CN105939675B - 用于外科缝合中的杂化辅助材料 - Google Patents

用于外科缝合中的杂化辅助材料 Download PDF

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CN105939675B
CN105939675B CN201480061193.XA CN201480061193A CN105939675B CN 105939675 B CN105939675 B CN 105939675B CN 201480061193 A CN201480061193 A CN 201480061193A CN 105939675 B CN105939675 B CN 105939675B
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F·E·谢尔顿四世
T·S·威登豪斯
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Abstract

本文提供了与类似于外科缝合装置的端部执行器一起使用的可植入材料以及与此类端部执行器的操作相关的方法。在一种示例性实施方案中，钉仓组件包括仓体和杂化辅助材料。所述仓体具有多个钉腔，所述钉腔被构造成能够在其中安置钉。所述杂化辅助材料可释放地保持在所述仓体上并且被构造成能够通过所述仓体中的所述钉的部署来递送到组织。所述材料包括生物组织膜、合成基底层、和至少一个可压缩弹性构件，所述至少一个可压缩弹性构件被构造成能够在对其施加压缩力时压缩并且能够在移除所述压缩力时提供回弹力。还提供了用于外科缝合的其他植入物、装置、和方法。

Description

用于外科缝合中的杂化辅助材料
技术领域
本发明涉及外科器械，具体地讲，涉及用于切割和缝合组织的方法、装置及其部件。
背景技术
外科缝合器用于外科手术中，以闭合特定手术中所涉及的组织、血管、导管、分流管、或者其他对象或身体部分中的开口。开口可为天然存在的，诸如血管或类似于胃的内部器官中的通道，或者它们可为在外科手术期间由外科医生形成的，诸如通过穿刺组织或血管以形成旁路或吻合或通过在缝合手术期间切割组织。
大多数缝合器具有柄部，该柄部具有细长轴，该细长轴具有形成于其端部上的一对可移动的相对的钳口，以用于在钳口之间保持钉并且使钉成形。钉通常容纳在钉仓中，该钉仓可容纳多排钉并且通常设置在两个钳口中的一者中以用于将钉射出到手术部位。在使用期间，钳口被定位成使得待缝合的对象设置在钳口之间，并且在钳口闭合并且装置致动时使钉射出并且成形。一些缝合器包括刀，该刀被构造成能够在钉仓中的钉排之间行进，以纵向地切割并且/或者打开钉排之间的已缝合组织。
尽管外科缝合器已经过多年改善，但它们自身仍存在多个问题。一个常见问题是当钉穿透组织或其中设置钉的其他对象时可因钉形成孔而产生渗漏。血液、空气、胃肠液、和其他流体可通过由钉形成的开口而渗出，甚至是在钉完全成形之后。经处理的组织也可因由缝合引起的创伤而发炎。此外，可结合类似于缝合的手术来植入的钉、以及其他对象和材料通常缺乏它们所植入的组织的一些特征。例如，钉以及其他对象和材料可缺乏它们所植入的组织的天然柔韧性。本领域的技术人员应当认识到，通常期望组织在钉设置其中后保持其尽可能多的天然特征。
在一些情况下，生物材料已结合组织缝合来使用。然而，生物材料的使用已呈现出多个问题。例如，生物制剂可缺乏期望的机械性能，诸如，弹性或弹力(即，它们在被压缩之后不恢复或回弹)。生物制剂可缺乏充分地增强手术部位处的组织的能力。此外，有时可难以或者甚至不可能将生物材料制备成精确的所需形状和/或厚度(例如，用以补偿组织厚度的变化，这可仅在手术时才知道)。
因此，仍需要改善的装置和方法，以用于缝合组织、血管、导管、分流管、或者其他对象或身体部分，使得渗漏和发炎最小化同时仍基本上保持治疗区域的天然特征。
发明内容
在各种方面和实施方案中，本发明提供了与类似于外科缝合装置的端部执行器一起使用的可植入材料以及与此类端部执行器的操作相关联的方法。
在一个方面，本发明提供了包括仓体和杂化辅助材料的钉仓组件。仓体具有多个钉腔，所述钉腔被构造成能够在其中安置钉。杂化辅助材料可释放地保持在仓体上并且被构造成能够通过仓体中的钉的部署来递送到组织。所述材料包括生物组织膜、合成基底层、和至少一个可压缩弹性构件，所述至少一个可压缩弹性构件被构造成能够在对其施加压缩力时压缩并且能够在移除压缩力时提供回弹力。
在另一个方面，本发明提供了杂化辅助材料，所述杂化辅助材料包括生物组织膜、合成基底层、和至少一个可压缩弹性构件，所述至少一个可压缩弹性构件被构造成能够在对其施加压缩力时压缩并且能够在移除压缩力时提供回弹力。此外，所述材料被构造成能够可释放地保持在外科缝合器仓体上，以用于在从仓体部署钉时递送到组织。
在另一个方面，本发明提供了用于缝合生物组织的方法。所述方法包括使组织与外科缝合器仓体在手术部位处接合，所述仓体具有可释放地保持在其上的杂化辅助材料，所述材料包括生物组织膜、合成基底层、和至少一个可压缩弹性构件，所述至少一个可压缩弹性构件被构造成能够在对其施加压缩力时压缩并且能够在移除压缩力时提供回弹力。所述方法还包括致动外科缝合器以使钉从仓体射入生物组织中，所述钉延伸穿过所述材料以将所述材料保持在手术部位处。
在各种实施方案中，本发明设想到上述各个方面与下文的特征结构中的任何一个或多个的全部功能组合(外加本文所述的其他方面和实施方案)。
在各种实施方案中，所述材料为可生物植入的和可生物吸收的。
在各种实施方案中，弹性构件设置在生物组织膜和合成基底层之间。另选地，弹性构件可设置在生物组织膜和合成基底层的一者或两者中。
在各种实施方案中，所述组件包括被构造成能够将所述材料联接到仓体的至少一个保持构件。所述至少一个保持构件可联接到仓体的外边缘以及生物组织膜和合成基底层的至少一者的外边缘。所述至少一个保持构件可包括缝合线。
在各种实施方案中，膜可包括生物基质。
在各种实施方案中，可压缩弹性构件包括合成的可生物吸收材料。合成的可生物吸收材料可为尼龙、聚丙烯、聚二氧六环酮、聚甘油癸二酸酯(PGS)、PGA(聚乙醇酸)、PCL(聚己内酯)、PLA或PLLA(聚乳酸)、PHA(聚羟基链烷酸酯)、PGCL(聚卡普隆25)、丙交酯乙交酯共聚物910、聚葡萄糖酸脂、PGA/TMC(聚乙交酯-三亚甲基碳酸酯)、聚羟基丁酸酯(PHB)、聚(乙烯吡咯烷酮)(PVP)、聚(乙烯醇)(PVA)、或它们的组合。
在各种实施方案中，可压缩弹性构件可包括在所述材料的至少一个维度上以正弦形式延伸的至少一个构件。可压缩弹性构件还可包括在所述材料的长度维度和宽度维度中的至少一者上延伸的多个正弦构件。
在各种实施方案中，可压缩弹性构件包括被构造成能够将膜固定到弹性构件的一个或多个表面特征结构。所述一个或多个表面特征结构可选自包括球形端帽、架、倒钩、以及它们的组合的组。
在各种实施方案中，可压缩弹性构件包括球形、卵形、半球形、穹顶形、插孔形、或三维辐射状形式中的一个或多个。
附图说明
根据以下具体实施方式并结合附图可更全面地理解本发明，附图中：
图1为具有附接到其远侧端部的附接部分的外科器械的一个示例性实施方案的透视图；
图2为图1的外科器械的透视图，其中附接部分与器械的轴脱离；
图3为包括至少一块辅助材料的图2的附接部分的透视图；
图4为图3的端部执行器的分解透视图，其中辅助材料被去除；
图5为与图4的端部执行器一起使用的钉仓的远侧端部的详细透视图；
图6为沿图5中所示的剖面线截取的侧剖视图；
图7为图5的钉仓的底部透视图；
图8为图4的外科器械的致动滑动件、推动器、和紧固件的详细透视图；
图9为用于外科器械的附接部分的另一个示例性实施方案的透视图；
图10为图9的附接部分的端部执行器的分解透视图；
图11与图4的端部执行器一起使用的驱动组件的分解图；
图12为图3的端部执行器的下钳口的透视图；
图13为图3的端部执行器的上钳口的透视图，所述上钳口具有与其相联的辅助材料；
图14为包括被构造成能够可释放地保持辅助材料的保持构件的图2的端部执行器的部分的透视图；
图15为图10的端部执行器的下钳口的透视图；
图16为根据本发明的具有杂化辅助材料的示例性钉仓的透视图。
图17-19为示出生物组织增强膜与仓体和示例性可压缩弹性构件的示例性附接的透视图。
图20A-20C为图17-19所示的可压缩弹性构件的变型的分解图。
图21-23为示出图16的示例性钉仓的操作的剖视图。
具体实施方式
现在将描述某些示例性实施方案，以从整体上理解本文所公开的装置和方法的结构、功能、制造和用途原理。这些实施方案的一个或多个示例已在附图中示出。本领域技术人员应当理解，本文具体描述并在附图中示出的装置和方法是非限制性的示例性实施方案，并且本发明的范围仅由权利要求书限定。结合一个示例性实施方案进行图解说明或描述的特征结构可与其他实施方案的特征结构进行组合。这些修改和变型旨在涵盖于本发明的范围之内。此外，在本公开中，各种实施方案的类似编号的部件通常具有类似的特征，此时这些部件具有类似的特性并且/或者用于类似的目的。
本说明书通篇提及的“各种实施方案”、“一些实施方案”、“一个实施方案”或“实施方案”等，意指结合实施方案描述的具体特征、结构或特性包括在至少一个实施方案中。因此，本说明书通篇出现的短语“在各种实施方案中”、“在一些实施方案中”、“在一个实施方案中”或“在实施方案中”等并不一定均指相同的实施方案。此外，在一个或多个实施方案中，具体特征、结构或特性可以任何合适的方式组合。因此，在无限制的情形下，结合一个实施例示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其它实施例的特征、结构或特性组合。这些修改和变型旨在包括在本发明的范围之内。
本文所用术语“近侧”和“远侧”是相对于操纵外科器械的柄部部分的临床医生而言的。术语“近侧”是指最靠近临床医生的部分，术语“远侧”则是指远离临床医生定位的部分。还应当理解，为简洁和清楚起见，本文可结合附图使用例如“竖直”、“水平”、“上”和“下”之类的空间术语。然而，外科手术器械在许多方向和位置中使用，并且这些术语并非限制性的和/或绝对的。
提供各种示例性装置和方法以执行腹腔镜式和微创外科手术操作。然而，本领域的技术人员将理解，本文所公开的各种方法和装置可用于许多外科手术和应用中。本领域中的技术人员将进一步理解，本文所公开的各种器械可以任何方式插入体内，例如通过自然腔道、通过形成于组织中的切口或穿刺孔、或通过进入装置，例如套管针插管。例如，器械的工作部分或端部执行器部分可直接插入患者体内或可通过具有工作通道的进入装置插入，外科器械的端部执行器和细长轴可通过所述工作通道推进。
可期望使用一种或多种生物材料和/或合成材料(在本文中统称为“辅助材料”)来与外科器械结合以有助于改善外科手术。本领域的技术人员可称这些类型的材料为辅助材料。尽管多种不同的端部执行器可受益于辅助材料的使用，但在一些示例性实施方案中，端部执行器可为外科缝合器。当与外科缝合器一起使用时，辅助材料可设置在缝合器的钳口之间和/或之上，结合到设置在钳口中的钉仓中，或以其他方式设置成邻近钉。当钉被部署时，辅助材料可利用钉保持在治疗部位处，这继而提供多个有益效果。在一些情况下，所述材料可用于在钉被植入组织、血管、和各种其他对象或身体部分中时有助于密封由钉形成的孔。另外，所述材料可用于提供治疗部位处的组织增强。此外，所述材料可有助于减少发炎，促进细胞生长，并且以其他方式改善愈合。
辅助材料的一些构型包括合成材料和生物材料。这两种材料的组合可导致杂化辅助材料的形成。杂化辅助材料在被适当地设计和/或选择时可在单个杂化辅助材料中组合合成材料的有益特征和生物材料的有益特征。因此，当在其他方面有利的生物材料可缺乏也有利的机械(或其他)特性时，将生物材料与提供机械(或其他)特性的合成材料组合在一起可提供具有两种有利特性的杂化辅助材料。例如，杂化辅助材料可被设计成将生物材料的有益效果(诸如，手术部位处的改善的愈合和组织向内生长)与合成材料的有利机械特性(诸如，所得杂化辅助材料中的弹性或弹力)组合在一起。
外科缝合器械
尽管多种外科器械可与本文所公开的辅助材料一起使用，但图1和图2示出了适于与一种或多种辅助材料一起使用的外科缝合器10的一个、非限制性示例性实施方案。如图所示，器械10包括柄部组件12、从柄部组件12的远侧端部12d朝远侧延伸的轴14、和可移除地联接到轴14的远侧端部14d的附接部分16。由于例示的实施方案为外科缝合器，因此附接部分16的远侧端部16d包括具有钳口52、54的端部执行器50，但其他类型的端部执行器可与轴14、柄部组件12、和与它们相联的部件一起使用。如图所示，外科缝合器包括相对的第一钳口52和第二钳口54，其中第一、下钳口52包括被构造成能够支撑钉仓100的细长通道56(图4)，并且第二、上钳口54具有面向下钳口52并且被构造成能够充当砧座以有助于部署钉仓的钉的内表面58(图3、图4和图6)。钳口52、54被构造成能够相对于彼此移动以夹持设置于其间的组织或其他对象，并且轴向驱动组件80(图11)被构造成能够穿过端部执行器50的至少一部分以将钉射入夹持的组织中。在各种实施方案中，刀片81可与轴向驱动组件80相联，以在缝合手术期间切割组织。
端部执行器50和驱动组件80的操作可利用来自临床医生在柄部组件12处的输入来开始。柄部组件12可具有被设计用于调控和操作与其相联的端部执行器的许多不同构型。在例示的实施方案中，柄部组件12具有手枪抓握型外壳18，所述手枪抓握型外壳18具有设置于其中的各种机械部件以操作该器械的各种特征结构。例如，柄部组件12可包括机械部件以作为通过触发器20致动的击发系统的一部分。触发器20可例如通过扭转弹簧而相对于固定式柄部22被偏压到打开位置，并且触发器20朝固定式柄部22的运动可致动击发系统以导致轴向驱动组件80穿过端部执行器50的至少一部分并且从设置于其中的钉仓射出钉。本领域的技术人员应当认识到击发系统的可用于射出钉和/或切割组织的各种部件构型(机械的或其他方式)，并且因此对其的详细解释为不必要的。
