CN106413577A - Implantable layers and methods for altering implantable layers for use with surgical fastening instruments - Google Patents

Implantable layers and methods for altering implantable layers for use with surgical fastening instruments Download PDF

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Publication number
CN106413577A
CN106413577A CN201580020868.0A CN201580020868A CN106413577A CN 106413577 A CN106413577 A CN 106413577A CN 201580020868 A CN201580020868 A CN 201580020868A CN 106413577 A CN106413577 A CN 106413577A
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CN
China
Prior art keywords
tissue thickness
thickness compensator
surface
portion
staple
Prior art date
Application number
CN201580020868.0A
Other languages
Chinese (zh)
Inventor
E·A·谢林
M·J·文德利
L·S·威纳
F·E·谢尔顿四世
T·W·阿伦霍尔特
D·L·雷诺兹二世
M·D·蒂默
J·J·唐纳斯
T·J·巴顿
Original Assignee
伊西康内外科有限责任公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to US14/187,383 priority Critical patent/US9839422B2/en
Application filed by 伊西康内外科有限责任公司 filed Critical 伊西康内外科有限责任公司
Priority to PCT/US2015/012162 priority patent/WO2015126556A1/en
Publication of CN106413577A publication Critical patent/CN106413577A/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07292Reinforcements for staple line, e.g. pledgets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064Surgical staples, i.e. penetrating the tissue
    • A61B17/0644Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00004(bio)absorbable, (bio)resorbable, resorptive
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00526Methods of manufacturing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07242Stapler heads achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07278Stapler heads characterised by its sled or its staple holder
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07285Stapler heads characterised by its cutter

Abstract

A method is disclosed for altering a implantable layer which includes the steps of obtaining an implantable layer comprising a surface at least partially comprised from a material with a glass transition temperature and a melting temperature, heating the surface to a temperature higher than the glass transition temperature and lower than the melting temperature, manipulating the surface, allowing the manipulated surface to cool below the glass transition temperature, and releasing the surface.

Description

可植入层和用于改变与外科紧固器械一起使用的可植入层的方法 The method of implantable layer and the layer used for an implantable surgical fastening instrument with changes in

背景技术 Background technique

[0001] 本发明涉及外科器械,并且在各种布置中,涉及被设计成缝合和切割组织的外科缝合和切割器械及其钉仓。 [0001] The present invention relates to surgical instruments and, in various arrangements, and that are designed to cut tissue stapling and cutting instrument of the surgical stapling and staple cartridge.

附图说明 BRIEF DESCRIPTION

[0002] 通过结合附图来参考本发明实施方案的以下说明,本发明的特征和优点以及实现这些特征和优点的方式将会变得更加明显,并且可更好地理解发明本身,其中: [0002] by reference to the following description of embodiments of the present invention in conjunction with the accompanying drawings, features and advantages of the present invention and the manner of implementation of these features and advantages will become more apparent and the invention itself will be better understood, in which:

[0003]图1为具有柄部部分的外科缝合和切断器械的左前透视图; [0003] Figure 1 is a left front perspective view of the handle portion of the surgical stapling and cutting instrument;

[0004]图2为图1的外科缝合和切断器械的两件式刀和击发杆(“E形梁”)的透视图; [0004] FIG. 2 is a surgical stapling and severing instrument of FIG. 1 is a perspective view a two-piece knife and firing bar of FIG. ( "E-beam"); ​​and

[0005]图3为钉施用组件的钉仓的楔形滑动件的透视图; [0005] FIG. 3 is a perspective view of the wedge of the slider staple cartridge of the staple applying assembly;

[0006]图4为钉仓和处于闭合位置的砧座的纵向剖面图,该钉仓包括刚性支撑部分和可压缩组织厚度补偿件,示出了钉在第一序列期间从未击发位置运动到击发位置; [0006] FIG. 4 is a longitudinal sectional view of a staple cartridge and the anvil in the closed position, the staple cartridge includes a rigid support portion and a compressible tissue thickness compensator, it shows a staple during a first unfired position to the sequence firing position;

[0007]图5为图4的砧座和钉仓的另一个剖面图,示出了完成击发序列后处于打开位置的石占座; [0007] FIG. 5 is an anvil and the staple cartridge 4 is another cross-sectional view illustrating the completion of the firing sequence in an open position of the seat on the stone;

[0008]图6为组织厚度补偿件和钉仓组件的分解透视图; [0008] FIG. 6 is an exploded perspective view of the tissue thickness compensator and the cartridge assembly of Figure 1;

[0009]图7为图6的钉仓组件的局部剖视图,示出定位在钉仓体的钉腔中且部分嵌入组织厚度补偿件中的未击发的钉; [0009] FIG. 7 is a partial cross-sectional view of the cartridge assembly of FIG. 6, is shown positioned in the staple cavities of the staple cartridge body and partially embedded in the unfired staple tissue thickness of compensator;

[0010]图8为图6的钉仓组件的局部剖视图,示出从钉仓体的钉腔射出且抵靠砧座成形的击发的钉,并且进一步示出组织厚度补偿件和捕获在所成形的钉的钉截留区域内的组织; [0010] FIG. 8 is a partial cross-sectional view of the cartridge assembly of FIG. 6, illustrating emitted from the staple cavities of the staple cartridge body and against the anvil forming firing staples, and further illustrating the tissue thickness compensator and capture the formed tissue in the region of the cutoff of the staple;

[0011]图9为外科紧固器械的端部执行器的局部透视图,其中一些部分移除而示出,并且其他部分以横截面示出;此外,端部执行器的切割构件被示为处于部分推进位置; [0011] FIG. 9 is a partial perspective view of the end effector of a surgical fastening instrument, with portions removed and shown, and other portions shown in cross-section; In addition, the end cutting member is shown as in a partially advanced position;

[0012]图10为图9的端部执行器的局部剖面端视图,其中示出患者组织捕获在端部执行器的砧座和组织厚度补偿件之间;此外,可移除地储存在端部执行器的仓体内的钉被示为处于未击发位置并且端部执行器的切割构件被示为处于靠近组织厚度补偿件的未推进位置; [0012] FIG. 10 is a view of the end effector 9 is a partial cross-sectional end view showing patient tissue captured between the end of the anvil and the tissue thickness compensator; moreover, the end is removably stored at a staple cartridge body portion of the actuator is shown in an unfired position and end cutting member is shown in a close tissue thickness compensator member is not advanced position;

[0013]图11为图9的端部执行器的局部剖面端视图,其中示出钉处于击发位置并且切割构件处于部分推进位置,其中患者组织已被至少部分地横切; [0013] FIG. 11 is a view of the end effector 9 is a partial cross-sectional end view showing the staples and cutting member in the cocked position in a partially advanced position, wherein the patient tissue has been at least partially cross;

[0014]图12为图9的端部执行器的局部剖面端视图,其中示出钉处于击发位置并且切割构件处于推进位置,其中组织厚度补偿件的至少一部分已被切割构件横切; [0014] FIG. 12 is a view of the end effector 9 is a partial cross-sectional end view showing the staple in the cocked position and the cutting member is in an advanced position, wherein the tissue thickness compensator has been cut at least a portion of cross member;

[0015]图13为包括组织厚度补偿件的紧固件仓的透视图; [0015] FIG. 13 is a perspective view of a fastener cartridge member of the tissue thickness compensator;

[0016]图14为图13的组织厚度补偿件的剖视图,示出相对于组织厚度补偿件的近侧端部定位的切割构件; Cross-sectional view of the tissue thickness compensator [0016] FIG 14 FIG 13 shows a cutting member proximal end tissue thickness compensator member positioned with respect to;

[0017]图15为组织厚度补偿件组件的分解图; [0017] FIG. 15 is an exploded view of the tissue thickness compensator assembly;

[0018]图16为组织厚度补偿件组件层的透视图; [0018] FIG. 16 is a perspective view of a tissue layer thickness compensator assembly;

[0019]图17为图15的组织厚度补偿件组件的剖视图; Cross-sectional view of the tissue thickness compensator assembly [0019] FIG 17 FIG 15;

[0020]图18为组装的组织厚度补偿件组件以及用于组装其的模具的剖面透视图; [0020] FIG. 18 is assembled tissue thickness compensator assembly and a sectional perspective view of a mold assembly which was;

[0021]图19为图18的组装的组织厚度补偿件组件的透视图; [0021] FIG. 19 is an assembled perspective view of FIG. 18 tissue thickness compensator assembly;

[0022]图20为组织厚度补偿件组件以及用于组装其的模具的透视图; [0022] 20 well tissue thickness compensator assembly for assembling a perspective view of a mold of FIG thereof;

[0023]图21为组织厚度补偿件组件以及用于组装其的模具的透视图; [0023] FIG. 21 is a perspective view of a mold assembly which tissue thickness compensator assembly and a map;

[0024]图22为图21的组织厚度补偿件组件以及图21的用于组装其的模具的剖面透视图; [0024] FIG 22 FIG 21 is a tissue thickness compensator assembly and a sectional perspective view of a 21 mold assembly thereof;

[0025]图23为包括组织厚度补偿件的端部执行器的透视图; [0025] FIG. 23 is a perspective view of the end effector of the tissue thickness compensator;

[0026]图24为图23的端部执行器和组织厚度补偿件以及修改组织厚度补偿件的修改构件的透视图; [0026] FIG 24 FIG 23 is a perspective view of a modified member of the end effector and the tissue thickness and alteration of the thickness of the compensator of the compensator;

[0027]图25为图23的包括图24的修改的组织厚度补偿件的端部执行器的透视图; [0027] FIG 25 FIG 23 is a perspective view of a modified tissue thickness compensator 24 of the end effector;

[0028]图26为组织厚度补偿件的剖面透视图; [0028] FIG. 26 is a cross-sectional perspective view of the tissue thickness compensator member;

[0029]图27为用于修改图26的组织厚度补偿件的模具的剖面透视图; [0029] FIG. 27 is a perspective cross-sectional view of a mold for the modified tissue thickness compensator of FIG. 26;

[0030]图28为图26的在由图27的模具修改之后的组织厚度补偿件的剖面透视图; [0030] FIG. 28 is a sectional perspective view of the tissue thickness compensator member from the mold after the modification of FIG. 27 in FIG. 26;

[0031]图29为组织厚度补偿件的剖面透视图; [0031] FIG. 29 is a sectional perspective view of the tissue thickness compensator member;

[0032]图30为用于修改图29的组织厚度补偿件的模具的剖面透视图; [0032] FIG. 30 is a perspective cross-sectional view of a mold for the modified tissue thickness compensator of FIG. 29;

[0033]图31为图29的在由图30的模具修改之后的组织厚度补偿件的剖面透视图; [0033] FIG. 31 is a cross-sectional perspective view of FIG. 29 tissue thickness compensator member from the mold after the modification in FIG. 30;

[0034]图32为组织厚度补偿件的剖面透视图; [0034] FIG. 32 is a perspective cross-sectional view of the tissue thickness compensator member;

[0035]图33为用于修改图32的组织厚度补偿件的模具的剖面透视图; [0035] Figure 33 a perspective cross-sectional view of a mold for tissue thickness compensator 32 of FIG modification;

[0036]图34为图32的在由图33的模具修改之后的组织厚度补偿件的剖面透视图; 34 a cross-sectional perspective view [0036] FIG. FIG. 32 is a modification from the mold after 33 tissue thickness compensator;

[0037]图35为包括第一高度的组织厚度补偿件的剖面透视图; [0037] FIG. 35 is a perspective view of a first cross section including the height of the tissue thickness compensator;

[0038]图36为图35的在修改以将第一高度改变为第二高度的组织厚度补偿件的剖面透视图; [0038] FIG. 36 is a modification of FIG. 35 is changed to a first height to a second height tissue thickness compensator sectional perspective view;

[0039]图37为用于修改图35的组织厚度补偿件的模具的剖视图; [0039] FIG. 37 is a cross-sectional view of a mold for the modified tissue thickness compensator of FIG. 35;

[0040]图38为组织厚度补偿件的剖面透视图; [0040] FIG. 38 is a sectional perspective view of the tissue thickness compensator member;

[0041]图39为图38的在修改之后的组织厚度补偿件的剖面透视图; [0041] FIG. 39 is a cross-sectional perspective view of the tissue thickness compensator in FIG. 38 after revision of;

[0042]图40为示出压缩力对组织厚度补偿件的弹性比率的影响的曲线图; [0042] FIG. 40 is a graph showing the influence of the resilient force of the compression ratio of the thickness of the compensator of the tissue;

[0043]图41为组织厚度补偿件的剖面透视图; [0043] FIG. 41 is a cross-sectional perspective view of the tissue thickness compensator member;

[0044]图42为用于修改图41的组织厚度补偿件的空间创建器的剖面透视图; A sectional perspective view of a space [0044] FIG 42 FIG 41 is a modified tissue thickness compensator creator;

[0045]图43为图41的在由图42的空间创建器修改之后的组织厚度补偿件的剖面透视图; [0045] FIG. 43 is a cross-sectional perspective view of the tissue thickness compensator member after the space created by the FIG. 42 is a modification of FIG. 41;

[0046]图44为根据至少一个实施方案的与包括击发构件的外科器械一起使用的紧固件仓的局部剖视正视图,其中部分移除而示出; [0046] FIG. 44 is a partial cross-sectional view of the fastener cartridge for use with a surgical instrument including a firing member in at least one embodiment of a front view in which is shown partially removed;

[0047]图45为局部剖视正视图,示出正从紧固件仓移除的图44的紧固件仓的组织厚度补偿件和示为处于锁定状态的图44的击发构件; [0047] FIG. 45 is a partial cross-sectional elevational view showing the fastener cartridge being removed from the fastener cartridge of FIG. 44 and compensator tissue thickness in a locked state shown in FIG. 44, the firing member;

[0048]图46为图45的组织厚度补偿件的局部透视图; [0048] FIG. 46 is a partial perspective view of FIG tissue thickness compensator 45 of FIG;

[0049]图47为根据至少一个实施方案的组织厚度补偿件的局部透视图; [0049] FIG. 47 is a partial perspective view of the tissue thickness compensator at least one member of the embodiment;

[0050]图48为包括具有图47的组织厚度补偿件的紧固件仓、滑动件以及由滑动件支撑的击发构件的外科器械的端部执行器的局部剖视正视图,其中部分移除而示出; [0050] FIG. 48 is a cartridge comprising a fastener having a tissue thickness compensator of FIG. 47, the local end of the slide member and the firing of the surgical instrument is supported by the sliding member cross-sectional elevational view, partly removed is shown;

[0051]图49为图48的端部执行器的局部剖视正视图,示出处于部分击发位置的击发构件; [0051] FIG. 49 is a partial end view of FIG. 48 is a front cross-sectional view showing the firing member in a partially fired position;

[0052]图50为图48的端部执行器的局部剖视正视图,示出从紧固件仓移除的组织厚度补偿件和处于锁定状态中的击发构件; Local [0052] FIG 50 FIG 48 is a cross-sectional end elevational view showing the firing member removed from the fastener cartridge and a tissue thickness compensator member in a locked state;

[0053]图51为根据至少一个实施方案的紧固件仓的局部透视图,其中部分移除而示出; [0053] FIG. 51, wherein partially removing a partial perspective view of a fastener cartridge according to at least one embodiment is shown;

[0054]图52为图51的紧固件仓的滑动件的透视图; [0054] FIG. 52 is a perspective view of the slide fastener cartridge of FIG. 51, FIG;

[0055]图53为图51的紧固件仓的局部透视图; [0055] FIG. 53 is a partial perspective view of the fastener cartridge of FIG 51;

[0056]图54为根据至少一个实施方案的滑动件的正视图; [0056] FIG. 54 is a front view of the sliding member to at least one embodiment;

[0057]图55为根据至少一个实施方案的被示为处于未锁定构型的滑动件的透视图; [0057] FIG. 55 is a perspective view of the configuration of the slide at least one embodiment is shown in an unlocked;

[0058]图56为图55的被示为处于锁定构型的滑动件的透视图; [0058] FIG. 56 is shown in FIG. 55 is a perspective view of a locking configuration of the sliding member;

[0059]图57为图55的定位在紧固件仓内的滑动件的局部剖视正视图,示出处于其未锁定构型的滑动件,由滑动件支撑的击发构件,以及与滑动件接合的紧固件仓的组织厚度补偿件; [0059] FIG. 57 is a positioning member 55 slides in the local fastener cartridge in cross-sectional elevational view, shown in its unlocked configuration, the slide member, the firing member supported by the slide member, and the sliding member tissue thickness compensator fastener cartridge engagement member;

[0060]图58为图57的正从图57的紧固件仓移除的组织厚度补偿件的局部剖视正视图,该紧固件仓将图55的滑动件置于其锁定构型并且将图57的击发构件置于锁定状态; [0060] FIG. 58 is a partially being removed from the fastener cartridge of FIG tissue thickness compensator 57 of FIG. FIG. 57 is a sectional elevational view of the slider of FIG fastener cartridge 55 is placed in its locked configuration, and FIG firing member 57 is in the locked state;

[0061]图59为根据至少一个实施方案的定位在紧固件仓的近侧端部处的滑动件的局部剖视正视图,其中部分移除而示出; [0061] FIG 59 is positioned according to at least one embodiment of the slide fastener in a partial proximal end of the cartridge at a sectional front view in which is shown partially removed;

[0062]图60为图59的被示为处于紧固件仓的远侧端部处的滑动件的局部剖视正视图; [0062] FIG. 60 is shown in FIG. 59 is a partial distal end of the slide fastener is at a cross-sectional elevational view of the cartridge;

[0063]图61是根据至少一个实施方案的滑动件的透视图; [0063] FIG. 61 is a perspective view of a sliding member at least one embodiment;

[0064]图62为示出根据至少一个实施方案的包括多个倒钩的钉的图示,其中钉被示为处于未成形构型和变形构型中; [0064] FIG. 62 is shown to include a plurality of barbs staples illustrating least one embodiment, wherein an unformed staple is shown in a configuration and the deformed configuration;

[0065]图63为根据至少一个实施方案的包括多个倒钩的钉的正视图,其中钉定位在处于未击发位置的钉腔内; [0065] FIG. 63 is a front view of a barb comprises a plurality of at least one embodiment of the staples, wherein the staples in the staple cavity positioned in the unfired position;

[0066]图64为根据至少一个实施方案的包括多个倒钩的钉的正视图; [0066] FIG. 64 is a front view of a staple comprising a plurality of barbs to at least one embodiment;

[0067]图65为根据至少一个实施方案的包括多个倒钩的钉的正视图; [0067] FIG. 65 is a front view of a staple comprising a plurality of barbs to at least one embodiment;

[0068]图66为根据至少一个实施方案的包括多个倒钩的钉的正视图; [0068] FIG. 66 comprises a plurality of barbs according staples elevational view of at least one embodiment;

[0069]图67为根据至少一个实施方案的包括多个倒钩的钉的正视图; [0069] FIG. 67 comprises a plurality of barbs is a front view of staples according to at least one embodiment;

[0070]图68为根据至少一个实施方案的包括多个倒钩的钉的正视图,其中钉定位在处于未击发位置的钉腔内; [0070] FIG. 68 is a front view of a barb comprises a plurality of at least one embodiment of the staples, wherein the staples in the staple cavity positioned in the unfired position;

[0071]图69为图68的钉和钉腔的平面图; [0071] FIG. 69 is a plan view of the staple and staple cavities 68;

[0072]图70为根据至少一个实施方案的带倒钩的钉腿的局部透视图; [0072] FIG. 70 is a partial perspective view of a barbed staple leg according to at least one embodiment;

[0073]图71为图68的钉的带倒钩的钉腿的局部透视图; [0073] FIG. 71 is a partial perspective view of the staple legs as the staples 68 of FIG barbed;

[0074]图71A为图71的带倒钩的钉腿的剖视平面图; [0074] FIG 71A is a cross-sectional plan view of the barbed legs of the staple of Figure 71;

[0075]图72为根据至少一个实施方案的带倒钩的钉腿的局部透视图;并且 [0075] FIG. 72 is a partial perspective view of a barbed staple leg according to at least one embodiment; and

[0076]图73为根据至少一个实施方案的带倒钩的钉腿的局部透视图。 [0076] FIG. 73 is a partial perspective view of a tape at least one embodiment of the barbed legs of the staple.

具体实施方式 Detailed ways

[0077] 本申请的申请人还拥有以下鉴定的美国专利申请,这些美国专利申请各自以引用方式各自整体并入本文: [0077] The present applicant has also identified the following U.S. patent applications, each of these U.S. patent applications are incorporated by reference in their entirety herein:

[0078]名称为“SURGICAL INSTRUMENTS WITH RECONFIGURABLE SHAFT SEGMENTS”的美国专利申请序列号12/894,311 (现为美国专利公布2012/0080496); [0078] entitled "SURGICAL INSTRUMENTS WITH RECONFIGURABLE SHAFT SEGMENTS" U.S. Patent Application Serial No. 12 / 894,311 (now U.S. Patent Publication 2012/0080496);

[0079]名称为“SURGICAL STAPLE CARTRIDGES SUPPORTING NON-LINEARLY ARRANGEDSTAPLES AND SURGICAL STAPLING INSTRUMENTS WITH COMMON STAPLE-FORMING POCKETS”的美国专利申请序列号12/894,340 (现为美国专利公布2012/0080482); [0079] entitled "SURGICAL STAPLE CARTRIDGES SUPPORTING NON-LINEARLY ARRANGEDSTAPLES AND SURGICAL STAPLING INSTRUMENTS WITH COMMON STAPLE-FORMING POCKETS" U.S. Patent Application Serial No. 12 / 894,340 (now U.S. Patent Publication 2012/0080482);

[0080]名称为“JAW CLOSURE ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号12/894,327(现为美国专利公布2012/0080499); [0080] entitled "JAW CLOSURE ARRANGEMENTS FOR SURGICAL INSTRUMENTS" U.S. Patent Application Serial No. 12 / 894,327 (now U.S. Patent Publication 2012/0080499);

[0081]名称为 “SURGICAL CUTTING AND FASTENING INSTRUMENTS WITH SEPARATE ANDDISTINCT FASTENER DEPLOYMENT AND TISSUE CUTTING SYSTEMS” 的美国专利申请序列号12/894,351 (现为美国专利公布2012/0080502); [0081] entitled "SURGICAL CUTTING AND FASTENING INSTRUMENTS WITH SEPARATE ANDDISTINCT FASTENER DEPLOYMENT AND TISSUE CUTTING SYSTEMS" U.S. Patent Application Serial No. 12 / 894,351 (now U.S. Patent Publication 2012/0080502);

[0082]名称为 “IMPLANTABLE FASTENER CARTRIDGE HAVING A NON-UNIFORMARRANGEMENT”的美国专利申请序列号12/894,338 (现为美国专利公布2012/0080481); [0082] entitled "IMPLANTABLE FASTENER CARTRIDGE HAVING A NON-UNIFORMARRANGEMENT" U.S. Patent Application Serial No. 12 / 894,338 (now U.S. Patent Publication 2012/0080481);

[0083]名称为“頂PLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER”的美国专利申请序列号12/894,369 (现为美国专利公布2012/0080344); [0083] entitled "Top PLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER" U.S. Patent Application Serial No. 12 / 894,369 (now U.S. Patent Publication 2012/0080344);

[0084]名称为“頂PLANTABLE FASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS”的美国专利申请序列号12/894,312(现为美国专利公布2012/0080479); [0084] entitled "Top PLANTABLE FASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS" U.S. Patent Application Serial No. 12 / 894,312 (now U.S. Patent Publication 2012/0080479);

[0085]名称为 “SELECTIVELY 0RIENTABLE IMPLANTABLE FASTENER CARTRIDGE” 的美国专利申请序列号12/894,377 (现为美国专利8,393,514); [0085] entitled "SELECTIVELY 0RIENTABLE IMPLANTABLE FASTENER CARTRIDGE" U.S. Patent Application Serial No. 12 / 894,377 (now U.S. Patent No. 8,393,514);

[0086]名称为 “SURGICAL STAPLING INSTRUMENT WITH COMPACT ARTICULAT1N CONTROLARRANGEMENT”的美国专利申请序列号12/894,339 (现为美国专利公布2012/0080500); [0086] entitled "SURGICAL STAPLING INSTRUMENT WITH COMPACT ARTICULAT1N CONTROLARRANGEMENT" U.S. Patent Application Serial No. 12 / 894,339 (now U.S. Patent Publication 2012/0080500);

[0087]名称为“SURGICAL STAPLING INSTRUMENT WITH A VARIABLE STAPLE FORMINGSYSTEM”的美国专利申请序列号12/894,360 (现为美国专利公布2012/0080484); [0087] entitled "SURGICAL STAPLING INSTRUMENT WITH A VARIABLE STAPLE FORMINGSYSTEM" U.S. Patent Application Serial No. 12 / 894,360 (now U.S. Patent Publication 2012/0080484);

[0088]名称为 “SURGICAL STAPLING INSTRUMENT WITH INTERCHANGEABLE STAPLECARTRIDGE ARRANGEMENTS”的美国专利申请序列号12/894,322 (现为美国专利公布2012/0080501); [0088] entitled "SURGICAL STAPLING INSTRUMENT WITH INTERCHANGEABLE STAPLECARTRIDGE ARRANGEMENTS" U.S. Patent Application Serial No. 12 / 894,322 (now U.S. Patent Publication 2012/0080501);

[0089]名称为 “SURGICAL STAPLE CARTRIDGES WITH DETACHABLE SUPPORT STRUCTURES”的美国专利申请序列号12/894,350 (现为美国专利公布2012/0080478); [0089] entitled "SURGICAL STAPLE CARTRIDGES WITH DETACHABLE SUPPORT STRUCTURES" U.S. Patent Application Serial No. 12 / 894,350 (now U.S. Patent Publication 2012/0080478);

[0090]名称为 “IMPLANTABLE FASTENER CARTRIDGE COMPRISING B10ABS0RBABLELAYERS”的美国专利申请序列号12/894,383 (现为美国专利公布2012/0080345); [0090] entitled "IMPLANTABLE FASTENER CARTRIDGE COMPRISING B10ABS0RBABLELAYERS" U.S. Patent Application Serial No. 12 / 894,383 (now U.S. Patent Publication 2012/0080345);

[0091]名称为“COMPRESSIBLE FASTENER CARTRIDGE”的美国专利申请序列号12/894,389(现为美国专利公布2012/0080335); [0091] entitled "COMPRESSIBLE FASTENER CARTRIDGE" U.S. Patent Application Serial No. 12 / 894,389 (now U.S. Patent Publication 2012/0080335);

[0092]名称为 “FASTENERS SUPPORTED BY A FASTENER CARTRIDGE SUPPORT” 的美国专利申请序列号12/894,345 (现为美国专利公布2012/0080483); [0092] entitled "FASTENERS SUPPORTED BY A FASTENER CARTRIDGE SUPPORT" U.S. Patent Application Serial No. 12 / 894,345 (now U.S. Patent Publication 2012/0080483);

[0093]名称为 “COLLAPSIBLE FASTENER CARTRIDGE” 的美国专利申请序列号12/894,306(现为美国专利公布2012/0080332); [0093] entitled "COLLAPSIBLE FASTENER CARTRIDGE" U.S. Patent Application Serial No. 12 / 894,306 (now U.S. Patent Publication 2012/0080332);

[0094]名称为“FASTENER SYSTEM COMPRISING A PLURALITY OF CONNECTED RETENT1NMATRIX ELEMENTS”的美国专利申请序列号12/894,318(现为美国专利公布2012/0080480); [0094] entitled "FASTENER SYSTEM COMPRISING A PLURALITY OF CONNECTED RETENT1NMATRIX ELEMENTS" U.S. Patent Application Serial No. 12 / 894,318 (now U.S. Patent Publication 2012/0080480);

[0095]名称为“FASTENER SYSTEM COMPRISING A RETENT1N MATRIX AND AN ALIGNMENTMATRIX”的美国专利申请序列号12/894,330 (现为美国专利公布2012/0080503); [0095] entitled "FASTENER SYSTEM COMPRISING A RETENT1N MATRIX AND AN ALIGNMENTMATRIX" U.S. Patent Application Serial No. 12 / 894,330 (now U.S. Patent Publication 2012/0080503);

[0096]名称为 “FASTENER SYSTEM COMPRISING A RETENT1N MATRIX” 的美国专利申请序列号12/894,361 (现为美国专利8,529,600); [0096] entitled "FASTENER SYSTEM COMPRISING A RETENT1N MATRIX" U.S. Patent Application Serial No. 12 / 894,361 (now U.S. Patent No. 8,529,600);

[0097]名称为 “FASTENING INSTRUMENT FOR DEPLOYING A FASTENER SYSTEMCOMPRISING A RETENT1N MATRIX”的美国专利申请序列号12/894,367 (现为美国专利公布2012/0080485); [0097] entitled "FASTENING INSTRUMENT FOR DEPLOYING A FASTENER SYSTEMCOMPRISING A RETENT1N MATRIX" U.S. Patent Application Serial No. 12 / 894,367 (now U.S. Patent Publication 2012/0080485);

[0098]名称为“FASTENER SYSTEM COMPRISING A RETENT1N MATRIX AND A COVER”的美国专利申请序列号12/894,388 (现为美国专利8,474,677); [0098] entitled "FASTENER SYSTEM COMPRISING A RETENT1N MATRIX AND A COVER" U.S. Patent Application Serial No. 12 / 894,388 (now U.S. Patent No. 8,474,677);

[0099]名称为“FASTENER SYSTEM COMPRISING A PLURALITY OF FASTENER CARTRIDGES”的美国专利申请序列号12/894,376 (现为美国专利公布2012/0080486); [0099] entitled "FASTENER SYSTEM COMPRISING A PLURALITY OF FASTENER CARTRIDGES" U.S. Patent Application Serial No. 12 / 894,376 (now U.S. Patent Publication 2012/0080486);

[0100]名称为 “SURGICAL STAPLER ANVIL COMPRISING A PLURALITY OF FORMINGPOCKETS”的美国专利申请序列号13/097,865 (现为美国专利公布2012/0080488); [0100] entitled "SURGICAL STAPLER ANVIL COMPRISING A PLURALITY OF FORMINGPOCKETS" U.S. Patent Application Serial No. 13 / 097,865 (now U.S. Patent Publication 2012/0080488);

[0101]名称为 “TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER” 的美国专利申请序列号13/097,936 (现为美国专利公布2012/0080339); [0101] entitled "TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER" U.S. Patent Application Serial No. 13 / 097,936 (now U.S. Patent Publication 2012/0080339);

[0102]名称为“STAPLE CARTRIDGE COMPRISING A VARIABLE THICKNESS COMPRESSIBLEPORT1N”的美国专利申请序列号13/097,954 (现为美国专利公布2012/0080340); [0102] entitled "STAPLE CARTRIDGE COMPRISING A VARIABLE THICKNESS COMPRESSIBLEPORT1N" U.S. Patent Application Serial No. 13 / 097,954 (now U.S. Patent Publication 2012/0080340);

[0103]名称为 “STAPLE CARTRIDGE ⑶MPRISING STAPLES POSIT1NED WITHIN ACOMPRESSIBLE PORT1N THEREOF”的美国专利申请序列号13/097,856 (现为美国专利公布2012/0080336); [0103] entitled "STAPLE CARTRIDGE ⑶MPRISING STAPLES POSIT1NED WITHIN ACOMPRESSIBLE PORT1N THEREOF" U.S. Patent Application Serial No. 13 / 097,856 (now U.S. Patent Publication 2012/0080336);

[0104]名称为 “TISSUE THICKNESS COMPENSATOR COMPRISING DETACHABLE PORT1NS” 的美国专利申请序列号13/097,928 (现为美国专利公布2012/0080490); [0104] entitled "TISSUE THICKNESS COMPENSATOR COMPRISING DETACHABLE PORT1NS" U.S. Patent Application Serial No. 13 / 097,928 (now U.S. Patent Publication 2012/0080490);

[0105]名称为 “TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER COMPRISINGAN ADJUSTABLE ANVIL”的美国专利申请序列号13/097,891 (现为美国专利公布2012/0080489); [0105] entitled "TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER COMPRISINGAN ADJUSTABLE ANVIL" U.S. Patent Application Serial No. 13 / 097,891 (now U.S. Patent Publication 2012/0080489);

[0106]名称为 “STAPLE CARTRIDGE COMPRISING AN ADJUSTABLE DISTAL PORT1N” 的美国专利申请序列号13/097,948 (现为美国专利公布2012/0083836); [0106] entitled "STAPLE CARTRIDGE COMPRISING AN ADJUSTABLE DISTAL PORT1N" U.S. Patent Application Serial No. 13 / 097,948 (now U.S. Patent Publication 2012/0083836);

[0107]名称为“COMPRESSIBLE STAPLE CARTRIDGE ASSEMBLY”的美国专利申请序列号13/097,907 (现为美国专利公布2012/0080338); [0107] entitled "COMPRESSIBLE STAPLE CARTRIDGE ASSEMBLY" U.S. Patent Application Serial No. 13 / 097,907 (now U.S. Patent Publication 2012/0080338);

[0108]名称为 “TISSUE THICKNESS ⑶MPENSAT0R COMPRISING PORT1NS HAVINGDIFFERENT PROPERTIES”的美国专利申请序列号13/097,861 (现为美国专利公布2012/0080337); [0108] entitled "TISSUE THICKNESS ⑶MPENSAT0R COMPRISING PORT1NS HAVINGDIFFERENT PROPERTIES" U.S. Patent Application Serial No. 13 / 097,861 (now U.S. Patent Publication 2012/0080337);

[0109]名称为 “STAPLE CARTRIDGE LOADING ASSEMBLY” 的美国专利申请序列号13/097,869 (现为美国专利公布2012/0160721); [0109] entitled "STAPLE CARTRIDGE LOADING ASSEMBLY" U.S. Patent Application Serial No. 13 / 097,869 (now U.S. Patent Publication 2012/0160721);

[0110]名称为 “COMPRESSIBLE STAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS” 的美国专利申请序列号13/097,917 (现为美国专利公布2012/0083834); [0110] entitled "COMPRESSIBLE STAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS" U.S. Patent Application Serial No. 13 / 097,917 (now U.S. Patent Publication 2012/0083834);

[0111]名称为 “STAPLE CARTRIDGE COMPRISING A RELEASABLE PORT1N” 的美国专利申请序列号13/097,873 (现为美国专利公布2012/0083833); [0111] entitled "STAPLE CARTRIDGE COMPRISING A RELEASABLE PORT1N" U.S. Patent Application Serial No. 13 / 097,873 (now U.S. Patent Publication 2012/0083833);

[0112]名称为“STAPLE CARTRIDGE COMPRISING COMPRESSIBLE DISTORT1N RESISTANTCOMPONENTS”的美国专利申请序列号13/097,938 (现为美国专利公布2012/0080491); [0112] entitled "STAPLE CARTRIDGE COMPRISING COMPRESSIBLE DISTORT1N RESISTANTCOMPONENTS" U.S. Patent Application Serial No. 13 / 097,938 (now U.S. Patent Publication 2012/0080491);

[0113]名称为 “STAPLE CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR” 的美国专利申请序列号13/097,924 (现为美国专利公布2012/0083835); [0113] entitled "STAPLE CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR" U.S. Patent Application Serial No. 13 / 097,924 (now U.S. Patent Publication 2012/0083835);

[0114]名称为 “SURGICAL STAPLER WITH FLOATING ANVIL” 的美国专利申请序列号13/242,029 (现为美国专利公布2012/0080493); [0114] entitled "SURGICAL STAPLER WITH FLOATING ANVIL" U.S. Patent Application Serial No. 13 / 242,029 (now U.S. Patent Publication 2012/0080493);

