In various embodiments, flowable polymer compositions can comprise 6-caprolactone and lactide (includes L-lactide, D-lactide, their blend and lactic acid copolymer) copolymer.In various enforcements In example, flowable polymer compositions can include that (such as, such as 35:65 is extremely from 30:70 to 70:30 65:35,45:55 to 35:65 and 50:50) the mol ratio of PCL Yu PGA.In various embodiments In, the amount of 6-caprolactone can be 30 to 45 molar percentages, and surplus is Acetic acid, hydroxy-, bimol. cyclic ester, such as, and such as ε- The amount of caprolactone is 35 to 40 molar percentages, and surplus is Acetic acid, hydroxy-, bimol. cyclic ester.In various embodiments, pressure-sensitive Binding agent can comprise [poly-(6-caprolactone-co-Acetic acid, hydroxy-, bimol. cyclic ester)] copolymer of 36:64 (moles/mole).Respectively Planting in embodiment, flowable polymer compositions can comprise dioxanone (Isosorbide-5-Nitrae-dioxane-2- Ketone) and the copolymer of lactide (including L-lactide, D-lactide and lactic acid).In various enforcements In example, flowable polymer compositions can comprise mol ratio be 40:60 to 60:40 to dioxa hexamethylene Ketone and lactide.In various embodiments, flowable polymer compositions can comprise 6-caprolactone and to two The copolymer of oxa-Ketohexamethylene.In various embodiments, flowable polymer compositions can comprise mol ratio For the 6-caprolactone of 30:70 to 70:30 with to dioxanone.

In various embodiments, tissue thickness's compensating part and flowable attachment part can comprise same polymerization Compositions, or polymer composition the most of the same race.In various embodiments, tissue thickness's compensating part and Flowable attachment part can comprise being total to of same bioabsorbable material, such as 6-caprolactone and Acetic acid, hydroxy-, bimol. cyclic ester Polymers (PCL/PGA).In various embodiments, tissue thickness's compensating part and flowable attachment part are in choosing Difference can be there is: material composition, modulus, elongation, solid from least one characteristic aspect of following characteristics There are viscosity, degree of crystallinity and Bioabsorbable.In various embodiments, tissue thickness's compensating part and can flowing Dynamic attachment part can comprise same copolymer, and this copolymer is at least one feature selected from following characteristics There is difference in aspect: material composition, modulus, elongation, intrinsic viscosity, degree of crystallinity and biological absorbable Property.Such as, tissue thickness's compensating part and flowable attachment part all can comprise PCL/PGA copolymer, This copolymer is in terms of the percentage by weight of 6-caprolactone and Acetic acid, hydroxy-, bimol. cyclic ester and/or 6-caprolactone and Acetic acid, hydroxy-, bimol. cyclic ester There is difference in mol ratio aspect.In at least one embodiment, tissue thickness's compensating part can comprise by weight The polymer composition of the PGA of meter about 50% and the combination of polymers of the PCL of by weight about 50% Thing, and flowable attachment part can comprise by weight about 64% PGA polymer composition and The polymer composition of the PCL of by weight about 36%.In at least one embodiment, tissue thickness Compensating part can comprise the PCL/PGA copolymer that mol ratio is 50:50 of 6-caprolactone and Acetic acid, hydroxy-, bimol. cyclic ester, and And flowable attachment part can comprise the PCL/PGA that mol ratio is 36:64 of 6-caprolactone and Acetic acid, hydroxy-, bimol. cyclic ester Copolymer.

In various embodiments, in the concentration of the 6-caprolactone in contact adhesive and tissue thickness's compensating part The concentration (both concentration is respectively based on the weight of polymer composition) of 6-caprolactone can differ at least 1 weight %.In various embodiments, the concentration of the 6-caprolactone in contact adhesive is mended with tissue thickness The concentration repaying the 6-caprolactone in part can differ at least 5 weight %.In various embodiments, pressure-sensitive adhesion The concentration of the 6-caprolactone in agent can differ at least with the concentration of the 6-caprolactone in tissue thickness compensating part 10 weight %.In various embodiments, the concentration of the 6-caprolactone in contact adhesive is mended with tissue thickness The concentration repaying the 6-caprolactone in part can differ at least 15 weight %.In various embodiments, pressure-sensitive viscous The concentration of the 6-caprolactone in mixture can differ with the concentration of the 6-caprolactone in tissue thickness compensating part 1 to 15 weight %.In various embodiments, the concentration of the 6-caprolactone in contact adhesive is mended with tissue thickness The concentration repaying the 6-caprolactone in part can differ 10 to 15 weight %.In various embodiments, pressure-sensitive viscous The concentration of the 6-caprolactone in mixture can differ 14 with the concentration of the 6-caprolactone in tissue thickness compensating part Weight %.In various embodiments, as it has been described above, the concentration of 6-caprolactone in contact adhesive may The concentration of the 6-caprolactone being different from tissue thickness's compensating part so that the 6-caprolactone in contact adhesive Concentration may be bigger than the concentration of the 6-caprolactone in tissue thickness compensating part or little.