可结合到柄部组件22中的影响与其相联的端部执行器的调控和操作的特征结构的其他非限制性示例包括可旋转旋钮24、关节运动杠杆26、和回缩钮28。如图所示，可旋转旋钮24可安装在柄部组件12的圆筒部分30的前端部上，以有利于轴14(或附接部分16)相对于柄部组件12围绕轴14的纵向轴线L的旋转。致动杠杆26也可安装在与可旋转旋钮24大致相邻的圆筒部分30的前端部上。杠杆26可沿着圆筒部分30的表面进行侧向调控，以有利于端部执行器50的往复关节运动。一个或多个回缩钮28可沿着圆筒部分30可移动地定位，以使得驱动组件80例如在击发系统已完成击发行程之后返回到回缩位置。如图所示，回缩钮28朝近侧移动到圆筒部分30的后端部，以回缩击发系统的部件，包括驱动组件80。
可结合到柄部组件22中的影响与其相联的端部执行器的调控和操作的特征结构的其他非限制性示例包括击发锁定组件、防反转离合器机构、和紧急返回按钮。击发锁定组件被构造成能够例如在端部执行器未完全联接到器械时防止击发系统在不期望的时间被致动。防反转离合器机构被构造成能够在不期望此类反向运动时(诸如在击发行程已仅部分完成但临时性停止时)防止击发系统的部件反向运动。紧急返回按钮被构造成能够允许击发系统的部件在击发行程完成之前(诸如在完成击发行程可能引起组织被不利切割的情况下)回缩。尽管诸如击发锁定组件、防反转离合器机构、和紧急返回按钮之类的特征结构在器械10中未明确示出，但本领域的技术人员应当认识到可在不脱离本公开的精神的情况下结合到外科缝合器的柄部组件和/或其他部分中的每个特征结构的各种构型。另外，可结合到柄部组件12中的特征结构的一些示例性实施方案被提供于在别处以引用方式并入本专利申请的专利和专利申请中。
轴14能够在轴14的近侧端部14p处可移除地联接到柄部组件12的远侧端部12d，并且轴14的远侧端部14d被构造成能够接收附接部分16。如图所示，轴14为大体圆柱形的和细长的，但任何类型的形状和构型可用于轴，这至少部分地取决于使用其的其他器械部件的构型和使用该器械的手术类型。例如，在一些实施方案中，一个轴的远侧端部可具有用于接收某些类型的端部执行器的特定构型，而另一轴的远侧端部可具有用于接收某些其他类型的端部执行器的不同构型。击发系统的部件(诸如控制杆32(图2))可设置在轴14中，以使得所述部件可到达端部执行器50和驱动组件80以提供它们的致动。例如，当触发器20操作击发系统时，控制杆32可穿过轴14的至少一部分朝远侧推进以导致钳口52、54朝向彼此塌缩并且/或者驱动驱动组件80朝远侧穿过端部执行器50的至少一部分。
轴14还可包括一个或多个传感器(未示出)以及有助于操作和使用传感器(未示出)的相关部件，诸如电子部件。传感器和相关部件被构造成能够向临床医生传送与轴14的远侧端部14d相联的端部执行器的类型(除了其他参数以外)。同样，柄部组件12可包括被构造成能够向临床医生传送与柄部组件12的远侧端部12d相联的端部执行器和/或轴的类型的一个或多个传感器和相关部件。因此，因为各种轴可与柄部组件12可互换地联接并且具有不同构型的各种端部执行器可与各种轴可互换地联接，所以传感器可有助于临床医生知道哪个轴和端部执行器正在被使用。另外，得自传感器的信息可有助于与该器械相关联的监测或控制系统知道哪些操作和测量参数与临床医生相关(基于联接到柄部组件的轴和端部执行器的类型)。例如，当端部执行器为缝合器时，有关驱动组件80被击发的次数的信息可为相关的，并且当端部执行器为另一类型的端部执行器，例如切割装置时，切割部分行进的距离可为相关的。该系统可基于被感测到的端部执行器向临床医生传达适当的信息。
本领域的技术人员应当认识到，监测和控制系统的各种构型可与本文提供的外科器械一起使用。例如，与端部执行器50、附接部分16、轴14、和柄部组件12中的任一个相关联的传感器被构造成能够监测其他系统参数，并且监测或控制系统可基于与柄部组件相联的轴或附接部分的类型来向临床医生传送相关的其他参数。有关传感器和相关部件以及监测和控制系统的另外的细节可见于在别处以引用方式并入本专利申请的专利和专利申请中。
如图3所示，附接部分16可包括位于其近侧端部16p处的近侧外壳部分34和位于其远侧端部16d处的端部执行器或工具50。在例示的实施方案中，近侧外壳部分34包括位于其近侧端部34p上的接合块36以用于可释放地接合轴14。块36与轴14的远侧端部14d形成卡口型联接。除了块36之外，还可使用任何数量的其他互补配合特征结构以允许附接部分16可移除地联接到轴14。
近侧外壳部分34的远侧端部34d可包括枢转地固定到其的安装组件40。如图4所示，安装组件40被构造成能够接收端部执行器50的近侧端部50p，使得安装组件40围绕垂直于外壳部分34的纵向轴线的轴线的枢转运动导致端部执行器50围绕枢转构件或销42的关节运动。这种枢转运动可由柄部组件28的致动杠杆26控制，其中设置在杠杆26和安装组件40之间的部件允许杠杆26运动，以使安装组件40并且由此使端部执行器50进行关节运动。类似于器械10的击发系统，本领域的技术人员应当认识到用于以机械方式或以其他方式导致关节运动的部件的各种构型，并且因此其详细解释为不必要的。适合与本文的公开内容一起使用的用于导致关节运动的部件的一些示例性实施方案提供于在别处以引用方式并入本专利申请的专利和专利申请中。
例示实施方案的端部执行器50为外科缝合工具，所述外科缝合工具具有充当仓组件或载体的第一、下钳口52和充当砧座的相对的第二、上钳口54。如图6所示，有时称为砧座部分的第二钳口54的内表面58可包括多个钉变形腔60和盖板62，所述盖板62固定到钳口54的顶部表面59以在其间限定腔64。盖板62可有助于防止外科缝合器的夹持和击发过程中的组织紧缩。腔64的尺寸可被设计成接收轴向驱动组件80的远侧端部80d。纵向狭槽66可延伸穿过砧座部分58以有利于轴向驱动组件80的保持凸缘82穿行到砧座腔64内。形成于砧座部分58上的凸轮表面57可被定位成接合轴向驱动组件80以有利于组织99的夹持。形成于砧座部分54上的一对枢转构件53可被定位在形成于载体52中的狭槽51中，以在打开位置和夹持位置之间引导砧座部分。一对稳定构件可接合形成于载体52上的相应肩部55以防止砧座部分54在凸轮表面57变形时相对于钉仓100轴向地滑动。在其他实施方案中，载体52和钉仓100可在打开位置和夹持位置之间进行枢转，同时砧座部分54保持基本上固定。
第一钳口52的细长支撑通道56的尺寸和构造可被设计成接收钉仓100，如图4、图5、和图7所示。分别沿着钉仓100和细长支撑通道56形成的相应的接片102和狭槽68用于将钉仓100保持在支撑通道56内。形成于钉仓100上的一对撑条103可被定位成安置在载体52的侧壁上，以进一步地将钉仓100稳定在支撑通道56内。钉仓100还可包括用于接收多个紧固件106和推动器108的保持狭槽105。多个间隔开的纵向狭槽107可延伸穿过钉仓100，以容纳击发系统的致动滑动件72的直立凸轮楔形件70(图4和图8)。中间纵向狭槽109可沿着钉仓100的长度延伸以有利于与轴向驱动组件80相联的刀片81的穿行。在外科缝合器的操作期间，致动滑动件72平移穿过钉仓100的纵向狭槽107以推进凸轮楔形件70与推动器108连续接触，由此导致推动器108在保持狭槽105内竖直地平移并且将紧固件106从狭槽105推压到砧座部分54的钉变形腔60内。
图9和图10示出了附接部分16'的另选的实施方案。附接部分16'可包括位于其近侧端部16p'处的近侧外壳部分34'和位于其远侧端部16d'处的端部执行器或工具50'。可提供块36'以将附接部分16'可移除地联接到外科器械的轴，并且可提供安装组件40'以将端部执行器或工具50'可移除地和/或可枢转地联接到近侧外壳部分34'。端部执行器50'可包括充当仓组件的第一、下钳口52'和充当砧座部分的第二、上钳口54'。第一钳口52'可具有许多与图3、图4、和图6的第一钳口52相同的特征结构，并且因此可包括细长支撑通道56'和狭槽68'，所述细长支撑通道56'的尺寸和构造被设定成接收钉仓100'，所述狭槽68'被构造成能够与钉仓100'的接片102'相对应以将仓100'保持在通道56'内。同样，仓100'可包括用以安置在钳口52'的侧壁上的撑条103'、用于接收多个紧固件106'和推动器108'的保持狭槽105'、用以容纳击发系统的致动滑动件72'的直立凸轮楔形件70'的多个间隔开的纵向狭槽107'、和有利于与轴向驱动组件80'相联的刀片81'的穿行的中央纵向狭槽109'。
类似于图3、图4和图6的第二钳口54，第二钳口54'可包括盖板62'，所述盖板62'固定到钳口的顶部表面以在其间限定腔。砧座板58'可充当钳口54'的内表面，并且可包括用于接收轴向驱动组件80'的远侧端部的纵向狭槽66'和用以使从仓100'射出的钉成形的多个钉变形凹坑或腔(未示出)。然而，在该实施方案中，当通过柄部组件和相关部件致动时，包括仓100'的下钳口52'被构造成能够朝上钳口54'枢转，同时上钳口54'保持基本上固定。
端部执行器和设置于其中的钉仓被构造成能够接收轴向驱动组件。轴向驱动组件80的一个非限制性示例性实施方案示于图11中。如图所示，驱动梁84的远侧端部可由竖直撑条86和邻接表面88限定，所述竖直撑条86支撑刀片81，所述邻接表面88被构造成能够在缝合手术期间接合致动滑动件72的中心部分。邻接表面88的基部处的底部表面85被构造成能够接收沿着钉仓100的底部可滑动地定位的支撑构件87(图4和图6)。刀片81可被定位成紧随致动滑动件72来平移穿过钉仓100中的中央纵向狭槽109以在成排的已缝合身体组织之间形成切口。保持凸缘82可从竖直撑条86向远侧突出，并且可在其远侧端部处支撑圆柱形凸轮辊89。凸轮辊89的尺寸和构造可被设计成接合砧座部分58上的凸轮表面57以抵靠身体组织来夹持砧座部分58。本领域的技术人员应当认识到，与外科缝合器或其他外科器械结合使用的驱动组件可具有不同于图11所示构型的许多其他构型，这些构型中的一些描述于在别处以引用方式并入本专利申请的专利和专利申请中。以非限制性示例的方式，驱动组件80可包括单个驱动梁或任何其他数量的驱动梁，并且驱动梁的远侧端部可具有被构造成能够用于端部执行器(驱动组件被构造成能够行进穿过所述端部执行器)的任何种类的形状。
在使用期间，外科缝合器可被设置在插管或端口中并且可被设置在手术部位处。可将待切割和缝合的组织布置在外科缝合器10的钳口52、54之间。缝合器10的特征结构(诸如，旋转旋钮24和致动杠杆26)可由临床医生根据需要来操作，以实现钳口52、54在手术部位处的所需位置以及组织相对于钳口52、54的所需位置。在已实现适当定位之后，可朝固定式柄部22牵拉触发器20以致动击发系统。触发器20可导致击发系统的部件工作，使得控制杆32朝远侧推进穿过轴14的至少一部分，以引起钳口52、54中的至少一者朝另一者塌缩由此夹持设置在其间的组织并且/或者驱动驱动组件80朝远侧穿过端部执行器50的至少一部分。
在一些实施方案中，触发器20的第一击发可导致钳口52、54夹持组织，而触发器20的后续击发可导致驱动组件80朝远侧推进穿过端部执行器50的至少一部分。单次、后续击发可完全推进驱动组件80穿过钉仓100以射出成排的钉，或者作为另外一种选择，柄部组件12中的部件被构造成能够使得需要后续击发来完全推进驱动组件80穿过钉仓100以射出成排的钉。可需要任何数量的后续击发，但在一些示例性实施方案中，两次至五次击发中的任一者均可完全推进驱动组件80穿过钉仓100。在其中驱动组件80包括用以切割待缝合的组织的刀81的实施方案中，当驱动组件朝远侧推进穿过端部执行器50并且因此穿过设置于其中的钉仓100时，刀81切割组织。在其他示例性实施方案中，设置于柄部组件12内并且与击发触发器相关的马达可响应于击发触发器的启动而自动地致动驱动组件80。
在驱动组件80已朝远侧推进穿过钉仓100之后，可朝近侧推进回缩钮28以使得驱动组件80反向回缩到其初始位置。在一些构型中，可在完全推进组件80穿过仓100之前使用回缩钮28来回缩驱动组件80。在其他实施方案中，驱动组件80的回缩可在预先确定的动作之后自动发生。例如，一旦驱动组件80已朝远侧推进到其期望位置，触发器80随后返回到偏压的打开位置的动作就可导致驱动组件80自动地回缩。可使用马达和相关部件而非回缩钮28和相关部件来回缩驱动组件80。另外，如上所述，在外科缝合器10的操作过程中，可依赖于其他特征结构，诸如击发锁定机构、防反转离合器机构和紧急返回按钮，正如本领域的技术人员将会理解的那样。
外科缝合器械10的例示实施方案提供了可与本文提供的公开内容一起使用的许多不同构型和相关使用方法中的一个。可根据本公开使用的外科缝合器、其部件、以及它们的相关使用方法的另外的示例性实施方案包括美国专利申请公布2012/0083835和美国专利申请公布2013/0161374中提供的装置、部件、和方法，这些专利申请公布中的每一个均全文以引用方式并入本文。
可植入材料
无论外科器械的构型如何，本公开提供了与器械操作结合的可植入材料(例如生物材料和/或合成材料，统称为“辅助材料”)的使用。如图12和图13所示，端部执行器50可包括定位在第一钳口构件52和第二钳口构件54中间的至少一块辅助材料200、200'并且其能够可释放地保持到支撑通道56和/或砧座部分58中的一者。在例示的实施方案中，通过下文更详细描述的保持构件202、202'来提供可释放保持。在至少一个实施方案中，辅助材料200、200'上的表面被构造成能够在组织夹持在第一钳口构件52和第二钳口构件54之间时接触组织。在此类实施方案中，辅助材料可用于将压缩夹持力分配到组织上，从组织移除多余的流体，并且/或者改善钉的抓紧。在各种实施方案中，一块或多块辅助材料可被定位在端部执行器50内。在至少一个实施方案中，一块辅助材料200可附接到钉仓100(图12)并且一块辅助材料200'可附接到砧座部分58(图13)。在至少一个其他实施方案中，例如，两块辅助材料200可被定位在支撑通道56上并且一块辅助材料200'可被定位在砧座部分58上。任何合适数量的辅助材料可位于端部执行器50内。
与本文提供的公开内容一起使用的辅助材料可具有任何种类的构型和特性。一般来讲，它们可由例如可生物吸收的材料、可生物降解的材料、和/或能够以其他方式分解的材料形成，使得辅助材料可在愈合过程中被吸收、降解、和/或分解。在至少一个实施方案中，辅助材料可包括例如被构造成能够随时间推移而释放以有助于组织愈合的治疗药物。在另外的各种实施方案中，辅助材料可包括例如非可吸收材料和/或不能够分解的材料。相似地，连接或保持构件可至少部分地由可生物吸收的材料、可生物降解的材料、和能够分解的材料中的至少一种形成，使得连接或保持构件可在体内被吸收、降解和/或分解。在各种实施方案中，连接或保持构件可包括例如被构造成能够随时间推移而释放以有助于组织愈合的治疗药物。在另外的各种实施方案中，连接或保持构件可包括例如非可吸收材料和/或不能够分解的材料，诸如塑料。