[0115]名称为 “CURVED END EFFECTOR FOR A STAPLING INSTRUMENT” 的美国专利申请序列号13/242,066 (现为美国专利公布2012/0080498); [0115] entitled "CURVED END EFFECTOR FOR A STAPLING INSTRUMENT" U.S. Patent Application Serial No. 13 / 242,066 (now U.S. Patent Publication 2012/0080498);

[0116]名称为“STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK”的美国专利申请序列号13/242,086 (现为美国专利公布2013/0075450); [0116] entitled "STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK" U.S. Patent Application Serial No. 13 / 242,086 (now U.S. Patent Publication 2013/0075450);

[0117]名称为 “STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK ARRANGEMENT” 的美国专利申请序列号13/241,912 (现为美国专利公布2013/0075448); [0117] entitled "STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK ARRANGEMENT" U.S. Patent Application Serial No. 13 / 241,912 (now U.S. Patent Publication 2013/0075448);

[0118]名称为 “SURGICAL STAPLER WITH STAT1NARY STAPLE DRIVERS” 的美国专利申请序列号13/241,922 (现为美国专利公布2013/0075449); [0118] entitled "SURGICAL STAPLER WITH STAT1NARY STAPLE DRIVERS" U.S. Patent Application Serial No. 13 / 241,922 (now U.S. Patent Publication 2013/0075449);

[0119]名称为 “SURGICAL INSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATINGMULTIPLE ACTUAT1N MOT1NS”的美国专利申请序列号13/241,637 (现为美国专利公布2012/0074201); [0119] entitled "SURGICAL INSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATINGMULTIPLE ACTUAT1N MOT1NS" U.S. Patent Application Serial No. 13 / 241,637 (now U.S. Patent Publication 2012/0074201);

[0120]名称为 “SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE ENDEFFECTOR”的美国专利申请序列号13/241,629 (现为美国专利公布2012/0074200); [0120] entitled "SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE ENDEFFECTOR" U.S. Patent Application Serial No. 13 / 241,629 (now U.S. Patent Publication 2012/0074200);

[0121]名称为 “TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OFCAPSULES”的美国专利申请序列号13/433,096 (现为美国专利公布2012/0241496); [0121] entitled "TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OFCAPSULES" U.S. Patent Application Serial No. 13 / 433,096 (now U.S. Patent Publication 2012/0241496);

[0122]名称为“TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF LAYERS”的美国专利申请序列号13/433,103(现为美国专利公布2012/0241498); [0122] entitled "TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF LAYERS" U.S. Patent Application Serial No. 13 / 433,103 (now U.S. Patent Publication 2012/0241498);

[0123] 名称为“EXPANDABLE TISSUE THICKNESS⑶MPENSAT0R”的美国专利申请序列号13/433,098 (现为美国专利公布2012/0241491); [0123] entitled "EXPANDABLE TISSUE THICKNESS⑶MPENSAT0R" U.S. Patent Application Serial No. 13 / 433,098 (now U.S. Patent Publication 2012/0241491);

[0124]名称为 “TISSUE THICKNESS COMPENSATOR COMPRISING A RESERVOIR” 的美国专利申请序列号13/433,102(现为美国专利公布2012/0241497); [0124] entitled "TISSUE THICKNESS COMPENSATOR COMPRISING A RESERVOIR" U.S. Patent Application Serial No. 13 / 433,102 (now U.S. Patent Publication 2012/0241497);

[0125]名称为 “RETAINER ASSEMBLY INCLUDING A TISSUE THICKNESS COMPENSATOR” 的美国专利申请序列号13/433,114(现为美国专利公布2012/0241499); [0125] entitled "RETAINER ASSEMBLY INCLUDING A TISSUE THICKNESS COMPENSATOR" U.S. Patent Application Serial No. 13 / 433,114 (now U.S. Patent Publication 2012/0241499);

[0126]名称为 “TISSUE THICKNESS COMPENSATOR COMPRISING AT LEAST ONEMEDICAMENT”的美国专利申请序列号13/433,136 (现为美国专利公布2012/0241492); [0126] entitled "TISSUE THICKNESS COMPENSATOR COMPRISING AT LEAST ONEMEDICAMENT" U.S. Patent Application Serial No. 13 / 433,136 (now U.S. Patent Publication 2012/0241492);

[0127]名称为“TISSUE THICKNESS COMPENSATOR COMPRISING CONTROLLED RELEASE ANDEXPANS1N”的美国专利申请序列号13/433,141 (现为美国专利公布2012/0241493); [0127] entitled "TISSUE THICKNESS COMPENSATOR COMPRISING CONTROLLED RELEASE ANDEXPANS1N" U.S. Patent Application Serial No. 13 / 433,141 (now U.S. Patent Publication 2012/0241493);

[0128]名称为“TISSUE THICKNESS ⑶MPENSAT0R ⑶MPRISING FIBERS TO PRODUCE ARESILIENT LOAD”的美国专利申请序列号13/433,144 (现为美国专利公布2012/0241500); [0128] entitled "TISSUE THICKNESS ⑶MPENSAT0R ⑶MPRISING FIBERS TO PRODUCE ARESILIENT LOAD" U.S. Patent Application Serial No. 13 / 433,144 (now U.S. Patent Publication 2012/0241500);

[0129]名称为“TISSUE THICKNESS COMPENSATOR COMPRISING STRUCTURE TO PRODUCE ARESILIENT LOAD”的美国专利申请序列号13/433,148 (现为美国专利公布2012/0241501); [0129] entitled "TISSUE THICKNESS COMPENSATOR COMPRISING STRUCTURE TO PRODUCE ARESILIENT LOAD" U.S. Patent Application Serial No. 13 / 433,148 (now U.S. Patent Publication 2012/0241501);

[0130]名称为“TISSUE THICKNESS COMPENSATOR COMPRISING RESILIENT MEMBERS”的美国专利申请序列号13/433,155(现为美国专利公布2012/0241502); [0130] entitled "TISSUE THICKNESS COMPENSATOR COMPRISING RESILIENT MEMBERS" U.S. Patent Application Serial No. 13 / 433,155 (now U.S. Patent Publication 2012/0241502);

[0131]名称为“METHODS FOR FORMING TISSUE THICKNESS COMPENSATOR ARRANGEMENTSFOR SURGICAL STAPLERS”的美国专利申请序列号13/433,163 (现为美国专利公布2012/0248169); [0131] entitled "METHODS FOR FORMING TISSUE THICKNESS COMPENSATOR ARRANGEMENTSFOR SURGICAL STAPLERS" U.S. Patent Application Serial No. 13 / 433,163 (now U.S. Patent Publication 2012/0248169);

[0132]名称为 “TISSUE THICKNESS ⑶MPENSAT0RS” 的美国专利申请序列号13/433,167(现为美国专利公布2012/0241503); [0132] entitled "TISSUE THICKNESS ⑶MPENSAT0RS" U.S. Patent Application Serial No. 13 / 433,167 (now U.S. Patent Publication 2012/0241503);

[0133] 名称为“LAYERED TISSUE THICKNESS⑶MPENSAT0R”的美国专利申请序列号13/433,175 (现为美国专利公布2012/0253298); [0133] entitled "LAYERED TISSUE THICKNESS⑶MPENSAT0R" U.S. Patent Application Serial No. 13 / 433,175 (now U.S. Patent Publication 2012/0253298);

[0134]名称为“TISSUE THICKNESS COMPENSATORS FOR CIRCULAR SURGICAL STAPLERS”的美国专利申请序列号13/433,179 (现为美国专利公布2012/0241505); [0134] entitled "TISSUE THICKNESS COMPENSATORS FOR CIRCULAR SURGICAL STAPLERS" U.S. Patent Application Serial No. 13 / 433,179 (now U.S. Patent Publication 2012/0241505);

[0135] 名称为“ADHESIVE FILM LAMINATE”的美国专利申请序列号13/763,028 (现为美国专利公布2013/0146643); [0135] entitled "ADHESIVE FILM LAMINATE" U.S. Patent Application Serial No. 13 / 763,028 (now U.S. Patent Publication 2013/0146643);

[0136]名称为“TISSUE THICKNESS ⑶MPENSAT0R ⑶MPRISING CAPSULES DEFINING ALOW PRESSURE ENVIRONMENT”的美国专利申请序列号13/433,115 (现为美国专利公布2013/0256372); [0136] entitled "TISSUE THICKNESS ⑶MPENSAT0R ⑶MPRISING CAPSULES DEFINING ALOW PRESSURE ENVIRONMENT" U.S. Patent Application Serial No. 13 / 433,115 (now U.S. Patent Publication 2013/0256372);

[0137]名称为 “TISSUE THICKNESS COMPENSATOR COMPRISED OF A PLURALITY OFMATERIALS”的美国专利申请序列号13/433,118 (现为美国专利公布2013/0256365); [0137] entitled "TISSUE THICKNESS COMPENSATOR COMPRISED OF A PLURALITY OFMATERIALS" U.S. Patent Application Serial No. 13 / 433,118 (now U.S. Patent Publication 2013/0256365);

[0138]名称为 “MOVABLE MEMBER FOR USE WITH A TISSUE THICKNESS COMPENSATOR” 的美国专利申请序列号13/433,135(现为美国专利公布2013/0256382); [0138] entitled "MOVABLE MEMBER FOR USE WITH A TISSUE THICKNESS COMPENSATOR" U.S. Patent Application Serial No. 13 / 433,135 (now U.S. Patent Publication 2013/0256382);

[0139]名称为 “TISSUE THICKNESS COMPENSATOR AND METHOD FOR MAKING THE SAME” 的美国专利申请序列号13/433,140 (现为美国专利公布2013/0256368); [0139] entitled "TISSUE THICKNESS COMPENSATOR AND METHOD FOR MAKING THE SAME" U.S. Patent Application Serial No. 13 / 433,140 (now U.S. Patent Publication 2013/0256368);

[0140]名称为 “TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OFMEDICAMENTS”的美国专利申请序列号13/433,129 (现为美国专利公布2013/0256367); [0140] entitled "TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OFMEDICAMENTS" U.S. Patent Application Serial No. 13 / 433,129 (now U.S. Patent Publication 2013/0256367);

[0141]名称为 “STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMEDSTAPLE HEIGHTS”的美国专利申请序列号11/216,562 (现为美国专利7,669,746); [0141] entitled "STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMEDSTAPLE HEIGHTS" U.S. Patent Application Serial No. 11 / 216,562 (now U.S. Patent No. 7,669,746);

[0142]名称为 “SURGICAL STAPLING DEVICE WITH ANVIL HAVING STAPLE FORMINGPOCKETS OF VARYING DEPTHS”的美国专利申请序列号11/714,049 (现为美国专利公布2007/0194082); [0142] name "SURGICAL STAPLING DEVICE WITH ANVIL HAVING STAPLE FORMINGPOCKETS OF VARYING DEPTHS" US Patent Application Serial No. 11 / 714,049 (now US Patent Publication 2007/0194082);

[0143]名称为“SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVINGDIFFERENT LENGTHS”的美国专利申请序列号11/711,979 (现为美国专利8,317,070); [0143] entitled "SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVINGDIFFERENT LENGTHS" U.S. Patent Application Serial No. 11 / 711,979 (now U.S. Patent No. 8,317,070);

[0144]名称为 “SURGICAL STAPLING DEVICE WITH STAPLE DRIVERS OF DIFFERENTHEIGHT”的美国专利申请序列号11/711,975 (现为美国专利公布2007/0194079); [0144] name "SURGICAL STAPLING DEVICE WITH STAPLE DRIVERS OF DIFFERENTHEIGHT" US Patent Application Serial No. 11 / 711,975 (now US Patent Publication 2007/0194079);

[0145]名称为 “SURGICAL STAPLING DEVICE WITH STAPLE DRIVER THAT SUPPORTSMULTIPLE WIRE DIAMETER STAPLES”的美国专利申请序列号11/711,977 (现为美国专利7,673,781); [0145] entitled "SURGICAL STAPLING DEVICE WITH STAPLE DRIVER THAT SUPPORTSMULTIPLE WIRE DIAMETER STAPLES" U.S. Patent Application Serial No. 11 / 711,977 (now U.S. Patent No. 7,673,781);

[0146]名称为 “SURGICAL STAPLING DEVICE WITH MULTIPLE STACKED ACTUATOR WEDGECAMS FOR DRIVING STAPLE DRIVERS”的美国专利申请序列号11/712,315 (现为美国专利7,500,979); [0146] entitled "SURGICAL STAPLING DEVICE WITH MULTIPLE STACKED ACTUATOR WEDGECAMS FOR DRIVING STAPLE DRIVERS" U.S. Patent Application Serial No. 11 / 712,315 (now U.S. Patent No. 7,500,979);

[0147]名称为 “STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMEDSTAPLE HEIGHTS”的美国专利申请序列号12/038,939(现为美国专利7,934,630); [0147] entitled "STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMEDSTAPLE HEIGHTS" U.S. Patent Application Serial No. 12 / 038,939 (now U.S. Patent No. 7,934,630);

[0148]名称为 “SURGICAL STAPLING SYSTEMS THAT PRODUCE FORMED STAPLES HAVINGDIFFERENT LENGTHS”的美国专利申请序列号13/020,263 (现为美国专利公布2011/0147434); [0148] entitled "SURGICAL STAPLING SYSTEMS THAT PRODUCE FORMED STAPLES HAVINGDIFFERENT LENGTHS" U.S. Patent Application Serial No. 13 / 020,263 (now U.S. Patent Publication 2011/0147434);

[0149]名称为 “ROBOTICALLY-CONTROLLED SURGICAL STAPLING DEVICES THAT PRODUCEFORMED STAPLES HAVING DIFFERENT LENGTHS”的美国专利申请序列号13/118,278 (现为美国专利公布2011/0290851); [0149] entitled "ROBOTICALLY-CONTROLLED SURGICAL STAPLING DEVICES THAT PRODUCEFORMED STAPLES HAVING DIFFERENT LENGTHS" U.S. Patent Application Serial No. 13 / 118,278 (now U.S. Patent Publication 2011/0290851);

[0150]名称为“ROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS”的美国专利申请序列号13/369,629 (现为美国专利公布2012/0138660); [0150] entitled "ROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS" U.S. Patent Application Serial No. 13 / 369,629 (now U.S. Patent Publication 2012/0138660);

[0151]名称为“SURGICAL STAPLING DEVICES FOR FORMING STAPLES WITH DIFFERENTFORMED HEIGHTS”的美国专利申请序列号12/695,359 (现为美国专利8,464,923); [0151] entitled "SURGICAL STAPLING DEVICES FOR FORMING STAPLES WITH DIFFERENTFORMED HEIGHTS" U.S. Patent Application Serial No. 12 / 695,359 (now U.S. Patent No. 8,464,923);

[0152]名称为 “STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMEDSTAPLE HEIGHTS”的美国专利申请序列号13/072,923 (现为美国专利8,567,656); [0152] entitled "STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMEDSTAPLE HEIGHTS" U.S. Patent Application Serial No. 13 / 072,923 (now U.S. Patent No. 8,567,656);

[0153]名称为 “LAYER OF MATERIAL FOR A SURGICAL END EFFECTOR” 的美国专利申请序列号13/766,325 (现为美国专利公布2013/0256380); [0153] entitled "LAYER OF MATERIAL FOR A SURGICAL END EFFECTOR" U.S. Patent Application Serial No. 13 / 766,325 (now U.S. Patent Publication 2013/0256380);

[0154]名称为“ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR”的美国专利申请序列号13/763,078 (现为美国专利公布2013/0256383); [0154] entitled "ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR" U.S. Patent Application Serial No. 13 / 763,078 (now U.S. Patent Publication 2013/0256383);

[0155]名称为“LAYER COMPRISING DEPLOYABLE ATTACHMENT MEMBERS”的美国专利申请序列号13/763,094 (现为美国专利公布2013/0256377); [0155] entitled "LAYER COMPRISING DEPLOYABLE ATTACHMENT MEMBERS" U.S. Patent Application Serial No. 13 / 763,094 (now U.S. Patent Publication 2013/0256377);

[0156]名称为“END EFFECTOR COMPRISING A DISTAL TISSUE ABUTMENT MEMBER”的美国专利申请序列号13/763,106 (现为美国专利公布2013/0256378); [0156] entitled "END EFFECTOR COMPRISING A DISTAL TISSUE ABUTMENT MEMBER" U.S. Patent Application Serial No. 13 / 763,106 (now U.S. Patent Publication 2013/0256378);

[0157]名称为 “TISSUE THICKNESS COMPENSATOR COMPRISING CHANNELS” 的美国专利申请序列号13/433,147 (现为美国专利公布2013/0256369); [0157] entitled "TISSUE THICKNESS COMPENSATOR COMPRISING CHANNELS" U.S. Patent Application Serial No. 13 / 433,147 (now U.S. Patent Publication 2013/0256369);

[0158]名称为“SURGICAL STAPLING CARTRIDGE WITH LAYER RETENT1N FEATURES”的美国专利申请序列号13/763,112(现为美国专利公布2013/0256379); [0158] entitled "SURGICAL STAPLING CARTRIDGE WITH LAYER RETENT1N FEATURES" U.S. Patent Application Serial No. 13 / 763,112 (now U.S. Patent Publication 2013/0256379);

[0159]名称为“ACTUATOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM AFASTENER CARTRIDGE”的美国专利申请序列号13/763,035 (现为美国专利公布2013/0214030); [0159] entitled "ACTUATOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM AFASTENER CARTRIDGE" U.S. Patent Application Serial No. 13 / 763,035 (now U.S. Patent Publication 2013/0214030);

[0160]名称为“RELEASABLE TISSUE THICKNESS COMPENSATOR AND FASTENER CARTRIDGEHAVING THE SAME”的美国专利申请序列号13/763,042 (现为美国专利公布2013/0221063); [0160] entitled "RELEASABLE TISSUE THICKNESS COMPENSATOR AND FASTENER CARTRIDGEHAVING THE SAME" U.S. Patent Application Serial No. 13 / 763,042 (now U.S. Patent Publication 2013/0221063);

[0161]名称为“FASTENER CARTRIDGE ⑶MPRISING A RELEASABLE TISSUE THICKNESSCOMPENSATOR”的美国专利申请序列号13/763,048 (现为美国专利公布2013/0221064); [0161] entitled "FASTENER CARTRIDGE ⑶MPRISING A RELEASABLE TISSUE THICKNESSCOMPENSATOR" U.S. Patent Application Serial No. 13 / 763,048 (now U.S. Patent Publication 2013/0221064);

[0162]名称为“FASTENER CARTRIDGE COMPRISING A CUTTING MEMBER FOR RELEASING ATISSUE THICKNESS COMPENSATOR”的美国专利申请序列号13/763,054; [0162] entitled "FASTENER CARTRIDGE COMPRISING A CUTTING MEMBER FOR RELEASING ATISSUE THICKNESS COMPENSATOR" U.S. Patent Application Serial No. 13 / 763,054;

[0163]名称为 “FASTENER CARTRIDGE ⑶MPRISING A RELEASABLY ATTACHED TISSUETHICKNESS⑶MPENSAT0R”的美国专利申请序列号13/763 ,065 (现为美国专利公布2013/0221065); [0163] entitled "FASTENER CARTRIDGE ⑶MPRISING A RELEASABLY ATTACHED TISSUETHICKNESS⑶MPENSAT0R" U.S. Patent Application Serial No. 13/763, 065 (now U.S. Patent Publication 2013/0221065);

[0164]名称为“STAPLE CARTRIDGE COMPRISING A RELEASABLE COVER”的美国专利申请序列号13/763,021; [0164] entitled "STAPLE CARTRIDGE COMPRISING A RELEASABLE COVER" U.S. Patent Application Serial No. 13 / 763,021;

[0165]名称为“ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR”的美国专利申请序列号13/763,078 (现为美国专利公布2013/0256383); [0165] entitled "ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR" U.S. Patent Application Serial No. 13 / 763,078 (now U.S. Patent Publication 2013/0256383);

[0166]名称为“LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES”的美国专利申请序列号13/763,095(现为美国专利公布2013/0161374); [0166] entitled "LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES" U.S. Patent Application Serial No. 13 / 763,095 (now U.S. Patent Publication 2013/0161374);

[0167]名称为“頂PLANTABLE ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES”的美国专利申请序列号13/463,147 (现为美国专利公布2013/0292398); [0167] entitled "Top PLANTABLE ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES" U.S. Patent Application Serial No. 13 / 463,147 (now U.S. Patent Publication 2013/0292398);

[0168]名称为“MULTIPLE THICKNESS IMPLANTABLE LAYERS FOR SURGICAL STAPLINGDEVICES”的美国专利申请序列号13/763,192 (现为美国专利公布2013/0146642); [0168] entitled "MULTIPLE THICKNESS IMPLANTABLE LAYERS FOR SURGICAL STAPLINGDEVICES" U.S. Patent Application Serial No. 13 / 763,192 (now U.S. Patent Publication 2013/0146642);

[0169]名称为 “RELEASABLE LAYER OF MATERIAL AND SURGICAL END EFFECTOR HAVINGTHE SAME”的美国专利申请序列号13/763,161 (现为美国专利公布2013/0153641); [0169] entitled "RELEASABLE LAYER OF MATERIAL AND SURGICAL END EFFECTOR HAVINGTHE SAME" U.S. Patent Application Serial No. 13 / 763,161 (now U.S. Patent Publication 2013/0153641);

[0170]名称为 “ACTUATOR FOR RELEASING A LAYER OF MATERIAL FROM A SURGICAL ENDEFFECTOR”的美国专利申请序列号13/763,177(现为美国专利公布2013/0146641); [0170] entitled "ACTUATOR FOR RELEASING A LAYER OF MATERIAL FROM A SURGICAL ENDEFFECTOR" U.S. Patent Application Serial No. 13 / 763,177 (now U.S. Patent Publication 2013/0146641);

[0171]名称为 “STAPLE CARTRIDGE COMPRISING A COMPRESSIBLE PORT1N” 的美国专利申请序列号13/763,037; [0171] entitled "STAPLE CARTRIDGE COMPRISING A COMPRESSIBLE PORT1N" U.S. Patent Application Serial No. 13 / 763,037;

[0172]名称为 “TISSUE THICKNESS ⑶MPENSAT0R COMPRISING TISSUE INGROWTHFEATURES”的美国专利申请序列号13/433,126 (现为美国专利公布2013/0256366); [0172] entitled "TISSUE THICKNESS ⑶MPENSAT0R COMPRISING TISSUE INGROWTHFEATURES" U.S. Patent Application Serial No. 13 / 433,126 (now U.S. Patent Publication 2013/0256366);

[0173]名称为 “DEVICES AND METHODS FOR ATTACHING TISSUE THICKNESSCOMPENSATING MATERIALS TO SURGICAL STAPLING INSTRUMENTS” 的美国专利申请序列号13/433,132 (现为美国专利公布2013/0256373)。 [0173] entitled "DEVICES AND METHODS FOR ATTACHING TISSUE THICKNESSCOMPENSATING MATERIALS TO SURGICAL STAPLING INSTRUMENTS" U.S. Patent Application Serial No. 13 / 433,132 (now U.S. Patent Publication 2013/0256373).

[0174]名称为“FASTENER CARTRIDGE ⑶MPRISING A TISSUE THICKNESS ⑶MPENSAT0RINCLUDING OPENINGS THEREIN”的美国专利申请序列号13/851,703; [0174] entitled "FASTENER CARTRIDGE ⑶MPRISING A TISSUE THICKNESS ⑶MPENSAT0RINCLUDING OPENINGS THEREIN" U.S. Patent Application Serial No. 13 / 851,703;

[0175]名称为“TISSUE THICKNESS COMPENSATOR COMPRISING A CUTTING MEMBER PATH”的美国专利申请序列号13/851,676; [0175] entitled "TISSUE THICKNESS COMPENSATOR COMPRISING A CUTTING MEMBER PATH" U.S. Patent Application Serial No. 13 / 851,676;

[0176]名称为“FASTENER CARTRIDGE ASSEMBLIES” 的美国专利申请序列号13/851,693;以及 [0176] entitled "FASTENER CARTRIDGE ASSEMBLIES" U.S. Patent Application Serial No. 13 / 851,693; and

[0177]名称为“FASTENER CARTRIDGE ⑶MPRISING A TISSUE THICKNESS ⑶MPENSATORAND A GAP SETTING ELEMENT”的美国专利申请序列号13/851,684。 [0177] entitled "FASTENER CARTRIDGE ⑶MPRISING A TISSUE THICKNESS ⑶MPENSATORAND A GAP SETTING ELEMENT" U.S. Patent Application Serial No. 13 / 851,684.

[0178] 本申请的申请人还拥有以下专利申请,所述专利申请与本申请同一天提交并且全文各自以引用方式并入本文: [0178] The applicant of the present application also has the following patent applications, the patent application filed on the same day as the present application and is incorporated by reference in their entirety herein:

[0179]名称为 “STAPLE CARTRIDGE INCLUDING A BARBED STAPLE” 的美国专利申请序列号_(代理人案卷号END7439USNP); [0179] entitled "STAPLE CARTRIDGE INCLUDING A BARBED STAPLE" U.S. Patent Application Serial No. _ (Attorney Docket No. END7439USNP);

[0180]名称为 “STAPLE CARTRIDGE INCLUDING A BARBED STAPLE” 的美国专利申请序列号_(代理人案卷号END7440USNP); [0180] entitled "STAPLE CARTRIDGE INCLUDING A BARBED STAPLE" U.S. Patent Application Serial No. _ (Attorney Docket No. END7440USNP);

[0181]名称为 “STAPLE CARTRIDGE INCLUDING A BARBED STAPLE” 的美国专利申请序列号_(代理人案卷号END7441USNP); [0181] entitled "STAPLE CARTRIDGE INCLUDING A BARBED STAPLE" U.S. Patent Application Serial No. _ (Attorney Docket No. END7441USNP);

[0182]名称为 “IMPLANTABLE LAYERS AND METHODS FOR ALTERING ONE OR MOREPROPERTIES OF IMPLANTABLE LAYERS FOR USE WITH FASTENING INSTRUMENTS” 的美国专利申请序列号_(代理人案卷号END7348USNP/130324); [0182] entitled "IMPLANTABLE LAYERS AND METHODS FOR ALTERING ONE OR MOREPROPERTIES OF IMPLANTABLE LAYERS FOR USE WITH FASTENING INSTRUMENTS" U.S. Patent Application Serial No. _ (Attorney Docket No. END7348USNP / 130324);

[0183]名称为“頂PLANTABLE LAYERS AND METHODS FOR MODIFYING THE SHAPE OF THEIMPLANTABLE LAYERS FOR USE WITH A SURGICAL FASTENING INSTRUMENT” 的美国专利申请序列号_(代理人案卷号END7347USNP/130325); [0183] entitled "Top PLANTABLE LAYERS AND METHODS FOR MODIFYING THE SHAPE OF THEIMPLANTABLE LAYERS FOR USE WITH A SURGICAL FASTENING INSTRUMENT" U.S. Patent Application Serial No. _ (Attorney Docket No. END7347USNP / 130325);

[0184] 名称为“頂PLANTABLE LAYER ASSEMBLIES”的美国专利申请序列号___(代理人案卷号END7346USNP/130326); [0184] entitled "Top PLANTABLE LAYER ASSEMBLIES" U.S. Patent Application Serial No. ___ (Attorney Docket No. END7346USNP / 130326);

[0185]名称为“頂PLANTABLE LAYERS COMPRISING A PRESSED REG1N”的美国专利申请序列号_(代理人案卷号END7345USNP/130327);以及 [0185] entitled "Top PLANTABLE LAYERS COMPRISING A PRESSED REG1N" U.S. Patent Application Serial No. _ (Attorney Docket No. END7345USNP / 130327); and

[0186]名称为 “FASTENING SYSTEM COMPRISING A FIRING MEMBER LOCKOUT” 的美国专利申请序列号_(代理人案卷号END7350USNP/130328)。 [0186] entitled "FASTENING SYSTEM COMPRISING A FIRING MEMBER LOCKOUT" U.S. Patent Application Serial No. _ (Attorney Docket No. END7350USNP / 130328).

[0187] 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、制造和使用的原理。 [0187] Certain exemplary embodiments will now be described embodiment, to be understood that the apparatus and methods disclosed herein from the overall structure, function, manufacture, and use of the principle. 这些实施方案的一个或多个示例在附图中示出。 One or more examples of these embodiments are illustrated in the accompanying drawings. 本领域的普通技术人员将会理解,在本文中具体描述并示出于附图中的装置和方法为非限制性的示例性实施方案,并且本发明的多个实施方案的范围仅由权利要求书限定。 Those of ordinary skill in the art will appreciate that the detailed description and shown in non-limiting exemplary embodiments in the drawings for the devices and methods herein, and the scope of various embodiments of the present invention is limited only by the claims book defined. 结合一个示例性实施方案示出或描述的特征可与其他实施方案的特征进行组合。 In connection with one exemplary embodiment of the features shown or described may be combined with features of other embodiments. 此类修改和变型旨在包括在本发明的范围内。 Such modifications and variations are intended to be included within the scope of the present invention.

[0188] 术语“包括”(以及包括的任何形式,诸如“包括(c ο m P rises) ”和“包括(comprising)”)、“具有”(和具有的任何形式,诸如“具有(has)”和“具有(having)”)、“包含”(和包含的任何形式,诸如“包含(includes) ”、和“包含(including) ”以及“含有”(和含有的任何形式,诸如“含有(contains) ”和“含有(containing)”)为开放式系动词。因此,“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件,但不限于仅具有这些一个或多个元件。同样,“包括”、“具有”、“包含”或“含有”一个或多个特征的系统、装置、或设备的元件具有这些一个或多个特征,但不限于仅具有这些一个或多个特征。 [0188] The term "comprising" (and any form of comprising, such as "comprising (c ο m P rises)" and "including (comprising,)"), "having" (and any form of having, such as "have (has) "and" having (hAVING) ")," including "(and any form of comprising, such as" comprising (Includes) ", and" comprising (Including) "and" containing "(and any form of containing, such as" comprising ( the contains) "and" comprising (containing) ") is open-ended linking verbs. Thus," comprising "," having "," contains "or" containing "one or more surgical system, apparatus, or device having such an element or a plurality of elements, but not limited to possessing only those one or more elements. Similarly, "including", "having", "contains" or "containing" one or more features element system, apparatus, or device having these one or more features, but is not limited to possessing only those one or more features.

[0189] 术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。 [0189] The terms "proximal" and "distal" are clinician manipulating the handle portion of the surgical instrument with respect to use herein. 术语“近侧”是指最靠近临床医生的部分,并且术语“远侧”是指远离临床医生的部分。 The term "proximal" refers to the portion closest to the clinician, and the term "distal" refers to a portion away from the clinician. 还应当理解,为简洁和清楚起见,本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”之类的空间术语。 It should also be appreciated that for brevity and clarity, the drawings may be incorporated herein such as "vertical", "horizontal", spatial terms "upper" and "lower" and the like. 然而,外科器械在许多取向和位置中使用,并且这些术语并非限制性和/或绝对化的。 However, the surgical instruments are used in many orientations and positions, and these terms are not limiting, and / or the absolute.

[0190] 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。 [0190] Various exemplary to provide a method and apparatus for performing laparoscopic and minimally invasive surgical procedures. 然而,本领域的普通技术人员将容易理解,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,包括例如与开放式外科手术相结合。 However, those of ordinary skill in the art will readily appreciate, various methods and devices disclosed herein can be used in many surgical procedures and applications, including, for example, in combination with open surgical procedures. 继续参阅本具体实施方式,本领域中的普通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,诸如通过自然腔道、通过形成于组织中的切口或穿刺孔等。 Continuing to refer to this specific embodiment, those skilled in the art will be further appreciated that the various instruments disclosed herein can be inserted into the body in any manner, such as through a natural orifice, through an incision formed in tissue or puncture hole. 器械的工作部分或端部执行器部分可被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而推进。 Working portion or the end portion of the instrument can be inserted directly into the patient or can be inserted through an access device having a working channel, the end effector and elongate shaft of a surgical instrument can be advanced through the working channel.

[0191] 转到附图,其中在所有附图中相似编号指示相似部件,图1示出适于与组织厚度补偿件组件一起使用的示例性外科缝合和切断器械8010,如下文中更详细地描述。 [0191] Turning to the figures, wherein like numerals indicate like parts throughout the drawings, FIG. 1 illustrates an exemplary suitable surgical stapling and severing instrument 8010 for use with a tissue thickness compensator assembly, as described in greater detail in . 外科缝合和切断器械8010可包括砧座8014,该砧座可围绕其到细长钉通道8016的枢转附接而被反复打开和闭合。 The surgical stapling and severing instrument 8010 can comprise an anvil 8014, the anvil can about its elongate staple channel to the pivotal attachment 8016 is repeatedly opened and closed. 钉施用组件8012可包括砧座8014和通道8016,其中组件8012可朝近侧附接到形成工具部分8022的细长轴8018。 A staple applying assembly 8012 can comprise an anvil 8014 and the channel 8016, wherein the assembly tool 8012 may be attached to form an elongated portion 8022 of shaft 8018 proximally. 当钉施用组件8012闭合时、或至少基本上闭合时,执行部分8022可呈现足够小的横截面,该横截面适于将钉施用组件8012穿过套管针插入。 When the staple applying assembly 8012 is closed, or at least substantially closed, the execution section 8022 can present a sufficiently small cross-section, the cross section is adapted to the staple applying assembly 8012 is inserted through the trocar. 在各种情况下,组件8012可由连接至轴8018的柄部8020操纵。 In various circumstances, it may be coupled to the handle assembly 8012 portion 8020 of shaft 8018 manipulation. 柄部8020可包括用户控件诸如旋钮8030,该旋钮使细长轴8018和钉施用组件8012围绕轴8018的纵向轴线旋转。 Handle 8020 may include a user control such as a knob 8030, the knob 8018 that the elongate shaft and staple applying assembly 8012 about the longitudinal axis of the rotary shaft 8018. 闭合触发器8026可在手枪式握把8036前方枢转以闭合钉施用组件8012。 The closure trigger 8026 may be transferred to close the staple applying assembly 8012 in the forward pivot pistol grip 8036. 例如,当闭合触发器8026被夹紧时,闭合释放按钮8038可向外存在于柄部8020上,使得释放按钮8038可被压下以松开闭合触发器8026并打开钉施用组件8012。 For example, when the closure trigger 8026 is clamped closure release button 8038 may be present on the handle portion 8020 outwardly, such that the release button 8038 can be depressed to release the closure trigger 8026 and 8012 to open the staple applying assembly. 可在闭合触发器8026前方枢转的击发触发器8034可使钉施用组件8012同时切断和缝合被夹紧在其中的组织。 Assembly 8012 can be administered in the staple firing trigger 8034 in front of the closure trigger 8026 to pivot simultaneously severing and stapling the tissue is clamped therein. 在各种情况下,可使用击发触发器8034来采用多个击发行程以减少每行程需要由外科医生的手施加的力的大小。 In each case, the firing trigger 8034 may be used to employ a plurality of firing strokes required to reduce the force exerted by the surgeon's hand size of each stroke. 在某些实施方案中,柄部8020可包括一个或多个可旋转指示器轮,诸如可指示击发进程的可旋转指示器轮8041。 In certain embodiments, the handle 8020 may include one or more rotatable indicator wheel, such as a firing process may indicate a rotatable indicator wheel 8041. 如果需要,手动击发释放杠杆8042可允许击发系统在完全击发行进完成之前回缩,并且此外,在击发系统卡住和/或失效的情况下,击发释放杠杆8042可允许外科医生或其他临床医生使击发系统回缩。 If desired, a manual firing release lever 8042 may be retracted to allow the firing system before full firing travel is completed, and in addition, the firing system in a jamming and / or failure situation, the firing release lever 8042 can allow a surgeon, or other clinician, retraction of the firing system. 关于外科缝合和切断器械8010和适于与本公开一起使用的其他外科缝合和切断器械的附加细节例如在2013年3月27日提交的名称为“FASTENERCARTRIDGE ASSEMBLY”的美国专利申请13/851,693中有所描述,该专利的全部公开内容以引用方式并入本文。 Additional details regarding the surgical stapling and severing instrument 8010 and other surgical stapling and severing instrument suitable for use with the present disclosure, for example, in the name of March 27, 2013, filed 13 / 851,693 as "FASTENERCARTRIDGE ASSEMBLY" U.S. Pat. are described, the entire disclosure of which is incorporated herein by reference. 此外,通电的外科缝合和切断器械也可与本公开一起使用。 Further, the energization of the surgical stapling and severing instrument can also be used with the present disclosure. 参见例如2008年8月8日提交的名称为“POWERED SURGICAL STAPLING DEVICE”的美国专利申请公布2009/0090763 Al,该专利的全部公开内容以引用方式并入本文。 See, for example, the name of August 8, 2008, filed as "POWERED SURGICAL STAPLING DEVICE" US Patent Application Publication 2009/0090763 Al, the entire disclosure of which is incorporated by reference herein.