In various embodiments, in the concentration of the polyglycolic acid in contact adhesive and tissue thickness's compensating part The concentration of polyglycolic acid can differ at least 1 weight %.In various embodiments, in contact adhesive The concentration of polyglycolic acid can differ at least 5 weights with the concentration of the polyglycolic acid in tissue thickness compensating part Amount %.In various embodiments, the concentration of the polyglycolic acid in contact adhesive and tissue thickness's compensating part In the concentration of polyglycolic acid can differ at least 10 weight %.In various embodiments, contact adhesive In the concentration of polyglycolic acid can differ at least 15 with the concentration of the polyglycolic acid in tissue thickness compensating part Weight %.In various embodiments, the concentration of the polyglycolic acid in contact adhesive compensates with tissue thickness The concentration of the polyglycolic acid in part can differ at least 20 weight %.In various embodiments, pressure-sensitive adhesion The concentration of the polyglycolic acid in agent can differ 1 weight with the concentration of the polyglycolic acid in tissue thickness compensating part Amount % to 20 weight %.In various embodiments, the concentration of the polyglycolic acid in contact adhesive and tissue The concentration of the polyglycolic acid in thickness compensation part can differ 15 weight % to 20 weight %.In various enforcements In example, the concentration of the polyglycolic acid in contact adhesive is dense with the polyglycolic acid in tissue thickness compensating part Degree can differ 16 weight %.In various embodiments, as it has been described above, PVOH in contact adhesive The concentration of acid likely differs from the concentration of the polyglycolic acid in tissue thickness's compensating part so that contact adhesive In the concentration of polyglycolic acid may be bigger than the concentration of the polyglycolic acid in tissue thickness compensating part or little.

In various embodiments, in the concentration of the 6-caprolactone in contact adhesive and tissue thickness's compensating part The concentration of 6-caprolactone can differ at least 1 mole of %.In various embodiments, in contact adhesive The concentration of 6-caprolactone can differ at least 5 with the concentration of the 6-caprolactone in tissue thickness compensating part and rub You are %.In various embodiments, the concentration of the 6-caprolactone in contact adhesive and tissue thickness's compensating part In the concentration of 6-caprolactone can differ at least 10 moles of %.In various embodiments, contact adhesive In the concentration of 6-caprolactone can differ at least 15 with the concentration of the 6-caprolactone in tissue thickness compensating part Mole %.In various embodiments, the concentration of the 6-caprolactone in contact adhesive compensates with tissue thickness The concentration of the 6-caprolactone in part can differ 1 mole of % to 15 mole of %.In various embodiments, pressure-sensitive The concentration of the 6-caprolactone in binding agent can differ with the concentration of the 6-caprolactone in tissue thickness compensating part 10 moles of % to 15 mole of %.In various embodiments, the concentration of the 6-caprolactone in contact adhesive 14 moles of % can be differed with the concentration of the 6-caprolactone in tissue thickness compensating part.In various embodiments In, as it has been described above, the concentration of the 6-caprolactone in contact adhesive likely differs from tissue thickness's compensating part In the concentration of 6-caprolactone so that the concentration of the 6-caprolactone in contact adhesive may compare tissue thickness The concentration of the 6-caprolactone in compensating part is big or little.