更具体地讲，可与本文提供的公开内容一起使用的一些合成材料的示例性、非限制性示例包括可生物降解的合成可吸收聚合物，例如，以商品名出售的聚二氧六环酮膜、或聚甘油癸二酸酯(PGS)膜、或者由PGA(聚乙醇酸，以商品名Vicryl出售)、PCL(聚己内酯)、PLA或PLLA(聚乳酸)、PHA(聚羟基链烷酸酯)、PGCL(聚卡普隆25，以商品名Monocryl出售)、PANACRYL(Ethicon公司(Somerville,N.J.))、丙交酯乙交酯共聚物910、聚葡萄糖酸酯、PGA/TMC(以商品名Biosyn出售的聚乙交酯-三亚甲基碳酸酯)、聚羟基丁酸酯(PHB)、聚(乙烯吡咯烷酮)(PVP)、聚(乙烯醇)(PVA)、或PGA、PCL、PLA、PDS单体共聚反应的共混物形成的其他可生物降解膜。在使用期间，合成材料可通过暴露于水而分解，使得水破坏合成材料的聚合物的键。因此，机械强度可减弱，并且材料的构造可分解成糊状支架或破碎支架。当发生进一步分解以使得材料分解成碳水化合物和酸组分时，患者的身体可代谢并且排出分解的材料。
可与本文提供的公开内容一起使用的生物衍生材料的一些示例性、非限制性示例包括缺乏血小板的血浆(PPP)、富含血小板的血浆(PRP)、淀粉、脱乙酰壳多糖、藻酸酯、血纤维蛋白、凝血酶、多糖、纤维素、胶原、牛胶原、牛心包膜、明胶-雷琐辛-福尔马林粘合剂、氧化纤维素、基于贻贝的粘合剂、聚(氨基酸)、琼脂糖、聚醚醚酮、直链淀粉、透明质烷、透明质酸、乳清蛋白、纤维素胶、淀粉、明胶、丝绸、或者适于与生物材料混合并且引入伤口或缺陷部位的其他材料，包括参考本文提供的公开内容对于本领域技术人员而言显而易见的材料的组合或任何材料。生物材料可源自多个源，包括源自将被植入生物材料的患者、并非将被植入生物材料的患者的人、或其他动物。
有关可与本文提供的公开内容一起使用的合成或聚合物材料和生物材料的另外的公开内容可见于美国专利申请公布2012/0080335、美国专利申请公布2012/0083835、2012年3月28日提交的名称为“Tissue Thickness Compensator Comprising CapsulesDefining a Low Pressure Environment”的美国专利申请序列13/433,115、2012年3月28日提交的名称为“Tissue Thickness Compensator Comprised of a Plurality ofMaterials”的美国专利申请序列13/433,118、2012年6月26日提交的名称为“TissueThickness Compensator Having Improved Visibility”的美国专利申请序列13/532,825、2012年12月11日提交的名称为“Electrosurgical End Effector with TissueTacking Features”的美国专利申请序列13/710,931、和2013年2月8日提交的名称为“Multiple Thickness Implantable Layers for Surgical Stapling Devices”的美国专利申请序列13/763,192，这些专利中的每一个均全文以引用方式并入本文。
在使用期间，辅助材料可预加载到装置和/或钉仓上，而在其他情况下，辅助材料可被单独封装。在其中辅助材料预加载到装置和/或钉仓上的情况下，可通过本领域的技术人员已知的方式来执行缝合手术。例如，在一些情况下，装置的击发可足以使辅助材料与装置和/或钉仓分离，由此不需要临床医生的进一步动作。在其他情况下，使辅助材料与装置和/或钉仓相联的任何剩余的连接构件或保持构件可在器械从手术部位移除之前被移除，由此将辅助材料留在手术部位处。在其中辅助材料被单独封装的情况下，该材料可在装置击发之前可释放地联接到端部执行器的部件和钉仓中的至少一个。辅助材料可被冷藏，并且因此可从冷藏机和相关包装移出，并且随后利用如本文所述或者本领域的技术人员已知的连接或保持构件联接到该装置。随后可通过本领域的技术人员已知的方式来执行缝合手术，并且如果需要，可如上所述使辅助材料与装置分离。
保持构件
连接构件或保持构件可用于将一块或多块辅助材料至少临时性地固定到端部执行器和/或钉仓上。这些保持构件可具有各种形式和构型，诸如一条或多条缝合线、粘合剂材料、钉、托架、卡扣或其他联接或配合元件等。例如，保持构件可被定位成邻近辅助材料的一个或多个侧面和/或端部，这样可在端部执行器通过套管针插入或与组织接合时有助于防止辅助材料从钉仓和/或砧座面剥离。在其他实施方案中，保持构件可与粘合剂一起使用或者呈粘合剂的形式，所述粘合剂适于将辅助材料可释放地保持到端部执行器，诸如氰基丙烯酸酯。在至少一个实施方案中，可在保持构件与辅助材料、钉仓、和/或砧座部分接合之前将粘合剂施加到保持构件。一般来讲，一旦完成击发，保持构件就可与辅助材料和/或端部执行器脱离，使得辅助材料可在端部执行器移除时保留在手术部位处。保持构件的一些示例性、非限制性实施方案在本文中相对于图12-15进行描述。
图12示出了连接或保持构件202的一个示例性实施方案，所述连接或保持构件202与辅助材料200相联以将材料200相对于端部执行器50的下钳口52固定在临时性位置。如图所示，辅助材料200被设置在位于下钳口52的细长通道56中的钉仓100上，并且保持构件202从中延伸穿过。在该实施方案中，保持构件202呈缝合穿过辅助材料200的多个位置的单根缝合线的形式，或者其可为设置在辅助材料200上的一个或多个位置处的多根缝合线。如图所示，缝合线被设置在围绕辅助材料200的周边的位置处，并且还邻近形成于辅助材料200中的中央纵向通道201。通道201可使得刀更易于穿过辅助材料200，以将材料200切割成两个或多个独立的条。在一些实施方案中，例如当保持构件202为穿过辅助材料200的多个位置的单根缝合线时，穿过下钳口52的刀可在一个或多个位置处切割保持构件202，由此允许保持构件202与辅助材料200分离并且从手术部位移除，同时辅助材料200通过从仓100射出的一个或多个钉仍保持固定在手术部位处。
图13示出了连接或保持构件202'的另一个实施方案，所述连接或保持构件202'与辅助材料200'相联以将材料200'固定在端部执行器50上的临时性位置处。保持构件202'具有与图12中的保持构件202相同的构型，然而，在该实施方案中，其用于将该材料固定到砧座或上钳口54，而非仓或下钳口52。
图14示出了连接或保持构件202”的另一个、非限制性实施方案，所述连接或保持构件202”用于将辅助材料200”可释放地保持到上钳口54和下钳口52中的至少一者。在该实施方案中，保持构件202”为单根缝合线，所述单根缝合线延伸穿过辅助材料200”的远侧部分200d”并且联接到上钳口54的近侧端部54p。保持构件202”的末端202t”可用于相对于钳口54、52来移动保持构件202”。在图14所示的其延伸位置中，当端部执行器50插入手术部位中时，保持构件202”可将辅助材料200”保持在适当位置。其后，端部执行器50的钳口52、54可闭合到例如组织上，并且来自钉仓100的钉可穿过辅助材料200”部署到组织中。保持构件202”可移动到其回缩位置中，使得保持构件202”能够可操作地脱离辅助材料200”。作为另外一种选择，保持构件202”可在钉被部署之前回缩。在任何情况下，鉴于上文所述，端部执行器50可被打开并且从手术部位抽出，从而留下辅助材料200”和组织。
图15示出了用于将辅助材料200”'的位置固定到端部执行器的连接或保持构件202”'的另一个、非限制性实施方案。具体地讲，辅助材料200”'和保持构件202”'与图9和图10的端部执行器50'一起使用。在该实施方案中，保持构件202”'呈缝合线的形式，所述缝合线用于将辅助材料200”'在第一、下钳口52'的近侧端部52p'和远侧端部52d'处系结到第一、下钳口52'。相似地，如图9和图10所示，辅助材料200”'也可在第二、上钳口54'的近侧端部54p'和远侧端部54d'处固定到第二、上钳口54'。任选地，可在钳口52'、54'的任一者或两者以及辅助材料200”'的任一者或两者中形成凹槽，所述凹槽可保护保持构件202”'以防外部对象的非预期切割。在使用期间，驱动器组件80'上的刀片81'可在其穿过端部执行器50'时切割保持构件202”'以释放辅助材料200”'。
本领域的技术人员应当认识到可相对于端部执行器临时性保持辅助材料的各种其他方式。在各种实施方案中，连接或保持构件被构造成能够从端部执行器释放并且能够与一块辅助材料一起被部署。在至少一个实施方案中，保持构件的头部部分被构造成能够与保持构件的主体部分分离，使得头部部分可与辅助材料一起进行部署，而主体部分保持附接到端部执行器。在其他各种实施方案中，当辅助材料脱离端部执行器时，保持构件的整体可保持与端部执行器接合。
具有可压缩弹性构件的杂化辅助材料
本文所述的或换句话讲本领域的技术人员已知的可压缩弹性构件可与多种辅助材料一起使用。尽管在一些情况下，辅助材料可为合成材料或生物材料，但在各种实施方案中，辅助材料包括合成材料和生物材料两者(即，其为杂化辅助材料)。所得组合可在单个杂化材料中显示出得自两种材料的有益特征。例如，杂化辅助材料可被设计成将生物材料的有益效果(诸如，手术部位处的改善的愈合和组织向内生长)与合成材料的有利机械特性(诸如，弹性或弹力)组合在一起。在各种实施方案中，合成材料还可提供结构并且支撑生物材料(例如，对纤维生物材料增加强度和/或抗剪切性)，同时仍允许生物材料接触手术部位并且支持和/或促进愈合。此外，杂化辅助材料被构造成能够减少发炎，促进细胞生长，并且/或者以其他方式改善愈合。杂化辅助材料可为可生物植入的和可生物吸收的。
图16为包括仓体和杂化辅助材料的示例性钉仓组件的透视图。此处，仓体和钉(未示出)由外科器械(参见例如图1和图10)的端部执行器的下钳口1052包封。仓体具有多个钉腔，所述钉腔被构造成能够在其中安置钉(参见图4和图10)。杂化辅助材料600可释放地保持在仓体和下钳口1052上并且被构造成能够通过从仓体部署钉而被递送到组织(如将在下文结合图21-23的示例所述)。材料600包括生物组织膜或基质604(示为被部分地切除以示出可压缩弹性构件或弹簧构件616)、合成基底层或基质602、和至少一个可压缩弹性构件或弹簧构件616，所述至少一个可压缩弹性构件或弹簧构件616被构造成能够在对其施加压缩力时压缩并且能够在移除压缩力时提供回弹力。由于可压缩弹性构件或弹簧构件616(也称为“骨架”)位于生物组织膜或基质604的内部，因此得自合成材料的刺激和炎症可被最小化，同时生物组织膜或基质604仍提供有顺应性增强。
在图16的例示实施方案中(并且类似地在图17-19和图21-23中)，生物组织膜604位于杂化辅助材料600的组织接触侧上，而合成基底层602位于面向仓体的材料600侧上。本领域的技术人员将会知道，层602和604的相对位置可被颠倒。本领域的技术人员还将会知道，当图16的仓组件包括杂化辅助材料时，可另选地使用包括一个或多个弹簧构件以及生物层和合成层中的仅一者的辅助材料。在各种实施方案中，杂化辅助材料可包括多个(以及一定布置方式的)可压缩弹簧构件，所述可压缩弹簧构件被选择以实现所需的机械性能。例如，弹簧构件的数量可匹配钉的数量(和位置)，或者弹簧构件的数量可为覆盖生物组织膜或合成基底层或者它们的预先确定的区域的数量(例如，弹簧构件和膜或层的尺寸的函数)。
此外，在图16的例示实施方案中(并且类似地在图17-19和图21-23中)，将杂化辅助材料组装到端部执行器以用于描述的语境和方便性。本领域的技术人员将会知道，杂化辅助材料可与端部执行器提供在另选构造的组件中，并且可独立于端部执行器(外科缝合器的其他部件)来提供并且随后附连到端部执行器的一部分。
杂化辅助材料可联接到端部执行器的钳口(在该示例中，通过合成基底层)并且可包括一个或多个配合特征结构以用于接收和联接到生物层。例如，图16示出了利用围绕钳口的近侧端部1052p和远侧端部1052d延伸的保持构件1202联接到钳口1052的杂化辅助材料600的合成材料层或基质602。此外，合成基质602可包括一个或多个突出部(此处示为弹簧616)，所述一个或多个突出部被构造成能够接合生物材料层或基质604以有助于将生物基质604配合到合成基质602，由此基本上保持生物基质604相对于合成基质602的位置。
在该实施方案中，可压缩弹性构件或弹簧构件616形成骨架结构，生物基质604围绕所述骨架结构而形成。例如，当生物基质604由胶原(如本公开在别处所述，其可熔融成液态并且随后重新成形为硬化状态)形成时，合成基质可浸入液态胶原中。当胶原重新成形或硬化时，其可围绕由弹簧616的构型限定的骨架结构来成形，由此将生物基质与合成基质整合在一起。所得的杂化辅助材料可为宏观复合物辅助材料，其受益于内部合成框架的强度和抗撕裂性以及由弹簧616提供的简单参数附接特征结构(例如，弹簧的形状和材料)，同时仍提供具有生物材料的有益效果。本领域的技术人员应当认识到多种其他突出部，所述突出部可从合成基质602的顶部表面602a延伸以提供用于形成杂化辅助材料的内部骨架结构。
本领域的技术人员将会知道，具有多种形状、尺寸、构型、和材料的可压缩弹性构件可与本文所公开的辅助材料一起使用。在图16所示的一个实施方案中，辅助材料包括弹簧构件616，所述弹簧构件616的形式为沿着辅助材料的至少一个维度延伸的细长构件。例如，在例示的实施方案中，弹簧构件616可为细长构件，所述细长构件具有由非凸起区段617隔开的凸起区段618。在一个示例中，细长构件616可形成正弦或波纹状图案。尽管图16示出了在宽度(W)维度上延伸的细长构件616，但本领域的技术人员应当认识到，细长构件可另选地或另外沿着长度(L)维度或另一个维度(即，在图16中，不平行于或不垂直于长度维度或宽度维度的维度)延伸。本领域的技术人员还将会知道，弹簧构件可呈现多种另选形式。事实上可使用任何形状，前提条件是其能够在压缩力被移除时提供回弹力。此外，弹簧构件可设置在生物层和/或合成层之中或之上，或者设置在这些层之间。