[0192] 结合图2和图3,击发组件(诸如击发组件9090)可与外科缝合和切断器械8010—起使用以推进包括多个楔形件9204的楔形滑动件9126,所述楔形件被构造成能够将钉从钉施用组件8012部署到捕获在砧座8014和细长钉通道8016之间的组织中。 [0192] in conjunction with FIGS. 2 and 3, the firing components (such as firing assembly 9090) may be surgical stapling and severing instrument 8010- used together to advance the wedge sled comprises a plurality of wedges 9204 9126, the wedge member being configured to a staple applying assembly can be deployed from staple 8012 to 8014 captured between the anvil and elongate staple channel 8016 tissue. 此外,在击发组件9090的远侧部分处的E形梁9102可有利于单独闭合和击发,以及在击发期间将砧座8014与细长钉通道8016间隔开。 Further, the firing assembly of the E-shaped distal portion 9090 of beam 9102 may facilitate separate closing and firing, the anvil and elongate staple channel 8014 and 8016 spaced apart during firing. E形梁9102可包括一对顶部销9110,可跟随楔形滑动件9126的部分9218的一对中间销9112,和底部销或支脚9114,以及锋利的切割刃9116,该切割刃可被构造成能够在击发组件9090朝远侧推进时切断所捕获的组织。 E-beam 9102 may comprise a pair of top pins 9110, may be followed by a pair of portions 9218 to 9126 of the intermediate wedge sled pin 9112, and a bottom pin or foot 9114, and a sharp cutting edge 9116, the cutting edge can be configured to be cut tissue captured in the 9090 firing assembly advanced distally. 此外,托住切割刃9116的每个垂直端的朝近侧突出的一体成型顶部导向件9118和中间导向件9120可进一步限定组织集结区域9122,从而有助于在切断组织前将组织引导至锋利的切割刃9116。 Furthermore, boosting the cutting edge of each vertical end 9116 integrally molded proximally projecting top guide member 9118 and the intermediate guide member 9120 may further define a tissue staging area 9122, thereby contributing to the tissue prior to severing tissue directed to the sharp cutting edge 9116. 中间导向件9120还可用于通过邻接楔形滑动件9126 (图2)的阶梯式中央构件9124来接合并击发钉施用组件8012,所述楔形滑动件通过钉施用组件8012影响钉成形。 The intermediate guide member 9120 may also be used by the abutment of the wedge sled 9126 (FIG. 2) a central stepped member 9124 to engage and fire the staple applying assembly 8012, a wedge sled through the staple applying assembly 8012 Effect of staple forming.

[0193] 在各种情况下,钉仓可包括用于对捕获在从钉仓部署的钉内的组织的厚度进行补偿的装置。 [0193] In various circumstances, the thickness of the cartridge device captured within the staples deployed from the staple cartridge of the tissue may include compensating for. 参见图4,钉仓(诸如钉仓10000)例如可与外科缝合和切断器械8010—起使用并且可包括刚性的第一部分(诸如支撑部分10010)以及可压缩的第二部分(诸如组织厚度补偿件10020)。 Referring to Figure 4, a staple cartridge (such as a staple cartridge 10000) may be, for example, surgical stapling and severing instrument 8010- used together and may comprise a first rigid portion (such as a support portion 10010) and a second compressible portion (such as tissue thickness compensator 10020). 支撑部分10010可包括仓体和多个钉腔10012。 The support portion 10010 may include a cartridge body and a plurality of staple cavities 10012. 钉10030例如可以可移除地定位在每个钉腔10012中。 10030 staples may be removably positioned in each staple cavity 10012. 主要参见图4和图5,每个钉10030可包括基部10031以及从基部10031延伸的一个或多个腿10032。 Referring primarily to FIGS. 4 and 5, each staple 10030 10031 may include a base and one or more legs extending from the base 10032 10031. 在钉10030被部署之前,钉10030的基部10031可由定位在支撑部分10010内的钉驱动器支撑,并且同时钉10030的腿10032可至少部分地容纳在钉腔10012内。 Before the staples are deployed 10030, 10030 10031 bases of the staples by staple drivers positioned within the support portion supports 10010 and 10030 while the staple legs 10032 may be at least partially housed within the staple cavities 10012. 在各种情况下,钉10030可被部署在未击发位置与击发位置之间,使得腿10032运动穿过组织厚度补偿件10020、穿透组织厚度补偿件10020的顶部表面、穿透组织T,并且接触与钉仓10000相对定位的砧座。 In various circumstances, the staples 10030 can be deployed between an unfired position and a fired position, such that movement of the legs through the tissue thickness compensator 10032 10020 penetrating the top surface of the tissue thickness compensator 10020 for penetrating tissue T, and staple cartridge 10000 into contact with the relative positioning of the anvil. 在腿10032抵靠砧座变形时,每个钉10030的腿10032可捕获组织厚度补偿件10020的一部分以及每个钉10030内的组织T的一部分,并且将压缩力施加到组织。 10032 leg is deformed against the anvil, each staple leg 10030 10032 can capture a portion of the tissue thickness compensator 10020 and a portion of tissue within each staple 10030 T, and apply a compressive force to the tissue. 对上文进行进一步描述,可使每个钉10030的腿10032向下朝钉的基部10031变形以形成钉截留区域,在该钉截留区域中,组织T和组织厚度补偿件10020可被捕获。 Further to the above description, that the base portion of each staple legs 10032 10030 10031 deform downwardly toward the staple to form the staple entrapment area, in which the staple entrapment area, the tissue T and the tissue thickness compensator 10020 can be captured. 在各种情况下,钉截留区域可被限定在已变形的腿10032的内表面与基部10031的内表面之间。 In various circumstances, the staple entrapment area may be defined between the inner surface of the inner surface of the deformed legs 10032 and 10031 of the base. 钉截留区域的尺寸可取决于若干因素,诸如腿的长度、腿的直径、基部的宽度和/或腿部变形的程度。 Staple entrapment area size may depend on several factors, such as the length of the legs, diameter, width and extent / or deformation of the leg portion of the base leg.

[0194] 在使用中,对上文进行进一步描述并且主要参见图4,外科缝合和切断器械8010的砧座诸如砧座8014可通过按压闭合触发器8026而运动到与钉仓10000相对的闭合位置中以推进E形梁9102。 [0194] In use, further to the above described and referring primarily to FIG. 4, the surgical stapling and severing instrument 8010 of the anvil, such as anvil 8014 may be moved relative to the staple cartridge 10000 closed position by depressing the closure trigger 8026 to promote the E-beam 9102. 砧座8014可将组织抵靠组织厚度补偿件10020定位,并且在各种情况下,例如将组织厚度补偿件10020抵靠支撑部分10010压缩。 The anvil 8014 may be tissue against the tissue thickness compensator 10020 positioned, and in each case, for example, the tissue thickness compensator 10020 10010 compressed against the support portion. 一旦砧座8014已适当定位,则可部署钉10030,同样如图4所示。 Once the anvil 8014 has been properly positioned, you can deploy the staples 10030, the same as shown in FIG. 在各种情况下,如上所述,在许多方面类似于滑动件9126 (参见图3)的钉击发滑动件10050可从钉仓10000的近侧端部朝远侧端部10002运动,如图5所示。 In each case, as described above, similar to the slide member 9126 (see FIG. 3) of the staple firing 10050 can slide toward the distal end from the proximal end of the staple cartridge 10000 10002 motion in many ways, as shown in FIG 5 Fig. 当击发组件9090被推进时,滑动件10050可接触钉驱动器10040并在钉腔10012内向上提升钉驱动器10040。 When the firing assembly 9090 is advanced, the slider may contact the staple driver 10050 10040 10040 and lift the staple drivers within the staple cavities on 10012. 在至少一个示例中,滑动件10050和钉驱动器10040可各自包括一个或多个斜坡或倾斜表面,所述一个或多个斜坡或倾斜表面可协作以使钉驱动器10040从它们的未击发位置向上运动。 In at least one example, the slide member and the staple driver 10040 10050 may each include one or more ramps or inclined surfaces, or a plurality of the ramp or inclined surface may cooperate to cause upward movement of staple drivers 10040 from their unfired position . 钉驱动器10040在它们各自的钉腔10012内被向上提升时,钉驱动器10040可向上提升钉10030,使得钉10030可从其钉腔10012出现。 When the staple driver 10040 is lifted upwardly within their respective cavities 10012 staple, the staple drivers 10040 10030 staples may be lifted up, so that the staples from the staple cavities 10030 10012 can occur. 在各种情况下,作为击发序列的一部分,滑动件10050可同时使若干钉向上运动。 In each case, as part of the firing sequence, the slide member 10050 can be simultaneously several staples upwards.

[0195] 如上所述并参见图5,当钉10030处于它们的未击发位置时,钉10030的钉腿10032可延伸到补偿件10020中超过支撑部分10010。 [0195] Referring to FIG. 5 and as described above, when the staples 10030 are in their unfired position, the staple legs of the staples 10032 10030 10020 can extend to more than compensate for the support portion 10010. 在各种情况下,当钉10030处于它们的未击发位置时,钉腿10032的尖端或钉腿10032的任何其他部分可能不突出穿过组织厚度补偿件10020的顶部组织接触表面10021。 In each case, when the staples 10030 are in their unfired position, any other portion of the staple legs 10032 10032 tip or may not be staple legs protruding through the top surface of the tissue contacting tissue thickness compensator 10021 10020. 在某些情况下,钉腿10032的尖端可包括能够切入和穿透组织厚度补偿件10020的锋利尖端。 In some cases, the tip of the staple legs 10032 may include the ability to cut and penetrate tissue thickness compensator 10020 sharp tip.

[0196] 在各种情况下,可能优选的是防止和/或限制组织厚度补偿件和钉之间的摩擦力。 [0196] In various circumstances, it may be preferable that the friction between the and / or limiting members and staple tissue thickness compensator prevented. 现在参见图6至图8,用于与钉仓组件20200—起使用的组织厚度补偿件20220可包括至少部分地延伸穿过组织厚度补偿件20220的多个间隙孔20224。 Referring now to FIGS. 6 to 8 for the cartridge assembly and 20200- from the tissue thickness compensator 20220 may be used at least partially comprise a plurality of clearance holes extending through the tissue thickness compensator 20220 20224. 在各种情况下,钉仓组件20200可包括钉仓体20210和相对于钉仓体20210可释放地固定的组织厚度补偿件20220。 In various circumstances, the cartridge assembly may include a staple cartridge 20200 and 20210 with respect to the fixed body tissue thickness compensator staple cartridge body is releasably 20210 20220. 仓体20210可包括例如仓平台20211和限定为穿过仓平台20211并且进入钉仓体20210的主体中的钉腔20212。 May comprise, for example, the cartridge body 20210 20211 internet cartridge and cartridge defined through the platform and into the staple cartridge 20211 20210 main body of a staple cavity 20212. 钉20230例如可以可移除地定位在钉腔20212中。 E.g. staples 20230 may be removably positioned in the staple cavities 20212. 组织厚度补偿件20220可包括组织接触表面20221 (图7)和平台接触表面20222 (图6)。 Tissue thickness compensator 20220 20221 may include a tissue-contacting surface (FIG. 7) and the contact surface internet 20222 (FIG. 6). 平台接触表面20222可以可释放地抵靠例如仓体20210的平台20211定位,并且组织接触表面20221可抵靠例如待缝合的组织T定位。 20222 internet can releasably contact surface against the cartridge body, for example, 20210 to 20211 positioning platform, and the tissue contacting surface 20 221 abut against the tissue T to be stapled is positioned example. 间隙孔20224可延伸穿过平台接触表面20222并且进入组织厚度补偿件20220中并且可例如在组织厚度补偿件20220内包括孔、狭缝、间隙、镗孔、开口和/或清除的路径。 Clearance hole 20224 20222 can extend through the surface and into contact with tissue internet compensator 20220 in thickness and may be, for example, within the tissue thickness compensator member 20220 includes an aperture, a slit, a gap, bore, opening and / or removal path.

[0197] 主要参见图7和图8,钉20230可定位在仓体20210的钉腔20212中。 [0197] Referring primarily to Figures 7 and 8, the staple can be positioned in the staple cavities 20230 20212 20210 of the cartridge body. 每个钉20230可包括基部20231和一对钉腿20232,例如,所述钉腿可从基部20231延伸。 Each staple 20230 20231 may include a base and a pair of staple legs 20232, e.g., the staple legs can extend from the base portion 20231. 每个钉腿20232可从基部20231的相对的两端部延伸。 20232 each staple leg can extend from opposite ends of the base portion 20231. 主要参见图7,组织厚度补偿件20220中的间隙孔20224中的一个或多个可包括平台接触表面20222中的开口。 Referring primarily to FIG. 7, the tissue thickness compensator 20220 20224 clearance hole in one or more of the contact surface may comprise openings 20222 in the internet. 间隙孔20224的开口可与定位在钉腔20212中的对应钉腿20232对准。 The clearance hole opening 20224 may be positioned in the staple cavities 20212 20232 corresponding staple legs are aligned. 例如,当组织厚度补偿件20220相对于仓体20210固定时,单个钉腿20232可与单个间隙孔20224的开口对准。 For example, when the tissue thickness compensator 20220 20210 fixed with respect to the cartridge body, the staple legs 20232 may be a single opening aligned with the hole 20224 of the single gap. 在某些情况下,钉腿20232可延伸到每个间隙孔20224中,使得钉20230的至少一部分嵌入例如组织厚度补偿件20220中。 In some cases, it may extend into the staple legs 20232 20224 clearance hole in each, so that at least a portion of the staples 20230 embedding member, such as tissue thickness compensator 20220. 例如,主要参见图7,钉20230可包括第一钉腿20232a和第二钉腿20232b。 For example, referring primarily to FIG. 7, a staple 20230 can comprise a first staple and a second staple leg leg 20232a 20232b. 此外,组织厚度补偿件20220可包括例如与第一钉腿20232a对准的第一间隙孔20224a,以及与第二钉腿20232b对准的第二间隙孔20224b。 Further, the second clearance hole tissue thickness compensator 20220 may include, for example, aligned with the first leg of the first clearance hole 20224a 20232a aligned, and a second leg 20232b 20224b. 在部署钉20230之前,例如,第一钉腿20232a可部分延伸穿过第一间隙孔20224a,并且第二钉腿20232b可部分延伸穿过第二间隙孔20224b。 Before deploying the staples 20230, e.g., the first leg portion 20232a may extend through the first clearance holes 20224a, 20232b and the second leg portion may extend through the second clearance holes 20224b. 组织厚度补偿件20220可包括例如不与钉腿20232对准的附加间隙孔20224。 Tissue thickness compensator 20220 may include, for example, additional clearance hole is not aligned with the staple legs 2023220224. 在某些情况下,钉仓组件20200可包括例如不与间隙孔20224对准的附加钉20230和/或钉腿20232。 In some cases, the cartridge assembly may include an additional staple 20200 is not aligned with the clearance holes 2022420230 and / or staple legs 20232.

[0198] 钉20230可从未击发构型(图7)运动到击发构型(图8)。 [0198] 20230 may unfired staple configuration (FIG. 7) to a fired configuration (FIG. 8). 每个钉20230可在未击发构型和击发构型之间运动时沿钉轴线运动。 20230 during each staple may be moved between configurations and firing unfired configuration along the axis of the nail. 当处于未击发构型时,钉腿20232可从钉腔20212延伸并进入例如组织厚度补偿件20220中。 When in the configuration unfired staple from the staple legs 20232 can extend into the cavity 20212 and 20220, for example, in tissue thickness compensator. 例如,当钉20230处于未击发构型时,钉腿20232可部分嵌入组织厚度补偿件20220中。 For example, when the 20230 is in the unfired staple configuration, the staple legs may be partially embedded 20232 compensator 20220 in tissue thickness. 此外,例如,当钉处于未击发构型时,钉腿20232的至少一部分可与组织厚度补偿件20220的间隙孔20224对准并且/或者定位在组织厚度补偿件的间隙孔内。 Further, for example, when the 20224 is in the alignment of the staple unfired configuration, at least a portion of the staple legs 20232 may be clearance holes tissue thickness compensator 20220 and / or located in the mesopores of the tissue thickness compensator. 在其他情况下,当处于未击发构型时,钉腿20232可被整个地定位在钉腔20212内,并且可与例如定位在仓平台20211 (图6)上方的间隙孔20224对准。 In other cases, when in an unfired configuration, the entire staple legs 20232 may be positioned within the staple cavities 20212, and 20224 may be positioned, for example in the alignment clearance hole 20211 (FIG. 6) of the cartridge over the internet.

[0199] 在击发行程期间,钉20230可从未击发构型(图7)运动到击发构型(图8),如本文所述。 [0199] During firing stroke, staples 20230 can never fired configuration (FIG. 7) to a fired configuration (FIG. 8), as described herein. 钉驱动器20240可被定位在每个钉腔20212内。 Staple driver 20240 may be positioned within each staple cavity 20212. 每个钉腔20212内的钉驱动器20240可朝仓平台20211 (图6)推动,例如,以将钉20230驱动到组织T中并且朝砧座20260驱动(图8),该砧座可在许多方面类似于本文所述的其他砧座,例如砧座8014 (图1)。 Staple driver within each staple cavity 2021220240 can be moved toward the cartridge deck 20211 (FIG. 6) driven, for example, to staple 20230 driven into the tissue T and toward the anvil drive 20 260 (FIG. 8), the anvil may be in many ways similar to other anvil described herein, such as an anvil 8014 (FIG. 1). 在每个钉20230从未击发构型运动到击发构型时,钉腿20232可运动穿过组织厚度补偿件20220中的间隙孔20224。 When each staple 20230 unfired configuration to firing configuration, the staple legs can move through a clearance hole 20232 20224 20220 tissue thickness compensator in. 间隙孔20224可具有组织厚度补偿件20220内的预定轨线。 20224 clearance hole may have a predetermined trajectory within the tissue thickness compensator 20220. 例如,间隙孔20224可沿垂直于并且/或者基本上垂直于组织厚度补偿件20220的组织接触表面20221 (图7)和/或平台接触表面20222 (图6)的轴线延伸。 For example, the gap may be a direction perpendicular to the hole 20224 and / or substantially perpendicular to the tissue thickness compensator 20220 20221 tissue contacting surface (FIG. 7) extending in axial and / or platform contact surface 20222 (FIG. 6). 在其他情况下,间隙孔20224可沿相对于例如组织厚度补偿件20220的组织接触表面20221和/或平台接触表面20222以斜角取向的轴线延伸。 In other cases, 20224 clearance holes along tissue contacting surface relative to the tissue thickness compensator 20220 and / or 20222 internet contact surface extending oblique axis orientation, for example, 20,221. 在某些情况下,一组间隙孔20224可为平行的。 In some cases, a set of clearance holes 20224 can be parallel. 在一些情况下,例如,组织厚度补偿件20220内的所有间隙孔20224可为平行的。 In some cases, for example, all of the clearance holes in the tissue thickness compensator 2022020224 may be parallel. 间隙孔20224可包括部分弯曲的轨线和/或部分线性的轨线。 20224 clearance hole portion may include a curved trajectory and / or a partial linear trajectory. 间隙孔20224的其他特性和特征在2013年3月27日提交的名称为“FASTENER CARTRIDGEASSEMBLY”的美国专利申请13/851,693中更详细地描述,该专利的全部公开内容以引用方式并入本文。 Other characteristics and features of the clearance hole 20224 in the name of March 27, 2013 entitled "FASTENER CARTRIDGEASSEMBLY" U.S. Patent Application No. 13 / 851,693 are described in more detail, the entire disclosure of which is incorporated herein by reference. 用于将组织厚度补偿件修改为包括间隙孔诸如间隙孔20224的方法和技术在下文中更详细地描述。 For tissue thickness compensator member is modified to include a clearance hole clearance hole 20224 of such methods and techniques described in more detail below.

[0200] 现在参见图9至图12,在许多方面类似于外科器械8010的外科器械的端部执行器22090例如可包括具有紧固件仓组件22000的第一钳口和具有砧座10060的第二钳口。 [0200] Referring now to FIGS. 9 to 12, is similar in many respects to a surgical instrument of the surgical instrument 8010, for example, an end effector can include a 22090 fastener cartridge assembly 22000 and 10060 of the first jaw having an anvil two jaws. 第一钳口可包括钉仓通道10070,该钉仓通道可被构造成能够可移除地接收仓组件22000。 The first jaw can include a staple cartridge channel 10070, the staple cartridge channel can be configured to receive the cartridge assembly 22000 can be removably. 另选地,钉仓通道10070和仓组件22000可包括整体单元。 Alternatively, staple cartridge channel 10070 and 22000 may include a cartridge assembly integral unit. 在各种情况下,砧座10060可在打开位置和闭合位置(图9至图12)之间运动。 In various circumstances, the anvil 10060 moveable between an open position and a closed position (FIGS. 9 to 12). 在砧座10060的打开位置中,例如,砧座10060可定位在患者的组织T (图10至图12)的第一侧上,并且仓组件22000可定位在组织T的第二或相对侧上。 In the open position of anvil 10060, for example, the anvil 10060 may be positioned on a first side of the patient's tissue T (FIGS. 10 to 12), and the cartridge assembly 22000 may be positioned on opposite or second side of the tissue T . 当砧座10060运动到其闭合位置中时,砧座10060可抵靠仓组件22000压缩组织T。 10060 when the anvil is moved to its closed position, abut against the anvil cartridge assembly 22000 10060 compress the tissue T. 另选地,包括仓组件22000的第一钳口可相对于砧座10060运动。 Alternatively, the cartridge assembly including a first jaw 22000 10060 with respect to the anvil movement. 在许多方面类似于击发组件9090(图3)的击发构件10052可从仓组件22000的近侧端部22001朝仓组件22000的远侧端部22002朝远侧推进以在击发构件10052从近侧端部22001朝仓组件22000的远侧端部22002推进时射出紧固件,诸如可移除地储存在仓组件22000的仓体22010中的钉22030。 10052 in many respects from the proximal end of the cartridge assembly distal end 22000 22001 22000 22002 advanced distally toward the cartridge assembly to the firing member 10052 from the proximal end of the firing assembly 9090 similar to the firing member (FIG. 3) when the distal end portion of fastener exit assembly 22000 22002 22001 Asakura propulsion unit, such as a removable stored in the staple cartridge assembly in the cartridge body 2201022000 22030.

[0201] 对上文进行进一步描述,钉22030可由钉驱动器10040支撑,该钉驱动器可动地定位在限定在仓体22010中的钉腔22012内。 [0201] Further to the above description, 10040 supporting the staples by staple driver 22030, the staple driver movably positioned within the staple cavity defined in the cartridge body 22010 22012. 此外,击发构件10052可被构造成能够在击发构件10052从近侧端部22001朝远侧端部22002运动时在仓体22010内朝远侧推进钉击发滑动件10050。 Further, the firing member 10052 can be configured to be capable of firing at a firing staples slide member 10052 10050 22001 advance from the proximal end 22010 within the cartridge body toward the distal movement when the distal end 22002. 在此类情况下,钉击发滑动件10050可被构造成能够朝砧座10060提升钉驱动器10040以及支撑在其上的钉22030。 In such cases, the staple firing sled 10050 can be configured to be capable of lifting 10,060 toward the anvil and the staple driver 10040 staples supported thereon 22030. 实质上,对上文进行进一步描述,钉驱动器10040可使钉22030从未击发位置(图10)运动到击发位置(图11和图12),其中钉22030可接触砧座10060并且在未变形构型(图10)和变形构型(图11和图12)之间变形。 Essentially, further to the above description, the staples can staple drivers 10040 22030 unfired position (FIG. 10) to a fired position (FIGS. 11 and 12), wherein the staple anvil may contact the 22030 and 10060 in the undeformed configuration between a deformation (Figure 10) and a deformed configuration (FIG. 11 and FIG. 12). 砧座10060可包括成形凹坑10062,该成形凹坑可被构造成能够接收钉22030并且使钉变形。 10060 can include anvil forming pockets 10062, the forming pockets may be configured to receive a staple 22 030 and deform the staples. 钉22030可与例如钉10030和/或本文所公开的任何其他钉相同或相似,并且因此,钉22030在本文中未更详细地描述。 22030 staple may be any other similar or the same as, for example, staple 10030 and / or disclosed herein, and therefore, not described in the staple 22030 in more detail herein. 然而,读者将注意到,钉22030例如在其未变形构型和/或其变形构型中包括任何合适的形状和/或合适的尺寸,诸如宽度和/或高度。 However, the reader will note, for example, a staple 22030 comprise any suitable shape and / or size suitable its undeformed configuration and / or a modified configuration, such as the width and / or height. 例如,在某些情况下,当钉22030处于其未击发位置时,钉22030可包括不延伸到仓体22010的平台表面22011之上的高度,而在其他情况下,当钉22030处于其未击发位置时,钉22030可包括其中钉22030的腿从平台表面22011向上延伸的高度,使得钉22030的腿至少部分地嵌入仓组件22000的组织厚度补偿件22010中。 For example, in some cases, when the staples in their unfired position 22030, 22030 may comprise the staple does not extend to a height above the platform surface of the cartridge body 22011 22010, while in other cases, when the staples are in their unfired 22030 position, which may comprise a staple 22030 22030 staple legs extending upwardly from the height of the deck surface 22011, 22030 such that staple legs cartridge assembly at least partially embedded tissue thickness compensator 22000 22010 in.

[0202] 继续参考图9至图12中所示的实施方案,对上文进行进一步描述,仓组件22000可包括仓体22010和组织厚度补偿件22020。 [0202] With continued reference to FIGS embodiment 12 shown in FIG. 9, further to the above description, the cartridge assembly may include a cartridge body 22000 22010 22020 compensator and tissue thickness. 在各种情况下,仓体22010可例如在许多方面类似于支撑部分10010,因此,为了简洁起见,此类方面中的许多在本文中不重复。 In each case, the cartridge body 22010 may be similar in many respects, for example, the support portion 10010, and therefore, for the sake of brevity, many of such aspects is not repeated herein. 此外,组织厚度补偿件22020可例如在许多方面类似于组织厚度补偿件10020。 Moreover, the tissue thickness compensator 22020, for example, may be similar in many respects tissue thickness compensator 10020. 对上文进行进一步描述,击发构件10052可包括切割部分10053,该切割部分可被构造成能够在击发构件10052朝远侧推进时横切定位在砧座10060和组织厚度补偿件22020之间的组织。 Further to the above description, the firing member 10052 may include a cutting portion 10053, the cutting portion may be configured to be positioned transversely between the anvil and the tissue thickness compensator 10060 22020 10052 when the firing member is advanced distally of tissue . 因此,在各种情况下,击发构件10052可被构造成能够同时击发钉22030以缝合组织T并且切割组织T。 Thus, in each case, the firing member 10052 can be configured to be capable of simultaneously firing the staples to staple tissue T 22030 and cut the tissue T. 在某些情况下,击发过程可至少部分地引起切割过程。 In some cases, the firing process may be at least partially caused by the cutting process. 换句话讲,切割过程可滞后击发过程。 In other words, the cutting process may lag the firing process. 在此类情况下,组织T的一部分可被缝合,然后切入。 In such cases, a portion of the tissue T may be sewn, and then cut.

[0203] 如图9至图12所示,仓体22010可包括仓刀狭槽22015,该仓刀狭槽可被构造成能够在击发构件10052朝远侧推进时接收击发构件10052的一部分。 [0203] As shown in FIG. 9 to FIG. 12, the cartridge may include a cartridge body 22010 22015 knife slot, the cartridge knife slot may be configured to be able to receive a portion of the firing member 10052 10052 when the firing member is advanced distally. 对上文进行进一步描述,石占座10060可包括砧座刀狭槽10065,该砧座刀狭槽可被构造成能够在击发构件10052朝远侧推进时接收击发构件10052的一部分。 Further to the above described, accounting stone 10060 can comprise an anvil knife slot 10065, the anvil knife slot may be configured to be able to receive a portion of the firing member 10052 10052 when the firing member is advanced distally. 在各种情况下,组织厚度补偿件22020可包括组织厚度补偿件刀狭槽22025,该组织厚度补偿件刀狭槽可与砧座刀狭槽10065和仓刀狭槽22015对准,使得击发构件10052可同时通过仓刀狭槽22015、砧座刀狭槽10065和组织厚度补偿件刀狭槽22025。 In various circumstances, tissue thickness compensator 22020 may include a tissue thickness compensator knife slot 22025, the tissue thickness compensator with knife slot 10065 and 22015 anvil knife slot aligned cartridge knife slot, such that the firing member 10052 by simultaneously cartridge knife slot 22015, 10065 anvil knife slot and tissue thickness compensator knife slot 22025. 在各种情况下,砧座刀狭槽10065可在组织厚度补偿件刀狭槽22025上方延伸,使得击发构件10052的切割部分10053可同时通过仓刀狭槽22015、砧座刀狭槽10065和组织厚度补偿件刀狭槽22025。 In various circumstances, the anvil knife slot 10065 can extend over the tissue thickness compensator knife slot 22025, the firing member such that the cutting portion may be simultaneously through 1005310052 cartridge knife slot 22015, 10065 anvil knife slot and organizations The thickness of the knife slot 22025 compensator. 组织厚度补偿件刀狭槽22025可限定切割部分10053的组织厚度补偿件刀路径,其中组织厚度补偿件刀路径可平行于砧座刀路径和仓刀路径。 Tissue thickness compensator knife slot 22025 10053 may define a cutting portion of the tool path compensator tissue thickness, wherein the tissue thickness compensator tool path may be parallel to the path of the knife and anvil blade cartridge path. 在各种情况下,组织厚度补偿件刀路径可为纵向的,而在某些情况下,组织厚度补偿件刀路径可为弯曲的。 In various circumstances, tissue thickness compensator knife longitudinal path may be, and in some cases, the tissue thickness compensator tool path may be curved. 对上文进行进一步描述,弯曲的端部执行器和弯曲的紧固件仓在美国专利申请公布2008/0169329中有所公开。 Further to the above description, the curved end of the curved fastener cartridge and in U.S. Patent Application Publication 2008/0169329 are disclosed in. 2007年I月11日提交的名称为“CURVED END EFFECTOR FOR ASURGICAL STAPLING DEVICE”的美国专利申请序列号11/652,164 (现为美国专利申请公布2008/0169329)的全部公开内容据此以引用方式并入本文中。 The entire disclosure of the name of May 11, 2007 I filed "CURVED END EFFECTOR FOR ASURGICAL STAPLING DEVICE" US Patent Application Serial No. 11 / 652,164 (now US Patent Application Publication 2008/0169329) hereby by reference incorporated herein. 在此类情况下,组织厚度补偿件可为弯曲的。 In such cases, the tissue thickness compensator may be curved. 在至少一个此类实施方案中,组织厚度补偿件可为弯曲的,以匹配紧固件仓的仓体的曲率。 In at least one such embodiment, the tissue thickness compensator member may be curved to match the curvature of the cartridge body of the fastener cartridge. 用于将组织厚度补偿件修改为包括刀狭槽诸如刀狭槽22025的方法和技术在下文中有所描述。 It means for modifying tissue thickness compensator comprises a knife slot to be hereinafter knife slot 22025 such methods and techniques described.

[0204] 对上文进行进一步描述,主要参见图9,组织厚度补偿件刀狭槽22025可在第一缝合部分22021a和第二缝合部分22021b之间延伸,该第一缝合部分可由第一组钉22030缝合,该第二缝合部分可由第二组钉22030缝合。 [0204] Further to the above described, referring primarily to FIG. 9, the tissue thickness compensator 22025 knife slot may extend between the first suture portion and a second sewn portion 22021a 22021b, the first sewn portion by the first group of staples 22030 suture, the second suture portion of the suture by a second set of staple 22030. 刀狭槽22025可将第一缝合部分2202 Ia可释放地连接到第二缝合部分22021b。 Knife slot 22025 may first suture portion 2202 Ia is releasably coupled to the second suture portion 22021b. 在使用中,如图9所示,切割部分10053可朝远侧推进穿过刀狭槽22025以横切刀狭槽22025并且将第一缝合部分22021a与第二缝合部分22021b分离。 In use, as shown in FIG. 9, the cutting portion 10053 can be advanced through knife slot 22025 to 22025 cross knife slot and the first suture portion 22021a 22021b separated from the second portion of the suture distally. 在某些情况下,刀狭槽22025可包括多个连接器或桥接件22026,其可在被切割部分10053横切之前连接第一缝合部分22021a和第二缝合部分22021b。 In some cases, the knife slot 22025 or may comprise a plurality of bridge connector 22026, which can be cut in the first suture portion connected to a second sewn portion 22021a and 22021b transverse section 10053 before. 在各种情况下,至少在组织厚度补偿件22020处于未压缩状态时,连接器22026可具有与第一缝合部分22021a和/或第二缝合部分22021b相同的厚度。 In each case, at least the tissue thickness compensator 22020 is in an uncompressed state, the connector may have a first suture portion 22026 22021a / or the same thickness and the second suture portion 22021b. 在至少一种这样的情况下,连接器22026、第一缝合部分22021a和/或第二缝合部分22021b可由例如平坦的或至少基本上平坦的材料片整体且一体地形成。 In at least one such case, the connector 22026, first suture portion 22021a and / or the second part 22021b may be integrally stitched and integrally formed at least substantially planar sheet or planar material, such as. 在各种其他情况下,第一缝合部分2202 Ia可包括第一厚度,第二缝合部分2202 Ib可包括第二厚度,并且连接器22026可包括第三厚度,其中第一厚度、第二厚度和第三厚度中的一者或多者可不同于其他厚度。 In various other circumstances, first suture portion 2202 Ia may comprise a first thickness, a second portion of the suture 2202 Ib may comprise a second thickness, and the connector 22026 may include a third thickness, wherein the first thickness, the second thickness, and the third thickness may be different from one or more of other thicknesses.