In various embodiments, in the concentration of the polyglycolic acid in contact adhesive and tissue thickness's compensating part The concentration of polyglycolic acid can differ at least 1 mole of %.In various embodiments, in contact adhesive The concentration of polyglycolic acid can differ at least 5 with the concentration of the polyglycolic acid in tissue thickness compensating part and rub You are %.In various embodiments, the concentration of the polyglycolic acid in contact adhesive and tissue thickness's compensating part In the concentration of polyglycolic acid can differ at least 10 moles of %.In various embodiments, contact adhesive In the concentration of polyglycolic acid can differ at least 15 with the concentration of the polyglycolic acid in tissue thickness compensating part Mole %.In various embodiments, the concentration of the polyglycolic acid in contact adhesive compensates with tissue thickness The concentration of the polyglycolic acid in part can differ at least 20 moles of %.In various embodiments, pressure-sensitive adhesion The concentration of the polyglycolic acid in agent can differ 1 with the concentration of the polyglycolic acid in tissue thickness compensating part and rub You are % to 20 mole of %.In various embodiments, the concentration of the polyglycolic acid in contact adhesive and tissue The concentration of the polyglycolic acid in thickness compensation part can differ 15 moles of % to 20 mole of %.In various enforcements In example, the concentration of the polyglycolic acid in contact adhesive is dense with the polyglycolic acid in tissue thickness compensating part Degree can differ 16 moles of %.In various embodiments, as it has been described above, PVOH in contact adhesive The concentration of acid likely differs from the concentration of the polyglycolic acid in tissue thickness's compensating part so that contact adhesive In the concentration of polyglycolic acid may be bigger than the concentration of the polyglycolic acid in tissue thickness compensating part or little.

In various embodiments, flowable polymer compositions can comprise other optional component, in order to enters One step improves machinability and/or the mechanical property of compositions, and other characteristics, such as cohesiveness, Light fastness aging, resistance to oxidative aging, heat-resistant aging and visual appearance.This type of optional component can include it His copolymer, flowable polymer compositions can comprise these other copolymers to obtain desired character, example If strengthening the tack with substrate or the compatibility.In various embodiments, this type of other optional component May include but be not limited to other polymer or copolymer, filler, cross-linking agent, viscosifier, plasticizer, face Material, dyestuff, antioxidant, coloring agent and stabilizer.In various embodiments, flowable polymer group Compound can comprise a certain amount of viscosifier, and its amount, based on the gross weight of polymer composition, is at least 0.1 Weight %, at least 2 weight % or at least 5 weight % up to 10 weight %, 25 weight % or 50 weights Amount %.In various embodiments, flowable polymer compositions can comprise a certain amount of plasticizer, its amount Based on the gross weight of polymer composition, it is at least 0.1 weight %, at least 2 weight % or at least 5 weights Amount % up to 10 weight %, 25 weight % or 50 weight %.

In various embodiments, flowable attachment part can include that flowable (plastically deformable) gathers Polymer composition.In various embodiments, (such as, 20 DEG C extremely in room temperature for flowable polymer compositions 25 DEG C) under generally can be tacky, and only to its apply modest pressure (such as finger pressure) just can be by it It is releasably attached to multiple substrate, is adhesively attached to substrate to be formed.In various embodiments, can flow Dynamic polymer composition is at up to 40 DEG C, up to 45 DEG C, up to 50 DEG C, up to 55 DEG C and/or many It is solid when reaching 60 DEG C.In various embodiments, flowable polymer compositions more than 40 DEG C, exceed 45 DEG C, will not melt more than 50 DEG C, more than 55 DEG C, more than 60 DEG C and/or more than 120 DEG C, but not Degraded.In various embodiments, flowable polymer compositions is up to 600 DEG C, is up to 500 DEG C, be up to 400 DEG C, be up to 300 DEG C, be up to 240 DEG C and/or be up to 180 DEG C all Melting and non-degradable.In various embodiments, flowable polymer compositions is at 40.1 DEG C to 600 DEG C Within the temperature range of, within the temperature range of 120 DEG C to 240 DEG C and/or at a temperature of 180 DEG C melting and Non-degradable.

In various embodiments, the feature of flowable polymer compositions can be: said composition 0.1g/dL hexafluoroisopropanol solution intrinsic viscosity at 25 DEG C is 0.6g/dL to 4.0g/dL, 0.8g/dL To 3.2g/dL, 1.0g/dL to 2.4g/dL and/or 1.6g/dL.In various embodiments, flowable poly- Polymer composition can not comprise gel.

In various embodiments, the one or many during flowable polymer compositions can possess following characteristic Kind: percent crvstallinity is less than about 25%, less than about 15%, and from 15% to 25%；Elongation hundred Proportion by subtraction is greater than about 200, greater than about 500, and from about 200 to about 500；And modulus is less than about In the range of 276MPa, less than about 138MPa, or about 138MPa to about 276MPa (about 40,000psi, less than about 20,000psi, or about 20,000psi to about 40,000psi).