图17-20C示出了生物组织增强膜与仓体和示例性可压缩弹性构件的另外的示例性附接。在图17中，杂化辅助材料2000包括设置在合成层2002和生物基质2004之间并且嵌入生物基质2004内的球形或轨道状弹性构件2016。在图18中，杂化辅助材料2100包括嵌入生物基质2104内的辐射状突出的、原子状、或插孔状弹性构件2116。在图19中，杂化辅助材料2200包括嵌入生物基质2204内的半球形或穹顶形弹性构件2216。
图20A为示于图17中的可压缩弹性构件的变型的分解图。球形或轨道状弹性构件2320包括限定三维球形或轨道状形状的多个圆形或椭圆形部件2330。本领域的技术人员将会知道，此类弹性构件可包括可布置成规则或不规则图案的两个或更多个圆形或椭圆形部件。本领域的技术人员还将会知道，可例如通过适当地选择圆形或椭圆形部件的材料、尺寸、形状、位置、和/或数量来调节此类弹性构件的机械性能。这些和其他弹性构件可包括一个或多个表面特征结构、或具有弹性构件自身的三维形状的特征结构，这些特征结构被构造成能够将膜固定到弹性构件。在图20A的示例中，膜或基质可围绕球形或轨道状弹性构件2320并且穿过由多个圆形或椭圆形部件2330限定的空隙而延伸，由此将弹性构件2320嵌入并且固定到膜或基质或者其内。
图20B为示于图19中的可压缩弹性构件的变型的分解图。半球形或穹顶形弹性构件2322包括附连到圆形或椭圆形基部2342并且限定三维半球形或穹顶形状的多个曲线部件2332。本领域的技术人员还将会知道，此类弹性构件可包括可布置成规则或不规则图案，并且固定到圆形、椭圆形、多边形、或其他二维基部的两个或更多个曲线部件。本领域的技术人员还将会知道，可例如通过适当地选择曲线部件和基部的材料、尺寸、形状、位置、和/或数量来调节此类弹性构件的机械性能。这些和其他弹性构件可包括一个或多个表面特征结构、或具有弹性构件自身的三维形状的特征结构，这些特征结构被构造成能够将膜固定到弹性构件。在图20A的示例中，膜或基质可围绕曲线弹性构件2332并且穿过由多个曲线弹性构件2332和/或基部2342限定的空隙而延伸，由此将弹性构件2322嵌入并且固定到膜或基质或者其内。
图20C为示于图18中的可压缩弹性构件的变型的分解图。辐射状突出的、原子状、或插孔状弹性构件2321包括核2331，臂2341从所述核2331辐射并且端接在球形端帽2351中。本领域的技术人员还将会知道，类似的弹性构件可包括从核(其不必为弹性构件的几何中心)辐射的两个或更多个臂(其不必为直的或等长度的)。本领域的技术人员还将会知道，可例如通过适当地选择臂、端帽和其他特征结构的材料、尺寸、形状、位置、和/或数量来调节此类弹性构件的机械性能。这些和其他弹性构件可包括被构造成能够将膜固定到弹性构件的一个或多个表面特征结构(例如，球形端帽、架、倒钩等等)。诸如球形端帽之类的特征结构可具有另外的有利特征，诸如，钝化臂2341的顶端，由此避免臂刺穿或以其他方式破坏膜或基质的相邻区域。在图20C的非限制性示例中，弹性构件2321具有辐射状突出臂2341并且球形端帽2351可嵌入膜或基质中，由此将弹性构件固定在膜和基质内并且减轻弹性构件在膜或基质内的运动。本领域的技术人员将会知道，在其他实施方案中可使用其他表面特征结构和构型。
本领域的技术人员将会知道，可在另选的实施方案中使用除了图17-20C的示例中所示的那些之外的形状，例如，球形的、卵形的、三维辐射状的非对称形式以及功能类似的二维或三维弹性构件形状。同样，弹性构件不必呈现例示实施方案的构型(例如，设置在合成层和生物层之间并且/或者嵌入生物层内---弹簧构件可设置在生物层和/或合成层之中或之上或者设置在这些层之间)。本领域的技术人员还将会知道，可例如通过适当地选择弹性构件的数量、类型和/或布置方式来调节杂化辅助材料的机械性能(例如，压缩和回弹特性)。例如，弹性构件的类型和/或布置方式可为均一的(例如，类似于图17)、无规的(例如，类似于图18)、或图案化的(例如，类似于图19，以将压缩和回弹力集中在钉周围)。此外，在各种实施方案中，杂化辅助材料可包括两种或更多种不同类型的弹性构件和/或两种或更多种图案(例如，缝合部位处的第一类型的弹性构件的规则图案以及别处的第二类型的弹性构件的无规图案)。
弹性构件可由具有所需机械特性(例如，弹性、可恢复的粘弹性、增强性等等)和生物特性(例如，可生物植入和可生物吸收)的基本上任何合成材料制成。代表性例子在上文的可植入材料部分中有所讨论。同样，可使用具有类弹簧特性的基本上任何形状和构型，前提条件是与杂化辅助材料600具有相容性(例如，形状、体积)。本领域的技术人员将会知道，杂化辅助材料(以及其层)的形状并不限于例示实施例中所示的平行六面体/菱面体形式。在各种实施方案中，杂化辅助材料(以及其层)不必具有如图16-19所示的对称形状，并且可例如在厚度方面有所变化或者具有不规则形状部分。
在另一个方面，本发明提供了用于缝合生物组织的方法。图21-23示出了通过由图16所示的端部执行器的下钳口1052包封的示例性钉仓的操作的一种此类方法的示例。尽管该示例方法参考图16来进行论述，但应当理解，由本发明提供的这种方法和其他方法适用于本文所述的具有不同类型的弹簧构件的辅助材料的使用。
图21示出了组织3000与外科缝合器仓体1100在手术部位处的接合。仓体1100具有可释放地附接到其的杂化辅助材料600。材料600包括生物组织膜604、合成基底层602、和至少一个可压缩弹性构件616，所述至少一个可压缩弹性构件616被构造成能够在对其施加压缩力时压缩并且能够在移除压缩力时提供回弹力。此处，组织3000接合在砧座或上钳口1054与下钳口1052之间，所述下钳口1052包封其中设置有钉1101的仓体1100并且支撑杂化辅助材料600。
图22示出了已使钉1101从仓体1100射出并且射入生物组织3000中的致动的外科缝合器。钉1101延伸穿过杂化辅助材料600以将材料600保持在手术部位处。在该示例中，外科缝合器的致动还切割钉1101之间的手术部位处的组织3000，如图22所示。此类切割实施方案的另外的实施方案和示例在上文中有所描述。然而，本发明还设想到如下实施方案，其中组织不必被切割或者其中组织的切割不必与外科缝合器的致动同时进行。
图23示出了钉1101和辅助材料600的部署之后的组织3000。如图所示，钉1101延伸穿过杂化辅助材料600和组织3000以将材料600保持在手术部位处。在该图示中，包括钉1101的组织3000通过杂化辅助材料600得到增强，由此避免或减轻手术部位的撕裂、流体(例如，血液)、或其他不利损害。避免不利损害可缩短外科恢复时间并且减轻外科并发症。此外，这种增强可通过生物基质604和/或其中的生物学活性化合物的作用来促进愈合。相似地，这种增强可避免或减轻得自合成材料的刺激和炎症，因为弹性构件或弹簧616位于生物组织膜或基质604的内部并且/或者因为合成基底层602基本上不接触组织3000。在另选的实施方案中，基本上全部合成材料可由生物材料包封，以防止或减轻得自合成材料的刺激和炎症。
可将本发明所公开的装置设计成单次使用后即进行处理，或者可将它们设计成是多次使用的。然而，在任一种情形下，所述装置均可进行修复，以在至少一次使用后再次使用。修复可包括拆卸装置、清洗或更换具体部件以及后续重新组装的其中任意几个步骤的组合。具体地讲，能够拆卸装置，并且能够按照任何组合选择性地更换或移除装置的任何数量的特定零件或部件，例如电极、电池或其它的电源、外部耐磨传感器和/或其外壳等。在清洗和/或更换特定部件后，能够在修复设备内或由外科手术小组紧接外科手术之前重新组装装置以便后续使用。本领域的技术人员将会知道，装置的重新修复可利用多种用于拆卸、清洗/更换和重新组装的技术。这些技术的用途以及得到的重新修复装置均在本发明的范围内。
在一些实施方案中，本文所述的装置可在手术之前进行处理。首先，获取新的或用过的器械，并根据需要进行清洗。然后可对器械进行灭菌。在一种灭菌技术中，将器械放置在闭合且密封的容器中，诸如塑料或TYVEK袋中。然后将容器和器械置于可穿透该容器的辐射场，诸如γ辐射、X射线或高-能量的电子辐射。辐射使杀死器械上和容器中的细菌。然后将灭菌后的器械存储在消毒容器中。该密封容器使器械保持无菌直到在医疗设施中打开该容器为止。
另外的示例性结构和部件在如下美国专利申请中有所描述：名称为“SealingMaterials For Use In Surgical Stapling”的美国专利申请____[100873-639/END7352USNP]、名称为“Hybrid Adjunct Materials For Use In Surgical Stapling”的美国专利申请____[100873-640/END7353USNP]、名称为“Positively ChargedImplantable Materials And Method Of Forming The Same”美国专利申请____[100873-641/END7353USNP]、和名称为“issue Ingrowth Materials And Method Of Using TheSame”的美国专利申请____[100873-642/END7355USNP]，这些专利申请与本申请同一天提交并且全文以引用方式并入本文。
根据上述实施例，本领域的技术人员应了解到本发明另外的特征和优点。因此，本发明不应受到已具体示出和描述内容的限制，除非所附权利要求有所指示。本文引用的所有出版物和参考文献全文明确地以引用方式并入本文中。

Claims (14)

1.一种与外科缝合器一起使用的钉仓组件，所述钉仓组件包括：
仓体，所述仓体具有多个钉腔，所述钉腔被构造成能够在其中安置钉；和
杂化辅助材料，所述杂化辅助材料可释放地保持在所述仓体上并且被构造成能够通过所述仓体中的所述钉的部署来递送到组织，所述材料具有生物组织膜和合成基底层，所述合成基底层具有至少一个可压缩弹性构件，所述可压缩弹性构件与所述基底层一体形成、从中延伸并具有围绕所述基底层形成的生物组织膜，使得至少一个可压缩弹性构件将所述生物组织膜配合到所述合成基底层，所述至少一个可压缩弹性构件被构造成能够在对其施加压缩力时压缩并且能够在移除所述压缩力时提供回弹力，其中所述至少一个可压缩弹性构件包括具有丝状构件的内部骨架丝框架，所述生物组织膜围绕所述内部骨架丝框架形成。
2.根据权利要求1所述的组件，其中所述材料为可生物植入的和可生物吸收的。
3.根据权利要求1所述的组件，还包括被构造成能够将所述材料联接到所述仓体的至少一个缝合保持构件。
4.根据权利要求3所述的组件，其中所述至少一个缝合保持构件联接到所述仓体的外边缘以及所述生物组织膜和所述合成基底层中的至少一者的外边缘。
5.根据权利要求4所述的组件，其中所述至少一个缝合保持构件包括缝合线。
6.根据权利要求1所述的组件，其中所述膜包括生物基质。
7.根据权利要求1所述的组件，其中所述可压缩弹性构件包括合成的可生物吸收材料。
8.根据权利要求7所述的组件，其中所述合成的可生物吸收材料包括尼龙、聚丙烯、聚二氧六环酮、聚甘油癸二酸酯(PGS)、PGA(聚乙醇酸)、PCL(聚己内酯)、PLA或PLLA(聚乳酸)、PHA(聚羟基链烷酸酯)、PGCL(聚卡普隆25)、丙交酯乙交酯共聚物910、聚葡萄糖酸脂、PGA/TMC(聚乙交酯-三亚甲基碳酸酯)、聚羟基丁酸酯(PHB)、聚(乙烯吡咯烷酮)(PVP)、聚(乙烯醇)(PVA)、或它们的组合。
9.根据权利要求7所述的组件，其中所述可压缩弹性构件包括在所述合成基底层的至少一个维度上以正弦型式延伸的至少一个构件。
10.根据权利要求9所述的组件，还包括在所述材料的长度维度和宽度维度中的至少一者上延伸的多个正弦构件。
11.根据权利要求1所述的组件，其中所述可压缩弹性构件包括被构造成能够将所述生物组织膜固定到所述弹性构件的一个或多个表面特征结构。
12.根据权利要求11所述的组件，其中所述一个或多个表面特征结构选自包括球形端帽、架、倒钩、以及它们的组合的组。
13.根据权利要求7所述的组件，其中所述可压缩弹性构件包括球形、卵形、半球形、穹顶形、插孔形、或三维辐射状形式中的一个或多个。
14.一种钉仓组件，包括：
仓体，所述仓体具有多个钉腔，所述钉腔被构造成能够在其中安置钉；
杂化辅助材料，所述杂化辅助材料可释放地保持在所述仓体上并且被构造成能够通过所述仓体中的所述钉的部署来递送到组织，所述杂化辅助材料包括：
生物组织膜和合成基底层，所述合成基底层具有至少一个可压缩弹性构件，所述至少一个可压缩弹性构件与所述基底层一体形成、从中延伸并具有围绕所述基底层形成的生物组织膜，使得至少一个可压缩弹性构件将所述生物组织膜固定到所述合成基底层，所述至少一个可压缩弹性构件被构造成能够在对其施加压缩力时压缩并且能够在移除所述压缩力时提供回弹力，其中所述至少一个可压缩弹性构件包括具有丝状构件的内部骨架丝框架，所述生物组织膜围绕所述内部骨架丝框架形成，以及
至少一个保持构件，所述至少一个保持构件被构造成将所述材料联接到所述仓体。
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Families Citing this family (558)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070084897A1 (en) 2003-05-20 2007-04-19 Shelton Frederick E Iv Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US11896225B2 (en) 2004-07-28 2024-02-13 Cilag Gmbh International Staple cartridge comprising a pan
US7938307B2 (en) 2004-10-18 2011-05-10 Tyco Healthcare Group Lp Support structures and methods of using the same
US7845536B2 (en) 2004-10-18 2010-12-07 Tyco Healthcare Group Lp Annular adhesive structure