[0205] 刀狭槽22025还可包括例如限定于其中的孔,诸如孔22024。 [0205] 22025 may further include a knife slot defining a hole therein, for example, such as a hole 22024. 例如,孔22024可为细长的并且可沿刀狭槽22025纵向延伸。 For example, the apertures may be elongate 22024 and 22025 may extend along the longitudinal knife slot. 在各种其他情况下,刀狭槽22025中的孔可包括任何合适的布置。 In various other circumstances, the knife slot 22025 aperture may comprise any suitable arrangement. 在某些情况下,孔22024可包括定位在连接器22026中间的穿孔,其可利用例如激光切割操作来形成。 In some cases, it may include a positioning hole 22024 at 22026 perforated intermediate connector which can be used to form, for example, a laser cutting operation. 在一些情况下,孔22024可从材料片切割以形成组织厚度补偿件22020,使得孔22024和连接器22026例如以交替布置的方式布置。 In some cases, the hole may be cut from the sheet material 22024 is formed to a thickness of tissue compensator 22020, 22024 such that the hole 22026 and the connector are arranged in alternating fashion, for example, are arranged. 在其他情况下,组织厚度补偿件22020可模制成孔22024已形成于其中。 In other cases, the tissue thickness compensator 22020 22024 may be molded holes formed therein. 在各种情况下,孔22024中的一个或多个可包括例如通孔。 In each case, one or more apertures 22024 may include, for example, through holes. 在各种情况下,孔22024中的一个或多个可包括例如间隙孔。 In each case, one or more apertures, for example, 22 024 may include a clearance hole. 在某些情况下,孔22024中的一个或多个可不包括通孔,并且相反可具有例如刀狭槽22025的减小厚度。 In some cases, one or more apertures 22 024 may not include the through holes, and instead may have a reduced thickness knife slot 22025, for example. 用于将组织厚度补偿件修改为包括孔诸如孔22024的方法和技术在下文中有所描述。 Tissue thickness compensator for a method of modifying techniques include holes such as holes and 22024 are described below.

[0206] 对上文进行进一步描述,再次参见图9至图11,当砧座10060处于打开位置时,患者组织可被定位在端部执行器22090的砧座10060和仓组件22000的组织厚度补偿件22020之间。 [0206] Further to the above described, Referring again to FIGS. 9 to 11, when the anvil 10 060 in the open position, tissue of a patient may be positioned at the end portion of the anvil and cartridge assembly 22090 10060 22000 tissue thickness compensator between 22020 pieces. 当砧座10060运动到闭合位置中时,砧座10060的底部表面或组织接触表面10063可接触组织T并且朝仓体22010的平台表面22011推动组织T。 10060 when the anvil is moved to the closed position, the bottom surface or tissue contacting surface of anvil 10060 and 10063 may be in contact with the platform surface tissue T 22010 22011 pushed toward the cartridge body tissue T. 组织T可接触组织厚度补偿件22020的顶部表面或组织接触表面22021,其中当砧座10060运动到其闭合位置中时,砧座10060可抵靠组织厚度补偿件22020按压组织T,并且对上文进行进一步描述,抵靠仓体22010的平台表面22011压缩组织厚度补偿件22020。 The top surface of the tissue T or tissue contacting surface may be in contact with the tissue thickness compensator 22020 22021, 10060 wherein the anvil is moved into its closed position, abut against the anvil 10060 22020 tissue thickness compensator member pressed against the tissue T, and to the above be further described, abuts against the deck surface of the cartridge body 22010 22011 22020 compressed tissue thickness compensator. 在各种情况下,组织厚度补偿件22020可包括底部表面22029,该底部表面可邻接平台表面22011。 In various circumstances, tissue thickness compensator 22020 22029 can comprise a bottom surface, the bottom surface of the deck surface may abut 22,011. 在一些情况下,在组织厚度补偿件22020抵靠仓体22010被压缩之前,间隙可存在于底部表面22029和平台表面22011之间。 In some cases, the tissue thickness compensator 22020 22010 against the cartridge body prior to being compressed, a gap may exist between the bottom surface of the deck surface 22029 and 22011. 在此类情况下,组织厚度补偿件22020可在抵靠仓体22010被压缩之前首先朝仓体平移。 In such cases, the tissue thickness compensator 22020 may first be translated toward the cartridge body against the cartridge body prior to 22010 is compressed. 当组织厚度补偿件22020抵靠仓体22010被压缩时,在各种情况下,组织厚度补偿件22020的第一缝合部分22021a和/或第二缝合部分22021b可横向运动。 When the tissue thickness compensator 22020 22010 against the cartridge body is compressed, in each case, a first portion of the suture in the tissue thickness compensator 22020 22021a and / or the second laterally movable stapling portion 22021b. 例如,第一缝合部分22021a和/或第二缝合部分22021b可横向移动远离仓刀狭槽22015。 For example, first suture portion 22021a and / or the second part 22021b may be sewn laterally moved away from the cartridge knife slot 22015. 在各种情况下,连接器22026可被构造成能够抑制第一缝合部分22021a和第二缝合部分22021b之间的此类横向运动。 In each case, connectors 22026 can be configured such lateral movement can be suppressed between the first suture portion and a second sewn portion 22021a 22021b. 在各种情况下,主要参见图11,连接器22026可被构造成能够拉伸以在砧座10060闭合时允许第一缝合部分22021a和第二缝合部分22021b之间的一些相对横向运动。 In each case, referring primarily to FIG. 11, connector 22026 can be configured to be stretched to allow the first suture when a number of the closed anvil 10060 relative lateral movement between the second portion and the stitched portion 22021a 22021b. 在砧座10060被重新打开的情况下,连接器22026可被构造成能够弹性地返回,或至少基本上返回到其未拉伸构型,并且作为结果,将第一缝合部分22021a和第二缝合部分22021b朝示于图10中的其初始位置横向拉回。 In the case of re-opened anvil 10060, 22026 connector may be configured to be elastically returned, or at least substantially return to its unstretched configuration, and as a result, the first suture and a second suture portion 22021a 22021b portion shown in FIG. 10 towards its initial position retracted laterally. 此外,当砧座10060运动到其闭合位置中时,砧座10060可压缩组织T。 Further, when the anvil 10060 into its closed position, the anvil 10060 compressible tissue T. 在此类情况下,组织T可至少部分地流动到孔22024中。 In such cases, the tissue T may be at least partially flow into the apertures 22024.

[0207] 在查看图1O至图12时,读者将认识到,组织厚度补偿件22020的刀狭槽22025沿其纵向长度包括比第一缝合部分22021a和/或第二缝合部分22021b少的材料。 [0207] In the view of FIG 1O to 12, the reader will appreciate, first suture portion 22021a 22025 and / or material thickness tissue compensator 22020 knife slot along its longitudinal length than the second sewn portion 22021b comprising less. 换句话讲,穿过第一缝合部分22021a和/或第二缝合部分22021b的纵向横截面将横切第一量的材料,而穿过刀狭槽22025的纵向横截面将横切比第一量的材料少的第二量的材料。 In other words, through the first suture portion 22021a and / or the second suture portion 22021b of the longitudinal cross section transverse to the first amount of material and the longitudinal cross section through a knife slot in the transverse than the first 22025 a second quantity of material less amount of material.

[0208] 一旦砧座10060已被适当地定位,对上文进行进一步描述,击发构件10052可朝远侧推进以击发钉,如图11所示,并且切入组织T和连接器22026,如图12所示。 [0208] Once the anvil has been properly positioned 10060, further to the above description, the firing member 10052 can be advanced distally to fire the staples, as shown in FIG. 11, and cut the tissue T and the connector 22026, 12 Fig. 此外,组织厚度补偿件切入力、组织切入力、组织厚度补偿件阻力、和/或组织阻力可使击发构件10052的切割部分10053钝化。 Moreover, the tissue thickness compensator cutting forces, cutting force tissue, tissue thickness compensator resistance, and / or cutting tissue resistance may cause a portion of the firing member 10052 10053 passivation. 钝刀可能不能够例如根据优选的方式横切组织T和/或组织厚度补偿件22020。 Blunt instrument may not be able, for example, according to a preferred embodiment T transecting tissue and / or tissue thickness compensator 22020. 主要参见图12,切割部分10053可包括例如第一刀刃区10053a、第二刀刃区10053b和/或第三刀刃区10053c,其中第一刀刃区10053a竖直定位在第二刀刃区10053b上方,并且其中第二刀刃区10053b竖直定位在例如第三刀刃区10053c上方。 Referring primarily to FIG. 12, the cutting portion 10053 may include a first edge region 10053a, 10053b second edge region and / or the third blade region 10053c, wherein the first edge region positioned vertically above the second 10053a edge region 10053b, and wherein 10053b second cutting edge region positioned above example, the third vertical edge region 10053c. 切割部分10053可包括任何合适数目和/或位置的刀刃区,其中出于讨论的目的已选择图12中所示的刀刃区。 The cutting blade portion 10053 may include any suitable number of regions and / or positions, wherein for purposes of discussion selected edge region 12 shown in FIG. 对上文进行进一步描述,第一刀刃区10053a可被构造成能够横切组织T,而第二刀刃区10053b可被构造成能够横切组织厚度补偿件22020。 Further to the above description, the first edge region may be configured to be 10053a transect the tissue T, and the second edge region 10053b may be configured to be transverse to the tissue thickness compensator 22020. 作为结果,第一刀刃区10053a可经受上述组织切入力和/或组织阻力。 As a result, the first edge region may be subjected to the above 10053a tissue cutting force and / or tissue resistance. 此类力可以第一速率磨损或钝化第一刀刃区10053a。 Such force may wear the blade or a first region passivation 10053a first rate. 第二刀刃区10053b可经受上述组织厚度补偿件切入力和/或组织厚度补偿件阻力。 10053b may be subjected to a second edge region of the tissue thickness compensator cutting force and / or tissue thickness compensator resistance. 此类力可以第二速率磨损或钝化第二刀刃区10053b。 Such force may be worn or the second cutting edge passivation zone 10053b second rate. 在各种情况下,第二速率可不同于第一速率。 In each case, the second rate may be different from the first rate.

[0209] 现在转向图13和图14,紧固件仓22400可包括组织厚度补偿件22420,该组织厚度补偿件可包括由刀狭槽22425连接的第一缝合部分22421a和第二缝合部分22421b。 [0209] Turning now to FIGS. 13 and 14, the fastener cartridge 22400 can comprise a tissue thickness compensator 22420, the tissue thickness compensator may comprise a first member and a second sewn portion 22421a 22421b by a stitched portion connected to the knife slot 22425. 刀狭槽22425可包括成角度的纵向连接器22426。 Knife slot 22425 may include an angled longitudinal connector 22426. 成角度的纵向连接器22426可在刀狭槽22425的近侧端部22401和刀狭槽22425的远侧端部22402之间延伸。 Longitudinal connector may extend at an angle 22426 between the proximal end of knife slot 22425 and 22401 of the distal end of knife slot 22425 22402. 在一些情况下,成角度的纵向连接器22426可延伸刀狭槽22425的整个长度,而在其他情况下,成角度的纵向连接器22426可延伸小于刀狭槽22425的长度。 In some cases, the angled longitudinal connectors 22426 can extend the entire length of the knife slot 22425, while in other cases, the angled connector 22426 longitudinal knife slot may extend less than the length of 22,425. 成角度的纵向连接器22426可在组织厚度补偿件22420的顶部表面22428和组织厚度补偿件22420的底部表面22429之间延伸。 Angled longitudinal connectors 22 426 22 429 may extend between the bottom surface of the tissue thickness compensator member top surface 22420 of 22428 and 22420 of the tissue thickness compensator. 在一些情况下,成角度的纵向连接器22426可延伸顶部表面22428和底部表面22429之间的整个距离,而在其他情况下,成角度的纵向连接器22426可延伸小于顶部表面22428和底部表面22429之间的距离。 In some cases, the longitudinal connector angled top surface 22 428 22 426 may extend the entire distance between the surface and bottom of 22429, while in other cases, the longitudinal connectors may extend at an angle of less than 22 426 a top surface and a bottom surface 22429 22428 the distance between. 在各种情况下,纵向连接器22426的近侧端部可从组织厚度补偿件的顶部表面22428延伸,而纵向连接器22426的远侧端部可从底部表面22429延伸。 In each case, the proximal end portion of the longitudinal connectors 22 426 may extend from a top surface of the tissue thickness compensator 22428, the distal end of longitudinal connector 22426 22429 may extend from the bottom surface. 另选地,纵向连接器22426的远侧端部可从组织厚度补偿件的顶部表面22428延伸,而纵向连接器22426的近侧端部可从底部表面22429延伸。 Alternatively, the distal end portion of the longitudinal connectors 22 426 may extend from a top surface of the tissue thickness compensator 22428, and the proximal end of longitudinal connector 22426 22429 may extend from the bottom surface. 在各种情况下,纵向连接器22426可包括薄的桥接件(S卩,小于组织厚度补偿件22420的整个厚度)或一系列薄的桥接件,该桥接件可例如将第一缝合部分22421a接合到第二缝合部分2242 Ib,该第一缝合部分可由第一组钉22030缝合,该第二缝合部分可由第二组钉22030缝合。 In each case, the longitudinal connectors 22426 can include a thin bridge (S Jie, less than the entire thickness of the tissue thickness compensator 22420), or a series of thin bridge member, the bridge member may be, for example, first suture engaging portion 22421a the second portion of the suture 2242 Ib, the first portion may be a first group of sewn stitching staples 22030, the second portion may be a second group of sewn stitching staples 22030. 这些薄的、成角度的桥接件和/或纵向连接器22426可在第二刀刃区10053b上分布磨损,而不是将其集中在一个点上。 These thin, angled bridges and / or longitudinal connectors 22426 can be distributed in the wear on the second edge region 10053b, rather than being concentrated on one point. 在各种情况下,作为结果,例如,出现在第二刀刃区10053b上的磨损可等于或接近等于出现在第一刀刃区10053a处的磨损。 In various circumstances, as a result, for example, appears on the second edge region 10053b wear may be equal or nearly equal to the wear occurs at the first edge region 10053a.

[0210] 现在参见图15至图17,示例性组织厚度补偿件组件1000可包括第一层1002和可附接到第一层1002的第二层1004。 [0210] Referring now to FIGS. 15 to 17, an exemplary tissue thickness compensator assembly 1000 may include a first layer 1002 and 1002 may be attached to the first layer, a second layer 1004. 组织厚度补偿件组件1000可用外科器械,诸如外科器械8010(图1)来使用。 Tissue thickness compensator assembly 1000 usable surgical instrument, such as surgical instrument 8010 (FIG. 1) is used. 另外,组织厚度补偿件组件1000可以与端部执行器22090的仓组件22000的组织厚度补偿件22020类似的方式来使用并且可替代组织厚度补偿件22020 (图9)。 In addition, tissue thickness compensator assembly 1000 may be used in a similar manner to end tissue thickness cartridge assembly 22090 22000 22020 compensator and alternatively the tissue thickness compensator 22020 (FIG. 9). 例如,组织厚度补偿件组件1000的第二层1004可包括可以与第一缝合部分22021a类似的方式定位在仓刀狭槽22015的第一侧上的平台表面22011上的第一部分1006,以及可以与第二缝合部分22021b类似的方式定位在仓刀狭槽22015的与第一侧相对的第二侧上的平台表面22011上的第二部分1008(图9至图11)。 For example, the second tissue thickness compensator assembly 1000 may include a layer 1004 may be positioned on a first surface of the platform portion 1006 22011 on a first side of the cartridge knife slot 22015 in a manner similar to the first sewn portion 22021a, and may be 22021b second suture portion is positioned in a similar manner on a second side opposite the first side of the cartridge knife slot 22015 of the second portion on the surface of the platform 1008 22011 (FIGS. 9 to 11). 在各种情况下,第二层1004的第一部分1006和第二部分1008可间隔开并且可在其间包括间隙1010,该间隙可包括用于击发构件10052的切割部分10053的刀路径并且可在组织厚度补偿件组件1000组装有仓端部执行器22090时至少部分地在仓刀狭槽22015上方延伸。 In each case, the second layer of the first portion 1006 and second portion 1004 may be spaced apart 1008 and 1010 may include a gap therebetween, the gap may include a blade section cutting path for the firing member 10053 and 10052 may be in a tissue thickness compensator assembly 1000 extends partially assembled cartridge end over at least 22,090 cartridge knife slot 22015. 在某些情况下,第一层1002可被构造成能够联接第一部分1006和第二部分1008并且至少部分地在间隙1010上方延伸,例如如图17所示。 In some cases, the first layer 1002 may be configured to be coupled to a first portion 1006 and second portion 1008 and extends at least partially over the gap 1010, such as shown in Figure 17.

[0211] 在使用中,组织T可被捕获在砧座10060和第一层1002的组织接触表面1012之间。 [0211] In use, the tissue T may be captured in the first layer and the anvil 10060 1002 1012 between the tissue-contacting surface. 在击发构件10052被推进时,第一组钉20030可被部署以缝合第一部分1006并且第二组钉可被部署以缝合第二部分1008。 When the firing member 10052 is advanced, a first set of staples 20030 can be deployed to a first portion of the suture 1006 and the second set of staples can be deployed to a second portion of the suture 1008. 第一组钉和第二组钉可被构造成能够分别穿透第二层1004的第一平台接触表面1007和第二平台接触表面1009,然后穿透第一层的组织接触表面1012,然后穿透所捕获的组织T以接触砧座10060的凹坑10062。 The first group and the second group of staples staples may be configured to be capable of penetrating each layer of the second contact surface of the first stage 1004 and second stage 1007 contacting surface 1009, and then penetrates the tissue contacting surface of the first layer 1012, and then through through the captured tissue T to contact the pits anvil 10060 10062. 此外,击发构件10052的推进可致使切割部分10053朝远侧推进穿过组织厚度补偿件组件1000的间隙1010。 Further, the firing member 10052 may cause the advancing cutting portion 10053 is advanced distally through the tissue thickness compensator gap assembly 1000 1010. 切割部分10053可横切第一层1002,同时推进穿过间隙1010,从而将第二层1004的第一部分1006和第二部分1008分离。 Transverse cutting portion 10053 may be a first layer 1002, while 1010 is advanced through the gap, thereby separating the first portion of the second layer 1004 1006 1008 and a second portion.

[0212] 再次参见图17,组织厚度补偿件组件1000的第一层1002可包括第一高度Hl,第二层1004的第一部分1006可包括第二高度H2,并且第二层1004的第二部分1008可包括第三高度H3。 [0212] Referring again to FIG. 17, the first tissue thickness compensator assembly 1000 may include a layer 1002 on Hl first height, a second layer 1004 of the first portion 1006 may include a second height H2, and a second portion of the second layer 1004 1008 may include a third height H3. 在某些情况下,如图17所示,第二高度H2和第三高度H3可为相同或基本上相同的。 In some cases, as shown in FIG. 17, the second height H2 and the third height H3 may be the same or substantially the same. 在其他情况下,第二高度H2可不同于第三高度H3。 In other cases, second height H2 may be different from the third height H3. 在某些情况下,第一高度Hl可小于第二高度H2和/或第三高度H3,如图17所示。 In some cases, it may be less than the first height Hl second height H2 and / or third height H3, shown in Figure 17. 组织厚度补偿件组件1000的第一层1002可包括第一密度,第二层1004的第一部分1006可包括第二密度,并且第二层1004的第二部分1008可包括第三密度。 A first tissue thickness compensator assembly 1000 may include a layer 1002 a first density, a second layer 1004 of the first portion 1006 may include a second density, a second portion 1004 and the second layer 1008 may include a third density. 在某些情况下,如图17所示,第二密度和第三密度可为相同或基本上相同的。 In some cases, shown in Figure 17, the second density and a third density can be the same or substantially the same. 在其他情况下,第二密度可不同于第三密度并且/或者不同于第一层1002的第一密度。 In other cases, the second density different from the third density and / or different from the first density of the first layer 1002. 第一部分1006和第二部分1008的材料组成可为相同或至少基本上相同的。 The first portion 1006 and second portion 1008 is composed of a material can be the same or at least substantially identical. 在其他情况下,第一部分1006和第二部分1008的材料组成可彼此不同并且/或者可不同于第一层1002的材料组成。 In other cases, second portion 1006 and the material of the first part 1008 may be different from one another and / or may be different from the material of the first layer 1002 composed.

[0213]如上所述,重复使用切割部分10053来切割组织T和组织厚度补偿件材料可钝化切割部分10053。 [0213] As described above, reuse of the cutting portion to cut the tissue T 10053 and the tissue thickness compensator material may be passivated cutting portion 10053. 为了减慢钝化过程,可能需要减少由切割部分10053切割的组织厚度补偿件材料。 To slow the passivation process, you may need to reduce tissue thickness compensator piece of material cut by the cutting portion 10053. 附加的益处可为在击发行程期间朝远侧推进击发构件10052所需的力减小。 Additional benefits may advance firing member 10052 reduced the force required to distally during the firing stroke. 为了减小切割部分10053的钝化,第一层1002可至少部分地包括例如薄膜。 In order to reduce passivation of the cutting portion 10053, a first layer 1002 may include, for example at least partially a thin film. 在此类情况下,第一高度Hl可显著小于第二高度H2和第三高度H3,如图17所示。 In such cases, the first height Hl can be significantly less than the second height H2 and the third height H3, shown in Figure 17. 在某些情况下,第一层1002可具有穿过其中的均匀或基本上均匀的高度,如图17所示。 In some cases, through the first layer 1002 may have a uniform or substantially uniform height therein, as shown in FIG. 17. 在其他情况下,第一层1002的间隙桥接部分1014可至少部分地在间隙1010上方延伸并且可比第一层1002的剩余部分薄。 In other cases, to bridge the gap portion 1014 of the first layer 1002 and may extend partially thinner than the remaining portion of the first layer over the gap 1002, at least 1010. 切割部分10053可横切第一层1002的间隙桥接部分1014同时推进穿过第二层1004的第一部分1006和第二部分1008之间的间隙1010,这可减小切割部分10053所经受的阻力并且/或者减慢切割部分10053的钝化。 Transverse cutting portion 10053 can bridge the gap portion 1014 of the first layer 1002 simultaneously advanced through the gap between the first portion 1006 of the second layer 1004 and a second portion 10081010, which may reduce the drag experienced by the cutting portion 10053 and / 10053 or slow down the cutting of the passivated portion. 在任何情况下,第一层1002可被构造成能够在被横切之前维持与第二层1004的第一部分1006和第二部分1008的联接接合,并且在切割部分10053被推进以横切第一层1002时用减小的阻力呈现切割部分10053。 In any case, the first layer 1002 may be configured to maintain the second layer of the first portion 1006 and second portion 1004 of the coupling 1008 engages before being transverse, and in the cutting portion 10053 is advanced to a first transverse layer exhibits cutting portion 1002 10053 with reduced resistance.

[0214] 为了进一步减少切割部分10053的钝化并且/或者减小切割部分10053所经受的阻力,间隙桥接部分1014可包括沿由间隙1010限定的刀路径的穿孔段1016,如图16所示。 [0214] To further reduce the cutting passivated portion 10053 and / or 10053 to reduce the cutting resistance portions are subjected, the gap may include a bridge portion 1014 as shown by the section along the perforation knife gap 1010 defined path 1016 in FIG. 16. 穿孔段1016可包括多个穿孔1018,所述穿孔可在例如将第一层1002组装到第二层1004之前切入第一层1002中。 Segment 1016 may comprise a plurality of perforations 1018 perforations, the perforations may be cut into the first layer 1002, for example, before assembling the first layer to the second layer 1002 1004. 在切割部分10053被推进穿过由间隙1010限定的刀路径时,穿孔1018可减小切割部分10053和第一层1002之间的相互作用,这可减慢切割部分10053的钝化并且/或者减小切割部分10053所经受的阻力。 When the cutting portion 10053 1010 is advanced through the gap defined by the tool path, the cutting perforations 1018 may reduce the interaction between the first layer 1002 and the portion 10053, which can slow the cutting passivated portion 10053 and / or Save small cut portion 10053 subjected resistance.

[0215] 在各种情况下,如下文更详细地描述,组织厚度补偿件组件1000可由一种或多种生物相容性材料构成。 [0215] In various circumstances, as described in more detail, the tissue thickness compensator assembly 1000 may be formed of one or more biocompatible materials. 在某些情况下,第一层1002可由例如生物相容性支撑材料和/或塑性材料(诸如聚二氧六环酮(PDS)和/或聚乙醇酸(PGA))构成,并且第二层1004可由例如可生物吸收的泡沫材料和/或可压缩止血材料(诸如,氧化再生纤维素(ORC))构成。 In some cases, the first layer 1002 may be formed, for example, a biocompatible support material and / or a plastic material (such as poly dioxanone (PDS) and / or polyglycolic acid (the PGA)) configured, and the second layer 1004 may be formed, for example, bioabsorbable foam material and / or compressible hemostatic material (such as oxidized regenerated cellulose (the ORC)) configured. 在某些情况下,第一层1002可为包含例如可生物吸收的材料的薄膜,所述可生物吸收的材料诸如以商品名Vicryl出售的聚乙醇酸(PGA)、聚乳酸(PLA或PLLA)、聚二氧六环酮(PDS)、聚羟基链烷酸酯(PHA)、以商品名Monocryl出售的聚卡普隆25 (PGCL)、聚己内酯(PCL)、和/或PGA、PLA、PDS、PHA、PGCL和/或PCL的复合物。 In some cases, the first layer 1002 may comprise a film, for example, a bioabsorbable material, said bioabsorbable material such as sold under the tradename Vicryl polyglycolic acid (PGA), polylactic acid (PLA or PLLA) , poly dioxanone (the PDS), polyhydroxy alkanoates (PHA), sold under the trade name Monocryl polyglecaprone 25 (PGCL), polycaprolactone (PCL), and / or PGA, PLA , PDS, PHA, PGCL and / or PCL composite. 在某些情况下,第二层1004的第一部分1006和/或第二部分1008可由例如包含聚乳酸(PLA)和/或聚乙醇酸(PGA)的冻干泡沫构成。 In some cases, a second layer 1004 of the first portion 1006 and / or 1008 may be formed, for example, the second portion comprising a polylactic acid (PLA) and / or polyglycolic acid (PGA) lyophilized foam configuration. 在某些情况下,第二层1004的第一部分1006和/或第二部分1008可由生物相容性泡沫构成,该生物相容性泡沫可包括多孔的开孔泡沫和/或多孔的闭孔泡沫。 In some cases, a second layer 1004 of the first portion 1006 and / or the second portion 1008 may be composed of biocompatible foam, the foam may comprise a biocompatible porous open cell foam and / or closed cell foam porous .

[0216] 再次参见图15和图17,第一层1002可至少部分地设置在第二层1004上,使得当组织厚度补偿件组件1000组装有端部执行器22090(图9)时,第二层1004可定位在第一层1002和平台表面22011 (图9)之间。 When [0216] Referring again to FIGS. 15 and 17, the first layer 1002 may be at least partially disposed on the second layer 1004, such that when the tissue thickness compensator assembly 1000 is assembled with an end effector 22 090 (FIG. 9), a second layer 1004 may be positioned between the first layer and the surface of the platform 1002 22011 (FIG. 9). 在其他情况下,第一层1002可定位在第一部分1006和第二部分1008 (未示出)下,使得当组织厚度补偿件组件1000组装有端部执行器22090 (图9)时,第一层1002可定位在第二层1004和平台表面22011 (图9)之间。 In other cases, the first layer 1002 may be positioned in the first portion 1006 and second portion 1008 (not shown), the tissue thickness such that when the compensator assembly 1000 is assembled with an end effector 22 090 (FIG. 9), a first layer 1002 may be positioned between the second layer and the surface of the platform 1004 22011 (FIG. 9). 在任何情况下,第一层1002可附接到第二层1004的第一部分1006的第一接触表面1020和第二部分1008的第二接触表面1022。 In any case, the first layer 1002 may be attached to the first surface of the first contacting portion 1006 of the second layer 1004 of the second contact surface 1020 and second portion 1008 of 1022. 第一层1002可通过涉及施加热量和/或压力的热压制过程而附接到第二层1004,如下文中更详细地描述。 The first layer 1002 may be heat-application of heat and / or pressure by a pressing process involving attached to the second layer 1004, as described in greater detail below. 在其他情况下,第一层1002可通过例如生物相容性粘合剂材料诸如纤维蛋白和/或蛋白水凝胶附接到第二层1004。 In other cases, the first layer 1002 may be, for example, by a biocompatible adhesive material such as a fiber protein and / or protein hydrogel attached to the second layer 1004. 本公开设想了用于将第一层1002附接到第二层1004的其他方式。 The present disclosure contemplates other means for the first layer 1002 is attached to the second layer 1004.

[0217] 现在参见图21和图22,第一层1002可至少部分地嵌入第二层1004的第一部分1006和/或第二部分1008中。 [0217] Referring now to FIGS. 21 and 22, the first layer 1002 may be at least partially embedded in the first portion 1004 of the second layer 1006 and / or 1008 of the second portion. 在此类情况下,组织厚度补偿件组件1000可使用模具1024来制备,例如如图21所示。 In such cases, tissue thickness compensator assembly 1000 may be prepared using a die 1024 such as shown in Figure 21. 在各种情况下,可将包含聚合物(诸如聚乳酸(PLA)和/或聚乙醇酸(PGA))的有机溶液倾倒入模具1024中。 In each case, it may comprise a polymer (such as polylactic acid (PLA) and / or polyglycolic acid (the PGA)) the organic solution was poured into a mold 1024. 可将第一层1002浸入有机溶液中。 The first layer 1002 may be immersed in an organic solution. 如图22所示,模具盖1028的中心架1026和中心梁1027可将第一层1002夹在两者间以确保第一层1002保持浸入有机溶液中,该有机溶液然后可使用例如常规冻干技术和/或任何其他合适的技术来冻干。 22, the mold cover and the center of the center frame 1026 may be 1027 beam 1028 first layer 1002 interposed therebetween to ensure the holding of the first layer 1002 was immersed in an organic solution, and the organic solution may then be used, for example, conventional freeze-drying technology and / or any other suitable technique lyophilized. 在完成冻干过程和/或任何其他合适的过程之后,模具盖1028可被移除并且组织厚度补偿件组件1000可从模具1028回收。 After completion of the lyophilization process and / or any other suitable process, the mold cover 1028 can be removed and the tissue thickness compensator assembly 1000 can be recovered from 1028 the mold.

[0218] 如图21所示,组织厚度补偿件1000的第一层1002可部分地定位在第二层1004的第一部分1006和第二部分1008内。 As shown in [0218] 21, the first tissue thickness compensator layer 1002 1000 may be partially positioned within the first portion 1006 and second portion 1004 of the second layer 1008. 在某些情况下,第一层1002可部分地定位在第一部分1006和第二部分1008中的一者内并且附接到第一部分1006和第二部分1008中的另一者的顶部表面或底部表面。 In some cases, the first layer 1002 may be partially positioned within the first portion 1006 and second portion 1008 and attached to one of the top or bottom of the other of the first 1006 and second portion 1008 portion surface.

[0219] 在某些情况下,当盖1028与模具1024处于闭合构型时,中心梁1027和架1026可至少部分地沿平行于或基本上平行于第一平台接触表面1007和/或第二平台接触表面1009的轴线延伸,如图22所示。 [0219] In some cases, when the lid 1028 and the mold 1024 is in the closed configuration, the center frame beams 1027 and 1026 may be at least partially in a direction parallel or substantially parallel to the first contact surface platform 1007 and / or the second internet contact surface 1009 extending axis 22 as shown in FIG. 在此类情况下,第一层1002可嵌入第一部分1006和/或第二部分1008中,使得第一层1002以与第一平台接触表面1007和/或第二平台接触表面1009平行或基本上平行的关系定位或基本上定位。 In such cases, the first layer 1002 may be embedded in a first portion 1006 and / or second portions 1008, 1002 such that the first layer is in contact with the first surface platform 1007 and / or the second contact surface 1009 parallel to the internet or substantially positioned substantially parallel relationship or positioning. 在其他情况下,虽然未示出,但当盖1028与模具1024处于闭合构型时,中心梁1027和架1026可至少部分地沿与第一平台接触表面1007和/或第二平台接触表面1008成斜角的轴线延伸。 In other cases, although the time is not shown, when the cap 1028 and the mold 1024 is in the closed configuration, along with the first contact surface platform 1027 and the center sill frame 1026 may be at least partially and / or the second stage 1007 contacting surface 1008 an axis extending at an oblique angle. 在此类情况下,第一层1002可嵌入第一部分1006和/或第二部分1008中,使得第一层1002相对于第一平台接触表面1007和/或第二平台接触表面1009以斜角定位或基本上定位。 In such cases, the first layer 1002 may be embedded in a first portion 1006 and / or second portions 1008, 1002 such that the first layer 1009 is positioned with respect to an oblique angle and / or the second contact surface of the first internet platform contact surface 1007 or substantially positioned. 本公开设想到用于将第一层1002部分地嵌入第一部分1006和/或第二部分1008中的其他技术。 The present disclosure is contemplated for the first layer 1002 partially embedded in the first portion 1006 other techniques and / or the second portion 1008.

[0220] 现在参见图18和图19,示出了在许多方面类似于组织厚度补偿件组件1000和组织厚度补偿件20020的组织厚度补偿件组件1033。 [0220] Referring now to FIGS. 18 and 19, it shows similar in many respects tissue thickness compensator assembly 1000 and the tissue thickness compensator 20020 1033 tissue thickness compensator assembly. 组织厚度补偿件组件1033可包括可间隔开并且由多个桥接构件或连接器1030可分离地联接在一起的第一部分1006和第二部分1008,所述桥接构件或连接器可跨第一部分1006和第二部分1008之间的间隙1010延伸。 Tissue thickness compensator assembly 1033 may be spaced apart and may comprise a plurality of bridging members or connector 1030 detachably coupled together, the first portion 1006 and second portion 1008, a bridge member or the connector and across the first portion 1006 gap between the second portion extending 10,081,010. 另外,组织厚度补偿件组件1033的连接器1030中的一些或全部可部分地嵌入第一部分1006和第二部分1008中,如图19所示。 In addition, some tissue thickness compensator assembly connector 1030 or 1033 may be partially embedded in all of the first portion 1006 and second portion 1008, as shown in Fig. 此外,连接器1030中的一些或全部可包括定位在第一部分1006内的第一端部、定位在第二部分1008内的第二端部,以及两者间的间隙桥接部分1032。 In addition, some connectors 1030 may comprise all or a first end portion positioned within the first portion 1006, a second end portion positioned within the second portion 1008, and the gap portion 1032 between the two bridges. 间隙桥接部分1032可跨第一部分1006和第二部分1008之间的间隙1010延伸,如图19所示。 Bridge the gap across the gap portion 1032 between the first 1006 and second portion 1008 extending portion 1010, as shown in Fig. 连接器1030可沿间隙1010的长度间隔开以将第一部分1006可分离地联接到第二部分1008。 The connector 1030 along the length of the gap 1010 may be spaced apart to a first portion 1006 is detachably coupled to the second portion 1008.

[0221] 在某些情况下,连接器1030可沿着沿间隙1010延伸的轴线均匀地分布,如图19所示。 [0221] In some cases, the connector 1030 may be uniformly distributed along an axis extending along the gap 1010, as shown in Fig. 在其他情况下,虽然未示出,但连接器1030可沿着沿间隙1010延伸的轴线不均匀地分布。 In other cases, although not shown, the connector 1030 may be non-uniformly distributed along an axis extending along the gap 1010. 切割部分10053可被构造成能够在切割部分10053在第一部分1006和第二部分1008之间推进穿过由间隙1010限定的刀路径时横切连接器1030的间隙桥接部分1032。 Cutting portion 10053 may be configured transversely to the connector bridging the gap portion 1032 through 1030 defined by the path of the knife can be advanced gap 1010 between the first portion 1006 and second portion 1008 of the cutting portion 10053. 在连接器1030沿着沿第一部分1006和第二部分延伸的轴线不均匀地分布的情况下,在至少一种情况下,连接器1030在间隙1010的远侧节段处可比在间隙1010的近侧节段处以更大的频率并且/或者更靠近彼此来设置,使得切割部分10053在沿由间隙1010限定的刀路径推进时可经受增加的阻力。 In the case where the connector 1030 is unevenly distributed along the axis of the second portion 1006 and extending along a first portion, in at least one case, the connector 1030 1010 than near the gap at the distal section of the gap 1010 side sections impose greater frequency and / or be disposed closer to each other, so that the cutting portion 10053 can be subjected to increased resistance when advancing along the path of the knife gap 1010 defined. 在其他情况下,连接器1030在间隙1010的近侧节段处可比在间隙1010的远侧节段处以更大的频率并且/或者更靠近彼此来设置,例如使得切割部分10053在沿由间隙1010限定的刀路径推进时可经受减小的阻力。 In other cases, the connector 1030 impose a greater frequency than in the distal section of the gap 1010 and / or closer to each other to set the gap at a proximal segment 1010, such that the cutting portion by a gap 10053 along 1010 may be subjected to reduced resistance during propulsion defined tool path.