In various embodiments, flowable attachment part can include the surface being attached to tissue thickness's compensating part And/or the one in the bar at edge, ribbon, band volume, tablet and membranoid substance.In various realities Executing in example, flowable attachment part can include pressure sensitive adhesive tape, and this pressure sensitive adhesive tape includes binding agent and backing. In various embodiments, during backing can include flexible backing material and non-deflection back lining materials Kind.The example of flexible backing material is including but not limited to plastic foil such as polypropylene, polyethylene, polychlorostyrene second Alkene, polyester (polyethylene terephthalate), Merlon, polymethyl methacrylate (PMMA), cellulose acetate, Triafol T and ethyl cellulose.Foam-back can be used. The example of deflection back lining materials does not includes but not limited to metal, metallized polymeric film, coating Indium sesquioxide. The glass of stannum and polyester, PMMA plate, polycarbonate plate, glass or ceramic sheet material.In various enforcements In example, pressure sensitive adhesive tape can include release liner.In various embodiments, by removing release liner thus Expose binding agent, pressure sensitive adhesive tape can be used.

In various embodiments, can use conventional coating techniques such as roller coat, flow coat, dip-coating, spin coating, Flowable attachment part is applied to tissue thickness's compensating part by spraying, blade coating and extrusion coated.In various realities Executing in example, flowable attachment part can such as have the about 1.25mm original depth to about 1.50mm. In certain embodiments, flowable attachment part can such as have the initial of about 0.5mm to about 0.75mm Thickness.In various embodiments, when applying pressure to flowable attachment part, it is final that it can have Thickness is the most at least 0.25mm.

In various embodiments, seeing Figure 26 3, flowable attachment part 30000 can include along tissue thickness The continuous strip of the longitudinally intermediate setting of a part of degree compensating part 30010 central shaft.The width of this band can It is for example, at least 1mm.The width of this band can be such as between about 0.5mm and about 1.5mm.Should The width of band can be such as between about 1.0mm and about 1.25mm.Flowable attachment part 30000 Primary importance can be spaced apart with anvil block 30020, and the first profile of flowable attachment part 30000 Neutrality (original) profile can be included.As shown in Figure 26 4, flowable attachment part 30000 can be with anvil block Space 30025 (slit such as, being such as centrally located) alignment in 30020.Such as Figure 26 5 institute Show, when applying, to flowable attachment part 30000, the pressure reaching threshold level, flowable attachment Divide 30000 can flow in slit 30025, firmly to engage with anvil block 30020.Flowable attachment part 30000 can be by least some of filling of slit 30025 so that flowable attachment part 30000 can be in The shape of existing slit 30025.The second position of flowable attachment part 30000 can connect with anvil block 30020 Touch, and the second profile of flowable attachment part 30000 can include and the wheel of slit 30025 complementation Wide.Tissue thickness's compensating part 30010 can be releasably attached to anvil block by flowable attachment part 30000 30020。

In various embodiments, seeing Figure 26 6, flowable attachment part 30000 can include two along group Knit the continuous strip that a part for thickness compensation part 30010 is longitudinally disposed and parallel to each other.The width of this band Degree can be for example, at least 1mm.The width of this band can such as between about 0.5mm and about 1.5mm it Between.The width of this band can be such as between about 1.0mm and about 1.25mm.Two separate bands Can be spaced apart with the central shaft of tissue thickness compensating part 30010 and lateral edges.The relief width of each interband Degree can be for example, at least 1mm, and each band gap width intermarginal with side can be for example, at least 1mm.The ratio in binding agent and adhesive-free space can be such as between about 1:4 and about 1:2.Binding agent Can be for example, at least 1:10 with the ratio in adhesive-free space.In all cases, binding agent and adhesive-free The ratio in space can be 0.In some cases, it may be desirable to constant layer is across whole surface.Flowable attachment The primary importance of part 30000 can be spaced apart with anvil block 30020, and flowable attachment part 30000 The first profile can include neutrality (original) profile.As shown in Figure 26 7, flowable attachment part 30000 can such as be directed at nail chamber 30030.As shown in Figure 26 8, when to flowable attachment part When 30000 applyings reach pressure (the such as finger pressure) of threshold level, flowable attachment part 30000 can flow into nail chamber 30030, are then formed with anvil block 30020 and firmly engage.Flowable attachment 30000 are divided can at least some of of nail chamber 30030 to fill so that the meeting of flowable attachment part 30000 Can be in the shape in nail chamber 30030.That follows closely chamber 30030 can be free of flowable attachment part at least partially 30000.The second position of flowable attachment part 30000 can contact with anvil block 30020, and can flow Second profile of dynamic attachment part 30000 can include and the profile of nail chamber 30030 complementation.Flowable attachment Tissue thickness's compensating part 30000 can be releasably attached to anvil block 30020 by part 30000.