US9364229B2 (en) 2005-03-15 2016-06-14 Covidien Lp Circular anastomosis structures
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US20110290856A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument with force-feedback capabilities
US7753904B2 (en) 2006-01-31 2010-07-13 Ethicon Endo-Surgery, Inc. Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US20110024477A1 (en) 2009-02-06 2011-02-03 Hall Steven G Driven Surgical Stapler Improvements
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US7552854B2 (en) 2006-05-19 2009-06-30 Applied Medical Resources Corporation Surgical stapler with firing lock mechanism
US8322455B2 (en) 2006-06-27 2012-12-04 Ethicon Endo-Surgery, Inc. Manually driven surgical cutting and fastening instrument
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
US20080078802A1 (en) 2006-09-29 2008-04-03 Hess Christopher J Surgical staples and stapling instruments
US11980366B2 (en) 2006-10-03 2024-05-14 Cilag Gmbh International Surgical instrument
US11291441B2 (en) 2007-01-10 2022-04-05 Cilag Gmbh International Surgical instrument with wireless communication between control unit and remote sensor
US8684253B2 (en) 2007-01-10 2014-04-01 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US8701958B2 (en) 2007-01-11 2014-04-22 Ethicon Endo-Surgery, Inc. Curved end effector for a surgical stapling device
CA2680148C (en) 2007-03-06 2015-09-01 Tyco Healthcare Group Lp Surgical stapling apparatus
US7604151B2 (en) 2007-03-15 2009-10-20 Ethicon Endo-Surgery, Inc. Surgical stapling systems and staple cartridges for deploying surgical staples with tissue compression features
US8893946B2 (en) 2007-03-28 2014-11-25 Ethicon Endo-Surgery, Inc. Laparoscopic tissue thickness and clamp load measuring devices
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US11564682B2 (en) 2007-06-04 2023-01-31 Cilag Gmbh International Surgical stapler device
US7665646B2 (en) 2007-06-18 2010-02-23 Tyco Healthcare Group Lp Interlocking buttress material retention system
US7753245B2 (en) 2007-06-22 2010-07-13 Ethicon Endo-Surgery, Inc. Surgical stapling instruments
US8062330B2 (en) 2007-06-27 2011-11-22 Tyco Healthcare Group Lp Buttress and surgical stapling apparatus
US11849941B2 (en) 2007-06-29 2023-12-26 Cilag Gmbh International Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis
US8758391B2 (en) 2008-02-14 2014-06-24 Ethicon Endo-Surgery, Inc. Interchangeable tools for surgical instruments
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
RU2493788C2 (ru) 2008-02-14 2013-09-27 Этикон Эндо-Серджери, Инк. Хирургический режущий и крепежный инструмент, имеющий радиочастотные электроды
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US11986183B2 (en) 2008-02-14 2024-05-21 Cilag Gmbh International Surgical cutting and fastening instrument comprising a plurality of sensors to measure an electrical parameter
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US11272927B2 (en) 2008-02-15 2022-03-15 Cilag Gmbh International Layer arrangements for surgical staple cartridges
US9770245B2 (en) 2008-02-15 2017-09-26 Ethicon Llc Layer arrangements for surgical staple cartridges
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US20100147921A1 (en) 2008-12-16 2010-06-17 Lee Olson Surgical Apparatus Including Surgical Buttress
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
CA2751664A1 (en) 2009-02-06 2010-08-12 Ethicon Endo-Surgery, Inc. Driven surgical stapler improvements
US7967179B2 (en) 2009-03-31 2011-06-28 Tyco Healthcare Group Lp Center cinch and release of buttress material
US9486215B2 (en) 2009-03-31 2016-11-08 Covidien Lp Surgical stapling apparatus
US9693772B2 (en) 2009-10-15 2017-07-04 Covidien Lp Staple line reinforcement for anvil and cartridge
US10842485B2 (en) 2009-10-15 2020-11-24 Covidien Lp Brachytherapy buttress
US20150231409A1 (en) 2009-10-15 2015-08-20 Covidien Lp Buttress brachytherapy and integrated staple line markers for margin identification
US8220688B2 (en) 2009-12-24 2012-07-17 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US11849952B2 (en) 2010-09-30 2023-12-26 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US8857694B2 (en) 2010-09-30 2014-10-14 Ethicon Endo-Surgery, Inc. Staple cartridge loading assembly
US9272406B2 (en) 2010-09-30 2016-03-01 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a cutting member for releasing a tissue thickness compensator
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
US9241714B2 (en) 2011-04-29 2016-01-26 Ethicon Endo-Surgery, Inc. Tissue thickness compensator and method for making the same
US9232941B2 (en) 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US9386988B2 (en) 2010-09-30 2016-07-12 Ethicon End-Surgery, LLC Retainer assembly including a tissue thickness compensator
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
US8789737B2 (en) 2011-04-27 2014-07-29 Covidien Lp Circular stapler and staple line reinforcement material
BR112013027794B1 (pt) 2011-04-29 2020-12-15 Ethicon Endo-Surgery, Inc Conjunto de cartucho de grampos
US11207064B2 (en) 2011-05-27 2021-12-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US9675351B2 (en) 2011-10-26 2017-06-13 Covidien Lp Buttress release from surgical stapler by knife pushing
US9351731B2 (en) 2011-12-14 2016-05-31 Covidien Lp Surgical stapling apparatus including releasable surgical buttress
US9113885B2 (en) 2011-12-14 2015-08-25 Covidien Lp Buttress assembly for use with surgical stapling device
US9237892B2 (en) 2011-12-14 2016-01-19 Covidien Lp Buttress attachment to the cartridge surface
US9326773B2 (en) 2012-01-26 2016-05-03 Covidien Lp Surgical device including buttress material
US9044230B2 (en) 2012-02-13 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
CN104334098B (zh) 2012-03-28 2017-03-22 伊西康内外科公司 包括限定低压强环境的胶囊剂的组织厚度补偿件
BR112014024102B1 (pt) 2012-03-28 2022-03-03 Ethicon Endo-Surgery, Inc Conjunto de cartucho de prendedores para um instrumento cirúrgico, e conjunto de atuador de extremidade para um instrumento cirúrgico
MX353040B (es) 2012-03-28 2017-12-18 Ethicon Endo Surgery Inc Unidad retenedora que incluye un compensador de grosor de tejido.