[0222] 在某些情况下,连接器1030可在可平行于或基本上平行于第一平台接触部分1007和/或第二平台接触部分1009的单个平面中延伸或基本上延伸,如图19所示。 Single plane [0222] In some cases, the connector portion 1030 may be 1007 and / or the second contact portion platform 1009 may be parallel to or substantially parallel to the first internet or contact extending substantially extend 19 Fig. 在其他情况下,虽然未示出,但连接器1030可沿可彼此平行或基本上彼此平行以及/或者平行于或基本上平行于第一平台接触部分1007和/或第二平台接触部分1009的多个平面延伸或基本上延伸。 In other cases, although not shown, the connector 1030 may be in parallel or substantially parallel to one another and / or parallel to or substantially parallel contact with the first portion of the platform 1007 and / or the second contact portion 1009 of the platform a plurality of substantially planar extension or extension.

[0223] 对上文进行进一步描述,连接器1030的间隙桥接部分1032中的一些或全部可比其相应连接器1030的其余部分薄以在切割部分10053被推进以横切连接器1030时使切割部分10053呈现在减小的阻力下,同时维持第二层1004的第一部分1006和第二部分1008的联接接合。 [0223] Further to the above description, the connector portion bridging the gap 1030 1032 than some or all of the remainder of its respective connector thinner in the cutting portion 1030 to 10053 is advanced to cross the connector 1030 when the cutting portion 10053 presented at a reduced resistance, while maintaining engagement of the first coupling portion of the second layer 1006 and second portion 1004 of 1008. 例如,连接器1030中的一些或全部可包括狗骨形状,该狗骨形状具有终止在第二层1004的第一部分1006和第二部分1008内的较厚端部和在其间延伸的较薄中心部分。 For example, the connector 1030 may include some or all of the dog-bone shape of a dog bone shape having a first portion 1004 terminates the second layer 1006 and a thicker inner end portion 1008 and second portion extending therebetween thinner in the center section. 在某些情况下,连接器1030可各自由一段缝合线构成,该缝合线可由可生物吸收的材料构成,所述可生物吸收的材料诸如以商品名Vicryl出售的聚乙醇酸(PGA)、聚乳酸(PLA或PLLA)、聚二氧六环酮(PDS)、聚羟基链烷酸酯(PHA)、以商品名Monocryl出售的聚卡普隆25 (PGCL)、聚己内酯(PCL)、和/或PGA、PLA、PDS、PHA、PGCL和/或PCL的复合物。 In some cases, the connector 1030 may each be composed of a length of suture, the suture can be composed of a bioabsorbable material, a bioabsorbable material such as sold under the tradename Vicryl polyglycolic acid (PGA), poly acid (PLA or PLLA), polydioxanone dioxanone (PDS), polyhydroxy alkanoates (PHA), sold under the trade name Monocryl polyglecaprone 25 (PGCL), polycaprolactone (PCL), and / or the PGA, PLA, PDS, PHA, PGCL and / or PCL composite.

[0224] 再次参见图18,组织厚度补偿件组件1033可使用模具1034来制备。 [0224] Referring again to FIG. 18, 1033 tissue thickness compensator assembly 1034 can be prepared using a mold. 可将包含聚合物(诸如聚乳酸(PLA)和/或聚乙醇酸(PGA))的有机溶液倾倒入模具1034中。 It may comprise a polymer (such as polylactic acid (PLA) and / or polyglycolic acid (the PGA)) the organic solution was poured into a mold 1034. 可将连接器1030浸入有机溶液中。 The connector 1030 may be immersed in an organic solution. 如图18所示,连接器1030中的一个或多个可各自由从模具盖1038延伸的一个或多个梁1039夹在中心架1036上的一个或多个专用狭槽1040中并且被构造成能够用于在模具盖1038与模具1034处于闭合构型时与狭槽1040配合接合以确保连接器1030保持浸没在有机溶液中。 18, one or more connectors 1030 may each beam from the mold cover clamped on the center frame 1039 1036 1038 extending in a one or more specific or more slots 1040 and is configured to 1038 can be used to mold cover and the mold 1034 is in the closed configuration with the slot 1040 to ensure mating engagement with the connector 1030 remains immersed in organic solution. 狭槽1 4 O的尺寸可被设定成接收或至少部分地接收桥接部分1032,当模具盖1038与模具1034处于闭合构型时,该桥接部分可由梁1039固定。 1 4 O slot size may be set to receive or at least partially received bridge portion 1032, the cap 1038 when the mold and the mold 1034 is in the closed configuration, the bridge portion 1039 is fixed by a beam. 连接器1030的从间隙桥接部分1032延伸的端部可在有机溶液中自由漂浮。 1032 connector ends extends freely floating bridge portion from a gap 1030 in organic solution. 另选地,连接器1030的端部可被固定到例如模具1034的侧面。 Alternatively, the end connectors 1030 may be fixed to the side surface of the mold, for example, 1034. 在某些情况下,连接器1030可在模具1034的侧面之间在有机溶液中拉伸。 In some cases, the connector 1030 may be stretched between the side surface 1034 of the die in the organic solution. 在其他情况下,连接器1030可松散地保持在模具1034的侧面之间以便例如以非线性方式延伸穿过有机溶液。 In other cases, the connector 1030 may be loosely held between the side surface of the mold 1034 in a nonlinear manner such as to extend through the organic solution.

[0225] 对上文进行进一步描述,在各种情况下,然后有机溶液可使用常规冻干技术和/或任何其他合适的技术来冻干。 [0225] Further to the above description, in each case, then the organic solution was freeze-dried using conventional techniques and / or any other suitable technique lyophilized. 在完成冻干过程之后,模具盖1036可被移除并且组织厚度补偿件组件1033可从模具1034回收。 After completion of the lyophilization process, the mold cover 1036 can be removed and the tissue thickness compensator assembly 1033 can be recovered from 1034 the mold. 如图19所示,所得组织厚度补偿件组件1033包括部分地定位在第一部分1006和第二部分1008内的连接器1030。 19, the resulting tissue thickness compensator assembly 1033 includes a portion positioned within the first portion 1006 and second portion 1008 of the connector 1030. 本公开设想到用于将连接器1030部分地嵌入第一部分1006和/或第二部分1008中的其他技术。 The present disclosure is contemplated for connecting other technologies 1030 partially embedded in the first portion 1006 and / or 1008 of the second portion. 读者将理解,连接器1030可通过改变中心架1038的高度和/或狭槽1040的深度而更靠近或更远离平台接触表面1007和1009定位。 The reader will be appreciated, the connector 1030 may be closer to or farther away from the contact surface 1007 and a platform 1009 positioned by changing the height of the center frame 1038 of depth and / or slot 1040.

[0226] 现在参见图20,示出在许多方面类似于组织厚度补偿件组件1033、组织厚度补偿件组件1000和/或组织厚度补偿件20020的组织厚度补偿件组件1042。 [0226] Referring now to FIG. 20, there is shown similar in many respects tissue thickness compensator assembly 1033, tissue thickness compensator assembly 1000 and / or tissue thickness compensator 20020 tissue thickness compensator assembly 1042. 组织厚度补偿件组件1042可包括可间隔开并且由可由多个桥接构件或连接器1046形成的连续柔性构件1044可分离地联接在一起的第一部分1006和第二部分1008,所述桥接构件或连接器可跨第一部分1006和第二部分1008之间的间隙1010延伸。 Tissue thickness compensator assembly 1042 may include a connecting member or may be spaced apart and a continuous flexible member may be formed by a plurality of bridging members or connectors 10461044 detachably coupled together a first portion 1006 and second portion 1008, the bridge may 1006 across the gap between the first portion 1008 and second portion 1010 extends. 连续柔性构件1044可包括第一端部1048、第二端部1050,以及在第一端部1048和第二端部1050之间延伸的柔性部分1052。 The continuous flexible member 1044 may include 1048, 1050, 1052 and a flexible portion between the first end portion 1048 and a second end portion extending a second end portion 1050 of the first end portion. 柔性部分1052可被构造成能够例如以之字形图案延伸穿过第一部分1006和第二部分1008若干次以形成连接器1046,如图20所示。 The flexible section 1052 may be configured to be, for example, in a zigzag pattern extending through the first portion 1006 and second portion 1008 to form several connectors 1046, as shown in Fig. 柔性部分1052可沿第一方向穿过第一部分1006的远侧节段1054和第二部分1008的远侧节段1056以跨间隙1010形成第一间隙桥接部分1046a。 The flexible section 1052 may pass through the first portion of the distal section 1006 and distal section 1054 of second portion 1008 across the gap 1056 to 1010 form a first bridge portion 1046a gap in the first direction. 柔性部分1052然后可沿与第一方向相反的第二方向循环并穿过在远侧节段1056近侧的第二部分1008并且穿过在远侧节段1054近侧的第一部分1006,从而形成在第一间隙桥接部分1046a近侧的第二间隙桥接部分1046b。 The flexible section 1052 and second section 1008 and 1054 passes through the proximal segment of the distal portion 1006 may be the first in a second direction opposite the first direction through the loop and the proximal distal section 1056, so as to form in the gap between the first bridging portion 1046b of the second gap proximal bridge portion 1046a. 附加间隙桥接部分1046c和1046d例如可以相同方式跨间隙1010形成,如图20所示。 Additional clearance bridging portion 1046c and 1046d can, for example, across the gap 1010 formed in the same manner, as shown in Fig.

[0227] 在某些情况下,连续柔性构件1044可包括缝合线并且可由缝合线材料构成,所述缝合线材料诸如以商品名Vicryl出售的聚乙醇酸(PGA)、聚乳酸(PLA或PLLA)、聚二氧六环酮(PDS)、聚羟基链烷酸酯(PHA)、以商品名Monocryl出售的聚卡普隆25 (PGCL)、聚己内酯(PCL)、和/或PGA、PLA、PDS、PHA、PGCL和/或PCL的复合物。 [0227] In some cases, continuous flexible member 1044 may comprise a suture and suture material, the suture material such as sold under the trade name Vicryl polyglycolic acid (PGA), polylactic acid (PLA or PLLA) , poly dioxanone (the PDS), polyhydroxy alkanoates (PHA), sold under the trade name Monocryl polyglecaprone 25 (PGCL), polycaprolactone (PCL), and / or PGA, PLA , PDS, PHA, PGCL and / or PCL composite. 在某些情况下,组织厚度补偿件组件1042可在第一部分1006和第二部分1008例如通过冻干制造之后来组装。 In some cases, tissue thickness compensator assembly 1042 may be a first portion 1006 and second portion 1008 and later assembled, for example, by lyophilization of manufacture. 在一些情况下,针(未示出)可附接到连续柔性构件1044的第一端部1048并且可例如以之字形图案穿过第一部分1006和第二部分1008以将第一部分1006联接到第二部分1008,如上所述。 In some cases, the needle (not shown) may be attached to a first end portion the continuous flexible member may be, for example, 1044 and 1048 in a zigzag pattern through the first portion 1006 and second portion 1008 to first portion 1006 is coupled to the second two section 1008, as described above. 连续柔性构件1044的第一端部1048和/或第二端部1050可通过在例如第一端部1048和/或第二端部1050处系紧一个或多个结而固定到第一部分1006和/或第二部分1008的侧壁。 The continuous flexible member 1044 of the first end portion 1048 and / or the second end portion 1050 may be accomplished by, for example, and / or the second end portion 1050 of the system one or more tight junction of the first end portion 1048 is fixed to the first portion 1006 and / or the second sidewall portion 1008. 结可紧靠第一部分1006和/或第二部分1008的侧壁以防止柔性部分1052相对于第一部分1006和/或第二部分1008解开。 Knot 1006 may be against the first side wall portion and / or the second portion 1008 to prevent the flexible section 1052 with respect to and / or the first and second portions 1006 1008 untied. 在其他情况下,组织厚度补偿件组件1042的第一部分1006和第二部分1008可围绕连续柔性构件1044形成。 In other cases, the first tissue thickness compensator assembly 1042 portion 1006 and second portion 1008 may be formed about a continuous flexible member 1044. 在此类情况下,如图20所示,连续柔性构件1044可例如以之字形图案设置在模具1062中,其中狭槽1064限定在侧壁1066中并且狭槽1068限定在中心架1070中。 In such case, as shown in FIG. 20, the continuous flexible member 1044 may be, for example, a zigzag pattern 1062 is provided in a mold, wherein the slot defined in the side wall 1064 and the slot 1066 is defined in the center frame 1068 1070. 可将包含聚合物(诸如聚乳酸(PLA)和/或聚乙醇酸(PGA))的有机溶液倾倒入模具1062中,直到连续柔性构件1044浸没在有机溶液中。 May comprise a polymer (such as polylactic acid (PLA) and / or polyglycolic acid (the PGA)) the organic solution was poured into a mold 1062, 1044 until the continuous flexible member is immersed in an organic solution. 模具盖1072可用于确保连续柔性构件1044保持浸没在有机溶液中,该有机溶液然后使用常规冻干技术和/或任何其他合适的技术来冻干。 Mold cover 1072 may be used to ensure a continuous flexible member 1044 remains immersed in an organic solvent, the organic solution is then freeze-dried using conventional techniques, and / or any other suitable technique lyophilized. 在例如使第一端部1048穿过开口1053并且使第二端部1050穿过开口1055之后,连续柔性构件1044的第一端部1048和第二端部1050可通过在第一端部1048和第二端部1050处系紧一个或多个结而分别固定在模具1062的开口1053和1055处。 For example, after the first end portion 1048 through the opening 1053 and the second end portion 1050 through the opening 1055, a first end portion the continuous flexible member 1044 and the second end portion 1048 may be 1050 by 1048 at a first end portion and a second end portion 1050 based one or more tight junction opening 1053 respectively fixed die 1062 and 1055. 结可紧靠模具1062的侧壁以防止连续柔性构件1044相对于模具1066解开。 Knot 1062 may abut the mold walls to prevent the continuous flexible member 1044 with respect to 1066 to unlock the mold. 在组织厚度补偿件已从模具移除之后,在各种情况下,连续柔性构件1044的部分(诸如部分1048、1050和/或1052)然后可被切割并且从组织厚度补偿件移除。 After the tissue thickness compensator removed from the mold, in each case, a continuous portion (such as portion 1048, 1050 and / or 1052) of the flexible member 1044 may then be cut and removed from the tissue thickness compensator. 本公开设想到用于组装组织厚度补偿件组件1042的其他技术。 The present disclosure contemplates other techniques for assembling tissue thickness compensator assembly 1042.

[0228] 在某些情况下,当将过大的力或压力施加到组织厚度补偿件组件(诸如组织厚度补偿件组件1042)时,其可损坏。 When [0228] In some cases, when excessive force or pressure applied to the tissue thickness compensator assembly (such as tissue thickness compensator assembly 1042), which may damage. 例如,当将组织厚度补偿件组件1042装载到钉仓(诸如钉仓10000)上时,可将压力施加到组织厚度补偿件组件(诸如组织厚度补偿件组件1042)上。 For example, when the tissue thickness compensator assembly is loaded into the staple cartridge 1042 (such as the staple cartridge 10000), the pressure may be applied to the tissue thickness compensator assembly (such as tissue thickness compensator assembly 1042) on. 组织厚度补偿件组件1042可装配有压力或力敏感构件,该压力或力敏感构件可向使用者提供组织厚度补偿件组件所经受的压力是否超过阈值的警告反馈。 Tissue thickness compensator assembly 1042 may be equipped with a pressure-sensitive or force member, the force-sensitive or pressure member may be provided if the tissue thickness compensator assembly is subjected exceeds a threshold pressure warning feedback to the user. 例如,压力或力敏感膜可附接到组织厚度补偿件组件1042并且可被构造成能够在经受超过阈值的压力时改变颜色。 For example, a pressure or force-sensitive film may be attached to the tissue thickness compensator assembly 1042 and may be configured to be able to change color when subjected to a pressure exceeding a threshold. 在某些情况下,压力或力敏感膜可被设置在第一部分1006和/或第二部分1008上方并且可通过例如粘合剂附接到其上。 In some cases, the force or pressure-sensitive film may be disposed above the first portion 1006 and / or 1008 and the second portion may be attached thereto for example by adhesive. 压力或力敏感膜可以是生物相容的以允许用组织厚度补偿件组件1042将压力或力敏感膜植入患者体内。 Pressure or force-sensitive film may be used to allow the biocompatible tissue thickness compensator assembly 1042 or the force of a pressure-sensitive film is implanted in the patient.

[0229] 现在参见图23至图25,示出了外科端部执行器1100。 [0229] Referring now to FIGS. 23 to 25, shows a surgical end effector 1100. 端部执行器1100在许多方面类似于本文在别处公开的各种端部执行器,诸如端部执行器22090 (图9)。 An end effector 1100 is similar to the various end effector herein disclosed elsewhere in many aspects, such as the end effector 22 090 (FIG. 9). 如图23所示,端部执行器1100可包括例如在许多方面类似于钉仓组件20200 (图6)的钉仓组件1102。 23, the end effector 1100 may comprise, for example, similar to staple cartridge assembly 20200 (FIG. 6) of staple cartridge assembly 1102 in many respects. 另外,端部执行器1100可包括例如在许多方面类似于本文件在别处所公开的其他组织厚度补偿件(诸如组织厚度补偿件22020 (图9)、组织厚度补偿件20220 (图6)和/或组织厚度补偿件10020 (图4))的组织厚度补偿件1104。 Further, the end effector 1100 may comprise, for example, similar in many respects to other tissue thickness compensator (such as tissue thickness compensator 22020 (FIG. 9), tissue thickness compensator 20220 (FIG. 6) as disclosed elsewhere in this document and / or tissue thickness compensator 10020 (FIG. 4)) tissue thickness compensator 1104.

[0230] 对上文进行进一步描述,端部执行器1100可包括组织厚度补偿件1104,其中组织厚度补偿件1104可使用常规冻干技术和/或任何其他合适的技术来制备。 [0230] Further to the above description, the end effector 1100 may include a tissue thickness compensator 1104, wherein the tissue thickness compensator 1104 may be prepared using conventional lyophilization techniques and / or any other suitable technique. 在至少一个示例中,组织厚度补偿件1104可通过使聚合物(诸如聚乳酸(PLA)和/或聚乙醇酸(PGA))溶解于有机溶剂中并且使溶液冻干来制备。 In at least one example, the tissue thickness compensator 1104 can be obtained by the polymer member (such as polylactic acid (PLA) and / or polyglycolic acid (the PGA)) was dissolved in an organic solvent and the prepared solution was lyophilized. 组织厚度补偿件1104可由生物相容性泡沫构成,该生物相容性泡沫可包括例如多孔的开孔泡沫和/或多孔的闭孔泡沫。 Tissue thickness compensator 1104 may be composed of biocompatible foam, the foam may comprise, for example, biocompatible porous open cell foam and / or closed-cell porous foam.

[0231] 对上文进行进一步描述,组织厚度补偿件1104可被改变或修改以用于外科手术中。 [0231] Further to the above, the tissue thickness compensator 1104 may be changed or modified to a surgical procedure. 例如,在完成冻干过程之后,组织厚度补偿件1104可与修改构件1106接触以修改组织厚度补偿件1104以用于特定外科手术中。 For example, after completion of the lyophilization process, the tissue thickness compensator 1104 may be modified to modify the contact member 1106 to the tissue thickness compensator 1104 for a particular surgical procedure. 在某些情况下,修改可在将组织厚度补偿件1104组装有端部执行器1100之后进行,如图23至图35所示。 In some cases, the modification may be tissue thickness compensator 1104 is incorporated performed after the end effector 1100, as shown in FIGS. 23 to 35. 例如,如图23所示,组织厚度补偿件1104可以可释放地组装到仓组件1102并且在组装有仓组件1102时修改。 For example, as shown in FIG. 23, the tissue thickness compensator 1104 may be releasably assembled to the cartridge assembly 1102 and 1102 when the cartridge assembly is assembled modifications. 在其他情况下,修改可在将组织厚度补偿件1104组装有端部执行器1100之前进行。 In other cases, the modification may be tissue thickness compensator 1104 member 1100 is incorporated prior to the end effector. 在至少一个示例中,在制造期间,修改可作为单独的步骤进行。 In at least one example, during manufacture, modification may be carried out as a separate step. 在又一个示例中,修改可在外科手术期间进行。 In yet another example, the modification may be performed during surgery.

[0232] 如下文更详细地描述,修改过程可涉及修改组织厚度补偿件1104的表面或多个表面。 [0232] As described in more detail below, the modification process may involve modifying surface or surfaces of the tissue thickness compensator 1104. 在某些情况下,修改过程可涉及修改组织厚度补偿件1104的一个或多个部分。 In some cases, the modification process may involve one or more modified portions 1104 tissue thickness compensator. 一个或多个部分可在单个修改过程中修改。 One or more portions may be modified in a single modification process. 另选地,多个部分可各自在连续修改过程中单独地修改。 Alternatively, a plurality of portions may be individually modified in a continuous modification process. 在某些情况下,修改过程可包括热压制过程,该热压制过程可用于改变组织厚度补偿件1104的至少一部分的形状、大小、尺寸和/或孔隙度。 In some cases, the modification process may include a hot pressing process, hot pressing process which can be used to change the shape, size, dimension and / or porosity of at least a portion of the tissue thickness compensator 1104. 此外,修改过程可包括用于在组织厚度补偿件1104的一个或多个部分内形成空间的方式。 Further, in the modification process may include a tissue thickness compensator member 1104 is formed of a space or a plurality of portions.

[0233] 再次参见图23至图25,在某些情况下,组织厚度补偿件1104的部分1107(图23)可通过热压制过程来修改,该热压制过程可包括将部分1107转变成玻璃态,将部分1107与修改构件1106接合,在部分1107处于玻璃态时将压力施加到其上,以及使部分1107冷却到玻璃态之下,同时修改构件1106仍与部分1107接合。 [0233] Referring again to FIGS. 23 to 25, in some cases, the tissue thickness compensator 1104 section 1107 (FIG. 23) may be modified by hot pressing process, the process can include hot pressing section 1107 into a glass the engagement portions 1107 and 1106 modifying member, when the section 1107 in the glassy state to apply pressure thereto, and causing section 1107 is cooled below the glass state, while modifying member 1106 remains engaged with the portion 1107. 修改构件1106可用于维持部分1107上的压力持续足以形成所得修改部分1108 (图25)的时间段。 Modifying member 1106 may be a pressure on the portion 1107 is formed for a time sufficient for maintaining the resultant modified portion 1108 (FIG. 25) period. 值得注意的是,材料到玻璃态的转变可为响应于材料的温度增加到玻璃化转变温度而从相对较硬状态到相对熔融或柔性状态的可逆转变。 Notably, the transition to a glassy state material may be increased in response to the temperature of the material relative to the glass transition temperature from a molten state to a relatively stiff flexible or reversibly transition state. 材料的玻璃化转变温度可为特定温度,或者在一些情况下为一定的温度范围。 The glass transition temperature of the material may be a specific temperature, or in some cases a range of temperatures. 本文所述的组织厚度补偿件修改过程通过以下方式来利用该现象:在组织厚度补偿件处于玻璃柔性状态时修改组织厚度补偿件,然后在维持修改时使组织厚度补偿件冷却到玻璃化转变温度以下。 Tissue thickness compensator modification process described herein by way of utilizing this phenomenon: the alteration of the thickness of the tissue thickness compensator compensator is a flexible glass state, and then the tissue thickness compensator cooled to the glass transition temperature while maintaining modified the following.

[0234] 对上文进行进一步描述,再次参见图23至图25,组织厚度补偿件1004的部分1107可通过以下方式而转变成玻璃态:至少将部分1107加热到大于或等于材料的玻璃化转变温度但是低于其熔融温度的温度,部分1107由所述材料构成。 [0234] Further to the above described, Referring again to FIGS. 23 to 25, a tissue thickness compensator 1004 section 1107 may be converted to a glassy state by: heating at least a portion 1107 of greater than or equal to the glass transition of the material temperature but below its melting temperature, said material is constituted by part 1107. 例如,组织厚度补偿件1104可由聚乙醇酸(PGA)构成,并且在此类情况下,部分1107可通过以下方式转变成玻璃态:将部分1107加热到大于或等于聚乙醇酸(PGA)的玻璃化转变温度但是低于其熔融温度的温度。 For example, tissue thickness compensator 1104 may be polyglycolic acid (PGA) configuration, and in such case, the section 1107 may be converted into a glassy state in the following manner: the heating section 1107 greater than or equal to the glass polyglycolic acid (PGA) of transition temperature but below its melting temperature. 在各种情况下,聚乙醇酸(PGA)的玻璃化转变温度可在例如35-40°C的范围内,并且其熔融温度可在例如225-230°C的范围内。 In each case, polyglycolic acid (PGA) in the glass transition range, for example 35-40 ° C, and a melting temperature in the range 225-230 ° C may be, for example, a temperature. 在至少一个示例中,组织厚度补偿件1104的部分1107可被加热到大于或等于35°C但低于225°C的温度,以便将部分1107转变成玻璃态。 In at least one example, the tissue thickness compensator 1104 section 1107 may be heated to greater than or equal to 35 ° C but below 225 ° C so that the section 1107 into a glassy state. 在另一个示例中,部分1107可通过以下方式转变成玻璃态:将部分1107加热到例如大于或等于40°C但低于200 °C的温度。 In another example, section 1107 can be converted into a glassy state in the following manner: the heating section 1107, for example, greater than or equal to 40 ° C but below the temperature to 200 ° C.

[0235] 对上文进行进一步描述,修改构件1106然后可用于在部分1107处于玻璃态时将压力施加到部分1107上。 [0235] Further to the above described, it may then be used to modify the member 1106 when the portion 1107 in the glassy state to apply pressure to the portion 1107. 可通过例如将部分1107冷却到低于35°C的温度而使部分1107退出玻璃态。 May exit the section 1107 by, for example glassy portion 1107 is cooled to a temperature below 35 ° C to. 可将压力维持足以允许组织厚度补偿件1104保持或至少部分地保持由修改构件1106施加的修改的时间段。 Maintaining the pressure may be sufficient to allow tissue thickness compensator 1104 holding member or at least partially held applied by modifying member 1106 modification period.

[0236] 在某些实施例中,压力可例如在处于玻璃态的时间期间维持约30秒至约8小时的时间段并且/或者例如在退出玻璃态之后维持约30秒至约8小时的时间段。 [0236] In certain embodiments, the pressure may be maintained, for example, a time period from about 30 seconds to about 8 hours during a time in the glassy state and / or maintained, for example, from about 30 seconds to about 8 hours after exiting the glassy segment. 在至少一个示例中,压力可在处于玻璃态的时间期间维持大约10分钟并且在退出玻璃态之后维持大约10分钟。 In at least one example, the pressure may be maintained at about 10 minutes during the time and maintaining the glassy state, after about 10 minutes to exit the glass. 本公开设想到用于维持压力的其他时间段。 The present disclosure contemplates other time periods for maintaining the pressure.

[0237] 在某些情况下,修改构件1106可用于在部分1107转变成玻璃态之前将压力施加到部分1107上。 [0237] In some cases, member 1106 may be used to modify the prior section 1107 is converted into a glass pressure is applied to the portion 1107. 在某些情况下,修改构件1106可在部分1107被加热以达到玻璃态时,在部分1107处于玻璃态时,以及/或者在部分1107转变或冷却到玻璃态以下的温度时向部分1107施加压力。 In some cases, modification member may be heated at 1106 to 1107 when partially glassy state is attained, a portion in the glassy state 1107, and / or applying pressure to the portion 1107 at section 1107 transition state or cooled to a temperature below the glass . 在某些情况下,例如在部分1107的温度逐渐增加以使部分1107朝玻璃态转变时,施加到部分1107的压力可逐渐朝阈值增加。 In some cases, for example in the temperature of the portion 1107 is gradually increased so that a portion 1107 toward the glass transition, the pressure applied to the section 1107 may be gradually increased toward the threshold value. 在某些情况下,在部分1107退出玻璃态时,在部分1107退出玻璃态之前,以及/或者在部分1107退出玻璃态之后,施加到部分1107的压力可被移除,逐渐移除,或至少部分地减小。 In some previous cases, when the exit glassy section 1107, the portion 1107 exits the glassy state, and / or exit the glass section 1107 after state, pressure applied to the section 1107 may be removed, gradually removing, or at least partially reduced.

[0238] 在某些情况下,修改构件1106还可以是用于使组织厚度补偿件1104的部分1107转变成玻璃态的热源。 [0238] In some cases, member 1106 may also be modified for tissue thickness compensator 1107 into a portion 1104 of the heat source glassy. 例如,修改构件1106可包括圆柱形远侧部分1110,如图24所示,该圆柱形远侧部分可包括加热线圈(未示出)。 For example, modifying member 1106 may include a cylindrical distal portion 1110, shown in Figure 24, the cylindrical distal portion may include a heating coil (not shown). 使用者可使加热线圈通电并且将组织厚度补偿件1104的部分1107与修改构件1106接合以将部分1107加热到大于或等于部分1107的材料组合物的玻璃化转变温度的温度。 Heating coil and the user can make the tissue thickness compensator 1104 and section 1107 to modify the engaging member 1106 section 1107 heated to a temperature greater than or equal to the glass transition temperature of the material composition portion 1107. 一旦达到所需温度,可抵靠部分1107按压修改构件,如图24所示。 Once the desired temperature, 1107 abut against the pressing portion member modification, shown in Figure 24. 另选地,在修改构件1106达到所需温度之前,可抵靠部分1107按压修改构件。 Alternatively, the modifying member 1106 before reaching the desired temperature, abut against the pressing portion 1107 modifying member. 如上所述,可将压力维持足以允许组织厚度补偿件1104保持或至少部分地保持由修改构件1106施加的修改的时间段。 As described above, the pressure may be maintained to allow sufficient tissue thickness compensator 1104 holding member or at least partially held applied by modifying member 1106 modification period. 另外,修改构件110 6的加热线圈可被关闭以使部分110 7的温度冷却到低于玻璃化转变温度。 Further, the heating coil modifying member 1106 may be closed to make the temperature of the portion 1107 is cooled below the glass transition temperature. 修改构件然后可被移除。 Modifying member may then be removed. 在某些情况下,由修改构件1106施加的压力可在部分1107进入玻璃态之前被引发并且在整个玻璃态内得以维持。 In some cases, the pressure applied by modifying member 1106 may be initiated prior to entering the glassy portion 1107 and maintained throughout the glassy state. 在一些情况下,在部分1107处于玻璃态时,由修改构件1106施加的压力可被移除。 In some cases, when the portion 1107 in the glassy state, can be removed from the modified pressure applying member 1106.

[0239] 如图23至图25所示,修改构件1106可被构造成能够改变组织厚度补偿件1104的部分1107的形状、大小、尺寸、密度、弹性比率和/或孔隙度。 [0239] As shown in FIG. 23 to FIG. 25, modifying member 1106 may be configured to be able to change shape, size, size, density, elasticity ratio and / or porosity tissue thickness compensator 1104 section 1107. 例如,修改部分1108可包括具有减小高度Hl的基本上凹形的顶部表面1114,而组织厚度补偿件1104的剩余部分可保持包括大于减小高度Hl的初始高度H的基本上平坦的顶部表面,如图25所示。 For example, the modified portion 1108 may comprise a substantially reduced height Hl of the concave top surface 1114, while the remaining portion of the tissue thickness compensator 1104 may remain substantially flat top surface comprising greater than a height Hl of reducing the initial height H , as shown in Figure 25. 如上所述,修改构件1106可包括圆柱形远侧部分1110。 As described above, modifying member 1106 may include a cylindrical distal portion 1110. 在此类情况下,所得凹形表面1114的曲率可部分地取决于在修改过程期间与组织厚度补偿件1104的部分1107接触的修改构件1106的圆柱形远侧部分1110的曲率。 In such cases, the resulting curvature of the concave surface 1114 may depend in part on the curvature of the cylindrical distal modification during the course of the thickness of the tissue section compensator 1104 1107 1106 modified portion of the contact member 1110. 此外,修改部分1108可具有与未修改部分1107相比较低的新孔隙度,这可至少部分地由在修改过程期间由修改构件1106施加到部分1107的压缩力导致,如上所述。 In addition, the new modification section 1108 may have a porosity lower compared to unmodified portion 1107, which may be at least partially caused by the compressive force applied by the section 1107 is modified during the modification procedure member 1106, as described above. 换句话讲,在修改过程期间施加到部分1107的压力可产生材料重新分布,其中在修改过程之前通过修改部分1108的横截面可具有比通过部分1107的相似横截面大的材料密度。 In other words, the pressure applied to the portion 1107 of generating material may redistribute during the modification process, wherein prior to modification process by modifying the cross-sectional portion is greater than 1108 may have a similar cross-section through a portion 1107 of the density of the material. 此夕卜,修改部分1108可具有与组织厚度补偿件1104的剩余部分不同的弹性比率,这可部分地由在修改过程期间由修改部分1108实现的密度和孔隙度的改变而导致,如下文更详细地描述。 This evening Bu, modified portion 1108 may have a remaining portion of the tissue thickness compensator 1104 is different from the spring rate, which may be partially by a change in the density and porosity during the modification procedure implemented by the modified portion 1108 and lead, as described in more describe in detail. 在至少一种情况下,修改部分1108的弹性比率可小于或大于未修改部分1107的弹性比率。 In at least one case, modifying the ratio of the elastic portion 1108 may be less than or greater than the unmodified portion 1107 of the spring rate.

[0240] 现在参见图26至图34,组织厚度补偿件可在组装有端部执行器诸如端部执行器22090 (图9)之前被修改。 [0240] Referring now to FIGS. 26 to 34, a tissue thickness compensator can be assembled with an end effector, such as end effector 22 090 (FIG. 9) before being modified. 在某些情况下,如图27、图30和图33所示,模具可用于使用热压制过程修改组织厚度补偿件,如上所述。 In some cases, as shown in FIG 27, FIG 30 and FIG 33, a mold pressing process may be modified for use in a thermal compensator tissue thickness, as described above. 例如,如图26至图28所示,组织厚度补偿件1120可被修改为包括纵向狭槽1122。 For example, as shown in FIG. 26 to FIG. 28, the tissue thickness compensator 1120 may be modified to include a longitudinal slot 1122. 组织厚度补偿件1120可在许多方面类似于别处所述的其他组织厚度补偿件,诸如组织厚度补偿件22020 (图9)。 Tissue thickness compensator 1120 may be similar to other tissue thickness compensator elsewhere in many ways, such as tissue thickness compensator 22020 (FIG. 9). 例如,如同补偿件22020,补偿件1120可与端部执行器22090—起使用。 For example, as the compensator 22020, compensator 1120 may be used with the end effector from 22090-. 此外,纵向狭槽1122可在许多方面类似于刀狭槽22025。 Furthermore, longitudinal slots 1122 may be similar to the knife slot 22025 in many ways. 例如,如同刀狭槽22025,狭槽1122可将用于切割部分10053的组织厚度补偿件刀路径限定在第一缝合部分1124a和第二缝合部分1124b之间。 For example, as the knife slot 22025, the slot 1122 may be used to cut tissue thickness portion 10053 compensator tool path defined between the first suture portion and the second stitched portions 1124a 1124b. 此外,第一缝合部分1124a和第二缝合部分1124b可在许多方面分别类似于组织厚度补偿件22020的第一缝合部分22021a (图9)和第二缝合部分22021b (图9)。 Further, the first suture portion 1124a and second portion 1124b may be similar stapling tissue thickness compensator part 22020 of the first suture member 22021a (FIG. 9) and a second sewn portion 22021b (FIG. 9) in many respects. 另外,狭槽1122可被构造成能够可释放地连接第一缝合部分1124a和第二缝合部分1124b,使得在与端部执行器22090—起使用时,切割部分10053可朝远侧推进穿过狭槽1122以横切狭槽1122并且将第一缝合部分1124a和第二缝合部分1124b分离。 Further, the slot 1122 can be configured to be releasably connected to the first sewn portion and a second sewn portion 1124a 1124b, such that in use with the end effector from 22090-, 10053 cut portion can be advanced distally through the slot the groove 1122 and the first suture portion 1124a and the second stitched portions separated transversely slot 1122 1124b.