In various embodiments, referring now to Figure 26 9 to Figure 27 3, can such as use nail bin application device The nail bin 30100 including support section 30102 and tissue thickness's compensating part 30110 is loaded into by 30140 In staple cartridge channel.In various embodiments, nail bin application device 30140 is except determining nail bin 30100 Position, in staple cartridge channel, can be also structured to make top tissue thickness compensation part 30110 relative to anvil Seat 30120 location.Nail bin application device 30140 can include can being releasably engaged with lock protuberance Hammerlock 30141, wherein lock protuberance extends from the support section 30102 of nail bin 30100 so that nail bin Application device 30140 is positively retained at the suitable position above tissue thickness's compensating part 30110 of nail bin 30100 Put.In various embodiments, top tissue thickness compensation part 30110 can be removably attached to nail bin Application device 30140 so that the anvil block 30120 of surgical instruments can close on application device 30140, Engage with tissue thickness compensating part 30110, and make tissue thickness's compensating part 30110 and nail bin use dress Put 30140 separation.In various embodiments, tissue thickness's compensating part 30110 and/or anvil block 30120 can Including one or more holding feature structures, this holding feature structure may be structured to can be by tissue thickness Compensating part 30110 releasably holds anvil block.In various embodiments, feature structure is kept to include Adhesive sheet and/or binding agent tab 30112.

In various embodiments, adhesive sheet and/or binding agent tab can be with tissue thickness compensating parts 30110 A part be integrally formed.In various embodiments, tissue thickness's compensating part 30110 can be along its edge bag Include at least one binding agent tab 30112.Binding agent tab 30112 can include release liner 30113. See Figure 27 1, anvil block 30120 can be moved to make position, to engage tissue thickness's compensating part 30110.Then, removable release liner 30113, to expose the binding agent table of binding agent tab 30112 Face.It follows that see Figure 27 2 and Figure 27 3, the first end of binding agent tab 30112 can be fixed The second end to anvil block and by binding agent tab 30112 is fixed to anvil block, tissue thickness to be compensated Part 30110 is releasably attached to anvil block.Can towards distally tractive binding agent tab 30112, with Tissue thickness's compensating part 30110 is separated from nail bin application device 30140.After completing aforesaid operations, can By anvil block and nail bin 30100 relative to the to be stapled and/or tissue positioned of incision.Then, clinician Can tractive binding agent tab 30112 so that tissue thickness's compensating part 30110 from anvil block separate.

Seeing Figure 28 4 to Figure 28 8, in various embodiments, tissue thickness's compensating part 30210 can be along it Distal side edge includes at least one binding agent tab 30212.Binding agent tab 30212 can include release liner Layer 30213.As described herein, nail bin application device 30240 may be structured to can be thick by top tissue Degree compensating part 30210 positions relative to anvil block 30220.Removable release liner 30213, viscous to expose The adhesive surface of mixture tab 30212.Binding agent tab 30212 can be turned down, and secure it to Anvil block 30220, so that tissue thickness's compensating part 30210 is releasably attached to anvil block 30220.Then can towards distally tractive binding agent tab 30212 so that tissue thickness's compensating part 30210 from Nail bin application device 30240 separates.Then, can be by anvil block 30220 and nail bin 30200 relative to waiting to stitch Close and/or the tissue positioned of incision.See Figure 28 9 to Figure 29 0, in use, can by firing member Nail deployment sliding part is advanced through nail bin towards distally, blade 30211 can be advanced through tissue then thick Degree compensating part 30210, in order to cut at least some of of binding agent tab 30212, and make tissue thick Degree compensating part 30210 is gradually disengaged from anvil block 30220.Clinician can be at new nail bin of reloading Before 30200, the remainder of binding agent tab 30212 is pulled away from anvil block 30220.