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US11202631B2 (en) 2012-06-28 2021-12-21 Cilag Gmbh International Stapling assembly comprising a firing lockout
US9204879B2 (en) 2012-06-28 2015-12-08 Ethicon Endo-Surgery, Inc. Flexible drive member
US20140001234A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Coupling arrangements for attaching surgical end effectors to drive systems therefor
BR112014032776B1 (pt) 2012-06-28 2021-09-08 Ethicon Endo-Surgery, Inc Sistema de instrumento cirúrgico e kit cirúrgico para uso com um sistema de instrumento cirúrgico
RU2636861C2 (ru) 2012-06-28 2017-11-28 Этикон Эндо-Серджери, Инк. Блокировка пустой кассеты с клипсами
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US9572576B2 (en) 2012-07-18 2017-02-21 Covidien Lp Surgical apparatus including surgical buttress
US20140048580A1 (en) 2012-08-20 2014-02-20 Covidien Lp Buttress attachment features for surgical stapling apparatus
US9161753B2 (en) 2012-10-10 2015-10-20 Covidien Lp Buttress fixation for a circular stapler
US9295466B2 (en) 2012-11-30 2016-03-29 Covidien Lp Surgical apparatus including surgical buttress
US9402627B2 (en) 2012-12-13 2016-08-02 Covidien Lp Folded buttress for use with a surgical apparatus
US9414839B2 (en) 2013-02-04 2016-08-16 Covidien Lp Buttress attachment for circular stapling device
US9504470B2 (en) 2013-02-25 2016-11-29 Covidien Lp Circular stapling device with buttress
US20140239047A1 (en) 2013-02-28 2014-08-28 Covidien Lp Adherence concepts for non-woven absorbable felt buttresses
RU2669463C2 (ru) 2013-03-01 2018-10-11 Этикон Эндо-Серджери, Инк. Хирургический инструмент с мягким упором
RU2672520C2 (ru) 2013-03-01 2018-11-15 Этикон Эндо-Серджери, Инк. Шарнирно поворачиваемые хирургические инструменты с проводящими путями для передачи сигналов
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US10470762B2 (en) 2013-03-14 2019-11-12 Ethicon Llc Multi-function motor for a surgical instrument
CA2904678C (en) 2013-03-14 2022-07-12 Applied Medical Resources Corporation Surgical stapler with partial pockets
KR102600899B1 (ko) 2013-03-15 2023-11-10 어플라이드 메디컬 리소시스 코포레이션 확장가능 조를 갖는 수술용 스테이플러
KR102227182B1 (ko) 2013-03-15 2021-03-15 어플라이드 메디컬 리소시스 코포레이션 회전가능 샤프트를 구비한 구동 메커니즘을 갖는 수술용 스테이플러
US9649110B2 (en) 2013-04-16 2017-05-16 Ethicon Llc Surgical instrument comprising a closing drive and a firing drive operated from the same rotatable output
BR112015026109B1 (pt) 2013-04-16 2022-02-22 Ethicon Endo-Surgery, Inc Instrumento cirúrgico
CN106028966B (zh) 2013-08-23 2018-06-22 伊西康内外科有限责任公司 用于动力外科器械的击发构件回缩装置
US20150053737A1 (en) 2013-08-23 2015-02-26 Ethicon Endo-Surgery, Inc. End effector detection systems for surgical instruments
US9655620B2 (en) 2013-10-28 2017-05-23 Covidien Lp Circular surgical stapling device including buttress material
US9700311B2 (en) 2013-11-08 2017-07-11 Ethicon Llc Tissue ingrowth materials and method of using the same
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
CN106232029B (zh) 2014-02-24 2019-04-12 伊西康内外科有限责任公司 包括击发构件锁定件的紧固系统
US10004497B2 (en) 2014-03-26 2018-06-26 Ethicon Llc Interface systems for use with surgical instruments
BR112016021943B1 (pt) 2014-03-26 2022-06-14 Ethicon Endo-Surgery, Llc Instrumento cirúrgico para uso por um operador em um procedimento cirúrgico
US9804618B2 (en) 2014-03-26 2017-10-31 Ethicon Llc Systems and methods for controlling a segmented circuit
BR112016023698B1 (pt) 2014-04-16 2022-07-26 Ethicon Endo-Surgery, Llc Cartucho de prendedores para uso com um instrumento cirúrgico
CN106456159B (zh) 2014-04-16 2019-03-08 伊西康内外科有限责任公司 紧固件仓组件和钉保持器盖布置结构
US20150297222A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
US9844369B2 (en) 2014-04-16 2017-12-19 Ethicon Llc Surgical end effectors with firing element monitoring arrangements
JP6612256B2 (ja) 2014-04-16 2019-11-27 エシコン エルエルシー 不均一な締結具を備える締結具カートリッジ
US9801627B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Fastener cartridge for creating a flexible staple line
US10172611B2 (en) 2014-06-10 2019-01-08 Ethicon Llc Adjunct materials and methods of using same in surgical methods for tissue sealing
WO2015191887A1 (en) 2014-06-11 2015-12-17 Applied Medical Resources Corporation Surgical stapler with circumferential firing
BR112017004361B1 (pt) 2014-09-05 2023-04-11 Ethicon Llc Sistema eletrônico para um instrumento cirúrgico
US10111679B2 (en) 2014-09-05 2018-10-30 Ethicon Llc Circuitry and sensors for powered medical device
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
AU2015318095B2 (en) 2014-09-15 2020-02-20 Applied Medical Resources Corporation Surgical stapler with self-adjusting staple height
US10105142B2 (en) 2014-09-18 2018-10-23 Ethicon Llc Surgical stapler with plurality of cutting elements
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
CN107427300B (zh) 2014-09-26 2020-12-04 伊西康有限责任公司 外科缝合支撑物和辅助材料
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US10736636B2 (en) 2014-12-10 2020-08-11 Ethicon Llc Articulatable surgical instrument system
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
RU2703684C2 (ru) 2014-12-18 2019-10-21 ЭТИКОН ЭНДО-СЕРДЖЕРИ, ЭлЭлСи Хирургический инструмент с упором, который выполнен с возможностью избирательного перемещения относительно кассеты со скобами вокруг дискретной неподвижной оси
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
US9931118B2 (en) 2015-02-27 2018-04-03 Ethicon Endo-Surgery, Llc Reinforced battery for a surgical instrument
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US10052044B2 (en) 2015-03-06 2018-08-21 Ethicon Llc Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures
JP2020121162A (ja) 2015-03-06 2020-08-13 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 測定の安定性要素、クリープ要素、及び粘弾性要素を決定するためのセンサデータの時間依存性評価
US10441279B2 (en) 2015-03-06 2019-10-15 Ethicon Llc Multiple level thresholds to modify operation of powered surgical instruments
US10433844B2 (en) 2015-03-31 2019-10-08 Ethicon Llc Surgical instrument with selectively disengageable threaded drive systems
JP7079194B2 (ja) 2015-08-06 2022-06-01 アプライド メディカル リソーシーズ コーポレイション ロック関節連結継手を備えた外科用ステープラ
US11058425B2 (en) 2015-08-17 2021-07-13 Ethicon Llc Implantable layers for a surgical instrument
US10086116B2 (en) 2015-08-31 2018-10-02 Ethicon Llc Adjunct material to provide controlled drug release
US10463366B2 (en) 2015-08-31 2019-11-05 Ethicon Llc Adjunct materials for delivery to liver tissue
US10499913B2 (en) 2015-08-31 2019-12-10 Ethicon Llc Tubular surgical constructs including adjunct material
US10172973B2 (en) 2015-08-31 2019-01-08 Ethicon Llc Surgical adjuncts and medicants for promoting lung function
US10245034B2 (en) 2015-08-31 2019-04-02 Ethicon Llc Inducing tissue adhesions using surgical adjuncts and medicants
US11020116B2 (en) 2015-08-31 2021-06-01 Ethicon Llc Surgical adjuncts with medicants affected by activators
US10188389B2 (en) 2015-08-31 2019-01-29 Ethicon Llc Adjunct material for delivery to colon tissue
US10111661B2 (en) 2015-08-31 2018-10-30 Ethicon Llc Matrix metalloproteinase inhibiting adjuncts for surgical devices
US10285692B2 (en) 2015-08-31 2019-05-14 Ethicon Llc Adjuncts for surgical devices including agonists and antagonists
US10076329B2 (en) 2015-08-31 2018-09-18 Ethicon Llc Adjunct material to promote tissue growth in a colon
US10569071B2 (en) 2015-08-31 2020-02-25 Ethicon Llc Medicant eluting adjuncts and methods of using medicant eluting adjuncts
US10076324B2 (en) 2015-08-31 2018-09-18 Ethicon Llc Adjunct material to provide controlled drug elution
US10188390B2 (en) 2015-08-31 2019-01-29 Ethicon Llc Adjunct material to provide heterogeneous drug elution
US9937283B2 (en) 2015-08-31 2018-04-10 Ethicon Endo-Surgery, Llc Adjunct material to provide drug elution from vessels
US10349938B2 (en) 2015-08-31 2019-07-16 Ethicon Llc Surgical adjuncts with medicants affected by activator materials
US10279086B2 (en) 2015-08-31 2019-05-07 Ethicon Llc Composite adjunct materials for delivering medicants
US10194936B2 (en) 2015-08-31 2019-02-05 Ethicon Endo-Surgery, Llc Adjunct material for delivery to stomach tissue
US10213520B2 (en) 2015-08-31 2019-02-26 Ethicon Llc Surgical adjuncts having medicants controllably releasable therefrom
US10130738B2 (en) 2015-08-31 2018-11-20 Ethicon Llc Adjunct material to promote tissue growth
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10363036B2 (en) 2015-09-23 2019-07-30 Ethicon Llc Surgical stapler having force-based motor control
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10327769B2 (en) 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
US20170086829A1 (en) * 2015-09-30 2017-03-30 Ethicon Endo-Surgery, Llc Compressible adjunct with intermediate supporting structures
US10172620B2 (en) 2015-09-30 2019-01-08 Ethicon Llc Compressible adjuncts with bonding nodes
JP7010813B2 (ja) * 2015-09-30 2022-01-26 エシコン エルエルシー ループ部材を有する圧縮性補助材
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US20170224332A1 (en) 2016-02-09 2017-08-10 Ethicon Endo-Surgery, Llc Surgical instruments with non-symmetrical articulation arrangements
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
JP6911054B2 (ja) 2016-02-09 2021-07-28 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 非対称の関節構成を備えた外科用器具
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10376263B2 (en) 2016-04-01 2019-08-13 Ethicon Llc Anvil modification members for surgical staplers
US10617413B2 (en) 2016-04-01 2020-04-14 Ethicon Llc Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts
EP3442430B1 (en) 2016-04-12 2021-07-14 Applied Medical Resources Corporation Reload shaft assembly for surgical stapler
ES2878152T3 (es) 2016-04-12 2021-11-18 Applied Med Resources Grapadora quirúrgica con mecanismo de articulación
ES2938241T3 (es) 2016-04-12 2023-04-05 Applied Med Resources Grapadora quirúrgica con un mango motorizado
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US11607239B2 (en) 2016-04-15 2023-03-21 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved stop/start control during a firing motion
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control during a firing motion
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10478181B2 (en) 2016-04-18 2019-11-19 Ethicon Llc Cartridge lockout arrangements for rotary powered surgical cutting and stapling instruments
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
US10959731B2 (en) * 2016-06-14 2021-03-30 Covidien Lp Buttress attachment for surgical stapling instrument
US11026686B2 (en) 2016-11-08 2021-06-08 Covidien Lp Structure for attaching buttress to anvil and/or cartridge of surgical stapling instrument
US10695055B2 (en) 2016-12-21 2020-06-30 Ethicon Llc Firing assembly comprising a lockout
US10881401B2 (en) 2016-12-21 2021-01-05 Ethicon Llc Staple firing member comprising a missing cartridge and/or spent cartridge lockout
US10675026B2 (en) 2016-12-21 2020-06-09 Ethicon Llc Methods of stapling tissue
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
US20180168615A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument
US10682138B2 (en) 2016-12-21 2020-06-16 Ethicon Llc Bilaterally asymmetric staple forming pocket pairs
US10448950B2 (en) 2016-12-21 2019-10-22 Ethicon Llc Surgical staplers with independently actuatable closing and firing systems
US10492785B2 (en) 2016-12-21 2019-12-03 Ethicon Llc Shaft assembly comprising a lockout
US20180168625A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling instruments with smart staple cartridges
US10736629B2 (en) 2016-12-21 2020-08-11 Ethicon Llc Surgical tool assemblies with clutching arrangements for shifting between closure systems with closure stroke reduction features and articulation and firing systems
US10639035B2 (en) 2016-12-21 2020-05-05 Ethicon Llc Surgical stapling instruments and replaceable tool assemblies thereof
US10856868B2 (en) 2016-12-21 2020-12-08 Ethicon Llc Firing member pin configurations
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
US10835246B2 (en) 2016-12-21 2020-11-17 Ethicon Llc Staple cartridges and arrangements of staples and staple cavities therein
US11419606B2 (en) 2016-12-21 2022-08-23 Cilag Gmbh International Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems
MX2019007311A (es) 2016-12-21 2019-11-18 Ethicon Llc Sistemas de engrapado quirurgico.