[0241] 再次参见图26至图28,组织厚度补偿件1120可使用传统冻干技术和/或任何其他合适的技术来制备。 [0241] Referring again to FIGS. 26 to 28, a tissue thickness compensator 1120 may be prepared using traditional lyophilization techniques and / or any other suitable technique. 另外,组织厚度补偿件1120可被修改或改变以穿过其中形成狭槽1122。 Moreover, the tissue thickness compensator 1120 may be modified or altered to form a slot 1122 therethrough. 类似于组织厚度补偿件1104,组织厚度补偿件1120可至少部分地由具有玻璃化转变温度的材料构成并且可通过将材料转变成玻璃态来修改。 Compensator 1104 is similar to the tissue thickness, tissue thickness compensator 1120 may be at least partially converted material having a glass transition temperature and the configuration can be modified by converting the material to a glassy state. 在一个示例中,组织厚度补偿件1120可在烘箱(未示出)中加热到大于或等于组织厚度补偿件1120的材料组合物的玻璃化转变温度但小于其熔融温度的温度。 In one example, the tissue thickness compensator 1120 may be an oven (not shown) heated to greater than or equal tissue thickness compensator 1120 has a glass transition temperature of the material composition, but less than its melting temperature. 如图27所示,包括中心梁1128的模具1126可用于通过以下方式形成狭槽1122:在组织厚度补偿件1120处于玻璃态时将中心梁1128插入组织厚度补偿件1120中。 27, 1128 including the beam center mold 1126 may be used to form a slot 1122 in the following manner: When the thickness of tissue compensator 1120 in the glassy state to the center sill member 1128 is inserted into tissue thickness compensator 1120. 在中心梁1128保持插入组织厚度补偿件1120中时,然后可使组织厚度补偿件1120冷却到低于玻璃化转变温度的温度。 1128 remains inserted in the center of the beam member when the tissue thickness compensator 1120, and 1120 allow the tissue thickness compensator cooled to a temperature below the glass transition temperature. 在一些情况下,在组织厚度补偿件1120处于其玻璃态时,中心梁1128可从组织厚度补偿件1120移除。 In some cases, the tissue thickness compensator 1120 is in its glassy state, central beam 1128 may be removed from the tissue thickness compensator 1120 members.

[0242] 在某些情况下,冷却介质可用于主动地冷却组织厚度补偿件1120。 [0242] In some cases, the cooling medium may be used to actively cool the tissue thickness compensator 1120. 在一些情况下,风扇可用于在组织厚度补偿件1120处于模具1126中时以及/或者在组织厚度补偿件1120已从模具移除之后在组织厚度补偿件1120上方生成空气流。 In some cases, the fan can be used in tissue thickness compensator 1120 when the mold 1126 and / or is generated on the tissue thickness compensator 1120 after the tissue thickness compensator 1120 is removed from the mold the air flow. 在一些情况下,制冷过程可用于在组织厚度补偿件1120处于模具1126中时以及/或者在组织厚度补偿件1120已从模具移除之后冷却组织厚度补偿件1120。 In some cases, the cooling process may be used in tissue thickness compensator 1120 is in the mold 1126 and / or cooling the tissue thickness compensator after the tissue thickness compensator 1120 1120 removed from the mold. 中心梁1128可在组织厚度补偿件1120转变退出玻璃态之后被移除。 Central beam 1128 may be tissue thickness compensator 1120 is removed after exiting the glass transition state. 中心梁1128可保持插入组织厚度补偿件1120中持续足以允许组织厚度补偿件1120保持或至少基本上保持中心梁1128所占据的空间的时间段。 Inserted central beam 1128 may be maintained in tissue thickness compensator 1120 duration sufficient to allow the tissue thickness compensator 1120 holding member holding period or at least substantially central beam of the space occupied by 1128. 在某些示例中,中心梁1128可例如在处于玻璃态的时间期间保持插入约30秒至约8小时的时间段并且/或者例如在退出玻璃态之后保持插入约30秒至约8小时的时间段。 In some examples, the central beam 1128 may be, for example, in the glassy state during the time period of insertion of holding from about 30 seconds to about 8 hours and / or inserted, for example, holding for about 30 seconds to about 8 hours after exiting the glassy segment. 在至少一个示例中,中心梁1128可在处于玻璃态的时间期间保持插入大约10分钟并且在退出玻璃态之后保持插入大约10分钟。 In at least one example, the central beam 1128 may be maintained at approximately 10 minutes after insertion remains inserted for approximately 10 minutes and during the time the glass exits the glassy state. 本公开可设想到用于将中心梁1128维持在组织厚度补偿件1120内的其他时间段。 The present disclosure may be contemplated for other periods central beam 1128 is maintained within a tissue thickness compensator 1120.

[0243] 对上文进行进一步描述,如图28所示,在修改过程期间由中心梁1128施加的压力可在组织厚度补偿件1120的部分1130处产生增加的材料密度。 [0243] Further to the above description, shown in Figure 28, the pressure during the modification process 1128 may be applied to the central beam section 1120 produce tissue thickness compensator 1130 increased material density. 部分1130可连接第一缝合部分1124a和第二缝合部分1124b,从而为狭槽1122提供附加稳定性。 A first connecting portion 1130 may be sewn stitched portion 1124a and a second portion 1124b, thereby providing additional stability to the slot 1122. 在某些情况下,模具1126可包括边缘改性剂,诸如边缘改性剂1132a和1132b,其可在修改过程期间修改组织厚度补偿件1120以分别产生修改的边缘1134a和1134b,如图28所示。 In some cases, the mold 1126 may include an edge modifiers, modifying agents such as edge 1132a and 1132b, which may modify the tissue thickness compensator during the modification process 1120 to produce a modified edge 1134a and 1134b, respectively, in FIG. 28 shows.

[0244] 再次参见图26至图28,可能需要从组织厚度补偿件1120移除显著量的材料以形成狭槽1122。 [0244] Referring again to FIGS. 26 to 28, may require a significant amount of material removed from the tissue thickness compensator 1120 to form a slot member 1122. 在此类情况下,中心梁1128可被加热到大于组织厚度补偿件1120的材料组合物的熔融温度的温度。 In such cases, the center beam 1128 may be heated to a temperature greater than the melting temperature of the material composition of the tissue thickness compensator 1120. 在将经加热的中心梁1128插入组织厚度补偿件1120中之后,中心梁1128可熔融穿过组织厚度补偿件1120,从而在组织厚度补偿件1120内形成用于狭槽1122的空间,如图28所示。 In the center of the heating after the beam was inserted into the tissue thickness compensator 1128 1120, 1128 meltable central beam through the tissue thickness compensator member 1120, thereby forming a space for a slot 1122 within the tissue thickness compensator member 1120, FIG. 28 Fig. 在某些情况下,可能需要逐渐增加由中心梁1128抵靠组织厚度补偿件1120施加的压力以将中心梁1128逐渐插入组织厚度补偿件1120中。 In some cases, it may be necessary to increase progressively from the central beam 1128 against pressure exerted by tissue thickness compensator 1120 to the center sill member 1128 gradually inserted into the tissue thickness compensator 1120.

[0245] 在某些情况下,可能需要增加组织厚度补偿件的一个或多个表面的材料密度。 [0245] In some cases, it may be necessary to increase the density of the material of one or more surfaces of the tissue thickness compensator. 如图29至图31所示,组织厚度补偿件1140可被修改或改变,使得组织厚度补偿件1140的表面1142可包括比组织厚度补偿件1140的剩余部分高的材料密度,在某些情况下,该更高的材料密度可在冻干后实现。 29 to FIG. 31, the tissue thickness compensator 1140 may be modified or changed, such that the tissue thickness compensator 11421140 surface may comprise a thickness greater than the remaining portion of tissue compensator 1140 material density, in some cases , the higher the material density can be achieved after lyophilization. 组织厚度补偿件1140可在许多方面类似于别处所述的其他组织厚度补偿件,诸如组织厚度补偿件22020 (图9)和/或组织厚度补偿件1120 (图26)。 Tissue thickness compensator 1140 may be similar to other tissue thickness compensator elsewhere in many ways, such as tissue 22020 (FIG. 9) and / or the thickness of the tissue thickness compensator compensator 1120 (FIG. 26). 表面改性剂1144可用于使用热压制过程修改组织厚度补偿件1140的表面1142,所述热压制过程在许多方面类似于用于修改组织厚度补偿件1104和/或组织厚度补偿件1120的热压制过程,如上所述。 Surface modifier 1144 may be used to modify the surface of the pressing process using a hot tissue thickness compensator 1140 1142, the hot pressing procedure analogous in many ways to modify the tissue thickness compensator hot pressing member 1104 and / or tissue thickness compensator 1120 process, as described above. 例如,组织厚度补偿件1140可至少部分地由包括玻璃化转变温度的材料构成并且可在转变成玻璃态之后被修改。 For example, tissue thickness compensator 1140 may be at least partially made of a material comprising a glass transition temperature and may be modified after the transition into the glass state.

[0246]如上所述,组织厚度补偿件(诸如组织厚度补偿件1140)可转变成玻璃态,其中该组织厚度补偿件被加热到大于或等于组织厚度补偿件1140的材料组合物的玻璃化转变温度但小于其熔融温度的温度。 [0246] As described above, the tissue thickness compensator (such as tissue thickness compensator 1140) can be converted into a glassy state, wherein the tissue thickness compensator compensator is heated to a thickness equal to or greater than the glass transition tissue material compositions 1140 temperature but less than its melting temperature. 在组织厚度补偿件1140处于玻璃态时,可抵靠表面1142按压表面改性剂1144。 When the thickness of tissue compensator 1140 in the glassy state, abut against the surface of the pressing surface modifier 1142 1144. 由表面改性剂1144施加的压力可压缩表面1142,从而增加表面1142的材料密度。 The pressure exerted by the compressible surface of the surface modifier 1144 1142, 1142 to increase the density of the surface of the material. 材料密度的增加可通过以下方式由表面1142保持:使表面1142冷却到低于玻璃化转变温度的温度。 Increasing the density of the material 1142 can be maintained by the surface in the following manner: the surface 1142 is cooled to below the glass transition temperature.

[0247] 在某些情况下,由表面改性剂1144抵靠表面1142施加的压力可例如在处于玻璃态的时间期间维持约30秒至约8小时的时间段并且/或者例如在退出玻璃态之后维持约30秒至约8小时的时间段。 [0247] In some cases, the surface modifier 1144 against surface 1142 may be applied to the pressure maintained, for example, a time period from about 30 seconds to about 8 hours during a time in the glassy state and / or exit glassy e.g. after the maintenance time period of about 30 seconds to about 8 hours. 在至少一个示例中,压力可在处于玻璃态的时间期间维持大约10分钟并且在退出玻璃态之后维持大约10分钟。 In at least one example, the pressure may be maintained at about 10 minutes during the time and maintaining the glassy state, after about 10 minutes to exit the glass. 本公开设想到用于维持由表面改性剂1144抵靠表面1142施加的压力的其他时间段。 The present disclosure contemplates other time period for maintaining the surface modifier 1144 1142 against the surface of the applied pressure.

[0248] 在一些情况下,风扇可用于在组织厚度补偿件1140与改性剂1144接触时以及/或者在组织厚度补偿件1140已从改性剂1144移除之后在组织厚度补偿件1140上方生成空气流。 [0248] In some cases, the fan can be used in tissue thickness compensator member 1140 when in contact with the modifying agent 1144 and / or is generated on the tissue thickness compensator 1140 after the tissue thickness compensator 1140 is removed from the modifier 1144 air flow. 在一些情况下,制冷过程可用于在组织厚度补偿件1140与改性剂1144接触时以及/或者在组织厚度补偿件1140已从改性剂1144移除之后冷却组织厚度补偿件1140。 In some cases, the cooling process may be used when the tissue thickness compensator 1140 into contact with the modifying agent 1144 and / or the cooling member after tissue thickness compensator tissue thickness compensator 1140 from 1144 to remove 1140 the modifier. 在组织厚度补偿件1140转变退出玻璃态之后,在各种情况下,表面改性剂1144可与组织厚度补偿件1140脱离接合。 After the tissue thickness compensator 1140 exit the glass transition state, in each case, the surface modifier 1144 and 1140 may be engaged from the tissue thickness compensator. 在某些情况下,表面改性剂1144可包括加热元件,该加热元件可用于将表面1142的温度增加到大于或等于组织厚度补偿件1140的材料组合物的玻璃化转变温度的温度,如上所述。 In some cases, the surface modifier 1144 may include a heating element, the heating element may be used to increase the temperature of the surface 1142 of the glass transition temperature of greater than or equal to the transition temperature of the material composition of the tissue thickness compensator 1140, above above.

[0249] 再次参见图30,表面改性剂1144可包括平坦的或至少基本上平坦的接触表面1146以用于接触例如表面1142。 [0249] Referring again to FIG. 30, 1144 can include surface modifying agents, or at least substantially flat, planar contact surface for contacting e.g. 1146 to 1142 surface. 在其他情况下,接触表面1146可具有各种纹理,诸如可在修改过程期间延伸到组织厚度补偿件1140的表面1142中的突起。 In other cases, the contact surface 1146 may have various textures, such as the surface of the protrusion 1142 may extend into the tissue thickness compensator member 1140 during the modification process. 在某些情况下,表面改性剂1144可用于在组织厚度补偿件1140转变到玻璃态之前将压力施加到组织厚度补偿件1140的表面1142上。 In some cases, the surface modifier may be used prior to 1144 tissue thickness compensator 1140 state transitions to the glass surface of the pressure applied to the tissue thickness compensator 1142 1140. 在某些情况下,表面改性剂1144可在组织厚度补偿件1140被加热以达到玻璃态时,在组织厚度补偿件1140处于玻璃态时,以及/或者在组织厚度补偿件1140转变或冷却到玻璃态以下的温度时向表面1142施加压力。 In some cases, the surface modifier may be tissue thickness compensator 1144 member 1140 is heated to the glass state is reached, when the tissue thickness compensator 1140 in the glassy state, and / or 1140 in the transition or cooling the tissue thickness compensator when pressure is applied to the surface temperature of the glass state 1142 below. 在某些情况下,例如在组织厚度补偿件1140的温度逐渐增加以使组织厚度补偿件1140朝玻璃态转变时,由表面改性剂1144施加到表面1142的压力可逐渐朝阈值增加。 In some cases, for example, the thickness of tissue temperature compensator 1140 is gradually increased to the tissue thickness compensator member 1140 toward the glass transition, the pressure applied by the surface 1142 of the surface modifier 1144 may be gradually increased toward the threshold value. 在某些情况下,在组织厚度补偿件1140退出玻璃态时,在组织厚度补偿件1140退出玻璃态之前,以及/或者在组织厚度补偿件1140退出玻璃态之后,施加到表面1142的压力可被移除、逐渐移除、或至少部分地减小。 In some cases, the tissue thickness compensator 1140 exit the glass state prior to exit the tissue thickness compensator 1140 glassy, ​​and / or after the tissue thickness compensator 1140 exit the glass state, a pressure is applied to the surface may be 1142 removal, gradually removing, or at least partially reduced.

[0250] 在某些情况下,组织厚度补偿件1140可被修改或改变为包括表皮或致密外层。 [0250] In some cases, the tissue thickness compensator 1140 may be modified or altered to include a dense outer layer or skin. 在某些情况下,所得表皮或致密外层可包括纹理,诸如可延伸到组织厚度补偿件1140的表面1142中的突起。 In some cases, the resulting skin or dense layer may include a texture, such as a protrusion may extend to the surface of the tissue thickness compensator 1142 in 1140. 在某些情况下,表面改性剂1144的接触表面1146可被加热到大于或等于组织厚度补偿件1140的材料组合物的熔融温度的温度。 In some cases, the contact surface 1144 of the surface modifier 1146 may be heated to a temperature greater than or equal to the thickness of tissue material composition compensator 1140 melting temperature. 表面改性剂1144和/或组织厚度补偿件1140可运动以使组织厚度补偿件1140的表面1142与表面改性剂1144的经加热接触表面1146接触,从而使表面1142熔融或至少基本上熔融。 1144 surface-modifying agent and / or tissue thickness compensator member 1140 movable to the tissue thickness compensator heated surface in contact with the surface modifier 1142 1144 11461140 contact with the surface, so that the melted surface 1142 or at least substantially molten. 表面改性剂1144和组织厚度补偿件1140然后可分离以允许修改的表面1142冷却到其熔融温度以下,这可将表皮或致密外层形成到组织厚度补偿件1140上。 Surface modifiers tissue thickness compensator 1144 and 1140 can then be isolated to allow the modified surface 1142 is cooled to below the melting temperature thereof, which may be formed on the outer skin or dense tissue thickness compensator 1140.

[0251] 在某些情况下,表面改性剂1144的接触表面1146可在与表面1142接触之前被加热。 [0251] In some cases, the contact surface 1144 of the surface modifier 1146 may be heated prior to the contact surface 1142. 在其他情况下,表面改性剂1144的接触表面1146可在与表面1142接触之后被加热。 In other cases, the contact surface 1144 of the surface modifier 1146 may be heated after contact with the surface 1142.

[0252] 在某些情况下,表面改性剂1144的接触表面1146可保持与组织厚度补偿件1140的表面1142接触足以使表面1142流入所需几何形状中的时间段。 [0252] In some cases, the contact surface 1144 of the surface modifier 1146 may be maintained in contact with the surface of the tissue thickness compensator 11421140 period sufficient to flow into the desired geometry of the surface 1142. 此类时间段可在例如约30秒至约8小时的范围内,本公开可设想到其他时间段。 Such time period may be in the range of, for example, from about 30 seconds to about 8 hours, the present disclosure may be contemplated other periods. 此类时间段可足以局部影响并且/或者熔融组织厚度补偿件1140的材料并且使其流入新的几何形状中。 Such time period may be sufficient to affect the local and / or molten material compensator 1140 tissue thickness and allowed to flow into the new geometry. 如本文所述,此类新几何形状可由用于制造组织厚度补偿件1140的工具规定。 As described herein, such new geometries may be used for producing tissue tool member 1140 a predetermined thickness compensator.

[0253] 在某些情况下,可在将表面改性剂1144与组织厚度补偿件1140分离之前使组织厚度补偿件1140的表面1142冷却或主动地冷却到低于组织厚度补偿件1140的熔融温度的温度。 [0253] In some cases, the tissue thickness compensator cooling surface 1142 or 1140 is actively cooled to a temperature below the melting tissue thickness compensator 1140 before the surface modifier 1144 and 1140 separate tissue thickness compensator temperature. 在其他情况下,可在将表面改性剂1144与组织厚度补偿件1140分离之后使组织厚度补偿件1140的表面1142冷却或主动地冷却到低于组织厚度补偿件1140的熔融温度的温度。 In other cases, the tissue thickness compensator member after the surface modifier with the tissue thickness compensator 1144 1140 1140 1142 separation surface active cooling or cooled to a temperature below the melting temperature of the tissue thickness compensator 1140.

[0254] 对上文进行进一步描述,修改的表面1142可包括密度,例如该密度比组织厚度补偿件114 O的剩余部分的密度大约1 %、比组织厚度补偿件114 O的剩余部分的密度大约20%、比组织厚度补偿件1140的剩余部分的密度大约30%,比组织厚度补偿件1140的剩余部分的密度大约40%、比组织厚度补偿件1140的剩余部分的密度大约50%、比组织厚度补偿件114 O的剩余部分的密度大约6 O %、比组织厚度补偿件114 O的剩余部分的密度大约70%、比组织厚度补偿件1140的剩余部分的密度大约80%、比组织厚度补偿件1140的剩余部分的密度大约90%、并且/或者比组织厚度补偿件1140的剩余部分的密度大约100%。 [0254] Further to the above description, the surface 1142 may comprise modified density, for example, the density is from about 1% than the density of the remaining portion of the tissue thickness compensator 114 O and a specific density of approximately the thickness of the remaining portion of the tissue of the compensator 114 O 20%, about 30% less than the density of the remaining portion of the tissue thickness compensator 1140, than the density of the remaining portion of the tissue thickness compensator 1140 is about 40%, than the density of the remaining portion of the tissue thickness compensator 1140 is about 50%, than the tissue density of the remaining portion of the thickness of compensator 114 O about 6 O%, than the density of the remaining portion of the tissue thickness compensator 114 O to about 70%, than the density of the remaining portion of the tissue thickness compensator 1140 is about 80%, than the tissue thickness compensator density of the remaining portion of the member 1140 is about 90%, and / or density than the remaining portion of the tissue thickness compensator 1140 is about 100%. 在各种情况下,表面1142可包括密度,例如该密度大于组织厚度补偿件1140的剩余部分的密度,并且小于组织厚度补偿件1140的剩余部分的密度的两倍。 In each case, the density of the surface 1142 may comprise, for example, a greater density than the remaining portion of the tissue thickness compensator 1140, and less than twice the density of the remaining portion of the tissue thickness compensator 1140. 在各种情况下,修改的表面1142可包括密度,例如该密度大于组织厚度补偿件1140的剩余部分的密度的两倍。 In all cases, the surface modifications 1142 may include density, for example, the density is greater than twice the density of the remaining portion of the tissue thickness compensator 1140.

[0255] 现在参见图32至图34,组织厚度补偿件1150可被修改为包括可至少部分地延伸穿过组织厚度补偿件1150的多个孔1152。 [0255] Referring now to FIGS. 32 to 34, a tissue thickness compensator 1150 may be modified to include at least a plurality of apertures extend partially through the thickness of tissue compensator 1150 1152. 组织厚度补偿件1150可在许多方面类似于本文所述的其他组织厚度补偿件,诸如组织厚度补偿件20220 (图6)。 Tissue thickness compensator 1150 may be similar to other tissue thickness compensator as described herein in many ways, such as tissue thickness compensator 20220 (FIG. 6). 如同补偿件20220,补偿件1150可与仓组件20200 (图6) —起使用,并且孔1152可在许多方面类似于至少部分地延伸穿过组织厚度补偿件20220的间隙孔20224。 As compensator 20220, compensator 1150 with cartridge assembly 20200 (FIG. 6) - used together, and the aperture 1152 may extend at least partially through a clearance hole 20220 of the tissue thickness compensator 20224 is similar in many respects. 例如,如同孔20224,当组织厚度补偿件1150组装有仓组件20200时,孔1152可与对应的钉腿20232 (图7)对准,使得钉腿20232可在钉腿20232从未击发构型运动到击发构型时运动穿过组织厚度补偿件1150中的间隙孔1152,如上文更详细地描述。 For example, as the hole 20224, the tissue thickness compensator 1150 when assembled with the cartridge assembly 20200, the apertures 1152 may be aligned with a corresponding staple legs 20232 (FIG. 7), so that the staple legs 20232 20232 unfired configuration can move the staple legs when firing configuration to move through a clearance hole 1150 in the tissue thickness compensator member 1152, as described in more detail herein.

[0256] 对上文进行进一步描述,再次参见图32至图34,组织厚度补偿件1150可使用传统冻干技术和/或任何其他合适的技术来制备。 [0256] Further to the above described, Referring again to FIGS. 32 to 34, a tissue thickness compensator 1150 can be prepared using traditional lyophilization techniques and / or any other suitable technique. 在某些情况下,具有玻璃化转变温度的聚合物(例如聚乳酸(PLA)和/或聚乙醇酸(PGA))可溶解于有机溶剂中以形成溶液,该溶液可被冻干以产生组织厚度补偿件1150。 In some cases, the polymer having a glass transition temperature (e.g., polylactic acid (PLA) and / or polyglycolic acid (the PGA)) dissolved in an organic solvent to form a solution, the solution may be lyophilized to produce tissue thickness compensator 1150. 此外,组织厚度补偿件1150可在冻干后使用热压制过程来修改,所述热压制过程在许多方面类似于用于修改组织厚度补偿件1104、组织厚度补偿件1120和/或组织厚度补偿件1140的热压制过程,如上所述。 Moreover, the tissue thickness compensator 1150 may be used after freeze-drying process to modify hot pressing, the hot pressing process is analogous in many ways to modify the tissue thickness compensator 1104, compensator 1120 tissue thickness and / or tissue thickness compensator 1140 hot pressing process, as described above. 例如,一旦组织厚度补偿件1150转变成玻璃态,组织厚度补偿件1150可被修改为包括孔1152。 For example, once the tissue thickness compensator 1150 into a glassy state, tissue thickness compensator 1150 may be modified to include aperture 1152.

[0257]如上所述,组织厚度补偿件(诸如组织厚度补偿件1150)可通过在烘箱(未示出)中加热到大于或等于组织厚度补偿件1150的材料组合物的玻璃化转变温度但小于其熔融温度的温度而转变成玻璃态。 [0257] As described above, the tissue thickness compensator (such as tissue thickness compensator 1150) by heating in an oven (not shown) in the glass transition temperature of the material composition is greater than or equal to the thickness of tissue compensator 1150 but less than the its melting temperature into a glass state. 包括多个柱、榫钉、销和/或突起的模具1154 (诸如针1156)可用于通过以下方式形成孔1152:在组织厚度补偿件1150处于玻璃态时将针1156插入组织厚度补偿件1150中。 Comprises a plurality of posts, dowels, pins and / or projections of the mold 1154 (1156 such as a needle) may be used to form a hole 1152 in the following manner: When the thickness of tissue compensator 1150 in the glassy state of the needle 1156 is inserted into the tissue thickness compensator 1150 . 在针1156保持插入组织厚度补偿件1150中时,然后可使组织厚度补偿件1150冷却到低于玻璃化转变温度的温度。 When the needle is inserted into tissue thickness compensator 1156 holding member 1150, and 1150 allow the tissue thickness compensator cooled to a temperature below the glass transition temperature. 在一些情况下,在组织厚度补偿件1150处于玻璃态时,针1156可从组织厚度补偿件1150移除。 In some cases, the tissue thickness compensator 1150 in the glassy state, the needle 1156 can be removed from the tissue thickness compensator 1150 members. 在一些情况下,风扇可用于在组织厚度补偿件1150与针1156接合时以及/或者在组织厚度补偿件1150已与针1156脱离接合之后在组织厚度补偿件1150上方生成空气流。 In some cases, the fan can be used and / or the air flow generated above the tissue thickness compensator 1150 after the tissue thickness compensator 1150 has been disengaged from the needle 1156 while engaging the tissue thickness compensator 1150 and the needle 1156. 在一些情况下,制冷过程可用于在组织厚度补偿件1150与针1156接合时以及/或者在组织厚度补偿件1150已与针1156脱离接合之后冷却组织厚度补偿件1150。 In some cases, the cooling process may be used when joining the tissue thickness compensator 1150 and the needle 1156 and / or cooling the tissue thickness compensator after the tissue thickness compensator 1150 has been disengaged from the needle 1156 and 1150. 在各种情况下,针1156可在组织厚度补偿件1150转变退出玻璃态之后被移除。 In each case, the needle 1156 may be tissue thickness compensator 1150 is removed after exiting the glass transition state. 针1156可保持插入组织厚度补偿件1150中持续足以允许组织厚度补偿件1150保持或至少基本上保持限定由针115 6占据的孔115 2的空间的时间段。 Insert the needle 1156 may be maintained in tissue thickness compensator 1150 duration sufficient to allow the tissue thickness compensator 1150 holding member holding period or at least substantially defined by the aperture 115 occupies the space of the needle 1156 2.

[0258] 在某些示例中,针1156可例如在处于玻璃态的时间期间保持插入约30秒至约8小时的时间段并且/或者例如在退出玻璃态之后保持插入约30秒至约8小时的时间段。 [0258] In some examples, the needle 1156 may be, for example, in the glassy state during the time period of insertion of holding from about 30 seconds to about 8 hours and / or inserted, for example, about 30 seconds holding to about 8 hours after exiting the glassy period of time. 在至少一个示例中,针1156可在处于玻璃态的时间期间保持插入大约10分钟并且在退出玻璃态之后保持插入大约10分钟。 In at least one example, the needle 1156 may be maintained at approximately 10 minutes after insertion remains inserted for approximately 10 minutes and during the time at the exit glassy vitreous. 本公开设想到用于维持针1156插入组织厚度补偿件1150中的其他时间段。 The present disclosure is contemplated for maintaining the needle 1156 is inserted into the other periods the tissue thickness compensator 1150.

[0259] 在某些情况下,在组织厚度补偿件1150转变退出玻璃态之前,针1156可从组织厚度补偿件1150移除。 [0259] In some cases, before the tissue thickness compensator 1150 exit the glass transition state, the needle 1156 can be removed from the tissue thickness compensator 1150 members. 在其他情况下,针1156可随着时间推移逐渐移除。 In other cases, the needle 1156 can be gradually removed over time. 例如,在组织厚度补偿件1150转变退出玻璃态之前,针1156可从组织厚度补偿件1150部分地移除。 For example, prior to the tissue thickness compensator 1150 exit the glass transition state, the needle 1156 can be removed from the tissue thickness compensator 1150 partially member. 在组织厚度补偿件1150转变退出玻璃态之后,针1156然后可从组织厚度补偿件1150完全移除。 After the tissue thickness compensator 1150 exit the glass transition state, the needle 1156 and 1150 may be completely removed from the tissue thickness compensator. 读者将理解,针1156插入组织厚度补偿件1150中的深度越大,组织厚度补偿件1150中可形成的对应孔1152的深度就越大。 The reader will appreciate, the greater the depth of the needle 1156 is inserted into the tissue thickness compensator 1150, the depth of the corresponding hole 1150 in the tissue thickness compensator 1152 may be formed greater.

[0260] 再次参见图32至图34,在某些情况下,针1156可被加热到大于或等于组织厚度补偿件1150的材料组合物的熔融温度的温度。 [0260] Referring again to FIGS. 32 to 34, in some cases, the needle 1156 may be heated to a temperature greater than or equal to the thickness of tissue material composition compensator 1150. melting temperature. 另外,针1156可被插入组织厚度补偿件1150中以通过熔融或至少部分地熔融穿过组织厚度补偿件1150的接收针1156的区域而形成孔1152。 Further, the needle 1156 may be inserted into tissue thickness compensator 1150 to at least partially by a molten or melted to form a hole through the region receiving the needle 1152 1156 tissue thickness compensator 1150. 在各种情况下,针1156可在插入组织厚度补偿件1150中之前被加热。 In each case, the needle 1156 may be inserted into the tissue thickness compensator member is heated prior to 1150. 在各种情况下,针1156可在插入组织厚度补偿件1150中之后被加热。 In each case, the needle 1156 may be inserted into the tissue thickness compensator element is heated after 1150. 在各种情况下,针1156可随着针1156被插入组织厚度补偿件1150中而逐渐加热。 In each case, the needle 1156 may be gradually heated with the needle 1156 is inserted into the tissue thickness compensator 1150.

[0261] 在某些情况下,针1156可保持定位在组织厚度补偿件1150内持续足以允许组织厚度补偿件1150的熔融材料流入所需几何形状中的时间段。 [0261] In some cases, the needle 1156 can remain positioned within the tissue thickness compensator 1150 for a sufficient period of time to allow the geometry of the molten material flows into the desired tissue thickness compensator 1150. 此类时间段可在例如约30秒至约8小时的范围内,本公开可设想到其他时间段。 Such time period may be in the range of, for example, from about 30 seconds to about 8 hours, the present disclosure may be contemplated other periods. 此类时间段可足以局部影响并且/或者熔融组织厚度补偿件1150的材料并且使其流入新的几何形状中。 Such time period may be sufficient to affect the local and / or molten material compensator 1150 tissue thickness and allowed to flow into the new geometry. 如本文所述,此类新几何形状可由用于制造组织厚度补偿件1150的工具规定。 As described herein, such new geometries may be used for producing tissue tool member 1150 a predetermined thickness compensator.

[0262] 在某些情况下,可在将针1156与组织厚度补偿件1150分离之前使组织厚度补偿件1150冷却或主动地冷却到低于组织厚度补偿件1150的熔融温度的温度。 [0262] In some cases, the tissue thickness compensator before the needle member 1156 with member 1150 separate tissue thickness compensator 1150 or actively cooled to a temperature below the melting temperature of the tissue thickness compensator 1150. 在其他情况下,可在将针1156与组织厚度补偿件1150分离之后使组织厚度补偿件1150冷却或主动地冷却到低于组织厚度补偿件1150的熔融温度的温度。 In other cases, the thickness of the tissue after the needle compensator 1156 and 1150 separate tissue thickness compensator 1150 or actively cooled to a temperature below the melting temperature of the tissue thickness compensator 1150.

[0263] 再次参见图32至图34,针1156可以被布置成沿模具1154的长度纵向延伸的排,该排可对应于钉仓(诸如钉仓组件20200 (图6))中的钉排。 [0263] Referring again to FIGS. 32 to 34, the needle 1156 may be arranged in a row along the length of the die 1154 extends longitudinally, the rows may correspond to a staple cartridge (such as a staple cartridge assembly 20200 (FIG. 6)) staple row. 例如,如图33所示,针1156可以布置成六排,其可被构造成能够形成六排孔1152,该六排孔可被构造成能够接收六排钉20230(图7)。 For example, shown in Figure 33, the needle 1156 may be arranged in six rows, which may be configured into six rows of holes 1152 can be formed, the six rows of holes may be configured to be able to receive six rows of staples 20230 (FIG. 7). 在某些情况下,如图33所示,针1156的排可以布置成两组,所述两组间隔开并且被构造成能够接收在组织厚度补偿件1150的两部分1158和1160中,从而形成由中间部分1162分离的两组孔1152。 In some cases, shown in Figure 33, the needle 1156 may be arranged in two rows, said two spaced apart and configured to be received within the tissue thickness compensator two parts 1158 and 1150 of 1160, thereby forming separated by the intermediate portion of the two sets of holes 1162 1152. 当组织厚度补偿件1150组装有钉仓组件20200时,中间部分1162可至少部分地定位在仓刀狭槽22015 (图6)上方。 When the thickness of tissue compensator 1150 20200 assembled with the cartridge assembly, the intermediate portion 1162 may be at least partially positioned within the cartridge knife slot 22015 (FIG. 6) above. 在使用中,击发构件10052 (图10)可朝远侧推进以推动钉腿20232 (图8)穿过部分1158和1160内的孔1152并且推进切割部分10053(图10)以横切中间部分1162并且分离部分1158和1160。 In use, the firing member 10052 (FIG. 10) can be advanced to push the staple legs 20232 (FIG. 8) through the aperture and the inner portion 1158 11601152 10053 and advance the cutting portion (10) transverse to the intermediate portion 1162 distally and separating section 1158 and 1160.