In various embodiments, adhesive sheet and/or binding agent tab can divide with tissue thickness's compensating part Open.See Figure 27 4 to Figure 27 6, at least one embodiment, can be by binding agent tab 30312 (referring also to Figure 28 8 and Figure 29 2) be arranged on nail bin 30300 and tissue thickness's compensating part 30310 it Between.Tissue thickness's compensating part 30310 can include recess 30311, and the size of this recess is configured to can And it is configured to coordinate with binding agent tab 30312, with by releasable for tissue thickness's compensating part 30310 Remain to anvil block 30320.Can be solid adjacent to recess 30311 by the first end of binding agent tab 30312 Surely arrive tissue thickness's compensating part 30310, and the second end of binding agent tab 30312 can be fixed to Anvil block 30320.As shown in Figure 27 7, the non-engagement recesses of binding agent tab 30,312 30311.Hereafter, Anvil block 30320 and nail bin 30300 can be positioned relative to be stapled and/or incision tissue T.

As it has been described above, in use, nail can be disposed sliding part by firing member and be advanced through towards distally Nail bin, in order to as outlined above, nail is penetrated from nail bin.When nail deformation, each nail can be by group Knit the part capture of thickness compensation part so that it is against tissue top surface.Meanwhile, firing member Blade can be advanced through tissue thickness's compensating part 30310, the most at least one embodiment, blade Tissue thickness's compensating part 30310 can be advanced through, so that tissue thickness's compensating part 30310 is transported towards distally Dynamic, and make binding agent tab 30312 right with recess 30311 as shown in Figure 27 7 to Figure 27 9 Accurate, in order to make blade cut tissue thickness's compensating part 30310, and make tissue thickness's compensating part 30310 Separate from anvil block 30320.In various embodiments, when following closely by staple drivers as described above from it Non-firing position when moving to their firing position, the tissue thickness's compensating part without recess 30310 can move downward, as shown in Figure 28 0 and Figure 28 1, with separating adhesive tab 30312, and And tissue thickness's compensating part 30310 is separated from anvil block 30320.After disposing nail, can be again turned on Anvil block 30320, and move, as shown in Figure 28 3 away from the tissue thickness's compensating part 30310 implanted. By comparison diagram 282 and Figure 28 3, reader is it will be appreciated that tissue thickness's compensating part 30310 can be described above It is fastened to tissue T, and the incision of cut component like that.

In various embodiments, by removing the first release liner from the first binding agent tab, thus expose Flowable attachment part (such as comprises contact adhesive), can use flowable attachment part.Then may be used First binding agent tab is rolled on the outer surface of substrate, or in other ways the first binding agent is dashed forward Sheet is pressed on the outer surface of substrate.Then the second release liner can be removed from the second binding agent tab, from And exposed pressure sensitive adhesive.Second binding agent tab now can be pressed into the outer surface and/or of substrate On one binding agent tab.After once contact adhesive being applied to tissue thickness's compensating part, it is just placed With contact nail bin and/or anvil block.Tissue thickness's compensating part can be fixed to substrate by contact adhesive.

Various embodiments described herein is described in the context of nail, and these nails are removably deposited Storage, in nail bin, is used together with surgery suturing appliance.In some cases, nail can include wire rod, should Wire rod can deform when contacting the anvil block of surgical stapling device.This type of wire rod can (such as) by metal (such as Rustless steel) and/or any other suitable material composition.This type of embodiment and its teachings can be applied In including the embodiment of securing member, this securing member is removably stored in fastener cartridge, with any properly Fastening instrument be used together.

Various embodiments described herein be attached to nail bin and/or fastener cartridge and/or with nail bin and/or The context of tissue thickness's compensating part that fastener cartridge is used together is described.This type of tissue thickness is mended Repay tissue thickness's change that part can be used for compensating from one end of nail bin to the other end, or be used for compensating capture and exist Tissue thickness in one nail or securing member is than the tissue thickness captured in another nail or securing member Change.This type of tissue thickness's compensating part can be additionally used in the tissue thickness compensated from the side of nail bin to opposite side Change.This type of embodiment and teachings thereof can be applicable to include to be attached to nail bin and/or fastener cartridge, And/or the embodiment of the one or more material layers being used together with nail bin and/or fastener cartridge.This material The bed of material can include buttress material.