JP6983893B2 (ja) 2016-12-21 2021-12-17 エシコン エルエルシーEthicon LLC 外科用エンドエフェクタ及び交換式ツールアセンブリのためのロックアウト構成
US11191540B2 (en) 2016-12-21 2021-12-07 Cilag Gmbh International Protective cover arrangements for a joint interface between a movable jaw and actuator shaft of a surgical instrument
JP7010956B2 (ja) 2016-12-21 2022-01-26 エシコン エルエルシー 組織をステープル留めする方法
US10874768B2 (en) 2017-01-20 2020-12-29 Covidien Lp Drug eluting medical device
US10869663B2 (en) 2017-02-17 2020-12-22 Ethicon Llc End effector configured to mate with adjunct materials
US10716564B2 (en) 2017-02-17 2020-07-21 Ethicon Llc Stapling adjunct attachment
US10575850B2 (en) 2017-02-17 2020-03-03 Ethicon Llc Systems for release of adjunct in a surgical stapling device
US10881402B2 (en) 2017-02-17 2021-01-05 Ethicon Llc Surgical end effector adjunct attachment
US10765426B2 (en) 2017-02-17 2020-09-08 Ethicon Llc Systems for coupling adjuncts to an end effector
US11006954B2 (en) 2017-02-17 2021-05-18 Ethicon Llc Suction attachment of an adjunct to a surgical instrument
US20180235625A1 (en) 2017-02-17 2018-08-23 Ethicon Llc End effector with adjunct materials
US10925601B2 (en) 2017-02-17 2021-02-23 Ethicon Llc Surgical end effector adjunct attachment
US11202632B2 (en) * 2017-02-17 2021-12-21 Cilag Gmbh International Adjunct material with mating features
US10729438B2 (en) 2017-02-17 2020-08-04 Ethicon Llc Hybrid mechanism for attachment of an adjunct to a surgical instrument
US10555734B2 (en) 2017-02-17 2020-02-11 Ethicon Llc Methods and systems for mating constrictable adjunct materials with end effectors
US10478183B2 (en) 2017-02-17 2019-11-19 Ethicon Llc Adjunct release for surgical staplers
US10485544B2 (en) 2017-02-17 2019-11-26 Ethicon Llc End effector having extension features for mating with adjuncts
US11141150B2 (en) 2017-02-17 2021-10-12 Cilag Gmbh International Buttress loader for surgical staplers
US10478280B2 (en) 2017-02-17 2019-11-19 Ethicon Llc Methods and devices for delivering and securing adjunct materials to a treatment site
US10646221B2 (en) 2017-02-17 2020-05-12 Ethicon Llc Surgical adjunct retaining mechanisms
US10925607B2 (en) 2017-02-28 2021-02-23 Covidien Lp Surgical stapling apparatus with staple sheath
US10368868B2 (en) 2017-03-09 2019-08-06 Covidien Lp Structure for attaching buttress material to anvil and cartridge of surgical stapling instrument
US11096610B2 (en) 2017-03-28 2021-08-24 Covidien Lp Surgical implants including sensing fibers
US11058804B2 (en) 2017-06-13 2021-07-13 Ethicon Llc Surgical fastener device for the prevention of ECM degradation
US20180353174A1 (en) 2017-06-13 2018-12-13 Ethicon Llc Surgical Stapler with Controlled Healing
US10939911B2 (en) 2017-06-13 2021-03-09 Ethicon Llc Surgical stapler with end effector coating
US11090046B2 (en) 2017-06-20 2021-08-17 Cilag Gmbh International Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument
US10327767B2 (en) 2017-06-20 2019-06-25 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10390841B2 (en) 2017-06-20 2019-08-27 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
US10368864B2 (en) 2017-06-20 2019-08-06 Ethicon Llc Systems and methods for controlling displaying motor velocity for a surgical instrument
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US11517325B2 (en) 2017-06-20 2022-12-06 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US11071554B2 (en) 2017-06-20 2021-07-27 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
US11382638B2 (en) 2017-06-20 2022-07-12 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance
US10888321B2 (en) 2017-06-20 2021-01-12 Ethicon Llc Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument
US10980537B2 (en) 2017-06-20 2021-04-20 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US10813639B2 (en) 2017-06-20 2020-10-27 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
US11141154B2 (en) 2017-06-27 2021-10-12 Cilag Gmbh International Surgical end effectors and anvils
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
USD854151S1 (en) 2017-06-28 2019-07-16 Ethicon Llc Surgical instrument shaft
USD851762S1 (en) * 2017-06-28 2019-06-18 Ethicon Llc Anvil
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
US11058424B2 (en) 2017-06-28 2021-07-13 Cilag Gmbh International Surgical instrument comprising an offset articulation joint
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
EP3420947B1 (en) 2017-06-28 2022-05-25 Cilag GmbH International Surgical instrument comprising selectively actuatable rotatable couplers
US11478242B2 (en) 2017-06-28 2022-10-25 Cilag Gmbh International Jaw retainer arrangement for retaining a pivotable surgical instrument jaw in pivotable retaining engagement with a second surgical instrument jaw
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
US10898183B2 (en) 2017-06-29 2021-01-26 Ethicon Llc Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US11304695B2 (en) 2017-08-03 2022-04-19 Cilag Gmbh International Surgical system shaft interconnection
US11944300B2 (en) 2017-08-03 2024-04-02 Cilag Gmbh International Method for operating a surgical system bailout
US11471155B2 (en) 2017-08-03 2022-10-18 Cilag Gmbh International Surgical system bailout
US11974742B2 (en) 2017-08-03 2024-05-07 Cilag Gmbh International Surgical system comprising an articulation bailout
US10849625B2 (en) 2017-08-07 2020-12-01 Covidien Lp Surgical buttress retention systems for surgical stapling apparatus
US10945733B2 (en) 2017-08-23 2021-03-16 Covidien Lp Surgical buttress reload and tip attachment assemblies for surgical stapling apparatus
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10729501B2 (en) 2017-09-29 2020-08-04 Ethicon Llc Systems and methods for language selection of a surgical instrument
US10765429B2 (en) 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
US10796471B2 (en) 2017-09-29 2020-10-06 Ethicon Llc Systems and methods of displaying a knife position for a surgical instrument
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
US11141151B2 (en) 2017-12-08 2021-10-12 Covidien Lp Surgical buttress for circular stapling
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US11197670B2 (en) 2017-12-15 2021-12-14 Cilag Gmbh International Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
US10828033B2 (en) 2017-12-15 2020-11-10 Ethicon Llc Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto
US10779825B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US10966718B2 (en) 2017-12-15 2021-04-06 Ethicon Llc Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US11006955B2 (en) 2017-12-15 2021-05-18 Ethicon Llc End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
US11020112B2 (en) 2017-12-19 2021-06-01 Ethicon Llc Surgical tools configured for interchangeable use with different controller interfaces
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
US10743868B2 (en) 2017-12-21 2020-08-18 Ethicon Llc Surgical instrument comprising a pivotable distal head
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US10695140B2 (en) 2018-02-15 2020-06-30 Ethicon Llc Near field communication between a surgical instrument and a robotic surgical system
US10702349B2 (en) 2018-02-20 2020-07-07 Ethicon Llc Robotic surgical instrument communication
CN112040884A (zh) 2018-02-21 2020-12-04 爱惜康有限责任公司 针织组织支架
USD885574S1 (en) 2018-02-21 2020-05-26 Ethicon Llc Knitted tissue scaffold
US10779817B2 (en) 2018-02-21 2020-09-22 Ethicon Llc Three dimensional adjuncts
USD882782S1 (en) 2018-02-21 2020-04-28 Ethicon Llc Three dimensional adjunct
US20190254667A1 (en) 2018-02-21 2019-08-22 Ethicon Llc Knitted tissue scaffolds
US10959721B2 (en) 2018-02-21 2021-03-30 Ethicon Llc Three dimensional adjuncts
US11065000B2 (en) 2018-02-22 2021-07-20 Covidien Lp Surgical buttresses for surgical stapling apparatus
WO2019169010A1 (en) 2018-02-27 2019-09-06 Applied Medical Resources Corporation Surgical stapler having a powered handle
US10758237B2 (en) 2018-04-30 2020-09-01 Covidien Lp Circular stapling apparatus with pinned buttress
US11284896B2 (en) 2018-05-09 2022-03-29 Covidien Lp Surgical buttress loading and attaching/detaching assemblies
US11426163B2 (en) 2018-05-09 2022-08-30 Covidien Lp Universal linear surgical stapling buttress
US11432818B2 (en) 2018-05-09 2022-09-06 Covidien Lp Surgical buttress assemblies
US11219460B2 (en) 2018-07-02 2022-01-11 Covidien Lp Surgical stapling apparatus with anvil buttress
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
US11039834B2 (en) 2018-08-20 2021-06-22 Cilag Gmbh International Surgical stapler anvils with staple directing protrusions and tissue stability features
US10806459B2 (en) 2018-09-14 2020-10-20 Covidien Lp Drug patterned reinforcement material for circular anastomosis
US10952729B2 (en) 2018-10-03 2021-03-23 Covidien Lp Universal linear buttress retention/release assemblies and methods
CA3131187A1 (en) 2019-02-27 2020-09-03 Applied Medical Resources Corporation Surgical stapling instrument having a two-position lockout mechanism
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11172929B2 (en) 2019-03-25 2021-11-16 Cilag Gmbh International Articulation drive arrangements for surgical systems
WO2020205643A1 (en) 2019-03-29 2020-10-08 Applied Medical Resources Corporation Reload cover for surgical stapling system
US11730472B2 (en) 2019-04-25 2023-08-22 Covidien Lp Surgical system and surgical loading units thereof
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US11478245B2 (en) 2019-05-08 2022-10-25 Covidien Lp Surgical stapling device
US11596403B2 (en) 2019-05-08 2023-03-07 Covidien Lp Surgical stapling device
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11350938B2 (en) 2019-06-28 2022-06-07 Cilag Gmbh International Surgical instrument comprising an aligned rfid sensor
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11969169B2 (en) 2019-09-10 2024-04-30 Covidien Lp Anvil buttress loading unit for a surgical stapling apparatus
US11642130B2 (en) 2019-09-16 2023-05-09 Cilag Gmbh International Compressible non-fibrous adjuncts
US11490890B2 (en) 2019-09-16 2022-11-08 Cilag Gmbh International Compressible non-fibrous adjuncts
US11571208B2 (en) 2019-10-11 2023-02-07 Covidien Lp Surgical buttress loading units
US11523824B2 (en) 2019-12-12 2022-12-13 Covidien Lp Anvil buttress loading for a surgical stapling apparatus
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11931033B2 (en) 2019-12-19 2024-03-19 Cilag Gmbh International Staple cartridge comprising a latch lockout
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11963711B2 (en) 2019-12-31 2024-04-23 Applied Medical Resources Corporation Electrosurgical system with tissue and maximum current identification
US11547407B2 (en) 2020-03-19 2023-01-10 Covidien Lp Staple line reinforcement for surgical stapling apparatus
US11337699B2 (en) 2020-04-28 2022-05-24 Covidien Lp Magnesium infused surgical buttress for surgical stapler
US11607216B2 (en) 2020-05-06 2023-03-21 Janssen Pharmaceuticals, Inc. Adaptive responses from smart packaging of drug delivery absorbable adjuncts
USD974560S1 (en) 2020-06-02 2023-01-03 Cilag Gmbh International Staple cartridge
USD975278S1 (en) 2020-06-02 2023-01-10 Cilag Gmbh International Staple cartridge
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
USD975850S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
US11737748B2 (en) 2020-07-28 2023-08-29 Cilag Gmbh International Surgical instruments with double spherical articulation joints with pivotable links
USD1029255S1 (en) 2020-09-01 2024-05-28 Cilag Gmbh International Stapling cartridge assembly with a compressible adjunct