[0264] 再次参见图32至图34,孔1152可被构造成能够在组织厚度补偿件1150内延伸并且终止在组织厚度补偿件1150内的一定深度处。 [0264] Referring again to FIGS. 32 to 34, the aperture 1152 can be configured to extend within the thickness of tissue compensator 1150 and terminates at a depth within the tissue thickness compensator 1150. 孔1152可包括均匀的深度,如图34所示。 Aperture 1152 can comprise a uniform depth, shown in Figure 34. 在其他情况下,孔1152可包括不同深度(未示出)。 In other cases, the holes 1152 may comprise different depths (not shown). 例如,第一排孔1152可包括第一深度,并且第二排孔1152可包括不同于第一深度的第二深度,而第三排孔1152可包括不同于第一深度和第二深度的第三深度。 For example, the first row of holes 1152 may comprise a first depth, and a second row of holes 1152 may include a second depth different than the first depth, while the third row may include a first aperture 1152 is different from the first depth and the second depth three depth. 孔1152的深度可至少部分地通过对应针1156的高度来确定。 The depth of the hole 1152 may be at least partially determined by the height corresponding to the needle 1156. 例如,包括第一高度的第一排针1156和包括大于第一高度的第二高度的第二排针1156可形成包括第一深度的第一排孔1152和包括大于第一深度的第二深度的第二排孔1152。 For example, a first height and a first row of pin 1156 includes a second height greater than the first height of the second pin 1156 may be formed comprising a first row of holes 1152 a first depth and the second depth is greater than the first depth comprises a second row of holes 1152.

[0265] 再次参见图32至图34,针1156可被构造成能够将用于孔1152的轨线限定在组织厚度补偿件1150内。 [0265] Referring again to FIG. 32 to FIG. 34, the needle 1156 can be configured to enable a hole 1152 defined in the trajectory of the tissue thickness compensator 1150. 在某些情况下,针1156可沿垂直于以及/或者基本上垂直于模具1154的模具表面1164的轴线延伸,如图33所示。 In some cases, the needle 1156 may be a direction perpendicular to and / or substantially perpendicular to the mold surface of the mold 1154 1164 extending axis 33 as shown in FIG. 将针1156插入组织厚度补偿件1150中同时维持模具表面1164和组织厚度补偿件1150的表面1166之间的平行关系可导致相对于组织厚度补偿件1150的表面1166限定用于孔1152的垂直和/或基本上垂直的轨线,如图34所示。 The parallel relationship between the surface of the needle 1166 is inserted into the tissue thickness compensator 1156 1150 1164 while maintaining the mold surface and the tissue thickness may lead compensator 1150 relative to the tissue thickness compensator surface 1166 defining a vertical hole 1150 and 1152 / or substantially vertical trajectory, shown in Figure 34. 在其他情况下,针1156可以斜角(未示出)从模具表面1164延伸并且/或者针1156到组织厚度补偿件1150中的插入轨线可成角度,使得针1156可相对于组织厚度补偿件1150的表面1166限定用于孔1152的非垂直轨线。 In other cases, the needle 1156 may be beveled (not shown) extending from the mold surface 1164 and / or the needle 1156 is inserted into the tissue thickness compensator trajectories 1150 may be angled so that the needle 1156 with respect to the thickness of tissue compensator 1150 surface 1166 defines a trajectory for the non-vertical hole 1152. 在某些情况下,一组针1156可彼此平行并且/或者基本上彼此平行,如图33所示,从而导致一组孔1152可彼此平行并且/或者基本上彼此平行,如图24所示。 In some cases, a group of needles 1156 may be parallel to each other and / or substantially parallel to each other, as shown in Figure 33, resulting in a set of holes 1152 may be parallel to each other and / or substantially parallel to each other, as shown in Fig.24. 在其他情况下,虽然未示出,但一组非平行的针可从模具表面1164延伸并且可在插入组织厚度补偿件1150中时产生非平行的孔。 In other cases, although not shown, a non-parallel set of pins 1164 may extend from the surface of the mold and may create holes in the 1150 non-parallel when inserted into the tissue thickness compensator member. 在一些情况下,针1156可被构造成能够在组织厚度补偿件1150内形成孔,该组织厚度补偿件可包括部分弯曲的轨线和/或部分线性的轨线。 In some cases, the needle 1156 can be configured to be capable of forming a hole in the tissue thickness compensator 1150, which may include a tissue thickness compensator partly curved trajectory and / or a partial linear trajectory. 例如,针1156可以部分弯曲的轨线从模具表面1164延伸并且可被插入组织厚度补偿件1150中以利用对应的部分弯曲的轨线在组织厚度补偿件1150内形成孔。 For example, the needle 1156 may be partially curved trajectory extending from the mold surface 1164 and can be inserted into the tissue thickness compensator 1150 to use a curved trajectory portion corresponding to the hole formed in the tissue thickness compensator 1150.

[0266] 再次参见图32至图34,针1156中的一些或全部可包括钝的远侧端部1168,如图33所示。 [0266] Referring again to FIGS. 32 to 34, the needle 1156 some or all of the distal end may comprise a blunt 1168, shown in Figure 33. 在其他情况下,针1156中的一些或全部可包括锐利的远侧端部(未示出)。 In other cases, some or all of the needle 1156 may comprise a sharp distal end (not shown). 针1156中的一些或全部可包括圆柱形或至少基本上圆柱形的形状,例如,如图33所示。 The needle 1156 may include some or all of at least substantially cylindrical or cylindrical shape, for example, shown in Figure 33. 本公开还可设想到其他形状。 The present disclosure also other shapes are contemplated. 在各种情况下,从模具表面1164延伸的针1156中的一个或多个可能不能够插入穿过组织厚度补偿件1150的整个厚度。 In each case, one or more of the mold surface from the needle 1156 extending in 1164 may not be inserted through the entire thickness of the tissue thickness compensator 1150. 在某些情况下,从模具表面1164延伸的针1156中的一个或多个可能能够插入穿过组织厚度补偿件1150的整个厚度以形成延伸穿过组织厚度补偿件1150的整个厚度的开口和/或孔。 In some cases, the needle 1156 extending from the mold surface of one or more 1164 may be inserted through the entire thickness of the tissue thickness compensator member 1150 to form an opening extending through the entire thickness of the tissue thickness compensator 1150 and / or hole. 在某些情况下,从模具表面1164延伸的针1156中的一个或多个可插入穿过组织厚度补偿件1150的第一侧并且穿过例如组织厚度补偿件1150的可与第一侧相对的第二侧离开。 In some cases, from one or more pins 1156 extending die surface 1164 may be inserted through a first side of the tissue thickness compensator 1150 and through the member such as tissue thickness compensator 1150 may be opposite to the first side away from the second side. 在某些情况下,针1156中的一个或多个可包括大于组织厚度补偿件1150的整个厚度的长度以有利于将一个或多个针1156插入穿过组织厚度补偿件1150的整个厚度。 In some cases, the needle 1156 may comprise one or more of a length greater than the entire thickness of the tissue thickness compensator 1150 to facilitate one or more pins 1156 inserted through the entire thickness of the tissue thickness compensator 1150.

[0267] 现在参见图35至图37,可能需要重新设定组织厚度补偿件的尺寸。 [0267] Referring now to FIGS. 35 to 37, may need to be sized tissue thickness compensator. 例如,组织厚度补偿件的一个或多个尺寸可被调整为对应于钉仓的尺寸以便在组织厚度补偿件组装有钉仓时向钉仓提供更好的配合。 For example, one or more dimensions of the tissue thickness compensator may be adjusted to correspond to the size of the staple cartridge in order to provide a better fit to the cartridge when the tissue thickness compensator assembled staple cartridge. 在某些情况下,组织厚度补偿件1170可通过将其高度从如图35所示的第一高度Hl改变为如图36所示的第二高度H2来重新设定尺寸。 In some cases, the tissue thickness compensator 1170 can be changed to a second height H2 as shown in FIG. 36 to resize the height from the first height Hl 35 as shown in FIG. 组织厚度补偿件1170可在许多方面类似于本文所述的其他组织厚度补偿件,诸如组织厚度补偿件22020 (图9)、组织厚度补偿件1140(图29)和/或组织厚度补偿件1150(图32)。 Tissue thickness compensator 1170 may be similar in many respects to other tissue thickness compensator as described herein, such as tissue thickness compensator 22020 (FIG. 9), tissue thickness compensator 1140 (FIG. 29) and / or tissue thickness compensator 1150 ( FIG 32). 例如,如同补偿件22020,补偿件1170可与端部执行器22090 (图9) 一起使用。 For example, as the compensator 22020, compensator 1170 can be used with the end effector 22 090 (FIG. 9).

[0268] 在各种情况下,再次参见图35至图37,组织厚度补偿件1170可使用传统冻干技术和/或任何其他合适的技术来制备。 [0268] In each case, referring again to FIG. 35 to FIG. 37, the tissue thickness compensator 1170 may be prepared using traditional lyophilization techniques and / or any other suitable technique. 在某些情况下,组织厚度补偿件1170可使用例如热压制过程和模具1172来重新设定尺寸,如图37所示。 In some cases, the tissue thickness compensator 1170 may be used, for example, hot pressing process and the mold 1172 to resize, shown in Figure 37. 模具1172可包括被构造成能够接收组织厚度补偿件1170的接收器1174以及能够部分地插入接收器1174中的调节构件1176。 Die 1172 may be configured to include a tissue thickness compensator capable of receiving member 1174 and a receiver 1170 capable of regulating member is partially inserted into the receiver 1174 in 1176. 当组织厚度补偿件1170转变成玻璃态时,组织厚度补偿件1170可被重新设定尺寸。 When the thickness of tissue compensator 1170 into a glassy state, tissue thickness compensator 1170 can be re-sized. 在一个实施方案中,组织厚度补偿件1170可在烘箱(未示出)中加热到大于或等于组织厚度补偿件1170的材料组合物的玻璃化转变温度但小于其熔融温度的温度。 In one embodiment, the tissue thickness compensator member 1170 may be an oven (not shown) heated to greater than or equal tissue thickness compensator 1170 has a glass transition temperature of the material composition, but less than its melting temperature. 在另一个实施方案中,接收器1174和/或调节构件1176可包括用于将组织厚度补偿件1170转变到玻璃态的加热元件。 In another embodiment, the receiver 1174 and / or 1176 may include a regulating member for tissue thickness compensator 1170 to transition to a glassy state the heating element. 调节构件1176然后可被插入接收器1174中距离H3,例如如图37所示,从而压缩组织厚度补偿件1170并且将其高度从第一高度Hl减小到第二高度H2。 Regulating member 1176 may then be inserted into the receiver 1174 distance H3, as shown in FIG 37, thereby compressing the tissue thickness compensator 1170 and its height Hl is reduced from a first height to a second height H2. 在一些情况下,可在组织厚度补偿件1170进入玻璃态之前或者正好在组织厚度补偿件1170进入玻璃态时将调节构件1176插入接收器1174中。 In some previous cases, in state 1170 into the glass tissue thickness compensator or just tissue thickness compensator 1170 into the glassy adjusting member 1176 is inserted into the receiver 1174. 调节构件1176可抵靠组织厚度补偿件1170保持以压缩组织厚度补偿件1170持续足以允许组织厚度补偿件1170保持或至少基本上保持第二高度H2的时间段,如图36所示。 1176 regulating member abut against the tissue thickness compensator 1170 holding member to compress the tissue thickness compensator 1170 duration sufficient to allow the tissue thickness compensator 1170 or at least substantially retaining the retention time section of the second height H2, as shown in Figure 36. 在处于来自调节构件1176的压缩下时,然后可使组织厚度补偿件1170冷却到低于玻璃化转变温度的温度。 From compression when in the adjusting member 1176, and 1170 allow the tissue thickness compensator cooled to a temperature below the glass transition temperature. 在组织厚度补偿件1170转变退出玻璃态之后,调节构件1176可回缩。 After the tissue thickness compensator 1170 exit the glass transition state, the adjustment member 1176 may be retracted. 在一些情况下,在组织厚度补偿件1170退出玻璃态之前,调节构件1176可回缩。 In some cases, before the tissue thickness compensator exit glassy 1170, 1176 regulating member can be retracted. 在某些情况下,上述重定尺寸过程可用于改变组织厚度补偿件1170的另一个尺寸,诸如组织厚度补偿件1170的长度或宽度。 In some cases, the above-described resizing process may be used to change the size of another tissue thickness compensator 1170, such as a length or width of the thickness of tissue compensator 1170. 在一些情况下,这些尺寸可以同时修改或按顺序修改。 In some cases, these dimensions may be modified in order to modify or simultaneously.

[0269] 在某些示例中,来自调节构件1176的压缩可例如在处于玻璃态的时间期间维持约30秒至约8小时的时间段并且/或者例如在退出玻璃态之后维持约30秒至约8小时的时间段。 [0269] In some examples, the compression from the regulating member 1176 may be maintained, for example, a time period from about 30 seconds to about 8 hours during a time in the glassy state and / or maintained, for example, after exiting the vitreous from about 30 seconds to about period of 8 hours. 在至少一个示例中,来自调节构件1176的压缩可在处于玻璃态的时间期间维持大约10分钟并且在退出玻璃态之后维持大约10分钟。 In at least one example, the compression from the regulating member 1176 may be maintained in the glassy state during a time of about 10 minutes and maintained in the glassy state, after about 10 minutes exit. 本公开可设想到用于维持由调节构件1176抵靠组织厚度补偿件1170施加的压缩的时间段。 The present disclosure may be contemplated by the adjusting member for maintaining 1176 period against the tissue thickness compensator 1170 is applied to the compression member.

[0270] 在某些情况下,调节构件1176可用于在组织厚度补偿件1170转变到玻璃态之前将压力施加到组织厚度补偿件1170上。 [0270] In some cases, adjustment member 1176 may be used prior to the tissue thickness compensator 1170 transition to a glassy state to apply pressure to the tissue thickness compensator 1170. 在某些情况下,调节构件1176可在组织厚度补偿件1170被加热以达到玻璃态时,在组织厚度补偿件1170处于玻璃态时,以及/或者在组织厚度补偿件1170转变或冷却到玻璃态以下的温度时向组织厚度补偿件1170施加压力。 In some cases, the tissue thickness regulating member 1176 may be compensator 1170 is heated to the glass state is reached, when the tissue thickness compensator 1170 in the glassy state, and / or tissue thickness compensator 1170 transition to a glassy state or a cooling member in applying pressure to the tissue thickness compensator temperature below 1170. 在某些情况下,例如在组织厚度补偿件1170的温度逐渐朝玻璃态转变时,施加到组织厚度补偿件1170的压力可逐渐朝阈值增加。 In some cases, for example when the temperature of the tissue thickness compensator member 1170 gradually changed toward the glassy state, applying pressure to the tissue thickness compensator 1170 may be gradually increased toward the threshold value. 在某些情况下,在组织厚度补偿件1170退出玻璃态时,在组织厚度补偿件1170退出玻璃态之前,以及/或者在组织厚度补偿件1170退出玻璃态之后,施加到组织厚度补偿件1170的压力可被移除、逐渐移除、或至少部分地减小。 In some cases, the tissue thickness compensator 1170 exit glassy, ​​in tissue thickness compensator 1170 before exiting the glassy state and / or after the tissue thickness compensator 1170 exit the glass state, is applied to the tissue thickness compensator 1170 pressure may be removed, gradually removing, or at least partially reduced.

[0271] 读者将理解,用于上述修改过程中的不同模具(诸如模具1144、1154和/或1172)是示例性示例。 [0271] The reader will appreciate, the above-described modification process for a different die (such as die 1144,1154 and / or 1172) is an illustrative example. 其他模具设计和构型也可用于以多种方式操纵组织厚度补偿件。 Other die designs and configurations may also be used in a variety of ways to manipulate tissue thickness compensator. 此外,操纵组织厚度补偿件所涉及的力不需要仅仅是压缩力。 Further, the thickness of the tissue manipulating force compensator involved need not only a compressive force. 例如,拉力也可用于以与上文所述的那些方式类似的方式修改组织厚度补偿件、重新设定组织厚度补偿件的形状和/或尺寸。 For example, the tension may also be used in a manner to those described above in a similar manner to modify tissue thickness compensator reset the shape and / or size of the tissue thickness compensator. 例如,也可使用拉力来拉伸组织厚度补偿件1170以将其高度从第一高度Hl (图35)减小到第二高度H2 (图36),例如,使用在许多方面类似于上述修改过程的修改过程。 For example, the tension may also be used to stretch the tissue thickness compensator 1170 to reduce its height from a first height on Hl (FIG. 35) to a second height H2 (FIG. 36), for example, in many respects similar to the above-described modification process the modification process. 在某些情况下,拉力和压缩力的组合可用于在修改过程期间操纵组织厚度补偿件。 In some cases, a combination of tensile and compressive forces may be used to manipulate tissue thickness compensator during the modification process.

[0272] 再次参见图35至图37,可能需要修改组织厚度补偿件的孔隙度以在外科手术中使用。 [0272] Referring again to FIGS. 35 to 37, may need to modify the porosity of the tissue thickness compensator for use in a surgical procedure. 组织厚度补偿件可包括例如多孔的开孔泡沫和/或多孔的闭孔泡沫。 Tissue thickness compensator may comprise, for example, a porous open-cell foam and / or closed-cell porous foam. 传统冻干技术可对组织厚度补偿件的孔隙度提供一定的控制,但此类控制可能不易于重复并且可能需要不可通过传统冻干技术获得的附加的精细调节。 Conventional lyophilization technology can provide some control over the porosity tissue thickness compensator member, but such control may not be easily repeated and may not require additional fine tuning by conventional lyophilization techniques. 如图35至图37所示,可使用例如上述修改过程使组织厚度补偿件1170的高度从第一高度Hl (图35)变为第二高度H2(图36)。 Shown in FIGS. 35 to 37, such as described above may be used to modify the thickness of the tissue during the height compensator 1170 from a first height on Hl (FIG. 35) to a second height H2 (FIG. 36). 另外,也可使用相同和/或相似的修改过程来修改组织厚度补偿件1170的孔隙度。 Alternatively, you can use the same and / or similar modifications of the procedure to modify the porosity of the tissue thickness compensator 1170. 例如,组织厚度补偿件1170可在修改过程之前具有第一孔隙度(图35),并且在完成修改过程之后具有第二孔隙度(图36),如上所述。 For example, tissue thickness compensator member 1170 may have a first porosity prior to the modification process (FIG. 35), and having a second porosity (FIG. 36) after completion of the modification process, as described above. 孔隙度的改变可至少部分地归因于在上述修改过程期间由调节构件1176施加到组织厚度补偿件1170的压缩力和/或能量。 Changing the porosity may be at least partly due to the compression force applied to tissue thickness 1176 compensator 1170 and / or energy by the above-described regulating member during the modification process.

[0273] 对上文进行进一步描述,组织厚度补偿件1170可包括多个孔隙1180。 [0273] Further to the above, the tissue thickness compensator 1170 may include a plurality of apertures 1180. 例如,作为上述修改过程的结果,孔隙1180中的一些或全部可在位置、尺寸和/或形状方面有所改变。 For example, as a result of the modification process, and some or all of the pores 1180 may change the position, size and / or shape. 例如,孔隙1180中的一个或多个可在修改过程之前包括球形或基本上球形的形状,作为修改过程的结果,该形状可被改变为椭圆形或基本上椭圆形的形状。 For example, the apertures 1180 may comprise one or more spherical or substantially spherical shape prior to the modification process, as a result of the modification process, this shape may be changed to an oval shape or a substantially elliptical. 在至少一个示例中,孔隙1180中的一个或多个可在修改过程之前包括第一尺寸并且作为修改过程的结果包括不同于第一尺寸的第二尺寸。 In at least one example, the aperture 1180 may comprise one or more of a first size before the modification process as a result of the modification process includes a second size different than the first size. 在某些情况下,如下文更详细地描述,孔隙度改变可局限于组织厚度补偿件1170的一个或多个区域或区。 In some cases, as described in more detail below, the porosity may be limited to one or more of changing the area or region 1170 tissue thickness compensator.

[0274] 此外,在某些情况下,组织厚度补偿件1170的孔隙度的改变可伴随着组织厚度补偿件1170的密度的改变。 [0274] Further, in some cases, the tissue thickness change porosity compensator 1170 may be accompanied by a change in the density of the tissue thickness compensator 1170. 换句话讲,在调节构件1176抵靠组织厚度补偿件1170推进时,压缩力可减小组织厚度补偿件1170所占据的空间,从而导致材料和/或孔隙重新分布,这可引起组织厚度补偿件1170的密度的增加和/或其孔隙度的减小。 In other words, when the regulating member 1176 against the tissue thickness compensator propulsion member 1170, the compressive force can reduce the space occupied by the tissue thickness compensator 1170, resulting in the material and / or pore redistribution, which can cause tissue thickness compensator increasing the density of the member 1170 and / or reduced porosity. 在某些情况下,如下文更详细地描述,密度改变可局限于组织厚度补偿件1170的一个或多个区域或区。 In some cases, as described in more detail below, the density change may be limited to a tissue thickness compensator 1170 or more regions or zones.

[0275] 对上文进行进一步描述,组织厚度补偿件1170的孔隙度和/或密度的改变可引起组织厚度补偿件1170的弹性比率的改变。 [0275] Further to the above description, changing the porosity of the tissue thickness compensator 1170 and / or density can cause changes in the elastic tissue thickness ratio compensator 1170. 当组织厚度补偿件抵靠由钉诸如钉20230 (图8)捕获的组织部署时,组织厚度补偿件的弹性比率可影响其补偿组织厚度的能力,如上文更详细地描述。 When the thickness of tissue compensator deployment against the tissue by the staples, such as staples 20230 (FIG. 8) captured tissue thickness ratio of the elastic compensator which compensates can affect the ability of the tissue thickness, described in more detail above. 此外,组织厚度补偿件的弹性比率也可影响其抵靠由钉用组织厚度补偿件捕获的组织施加压力的能力。 Further, the thickness of the elastic tissue ratio compensator may also affect its ability to exert a pressure against the tissue by the staples captured by the tissue thickness compensator. 换句话讲,组织厚度补偿件的弹性比率的变化可改变由组织厚度补偿件抵靠由钉捕获的组织所施加的压力。 In other words, the ratio of change in the elastic tissue thickness compensator can be varied by the abutment member against the tissue thickness compensator staple tissue captured by the pressure applied. 由于不同组织类型可对一定压力作出更积极的响应,所以对组织厚度补偿件的弹性比率的精细控制可为有利的。 Since different tissue types can be made more positive in response to a certain pressure, the ratio of fine control of the elastic member to the tissue thickness compensator may be advantageous.

[0276] 如图35至图37所示,组织厚度补偿件1170可包括第一弹性比率(图35),该第一弹性比率可使用上述修改过程改变或修改为不同于第一弹性比率的第二弹性比率(图36)。 [0276] FIG 35 to FIG 37, the tissue thickness compensator may comprise a first resilient member 1170 ratio (FIG. 35), the first spring rate may be modified using the process of change or modify the spring rate different from the first two elastic ratio (FIG. 36). 例如,如上所述,在组织厚度补偿件1170处于玻璃态时,调节构件1176可抵靠组织厚度补偿件1170推进。 For example, as described above, when the tissue thickness compensator 1170 in the glassy state, abut against the regulating member 1176 compensator 1170 to promote tissue thickness. 作为响应,组织厚度补偿件1170可被压缩,这导致组织厚度补偿件1170的弹性比率的改变。 In response, the tissue thickness compensator 1170 can be compressed, which results in changing the ratio of the elastic tissue thickness compensator 1170. 调节构件1176可保持在推进位置中持续足以允许组织厚度补偿件1170保持或至少基本上保持弹性比率的变化的时间段。 Regulating member 1176 may remain in the advanced position for a time sufficient to allow the tissue thickness compensator holding member 1170, or at least substantially elastic holding period ratio change. 另外,可使组织厚度补偿件1170冷却到其材料组合物的玻璃化转变温度以下,同时维持由调节构件1176抵靠组织厚度补偿件1170施加的压力。 Further, the thickness of the tissue can compensator 1170 which is cooled to the glass transition temperature of the material composition or less, by the adjusting member 1176 while maintaining the pressure against the tissue thickness compensator 1170 is applied to the member.

[0277] 在某些情况下,调节构件1176可例如在处于玻璃态的时间期间抵靠组织厚度补偿件1170维持在推进位置中持续约30秒至约8小时的时间段并且/或者例如在退出玻璃态之后持续约30秒至约8小时的时间段。 [0277] In some cases, adjustment member 1176 may be, for example, against the tissue thickness compensator member 1170 is maintained in the glassy state during a time period of about 30 seconds to about 8 hours period of time and / or for example to promote the exit position period of about 30 seconds to about 8 hours after the glassy state. 在至少一个示例中,调节构件1176可例如在处于玻璃态的时间期间抵靠组织厚度补偿件1170维持在推进位置中持续大约10分钟并且在退出玻璃态之后持续大约10分钟。 In at least one example, the adjusting member 1176 may be, for example, during the time in the glassy state against the tissue thickness compensator member 1170 continuously maintained in the advanced position and approximately 10 minutes after exiting a glassy state lasts about 10 minutes. 本公开可设想到用于将调节构件1176抵靠组织厚度补偿件1170维持在推进位置中的其他时间段。 The present disclosure may be contemplated for adjusting the thickness of member 1176 against the tissue compensator 1170 in another time period to maintain the advanced position.

[0278] 在某些情况下,调节构件1176可用于在组织厚度补偿件1170转变到玻璃态之前将压力施加到组织厚度补偿件1170上以改变组织厚度补偿件1170的弹性比率。 [0278] In some cases, adjustment member 1176 may be used prior to the tissue thickness compensator 1170 transition to a glassy state to apply pressure to the tissue thickness change ratio of the elastic compensator 1170 on the tissue thickness compensator 1170. 在某些情况下,调节构件1176可在组织厚度补偿件1170被加热以达到玻璃态时,在组织厚度补偿件1170处于玻璃态时,以及/或者在组织厚度补偿件1170转变或冷却到玻璃态以下的温度时向组织厚度补偿件1170施加压力。 In some cases, the tissue thickness regulating member 1176 may be compensator 1170 is heated to the glass state is reached, when the tissue thickness compensator 1170 in the glassy state, and / or tissue thickness compensator 1170 transition to a glassy state or a cooling member in applying pressure to the tissue thickness compensator temperature below 1170. 在某些情况下,例如在组织厚度补偿件1170的温度逐渐增加以使组织厚度补偿件1170朝玻璃态转变时,施加到组织厚度补偿件1170的压力可逐渐朝阈值增加。 In some cases, for example, the thickness of tissue temperature compensator 1170 is gradually increased to the tissue thickness compensator member 1170 toward the glass transition, is applied to the tissue thickness compensator pressure member 1170 may be gradually increased toward the threshold value. 在某些情况下,在组织厚度补偿件1170退出玻璃态时,在组织厚度补偿件1170退出玻璃态之前,以及/或者在组织厚度补偿件1170退出玻璃态之后,施加到组织厚度补偿件1170的压力可被移除、逐渐移除、或至少部分地减小。 In some cases, the tissue thickness compensator 1170 exit glassy, ​​in tissue thickness compensator 1170 before exiting the glassy state and / or after the tissue thickness compensator 1170 exit the glass state, is applied to the tissue thickness compensator 1170 pressure may be removed, gradually removing, or at least partially reduced.

[0279] 再次参见图35至图40,组织厚度补偿件1170可使用传统冻干技术和/或任何其他合适的技术以自然的弹性比率来制造。 [0279] Referring again to FIGS. 35 through 40, a tissue thickness compensator 1170 using conventional lyophilization techniques and / or any other suitable technique to producing a natural spring rate. 如上所述,组织厚度补偿件1170的弹性比率可影响其抵靠由钉用组织厚度补偿件1170捕获的组织施加压力的能力。 As described above, the ratio of the elastic tissue thickness compensator 1170 may affect its ability to apply pressure against the tissue by the staple member 1170 with tissue thickness compensator captured. 上述修改过程可用于调节组织厚度补偿件1170的自然弹性比率以调节其抵靠由钉用组织厚度补偿件1170捕获的组织施加压力的能力。 Modifying the above-described process can be used to adjust the ratio of the natural elasticity of the tissue thickness compensator 1170 is its ability to adjust the pressure exerted by the tissue against the staple member 1170 with tissue thickness compensator captured. 在某些情况下,组织厚度补偿件1170的自然弹性比率可从点A (图40)处的第一弹性比率增加到第二弹性比率,该第二弹性比率包括并且最多至点B (图40)处的最大弹性比率。 In some cases, the natural resilience of the tissue thickness ratio compensator 1170 may be at a first spring rate increases from point A (FIG. 40) a second spring rate, the spring rate of the second up to and including the point B (FIG. 40 ) at a ratio of the maximum elasticity. 在某些情况下,组织厚度补偿件1170的弹性比率的此类增加可通过以下方式实现:在组织厚度补偿件1170处于玻璃态时,使用调节构件1176向组织厚度补偿件1170施加压缩力,如上述修改过程中所解释的。 In some cases, such an increase in tissue thickness ratio of the elastic compensator 1170 may be implemented in the following manner: When the thickness of tissue compensator 1170 in the glassy state, using the adjustment member 1176 applies a compressive force to the tissue thickness compensator element 1170, such as modifying the above-described process explained. 如图40所示,点B代表组织厚度补偿件1170的最大弹性产率。 As shown, the point B represents the maximum elastic tissue thickness compensator yield 40 as shown in 1170. 因此,由调节构件1176在点B处施加到组织厚度补偿件1170的超过阈值压缩的任何附加压缩可导致被修改的组织厚度补偿件1170的弹性比率的减小。 Thus, by the adjusting member 1176 is applied at point B to the tissue thickness compensator element 1170 exceeds a threshold value of any additional compression may result in reduced elastic compression ratio is modified tissue thickness compensator 1170. 例如,如图40所示,在点C处的弹性比率小于在点B处的弹性比率,即使由调节构件1176在点C处施加到组织厚度补偿件1170的压缩力大于在点B处施加的压缩力。 For example, as shown, the spring rate at point C is less than 40 at point B at the ratio of the elastic, even when the compressive force exerted by the adjusting member 1176 at point C to the tissue member 1170 is larger than the thickness compensator applied at point B compressive forces.

[0280]如上所述,一个或多个过程可用于影响与例如紧固件仓和/或外科紧固器械结合使用的材料的弹性比率和/或任何其他特性。 [0280] As described above, one or more processes may be used to affect the spring rate with, for example using fasteners cartridge and / or surgical fastening instrument binding material and / or any other characteristic. 材料的弹性比率和/或任何其他特性可在整个修改过程中改变。 Spring rate and / or any other characteristics of the material may vary throughout the modification process. 在一些情况下,此类改变可能是逐渐的,而在其他情况下,该改变可能是突然的。 In some cases, such changes may be gradual, while in other cases, the change may be sudden. 在各种情况下,修改过程的步骤中的一个或多个可导致材料的弹性比率增加,而一个或多个步骤可导致材料的弹性比率的降低。 In each case, the process in the step of modifying the one or more ratios may result in increased elastic material, while one or more of the steps may result in the reduction ratio of the elastic material. 最终,在修改过程开始之前的初始弹性比率与修改过程之后的后续弹性比率之间的比较已完成时,可测量弹性比率的净变化。 Finally, when comparing the ratio of elasticity between before and after the subsequent modification process begins with an initial spring rate modification process has been completed, a measurable change in the spring rate of the net. 在各种情况下,在材料已被加热并且然后冷却之后,材料可具有改变的弹性比率。 In each case, after the material has been heated and then cooled, the elastic material may have a ratio change.

[0281] 在某些情况下,可能需要将上述修改过程中的一个或多个应用于组织厚度补偿件。 [0281] In some cases, it may be a need to modify the above-described process is applied to one or more tissue thickness compensator. 例如,第一修改过程可用于修改组织厚度补偿件的孔隙度,如上文相对于组织厚度补偿件1170所述。 For example, a first modification process may be used to modify the porosity of the tissue thickness compensator, as described above with respect to the tissue thickness compensator 1170. 第一修改过程之后的第二修改过程可用于改变组织厚度补偿件的表面,如上文相对于组织厚度补偿件1140所述。 A second process after the first modification may be used to modify the surface modification process of tissue thickness compensator member, as described above with respect to the tissue thickness compensator 1140. 此外,第三修改过程可用于将组织厚度补偿件修改为包括类似于组织厚度补偿件1120的纵向狭槽1122的纵向狭槽。 In addition, the third process may be used to modify the tissue thickness compensator modified to include a similar tissue thickness compensator longitudinal slot 1120 in the longitudinal slot 1122. 在又一个第四修改过程中,组织厚度补偿件可被修改为包括类似于组织厚度补偿件1150的孔1152的孔。 In yet a fourth modification process, the tissue thickness compensator can be modified to include a similar tissue thickness compensator Kong and Kong 1150 1152. 读者将理解,上述修改中的一些可在单个修改过程中组合或分组。 The reader will appreciate, some of the above modifications may be combined in a single packet or modification process. 例如,模具可被设计为包括模具1154的针1156和模具1126的中心梁1128。 For example, the mold may be designed to include the mold pins 1156 and 1154 of the center sill of the mold 1126 1128. 本公开可设想到其他修改布置方式。 The present disclosure other modifications may be contemplated arrangement.

[0282] 现在参见图38和图39,可使用上述修改过程中的一个或多个将组织厚度补偿件诸如组织厚度补偿件1190改变或修改为包括具有不同弹性比率、孔隙度和/或密度的部分。 [0282] Referring now to FIGS. 38 and 39, may be modified using one or more of the above-described process of the tissue thickness compensator such as tissue thickness change or modify compensator 1190 to include a different spring rate, porosity and / or density section. 在某些情况下,可使用上述修改过程中的一个或多个将组织厚度补偿件1190修改为包括梯度孔隙形态(即,小孔隙的尺寸跨组织厚度补偿件1190的厚度沿一个方向逐渐增加成大孔隙)。 In some cases, the process may be used to modify one of the one or more tissue thickness compensator 1190 is modified to include a gradient morphology of the pores (i.e., pores small thickness dimension across the tissue thickness compensator 1190 is gradually increased in one direction into large pores). 此类形态对于组织生长或止血行为而言更为理想。 Such form is more ideal for the growth of tissue or stop bleeding in terms of behavior. 另外,梯度还可与变化的生物吸收剖面相组合。 Further, the gradient may be combined with bio-absorption cross-section changes. 短期吸收剖面可能更适合实现止血,而长期吸收剖面可以实现更好的组织愈合而不渗漏。 Short-term absorption profile may be more appropriate to achieve hemostasis, and long-term absorption profile allows for better tissue healing without leakage.