Various embodiments described herein is at linear end effector and/or the context in linear fastener storehouse In be described.This type of embodiment and teachings thereof can be applicable to nonlinear end executor and/or Non-linear fastener cartridge, the most circular and/or contoured end effector.Such as, various ends Executor, including nonlinear end executor, is being filed on February 28th, 2011, entitled The U.S. Patent Application Serial Number of " SURGICAL STAPLING INSTRUMENT " 13/036,647 (now for U.S. Patent Application Publication 2011/0226837) there are disclosure, this patent application It is incorporated by reference in its entirety accordingly herein.It addition, be filed in the entitled of JIUYUE in 2012 29 days The U.S. Patent Application Serial Number 12/893,461 of " STAPLE CARTRIDGE " (is now that the U.S. is special Profit application discloses 2012/0074198) it is incorporated by reference in its entirety accordingly herein.It is filed in 2008 Entitled " the END EFFECTORS FOR A SURGICAL CUTTING AND on February 15 STAPLING INSTRUMENT " U.S. Patent Application Serial Number 12/031,873 (be now the U.S. Patent 7,980,443) it is incorporated by reference in its entirety the most accordingly herein.

According to stating any patent, announcement or other the open materials in full or being partly expressly incorporated herein with way of reference Material be all only at be incorporated to material not with the existing definition described in the disclosure, statement or other open material phases It is expressly incorporated herein in the range of conflict.Therefore, in the case of necessary, the disclosure being expressly recited herein May replace any material being incorporated by reference this paper conflicted therewith.Any evidence is stated with way of reference also Enter herein but with existing definition as herein described, statement or other open afoul any materials of material or Its part, is incorporated to this under the degree only not producing conflict between the material being incorporated to and existing open material Literary composition.

Although invention was described as having exemplary design, but can be in the spirit and scope of the disclosure The present invention is revised further.Therefore the application is intended to use any of its general principles Modification, purposes or modified version.Additionally, the application is intended in art of the present invention belong to known Or the used pattern different from the disclosure having in practical framework.

Claims (22)

1., for an end effector for surgical stapling device, described end effector includes:

First jaw member, wherein said first jaw member includes proximal end and distal end；

Nail bin, described nail bin is relative to described first jaw member layout, and wherein said nail bin includes The nose part arranged relative to the described distal end of described first jaw member；

Layer, described layer is arranged relative to described nail bin, and wherein said layer includes main body and from described master The distal end portion that body extends, and the described distal end portion of wherein said layer and described nail The described nose part in storehouse is releasably engaged；

Cutting element, described cutting element relative to described nail bin described nose part arrange, its Described in cutting element can move between the first position and the second position, with at described distal end portion Portion's part nearside cuts described layer so that the described main body of described layer is partially disengaged from described nose； And

Firing member, described firing member is configured to engage described cutting element so that institute State cutting element to move between described primary importance and the described second position.

End effector the most according to claim 1, wherein said firing member can be described first Transport between described proximal end and the described distal end of described first jaw member of jaw member It is dynamic, so that described cutting element is moved to the described second position from described primary importance.

End effector the most according to claim 1, the described nose part of wherein said nail bin includes Antelabium, described antelabium is configured to keep the described distal end portion of described layer, Qi Zhongsuo State antelabium limit gap, the described distal end portion confining layers thickness of wherein said layer, and its Described in layer thickness more than described gap.

End effector the most according to claim 1, the described nose part of wherein said nail bin includes Post, and the described distal end portion restriction hole of wherein said layer, described hole receives described post.

End effector the most according to claim 1, wherein said nail bin includes multiple nail chamber, and Wherein said end effector also includes the multiple nails being positioned at described nail intracavity.

End effector the most according to claim 1, wherein said firing member include staple drivers and At least one in tissue cutter.

End effector the most according to claim 1, it is logical that the restriction of wherein said nail bin passes through Road, and wherein said passage is configured to receive described firing member.

End effector the most according to claim 1, wherein said nail bin limits cutting element chamber, its Described in cutting element be positioned in described cutting element intracavity when being in described primary importance, and And wherein said cutting element when being in the described second position at least in part from described cutting element Chamber highlights.