US11707276B2 (en) 2020-09-08 2023-07-25 Covidien Lp Surgical buttress assemblies and techniques for surgical stapling
US11399833B2 (en) 2020-10-19 2022-08-02 Covidien Lp Anvil buttress attachment for surgical stapling apparatus
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
US11771428B2 (en) 2020-10-29 2023-10-03 Applied Medical Resources Corporation Actuation shaft retention mechanism for surgical stapler
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
US11730475B2 (en) 2020-10-29 2023-08-22 Applied Medical Resources Corporation Surgical stapler having a powered handle
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
US11617577B2 (en) 2020-10-29 2023-04-04 Cilag Gmbh International Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable
US11931025B2 (en) 2020-10-29 2024-03-19 Cilag Gmbh International Surgical instrument comprising a releasable closure drive lock
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
US11707279B2 (en) 2020-11-25 2023-07-25 Cilag Gmbh International Compressible knitted adjuncts with finished edges
US11648007B2 (en) 2020-11-25 2023-05-16 Cilag Gmbh International Compressible knitted adjuncts with varying fiber features
US11446027B2 (en) 2020-11-25 2022-09-20 Cilag Gmbh International Compressible knitted adjuncts with surface features
US11690617B2 (en) 2020-11-25 2023-07-04 Cilag Gmbh International Compressible knitted adjuncts with finished edges
US11678883B2 (en) 2020-11-25 2023-06-20 Cilag Gmbh International Compressible knitted adjuncts with varying interconnections
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11944296B2 (en) 2020-12-02 2024-04-02 Cilag Gmbh International Powered surgical instruments with external connectors
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11534170B2 (en) 2021-01-04 2022-12-27 Covidien Lp Anvil buttress attachment for surgical stapling apparatus
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11950779B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Method of powering and communicating with a staple cartridge
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11980362B2 (en) 2021-02-26 2024-05-14 Cilag Gmbh International Surgical instrument system comprising a power transfer coil
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11950777B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Staple cartridge comprising an information access control system
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11944336B2 (en) 2021-03-24 2024-04-02 Cilag Gmbh International Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11504125B2 (en) 2021-03-30 2022-11-22 Cilag Gmbh International Tissue thickness compensating adjuncts having regions of differential expansion
US20220313259A1 (en) 2021-03-30 2022-10-06 Cilag Gmbh International Implantable adjuncts having adjustable degradation profile
US11627961B2 (en) 2021-03-30 2023-04-18 Cilag Gmbh International Compressible adjuncts with different behavioral zones
US11849950B2 (en) 2021-03-30 2023-12-26 Cilag Gmbh International Compressible adjuncts with drug dosage control features
US11786240B2 (en) 2021-03-30 2023-10-17 Cilag Gmbh International Using smart packaging in adjusting use of tissue adjuncts
US11850332B2 (en) 2021-03-30 2023-12-26 Cilag Gmbh International Method for treating tissue
US11602341B2 (en) 2021-03-30 2023-03-14 Cilag Gmbh International Compressible adjuncts with drug release features
US20220313256A1 (en) 2021-03-30 2022-10-06 Cilag Gmbh International Passively powered packaging for tissue adjuncts
US20220313145A1 (en) 2021-03-30 2022-10-06 Cilag Gmbh International Monitoring healing after tissue adjunct implantation
US11896226B2 (en) 2021-03-30 2024-02-13 Cilag Gmbh International Compressible adjuncts with healing-dependent degradation profile
US11839374B2 (en) 2021-03-30 2023-12-12 Cilag Gmbh International Compressible adjuncts with drug release features
US20220313262A1 (en) 2021-03-30 2022-10-06 Cilag Gmbh International Composite adjuncts that degrade through multiple different mechanisms
US11864765B2 (en) 2021-03-30 2024-01-09 Cilag Gmbh International Compressible adjuncts with fluid control features
US20220313255A1 (en) 2021-03-30 2022-10-06 Cilag Gmbh International Smart packaging for tissue adjuncts
US20220378426A1 (en) 2021-05-28 2022-12-01 Cilag Gmbh International Stapling instrument comprising a mounted shaft orientation sensor
US11596399B2 (en) 2021-06-23 2023-03-07 Covidien Lp Anvil buttress attachment for surgical stapling apparatus
US11510670B1 (en) 2021-06-23 2022-11-29 Covidien Lp Buttress attachment for surgical stapling apparatus
US11672538B2 (en) 2021-06-24 2023-06-13 Covidien Lp Surgical stapling device including a buttress retention assembly
US11678879B2 (en) 2021-07-01 2023-06-20 Covidien Lp Buttress attachment for surgical stapling apparatus
US11684368B2 (en) 2021-07-14 2023-06-27 Covidien Lp Surgical stapling device including a buttress retention assembly
US11801052B2 (en) 2021-08-30 2023-10-31 Covidien Lp Assemblies for surgical stapling instruments
US20230103005A1 (en) 2021-09-29 2023-03-30 Cilag Gmbh International Methods for Controlling Cooperative Surgical Instruments
WO2023052935A1 (en) 2021-09-29 2023-04-06 Cilag Gmbh International Surgical devices, systems, and methods for control of one visualization with another
WO2023052937A1 (en) 2021-09-29 2023-04-06 Cilag Gmbh International Surgical system for altering the body's sensing of food
EP4225188A1 (en) 2021-09-29 2023-08-16 Cilag GmbH International Surgical devices, systems, and methods for control of one visualization with another
WO2023052945A1 (en) 2021-09-29 2023-04-06 Cilag Gmbh International Surgical devices, systems, and methods for control of one visualization with another
US20230096268A1 (en) 2021-09-29 2023-03-30 Cilag Gmbh International Methods for Controlling Cooperative Surgical Instruments
WO2023052941A1 (en) 2021-09-29 2023-04-06 Cilag Gmbh International Surgical system for delivering energy to tissue in an anatomic space and monitoring a tissue parameter in a different anatomic space
WO2023052936A1 (en) 2021-09-29 2023-04-06 Cilag Gmbh International Systems for controlling cooperative surgical instruments with variable surgical site access trajectories
WO2023052947A1 (en) 2021-09-29 2023-04-06 Cilag Gmbh International Surgical devices, systems, and methods for control of one visualization with another
US20230100698A1 (en) 2021-09-29 2023-03-30 Cilag Gmbh International Methods for Controlling Cooperative Surgical Instruments
US11751875B2 (en) 2021-10-13 2023-09-12 Coviden Lp Surgical buttress attachment assemblies for surgical stapling apparatus
US11980363B2 (en) 2021-10-18 2024-05-14 Cilag Gmbh International Row-to-row staple array variations
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters
US11957337B2 (en) 2021-10-18 2024-04-16 Cilag Gmbh International Surgical stapling assembly with offset ramped drive surfaces
US11937816B2 (en) 2021-10-28 2024-03-26 Cilag Gmbh International Electrical lead arrangements for surgical instruments
US11950781B2 (en) 2021-10-29 2024-04-09 Cilag Gmbh International Discrete adjunct attachment features for surgical stapler
US11806017B2 (en) 2021-11-23 2023-11-07 Covidien Lp Anvil buttress loading system for surgical stapling apparatus

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101069649A (zh) * 2006-01-31 2007-11-14 伊西康内外科公司 具有带组织定位器的砧座的一次性钉仓
CN104582592A (zh) * 2012-03-28 2015-04-29 伊西康内外科公司 具有结合亲水剂的厚度补偿件的组织缝合器

Family Cites Families (30)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5698213A (en) 1995-03-06 1997-12-16 Ethicon, Inc. Hydrogels of absorbable polyoxaesters
US5700583A (en) 1995-03-06 1997-12-23 Ethicon, Inc. Hydrogels of absorbable polyoxaesters containing amines or amido groups
RU2161450C1 (ru) * 1999-07-22 2001-01-10 Каншин Николай Николаевич Хирургический сшиватель
US20040044364A1 (en) * 2002-08-29 2004-03-04 Devries Robert Tissue fasteners and related deployment systems and methods
DE602005000891T2 (de) 2004-02-17 2008-01-17 Tyco Healthcare Group Lp, Norwalk Chirurgisches Klammernahtgerät mit Verriegelungsmechanismus
US7143925B2 (en) 2004-07-28 2006-12-05 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating EAP blocking lockout mechanism
EP1809342B1 (en) 2004-10-20 2015-08-05 Ethicon, Inc. Absorbable hemostat
US7772352B2 (en) 2005-01-28 2010-08-10 Bezwada Biomedical Llc Bioabsorbable and biocompatible polyurethanes and polyamides for medical devices
US7673781B2 (en) 2005-08-31 2010-03-09 Ethicon Endo-Surgery, Inc. Surgical stapling device with staple driver that supports multiple wire diameter staples
US20070260273A1 (en) 2006-05-08 2007-11-08 Ethicon Endo-Surgery, Inc. Endoscopic Translumenal Surgical Systems
CA2680148C (en) 2007-03-06 2015-09-01 Tyco Healthcare Group Lp Surgical stapling apparatus
US7604151B2 (en) 2007-03-15 2009-10-20 Ethicon Endo-Surgery, Inc. Surgical stapling systems and staple cartridges for deploying surgical staples with tissue compression features
US8062330B2 (en) * 2007-06-27 2011-11-22 Tyco Healthcare Group Lp Buttress and surgical stapling apparatus
US10500309B2 (en) * 2007-10-05 2019-12-10 Cook Biotech Incorporated Absorbable adhesives and their formulation for use in medical applications
US9770245B2 (en) 2008-02-15 2017-09-26 Ethicon Llc Layer arrangements for surgical staple cartridges
US20090234193A1 (en) 2008-03-13 2009-09-17 Ethicon Endo-Surgery, Inc. Apparatus for keeping clean a distal scope end of a medical viewing scope
US20090270686A1 (en) 2008-04-29 2009-10-29 Ethicon Endo-Surgery, Inc. Methods and devices for maintaining visibility during surgical procedures
US8801735B2 (en) 2010-07-30 2014-08-12 Ethicon Endo-Surgery, Inc. Surgical circular stapler with tissue retention arrangements
US8529600B2 (en) 2010-09-30 2013-09-10 Ethicon Endo-Surgery, Inc. Fastener system comprising a retention matrix
US9272406B2 (en) 2010-09-30 2016-03-01 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a cutting member for releasing a tissue thickness compensator
US9232941B2 (en) * 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US8857694B2 (en) 2010-09-30 2014-10-14 Ethicon Endo-Surgery, Inc. Staple cartridge loading assembly
US9220500B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising structure to produce a resilient load
US9414838B2 (en) 2012-03-28 2016-08-16 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprised of a plurality of materials
US8348130B2 (en) * 2010-12-10 2013-01-08 Covidien Lp Surgical apparatus including surgical buttress
US9198662B2 (en) 2012-03-28 2015-12-01 Ethicon Endo-Surgery, Inc. Tissue thickness compensator having improved visibility
CA2879933A1 (en) 2012-07-24 2014-01-30 Omrix Biopharmaceuticals Ltd. Device and method for the application of a curable fluid composition to a bodily organ
US9445808B2 (en) 2012-12-11 2016-09-20 Ethicon Endo-Surgery, Llc Electrosurgical end effector with tissue tacking features
US20150173756A1 (en) 2013-12-23 2015-06-25 Ethicon Endo-Surgery, Inc. Surgical cutting and stapling methods
US9913642B2 (en) 2014-03-26 2018-03-13 Ethicon Llc Surgical instrument comprising a sensor system

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101069649A (zh) * 2006-01-31 2007-11-14 伊西康内外科公司 具有带组织定位器的砧座的一次性钉仓
CN104582592A (zh) * 2012-03-28 2015-04-29 伊西康内外科公司 具有结合亲水剂的厚度补偿件的组织缝合器

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BR112016010236B1 (pt) 2022-03-15
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