9. the nail bin used in surgical stapling device, described surgical stapling device include having proximal end and First jaw member of distal end, endoscopic surgical stiching instrument includes firing member, described in hit Sending out component, be configured to can be along described first jaw member in described proximal end and described distally Moving between end, described nail bin includes:

Warehouse, wherein said warehouse is configured to be operatively engaged described surgical stapling device Described first jaw member, wherein said warehouse includes following closely platform and nose part, wherein said storehouse Body limits the passage passed through, and wherein said nail platform includes and the slit of described channel connection, And wherein when described warehouse engages with described first jaw member of described surgical stapling device, institute State passage and be configured to receive the described firing member of described surgical stapling device；

Layer, described layer is arranged relative to described nail platform, and wherein said layer includes main body and from described The distal end portion that main body extends, and the described distal end portion of wherein said layer is with described The described nose part of nail bin is releasably engaged；And

Cutting element, described cutting element relative to described nail bin described nose part arrange, its Described in cutting element can move between the first position and the second position, with at described distal end portion Portion's part nearside cuts described layer so that when the described firing member of described surgical stapling device is described Between described proximal end and the described distal end of described first jaw member of the first jaw member During motion, the described main body of described layer is partially disengaged from described nose.

Nail bin the most according to claim 9, the described nose part of wherein said nail bin includes lip Edge, described antelabium is configured to keep the described distal end portion of described layer, Qi Zhongsuo State antelabium limit gap, the described distal end portion confining layers thickness of wherein said layer, and Wherein said layer thickness is more than described gap.

11. nail bins according to claim 9, the described nose part of wherein said nail bin includes post, And the described distal end portion of wherein said layer limits hole, described hole receives described post.

12. nail bins according to claim 9, wherein said nail bin includes multiple nail chamber, and wherein Described nail bin also includes the multiple nails being positioned at described nail intracavity.

13. nail bins according to claim 9, wherein said firing member includes staple drivers and tissue At least one in cutter.

14. nail bins according to claim 9, wherein said nail bin limits the passage passed through, and And wherein said passage is configured to receive described firing member.

15. nail bins according to claim 9, wherein said nail bin limits cutting element chamber, Qi Zhongsuo State cutting element and be positioned in described cutting element intracavity when being in described primary importance, and Wherein said cutting element when being in the described second position at least in part from described cutting element Chamber highlights.

16. 1 kinds of fastener cartridge, including:

Warehouse, described warehouse includes platform；

Multiple securing members, the plurality of securing member is positioned at least partially in described warehouse；

Firing member, described firing member is configured to move along percussion path, so that Each described securing member moves between non-firing position and firing position；

Layer, described layer positions on the platform；And

Cutting element, described cutting element can the most transversely Moving to cut described layer in direction, wherein said horizontal direction is transverse to described percussion path.

17. fastener cartridge according to claim 16, wherein said firing member is configured to can be Move between described primary importance and the described second position described cutting element.

18. fastener cartridge according to claim 17, wherein said percussion path limit first end and The second end, wherein said percussion path starts and at described second end at described first end Terminate at portion, and wherein said cutting element is positioned at described the second end.

19. fastener cartridge according to claim 16, wherein said layer includes tissue thickness's compensating part, Described tissue thickness compensating part is installed to described warehouse at described the second end.

20. fastener cartridge according to claim 16, wherein said horizontal direction is perpendicular to described percussion Path.

21. 1 kinds of fastener cartridge, including:

Warehouse, described warehouse includes platform；

Multiple securing members, the plurality of securing member is positioned at least partially in described warehouse；

Compressible stratum, described compressible stratum positions on the platform, the most each described fastening Part can be deployed in and not fire between configuration and percussion configuration to capture described compressible stratum wherein At least some of, and wherein said compressible stratum includes the installed part that is installed to described warehouse Part；

First cutting element, described first cutting element is configured to can be horizontal along percussion path Cutting described compressible stratum, described percussion path extends the most in a first direction；And

Second cutting element, described second cutting element is configured to exist along disjoint paths Crosscutting described compressible stratum in second direction, wherein said second direction is with described first direction not With.

22. 1 kinds of fastener cartridge, including:

Warehouse, described warehouse includes:

Proximal end；

Distal end；With

Platform, described platform is positioned in the middle of described proximal end and described distal end；

Multiple securing members, the plurality of securing member is positioned at least partially in described warehouse；

Compressible stratum, described compressible stratum positions on the platform, the most each described securing member Can be deployed in and not fire between configuration and percussion configuration to capture described compressible stratum wherein extremely A part, and wherein said compressible stratum less includes the installed part part being installed to described warehouse；

Percussion sliding part, described percussion sliding part can be from described proximal end towards described distal end portion Portion moves, not fire, described, the described securing member that moves between configuration and described percussion configuration； And

Cutting element, described cutting element is configured to can be crosscutting described from described compressible stratum Installed part part, wherein when described percussion sliding part is close to described distal end, described cutting Component can be activated by described percussion sliding part.