[0283] 再次参见图38和图39,组织厚度补偿件1190可具有与组织厚度补偿件1196的剩余部分不同的一个或多个区域几何形状。 [0283] Referring again to FIGS. 38 and 39, a tissue thickness compensator 1190 may have one or more regions of the remainder of the tissue thickness compensator 1196 different geometries. 例如,如图38所示,组织厚度补偿件1190可包括一个或多个突起部分,诸如突起部分1196。 For example, shown in Figure 38, the tissue thickness compensator 1190 may include one or more projecting portions, such as a protruding portion 1196. 另外,组织厚度补偿件1190可包括穿过包括一个或多个区域几何形状的组织厚度补偿件1190的均匀的或至少基本上均匀的第一弹性比率、第一孔隙度和/或第一密度,如图38所示。 Further, the thickness of tissue through compensator 1190 may include a uniform or at least substantially uniform first spring rate comprises one or more regions of the geometry of the tissue thickness compensator 1190, a first porosity and / or first density, shown in Figure 38. 在某些情况下,可使用上述修改过程中的一个或多个来改变或修改组织厚度补偿件1190以改变或修改一个或多个区域几何形状并且/或者引起例如第一弹性比率、第一孔隙度和/或第一密度的局部改变。 In some cases, may be altered or modified tissue thickness compensator 1190 to change or modify the geometry of one or more regions and / or cause such as a first spring rate using one or more of the modification process, a first aperture and / or local change in the first density. 修改的组织厚度补偿件1190可包括一个或多个修改的区域,所述修改的区域具有与其他修改的区域以及/或者组织厚度补偿件1190的剩余部分的第一弹性比率、第一孔隙度和/或第一密度分别不同的弹性比率、孔隙度和/或密度。 Modified tissue thickness compensator 1190 may include one or more modified regions, the modified region having a region other modifications of and / or the remaining portion of the first elastic tissue thickness ratio compensator 1190, and the first porosity / or the first spring rate different densities, porosity and / or density. 在某些情况下,所得一个或多个修改的区域可对应于一个或多个区域几何形状。 In some cases, the resulting one or more modified regions may correspond to one or more regions geometry. 例如,如图39所示,组织厚度补偿件1190可被改变或修改为与突起部分1196水平或至少基本上水平,并且形成例如平坦或至少基本上平坦的表面1198。 For example, shown in Figure 39, the tissue thickness compensator 1190 may be changed or modified with the protruding portion or at least substantially horizontal level 1196, and is formed, for example, at least substantially flat or planar surface 1198. 修改的组织厚度补偿件1190可包括具有第一弹性比率、第一孔隙度和/或第一密度的第一部分1192以及具有分别不同于第一弹性比率、第一孔隙度和/或第一密度的第二弹性比率、第二孔隙度和/或第二密度的第二部分1194。 Modified tissue thickness compensator 1190 may include a first spring rate, a first porosity and / or a first density and a first portion 1192, a first porosity / or having a first density and a first spring rate is different from each of a second spring rate, a second porosity and / or the second portion 1194 of the second density. 第二部分1194可对应于突起部分1196,并且可导致与突起部分1196水平或至少基本上水平,以形成例如平坦或至少基本上平坦的表面1198。 The second portion 1194 may correspond to the protruding portions 1196 and 1196 projecting portion may result in at least a horizontal or substantially horizontal, flat or, for example, to form a substantially planar surface of at least 1198. 在某些方面,在组织厚度补偿件1190的修改之前突起部分1196的几何形状反映、匹配或类似在组织厚度补偿件1190已被修改之后第二部分1194的几何形状。 In some aspects, the tissue thickness compensator before modifying the geometry of the protrusion portion 1190 of the 1196 reflection geometry matching or the like after the tissue thickness compensator 1190 has been modified second portion 1194.

[0284] 再次参见图37至图39,可以类似于组织厚度补偿件1170的方式使用模具1172来改变或修改组织厚度补偿件1190。 [0284] Referring again to FIGS. 37 through 39, may be similar to the way the tissue thickness compensator 1170 to 1172 using a mold change or modify the tissue thickness compensator 1190. 例如,组织厚度补偿件1190可在接收器1174中加热到大于或等于组织厚度补偿件1190的材料组合物的玻璃化转变温度但小于其熔融温度的温度。 For example, tissue thickness compensator 1190 may be heated in a receiver 1174 to greater than or equal tissue thickness compensator 1190 glass transition temperature of the material composition, but less than its melting temperature. 在某些情况下,在组织厚度补偿件1190处于玻璃态时,调节构件1176可抵靠突起部分1196推进,从而压缩突起部分1196并且重新布置其几何形状以形成第二部分1194,如图39所示。 In some cases, the tissue thickness compensator 1190 in the glassy state, abut against the regulating member 1176 projecting portion 1196 forward, thereby compressing the projecting portion 1196 and its geometry rearranged to form a second portion 1194, FIG. 39 shows. 对上文进行进一步描述,调节构件1176可被构造成能够维持抵靠突起部分1196的压缩持续足以允许组织厚度补偿件1190保持或至少基本上保持由调节构件1176施加的修改的时间段。 Further to the above description, the adjustment member 1176 may be configured to maintain compression against the projecting portion 1196 is sustained tissue thickness sufficient to allow holding compensator 1190 or at least substantially held exerted by the regulating member 1176 modification period. 在处于来自调节构件1176的压缩下时,可使组织厚度补偿件1190冷却或可主动地冷却到低于其玻璃化转变温度的温度。 When in the compression from the regulating member 1176, compensator 1190 can cool the tissue thickness or may be actively cooled to a temperature below its glass transition temperature. 在组织厚度补偿件1190转变退出玻璃态之后,调节构件1190可回缩。 After the tissue thickness compensator 1190 exit the glass transition state, the adjustment member 1190 may be retracted. 组织厚度补偿件1190可保持或至少基本上保持第二部分1194,如图39所示。 Tissue thickness compensator 1190 may be maintained or at least substantially retaining a second portion 1194, shown in Figure 39. 在某些情况下,调节构件1176可在组织厚度补偿件1190被加热以达到玻璃态时,在组织厚度补偿件1190处于玻璃态时,以及/或者在组织厚度补偿件1190转变或冷却到玻璃态以下的温度时将压力施加到突起部分1196上。 In some cases, the tissue thickness regulating member 1176 may be compensator 1190 is heated to the glass state is reached, when the tissue thickness compensator 1190 in the glassy state, and / or tissue thickness compensator 1190 transition to a glassy state or a cooling member in when a temperature below the pressure is applied to the protrusion portion 1196. 在某些情况下,例如在组织厚度补偿件1190的温度逐渐增加以使组织厚度补偿件1190朝玻璃态转变时,施加到组织厚度补偿件1190的突起部分1196的压力可逐渐朝阈值增加。 In some cases, for example at a temperature compensator 1190 tissue thickness gradually increases to the tissue thickness compensator member 1190 toward the glass transition, the pressure applied to the tissue thickness compensator 1196 projecting portions 1190 may be gradually increased toward the threshold value. 在某些情况下,在组织厚度补偿件1190退出玻璃态时,在组织厚度补偿件1190退出玻璃态之前,以及/或者在组织厚度补偿件1190退出玻璃态之后,施加到组织厚度补偿件1190的突起部分1196的压力可被移除、逐渐移除、或至少部分地减小。 In some cases, when the exit 1190 glassy tissue thickness compensator, the tissue thickness compensator 1190 before exiting the glassy state and / or after the tissue thickness compensator 1190 exit the glass state, is applied to the tissue thickness compensator 1190 pressure protruding portions 1196 may be removed, gradually removing, or at least partially reduced.

[0285] 现在参见图41至图43,可使用传统冻干技术和/或任何其他合适的技术来制备组织厚度补偿件,诸如组织厚度补偿件1200。 [0285] Referring now to FIGS. 41 to 43, the tissue thickness may be prepared using traditional lyophilization techniques compensator and / or any other suitable technique, such as tissue thickness compensator 1200. 另外,组织厚度补偿件1200可被修改或改变以用于例如外科手术中。 Moreover, the tissue thickness compensator 1200 may be modified or changed to for example surgery. 组织厚度补偿件1200可在许多方面类似于其他组织厚度补偿件,诸如组织厚度补偿件22020 (图9)和/或组织厚度补偿件1120 (图26)。 Tissue thickness compensator 1200 may be similar to other tissue thickness compensator in many ways, such as tissue 22020 (FIG. 9) and / or the thickness of the tissue thickness compensator compensator 1120 (FIG. 26). 例如,如同组织厚度补偿件22020,组织厚度补偿件1200可与端部执行器22090—起使用。 For example, as the tissue thickness compensator 22020, tissue thickness compensator 1200 and the end effector can be used together 22090-. 此外,如图41至图43所示,组织厚度补偿件1200可被修改为包括纵向狭槽1202,该纵向狭槽如同刀狭槽22025,可将用于切割部分10053的组织厚度补偿件刀路径限定在第一缝合部分1204a和第二缝合部分1204b之间。 Further, as shown in FIG. 41 to FIG. 43, the tissue thickness compensator 1200 may be modified as tissue thickness compensator tool path includes a longitudinal slot 1202, the longitudinal slot as the knife slot 22025, 10053 may be used to cut part of the is defined between the first suture portion 1204a and 1204b in the second stitched portions. 此外,第一缝合部分1204a和第二缝合部分1204b可在许多方面类似于组织厚度补偿件22020的第一缝合部分22021a (图9)和第二缝合部分22021b (图9)。 Further, the first suture portion 1204a and second portion 1204b may be similar to suture tissue thickness compensator part 22020 of the first suture member 22021a (FIG. 9) and a second sewn portion 22021b (FIG. 9) in many respects. 另外,狭槽1202可被构造成能够可释放地连接第一缝合部分1204a和第二缝合部分1204b,使得在与端部执行器22090—起使用时,切割部分10053可朝远侧推进穿过狭槽1202以横切狭槽1202并且将第一缝合部分1204a和第二缝合部分1204b分离。 Further, the slot 1202 can be configured to be releasably connected to the first sewn portion and a second sewn portion 1204a 1204b, such that in use with the end effector from 22090-, 10053 cut portion can be advanced distally through the slot the groove 1202 and the first suture portion 1204a and the second stitched portions separated transversely slot 1202 1204b.

[0286] 再次参见图41至图43,组织厚度补偿件1200可在组装有端部执行器诸如端部执行器22090 (图9)之前被修改。 [0286] Referring again to FIGS. 41 to 43, a tissue thickness compensator 1200 may be modified before the assembled end effector such as the end effector 22 090 (FIG. 9). 另选地,组织厚度补偿件1200可在其已组装有端部执行器之后被修改。 Alternatively, the tissue thickness compensator member 1200 may be modified after it has been assembled the end effector. 如上所述,组织厚度补偿件1200可使用传统冻干技术和/或任何其他合适的技术来制备。 As described above, the tissue thickness compensator 1200 can be prepared using traditional lyophilization techniques and / or any other suitable technique. 空间创建器1206可用于在热压制过程中修改组织厚度补偿件1200,如图41至图43所示。 Creating space 1206 may be used to modify the tissue thickness compensator 1200 hot pressing process, as shown in FIG. 41 to FIG. 43. 例如,空间创建器1206可被加热到大于或等于组织厚度补偿件1200的材料组合物的熔融温度的温度。 For example, to create the space 1206 may be heated to a temperature greater than or equal to the thickness of tissue material composition compensator 1200 melting temperature. 空间创建器1206然后可与组织厚度补偿件1200对准并且插入组织厚度补偿件中,以形成纵向狭槽1202。 Creating space 1206 may then tissue thickness compensator member 1200 is aligned with and inserted into the tissue thickness compensator to form a longitudinal slot 1202. 空间创建器1206可熔融穿过组织厚度补偿件1200以针对纵向狭槽1202创建空间。 Space creating 1206 melt through the tissue thickness compensator 1200 to 1202 to create space for the longitudinal slot. 空间创建器1206可在达到组织厚度补偿件1200内的所需深度之后回缩。 Creating space 1206 can be retracted after the desired depth within the tissue thickness compensator 1200. 在某些情况下,热压制过程可通过将经加热的空间创建器1206重新插入穿过组织厚度补偿件1200来重复以加宽针对纵向狭槽1202创建的空间。 In some cases, the hot pressing process by the creator through 1206 back into the heating space through the tissue thickness compensator 1200 is repeated for space to widen the longitudinal slot 1202 is created.

[0287] 再次参见图41至图43,空间创建器1206可包括热金属丝。 [0287] Referring again to FIGS. 41 to 43, creating the space 1206 may include a hot wire. 例如,空间创建器1206可包括可由例如镍铬合金或不锈钢制成的薄的、拉紧的金属线,或预成型为所需形状的较厚线。 For example, the space may be created 1206 may include a thin or made of stainless steel, nickel-chromium alloy, for example, the tensioning wires, a thick line or preformed into a desired shape. 热金属丝可通过电阻加热到所需温度。 Hot wire may be heated to the desired temperature via a resistor. 在空间创建器1206的热金属丝穿过组织厚度补偿件1200的材料时,来自热金属丝的热量可正好在接触之前使材料蒸发。 When creating a hot wire in the space 1206 through the material of the tissue thickness compensator 1200, the heat from the hot wire can be just prior to contacting the evaporated material. 在某些情况下,热金属丝可具有圆柱形或基本上圆柱形的形状,如图42所示。 In some cases, the hot wire may have a cylindrical or substantially cylindrical shape, shown in Figure 42. 纵向狭槽1202的深度可部分地取决于空间创建器1206穿过组织厚度补偿件1200的插入深度,并且纵向狭槽1202的宽度可部分地取决于空间创建器1206的热金属丝的直径。 Longitudinal slot depth may depend in part 1202 creates a space 1206 through the tissue thickness compensator 1200 insertion depth, and width of the longitudinal slot 1202 may depend in part on the diameter of the space creator 1206 hot wire.

[0288] 在某些情况下,空间创建器1206可部分地插入穿过组织厚度补偿件的整个厚度。 [0288] In some cases, the space creator 1206 may be partially inserted through the entire thickness of the tissue thickness compensator. 在某些情况下,空间创建器1206可完全插入穿过组织厚度补偿件1200的整个厚度以形成延伸穿过组织厚度补偿件1200的整个厚度的开口、孔和/或狭槽。 In some cases, the space creator 1206 may be fully inserted through the entire thickness of the tissue thickness compensator 1200 to form the openings, holes and / or slots extend through the entire thickness of the tissue thickness compensator 1200. 在某些情况下,空间创建器1206可插入穿过组织厚度补偿件1200的第一侧并且穿过例如组织厚度补偿件1200的可与第一侧相对的第二侧离开。 In some cases, the space creator 1206 may be inserted through the first side of the tissue thickness compensator member 1200 and through the second side may be, for example, the first side of the tissue thickness compensator 1200 relative to leave.

[0289] 本文公开了许多工艺,所述工艺利用热能量来修改组织厚度补偿件。 [0289] Many processes disclosed herein, the process using thermal energy to modify tissue thickness compensator. 此类工艺可称为制毡工艺。 Such processes may be referred to felting process. 在某些情况下,制毡工艺也可利用向组织厚度补偿件施加压缩力和/或拉力。 In some cases, using felting process may also apply a compressive force and / or force to the tissue thickness compensator. 在其他情况下,制毡工艺不可利用向组织厚度补偿件施加压缩力和/或拉力。 In other cases, non-felting process by applying a compressive force and / or force to the tissue thickness compensator. 在任一种情况下,本文所公开的制毡工艺也可用于例如修改和适当地植入层和/或支撑材料。 In either case, the herein disclosed felting processes may also be used to modify, for example, and the layer and / or the support material properly implanted.

[0290] 在各种情况下,组织厚度补偿件组件可包含聚合物组合物。 [0290] In various circumstances, tissue thickness compensator assembly may comprise a polymer composition. 聚合物组合物可包括一种或多种合成聚合物和/或一种或多种非合成聚合物。 The polymer composition may comprise one or more synthetic polymers and / or one or more non-synthetic polymers. 合成聚合物可包括合成的可吸收聚合物和/或合成的非可吸收聚合物。 Synthetic polymers may include synthetic absorbable polymers and / or non-synthetic absorbable polymers. 在各种情况下,聚合物组合物可包含例如生物相容性泡沫。 In each case, the polymer composition may comprise, for example, a biocompatible foam. 生物相容性泡沫可包括例如多孔的开孔泡沫和/或多孔的闭孔泡沫。 Biocompatible foam may comprise, for example, a porous open-cell foam and / or closed-cell porous foam. 生物相容性泡沫可具有均匀的孔形态,或者可具有梯度孔形态(即,在一个方向跨泡沫的厚度,小孔尺寸逐渐增加变成大孔)。 Biocompatible foam may have a uniform pore morphology, or may have a gradient pore morphology (i.e., in a direction across the thickness of the foam, increasing the pore size becomes large pore). 在各种情况下,聚合物组合物可包括多孔支架、多孔基质、凝胶基质、水凝胶基质、溶液基质、丝状基质、管状基质、复合基质、膜基质、生物稳定聚合物和可生物降解的聚合物中的一种或多种、以及它们的组合。 In each case, the polymer composition may comprise a porous scaffold, a porous matrix, gel matrix, the hydrogel matrix, the matrix solution, filamentous matrix, the tubular matrix, composite matrix, membrane matrix, biodegradable and biostable polymers one or more degradable polymers, and combinations thereof. 例如,组织厚度补偿件组件可包括通过丝状基质增强的泡沫,或者可包括具有附加的水凝胶层的泡沫,该附加的水凝胶层在体液存在下伸展,以在组织上进一步提供压缩。 For example, tissue thickness compensator assembly can include a matrix reinforced by filamentary foam having a foam or may comprise an additional hydrogel layer, the hydrogel layer extends additional presence of body fluids, to further provide compression on the tissue . 在各种情况下,组织厚度补偿件组件还可由材料和/或第二层或第三层上的涂层构成,该涂层在体液存在下伸展,以在组织上进一步提供压缩。 In various circumstances, tissue thickness compensator assembly may also be formed of and / or coated on the third layer of material or the second layer, the coating fluid in the presence of the extension, to further provide compression on the tissue. 此类层可为水凝胶,该水凝胶可为合成的和/或天然源材料,并且例如可为生物耐用的和/或可生物降解的。 Such layer may be a hydrogel, the hydrogel may be synthetic and / or natural source material, and for example may be biologically durable and / or biodegradable. 在某些情况下,可使用例如能提供附加柔韧性、刚度、和/或强度的纤维非织造材料或纤维网孔类型元件来增强组织厚度补偿件组件。 In some cases, for example, may be used to provide additional flexibility, fiber stiffness and / or strength of a nonwoven fibrous material or a mesh type element to enhance tissue thickness compensator assembly. 在各种情况下,组织厚度补偿件组件具有多孔形态,该多孔形态表现出梯度结构,例如,在一个表面上是小孔,而在另一表面上是较大的孔。 In various circumstances, tissue thickness compensator assembly having a porous morphology The morphology of the gradient porous structure, for example, on one surface of a hole, and on the other surface of the larger holes. 此类形态对于组织生长或止血行为而言更为理想。 Such form is more ideal for the growth of tissue or stop bleeding in terms of behavior. 另外,梯度还可与变化的生物吸收剖面相组合。 Further, the gradient may be combined with bio-absorption cross-section changes. 短期吸收剖面可能更适合实现止血;而长期吸收剖面可以实现更好的组织愈合又不会渗漏。 Short-term absorption profile may be more appropriate to achieve hemostasis; and long-term absorption profile allows for better tissue healing and would not leak.

[0291]非合成聚合物的示例包括但不限于冻干多糖、糖蛋白类、弹性蛋白、蛋白聚糖、明胶、胶原和氧化再生纤维素(ORC)。 [0291] Examples of non-synthetic polymers include, but are not limited to lyophilization polysaccharides, glycoproteins, elastin, proteoglycans, gelatin, collagen and oxidized regenerated cellulose (ORC). 合成的可吸收聚合物的示例包括但不限于聚(乳酸)(PLA)、聚(L-乳酸)(PLLA)、聚己内酯(PCL)、聚乙醇酸(PGA)、聚(三亚甲基碳酸酯)(TMC)、聚对苯二甲酸乙二醇酯(PET)、多羟基链烷酸酯(PHA)、乙交酯和ε-己内酯的共聚物(PGCL)、乙交酯和三亚甲基碳酸酯的共聚物、聚(癸二酸甘油酯)(PGS)、聚对二氧环己酮、聚(原酸酯)、聚酸酐、多糖、聚(酯-酰胺)、酪氨酸基聚芳酯、酪氨酸基聚亚氨碳酸酯、酪氨酸基聚碳酸酯、聚(D,L-丙交酯-氨基甲酸酯)、聚(B-羟基丁酸)、聚(Ε-己内酯)、聚乙二醇(PEG)、聚[二(羧基苯氧基)磷腈]、聚(氨基酸)、拟聚(氨基酸)、可吸收聚氨酯,以及它们的组合。 Examples of synthetic resorbable polymers include, but are not limited to poly (lactic acid) (PLA), poly (L- lactic acid) (PLLA), polycaprolactone (PCL), polyglycolic acid (PGA), poly (trimethylene carbonate) (TMC), polyethylene terephthalate (PET), a polyhydroxy alkanoate (PHA), glycolide and ε- caprolactone (PGCL), glycolide and a copolymer of trimethylene carbonate, poly (glycerol sebacate) (the PGS), poly dioxanone, poly (orthoesters), polyanhydrides, polysaccharides, poly (ester - amide), tyrosine acid groups polyarylate, poly imino tyrosine carbonate group, tyrosine-based polycarbonate, poly (D, L- lactide - urethane), poly (B- hydroxybutyric acid), poly ([epsilon] -caprolactone), polyethylene glycol (PEG), poly [di (carboxylatophenoxy) phosphazene], poly (amino acids), to be poly (amino acids), resorbable polyurethanes, and combinations thereof. 在各种情况下,该聚合物组合物可包含例如按聚合物组合物的重量计大约50%至大约90%的PLLAjP按聚合物组合物的重量计大约50%至大约10%的PCL。 In each case, the polymer composition may comprise, for example, by weight of the polymer composition, about 50% to about 90% by weight of the polymer PLLAjP composition, from about 50% to about 10% PCL. 在至少一个实施方案中,该聚合物组合物可包含例如按重量计大约70%的PLLA,和按重量计大约30%的PCL。 In at least one embodiment, the polymer composition may comprise, for example, about 70% by weight of of PLLA, and about 30% by weight of the PCL. 在各种情况下,该聚合物组合物可包含例如按聚合物组合物的重量计大约55%至大约85%的PGA,和按聚合物组合物的重量计15%至45%的PCL。 In each case, the polymer composition may comprise, for example, by weight of the polymer composition, about 55% to about 85% of the PGA, and the weight of the polymer composition by 15% to 45% PCL. 在至少一个实施方案中,该聚合物组合物可包含例如按重量计大约65%的PGA,和按重量计大约35%的PCL。 In at least one embodiment, the polymer composition may comprise, for example, about 65% by weight of PGA, and about 35% by weight of the PCL. 在各种情况下,该聚合物组合物可包含例如按聚合物组合物的重量计大约90%至大约95%的PGA,和按聚合物组合物的重量计大约5%至大约10%的PLA。 In each case, the polymer composition may comprise, for example, by weight of the polymer composition, about 90% to about 95% of the PGA, and by weight of the polymer composition, from about 5% to about 10% PLA .

[0292] 在各种情况下,合成的可吸收聚合物可包括可生物吸收的生物相容性弹性体共聚物。 [0292] In each case, a synthetic absorbable biocompatible polymers can include elastomeric copolymer bioabsorbable. 合适的可生物吸收的、生物相容性的弹性体共聚物包括但不限于ε-己内酯和乙交酯的共聚物(ε-己内酯与乙交酯的摩尔比优选地为约30:70至约70:30,优选地为35:65至约65:35,并且更优选地为45: 55至35:65) ;ε_己内酯和丙交酯(包括L-丙交酯、D-丙交酯、它们的共混物或乳酸共聚物)的弹性体共聚物(ε_己内酯与丙交酯的摩尔比优选地为约35:65至约65:35,并且更优选地为45:55至30:70);对二氧杂环己酮(I,4-二氧杂环己烷-2-酮)和丙交酯(包括L-丙交酯、D-丙交酯和乳酸)的弹性体共聚物(对二氧杂环己酮与丙交酯的摩尔比优选地为约40:60至约60:40) ; ε-己内酯和对二氧杂环己酮的弹性体共聚物(ε-己内酯与对二氧杂环己酮的摩尔比优选地为约30:70至约70:30);对二氧杂环己酮和三亚甲基碳酸酯的弹性体共聚物(对二氧杂环己酮与三亚甲基碳酸酯的摩尔比优选为约30:70至约70:30);三亚甲 Suitable bioabsorbable, biocompatible elastomeric copolymers include, but are not limited to copolymers of [epsilon] -caprolactone and glycolide ([epsilon] -caprolactone and glycolide molar ratio of preferably about 30 : 70 to about 70:30, preferably from 35:65 to about 65:35, and more preferably from 45: 55 to 35:65); ε_ caprolactone and lactide (including L- lactide , D- lactide, blends thereof or lactic acid copolymers) of the elastomeric copolymer (ε_ caprolactone and lactide molar ratio is preferably from about 35:65 to about 65:35, and more preferably from 45:55 to 30:70); of dioxanone (I, 4- dioxan-2-one) and lactide (including L- lactide, D- propyl lactide and lactic acid) of the elastomeric copolymer (lactide on the prop dioxanone molar ratio is preferably from about 40:60 to about 60:40); ε- caprolactone and p-dioxanone elastomeric copolymer hexanone ([epsilon] -caprolactone and p-dioxanone ketone molar ratio is preferably from about 30:70 to about 70:30); of dioxanone and trimethylene carbonate esters elastomeric copolymer (molar ratio of preferably dioxanone to trimethylene carbonate of from about 30:70 to about 70:30); trimethylene 碳酸酯和乙交酯的弹性体共聚物(三亚甲基碳酸酯与乙交酯的摩尔比优选为约30:70至约70:30);三亚甲基碳酸酯和丙交酯(包括L-丙交酯、D-丙交酯、它们的共混物或乳酸共聚物)的弹性体共聚物(三亚甲基碳酸酯与丙交酯的摩尔比优选为约30:70至约70:30);以及它们的共混物。 Elastomeric copolymers carbonate and glycolide (trimethylene carbonate and glycolide molar ratio is preferably from about 30:70 to about 70:30); trimethylene carbonate and lactide (including L- lactide, D- lactide, blends thereof or lactic acid copolymers) of the elastomeric copolymer (trimethylene carbonate and lactide molar ratio is preferably from about 30:70 to about 70:30) ; and blends thereof. 在一个实施方案中,弹性体共聚物为乙交酯和ε-己内酯的共聚物。 In one embodiment, the elastomeric copolymer is a copolymer of glycolide and ε- caprolactone acrylate. 在另一个实施方案中,弹性体共聚物为丙交酯和己内酯的共聚物。 In another embodiment, the elastomeric copolymer is a copolymer of lactide and caprolactone.

[0293] 公布于1995年11月21日的名称为“ELASTOMERIC MEDICAL DEVICE”的美国专利5,468,253和公布于2001 年12月4 日的名称为“FOAM BUTTRESS FOR STAPLING APPARATUS” 的美国专利6,325,810的公开内容据此各自全文以引用方式并入本文。 [0293] published on November 21, 1995, entitled "ELASTOMERIC MEDICAL DEVICE" US Patent 5,468,253 and published on December 4, 2001, entitled "FOAM BUTTRESS FOR STAPLING APPARATUS" US Patent 6,325 , 810 disclosure is hereby incorporated by reference in their entirety.

[0294] 在各种情况下,合成的可吸收聚合物可例如包括下列物质中的一种或多种:可以商品名称VICRYL (polyglactic 910)从Ethicon,Inc.商购获得的90/10聚(乙交酯-L-丙交酯)共聚物、可以商品名称DEXON从American Cyanamid C0.商购获得的聚乙交酯、可以商品名称PDS从Ethicon ,Inc.商购获得的聚二氧杂环己酮、可以商品名称MAXON从AmericanCyanamid C0.商购获得的聚(乙交酯-三亚甲基碳酸酯)无规嵌段共聚物、可以商品名称M0N0CRYL从Ethicon商购获得的75/25聚(乙交酯-E-己内酯-poliglecaprolactone 25)共聚物。 [0294] In each case, synthetic absorbable polymers may include one or more of the following materials, for example: the trade names VICRYL (polyglactic 910) commercially available from Ethicon, Inc commercially 90/10 poly ( -L- glycolide-lactide) copolymer, lactide tradename DEXON from American Cyanamid C0. polyethylene commercially available under the trade name PDS commercially available from Ethicon, Inc. supplier polydioxanone poly (glycolide - trimethylene carbonate) -one, tradename commercially available from MAXON AmericanCyanamid C0 supplier. random block copolymer, trade name M0N0CRYL commercially available from Ethicon 75/25 poly (glycolide caprolactone acrylate -E- -poliglecaprolactone 25) copolymer.

[0295] 合成的非可吸收聚合物的示例包括但不限于聚氨酯泡沫塑料、聚丙烯(PP)、聚乙烯(PE)、聚碳酸酯、聚酰胺,诸如尼龙、聚氯乙烯(PVC)、聚甲基丙烯酸甲酯(PMMA)、聚苯乙烯(PS)、聚酯、聚醚醚酮(PEEK)、聚四氟乙烯(PTFE)、聚三氟氯乙烯(PTFCE)、聚氟乙烯(PVF)、氟化乙烯丙烯(FEP)、聚缩醛、聚砜、以及它们的组合。 [0295] Examples of non-absorbable synthetic polymers include, but are not limited to, polyurethane foam, polypropylene (PP), polyethylene (PE), polycarbonates, polyamides, such as nylon, polyvinyl chloride (PVC), poly methyl methacrylate (PMMA), polystyrene (PS), polyester, polyether ether ketone (PEEK), polytetrafluoroethylene (PTFE), polytrifluorochloroethylene (PTFCE), polyvinyl fluoride (PVF) , fluorinated ethylene propylene (FEP), polyacetal, polysulfone, and combinations thereof. 合成的非可吸收聚合物可包括但不限于泡沫弹性体和多孔弹性体,诸如硅酮、聚异戊二烯和橡胶。 Synthetic non-absorbable polymers may include, but are not limited to foamed elastic member and the porous elastic body, such as silicone, polyisoprene and rubber. 在各种情况下,所述合成聚合物可包括可以商标名称G0RE-TEX Soft Tissue Patch从WLGore&Associates, Inc.商购获得的膨体聚四氟乙烯(ePTFE),和可以商标名称NASOPORE从Polyganics商购获得的共聚醚酯聚氨酯泡沫。 In each case, the synthetic polymer may include trade designation G0RE-TEX Soft Tissue Patch NASOPORE commercially available from WLGore & Associates, expanded polytetrafluoroethylene (ePTFE) Inc. commercially available, and commercially under the trade designation from Polyganics copolyetherester obtained polyurethane foam.

[0296] 组织厚度补偿件组件的聚合物组合物的特征可在于例如孔隙度百分比、孔尺寸、和/或硬度。 [0296] The polymer composition of the tissue thickness compensator assembly that may be, for example, the percentage of porosity, pore size, and / or hardness. 在各种情况下,该聚合物组合物可具有例如按体积计大约30%至大约99%的孔隙度百分比。 In each case, the polymer composition may have, for example, by volume percentage porosity of about 30% to about 99%. 在某些情况下,该聚合物组合物可具有例如按体积计大约60%至大约98%的孔隙度百分比。 In some cases, the polymer composition may have, for example, by volume percentage porosity of about 60% to about 98%. 在各种情况下,该聚合物组合物可具有例如按体积计大约85%至大约97%的孔隙度百分比。 In each case, the polymer composition may have, for example, by volume percentage porosity of about 85% to about 97%. 在至少一个实施方案中,该聚合物组合物可包含例如按重量计大约70%的PLLA和按重量计大约30%的PCL,并且可包括例如按体积计大约90%的孔隙度。 In at least one embodiment, the polymer composition may comprise, for example, about 70% by weight of PLLA and about 30% by weight of the PCL, and may comprise, for example, about 90% by volume porosity. 在至少一个此类实施方案中,因此,该聚合物组合物将包含按体积计大约10%的共聚物。 At least one such embodiment, therefore, the polymer composition will comprise about 10% by volume of the copolymer. 在至少一个实施方案中,该聚合物组合物可包含例如按重量计大约65%的PGA和按重量计大约35%的PCL,并且可具有例如按体积计大约93%至大约95%的孔隙度百分比。 In at least one embodiment, the polymer composition may comprise, for example, about 65% by weight of PGA and about 35% by weight of the PCL, and may have, for example about 93% by volume to about 95% porosity percentage. 在各种情况下,聚合物组合物可包括按体积计大于85%的孔隙度。 In each case, the polymer composition may comprise greater than 85% by volume porosity. 聚合物组合物可具有例如大约5微米至大约2000微米的孔尺寸。 The polymer composition may have a pore size of about 5 microns to about 2000 microns. 在各种情况下,聚合物组合物可具有例如介于大约10微米至大约100微米之间的孔尺寸。 In each case, the polymer composition may have, for example, a pore size range between about 10 microns to about 100 microns. 在至少一个此类实施方案中,该聚合物组合物可包含例如PGA和PCL的共聚物。 At least one such embodiment, the polymer composition may comprise, for example, a copolymer of PGA and PCL. 在某些情况下,聚合物组合物可具有例如介于大约100微米至大约1000微米之间的孔尺寸。 In some cases, for example, the polymer composition may have a pore size range between about 100 microns to about 1000 microns. 在至少一个此类实施方案中,该聚合物组合物可包含例如PLLA和PCL的共聚物。 At least one such embodiment, the polymer composition may comprise, for example, a copolymer of PLLA and PCL. 根据某些方面,聚合物组合物的硬度可以用肖氏硬度表示,该肖氏硬度可被定义为用硬度计(诸如肖氏硬度计)测定的材料对永久压痕的抗性。 According to certain aspects, the hardness of the polymer composition may be represented by Shore hardness, the Shore hardness may be defined with a durometer (such as a Shore Durometer) measured by the material's resistance to permanent indentation. 为了评估给定材料的硬度计值,根据名称为“Standard Test Method for Rubber Property-Durometer Hardness” 的ASTM程序D2240-00(其全文以引用方式并入本文),用硬度计压头脚向材料施压。 In order to assess a given material durometer, according to the name of ASTM procedure D2240-00 "Standard Test Method for Rubber Property-Durometer Hardness" (which is incorporated herein by reference in entirety), is applied to the material indenter foot pressure. 可将硬度计压头脚压入材料,保持足够长的时间(诸如15秒),在这种情况下,随后由合适的标度读取读数。 May indenter foot is pressed into the material, for a sufficient period of time (such as 15 seconds), in this case, followed by the readings the appropriate scale. 根据所用的标度类型,当压头脚完全穿透材料时,可获得读数O,并且当材料未被穿透时,可获得读数100。 Depending on the type of scale used, when the indenter foot completely penetrates the material, O readings obtained, and when the material has not been penetrated, 100 readings obtained. 该读数是无量纲的。 The reading is dimensionless. 在各种情况下,可根据ASTM D2240-00,采用任何合适的标度例如A类和/或00类标度来确定硬度。 In each case, according to ASTM D2240-00, using any suitable scale, for example, Type A and / or class 00 hardness scale determined. 在各种情况下,组织厚度补偿件组件的聚合物组合物可具有例如大约4A至大约16A的肖氏A硬度值,该硬度值在肖氏00范围内为大约4500至大约6500。 In each case, the polymer composition of a tissue thickness compensator assembly 4A may have, for example from about A to about a Shore hardness value of 16A, the hardness value in the range from about 00 Shore 4500 to about 6500. 在至少一个此类实施方案中,该聚合物组合物可包含例如PLLA/PCL共聚物或PGA/PCL共聚物。 At least one such embodiment, the polymer composition may comprise, for example, PLLA / PCL copolymer, or PGA / PCL copolymer. 在各种情况下,组织厚度补偿件组件的聚合物组合物可具有小于15A的肖氏A硬度值。 In various circumstances, tissue thickness compensator assembly polymer composition may have a Shore A hardness of less than 15A. 在各种情况下,组织厚度补偿件组件的聚合物组合物可具有小于1A的肖氏A硬度值。 In various circumstances, tissue thickness compensator assembly polymer composition may have a Shore A hardness value of less than 1A. 在各种情况下,组织厚度补偿件组件的聚合物组合物可具有小于5A的肖氏A硬度值。 In various circumstances, tissue thickness compensator assembly polymer composition may have a Shore A hardness value of less than 5A. 在某些情况下,聚合物材料可具有例如大约3500至大约7500的肖氏00组合物值。 In some cases, the polymeric material may have a composition, for example, a Shore 00 value of about 3500 to about 7500.

[0297] 在各种情况下,聚合物组合物可具有上述识别出的特性中的至少两种。 [0297] In each case, the polymer composition may have at least two of the above identified properties of. 在各种情况下,聚合物组合物可具有上述识别出的特性中的至少三种。 In each case, the polymer composition may have at least three identified characteristic of the foregoing. 该聚合物组合物可具有例如按体积计85%至97%的孔隙度、5微米至2000微米的孔尺寸、和4A至16A的肖氏A硬度值,以及4500至6500的肖氏00硬度值。 The polymer composition may have, for example, by volume 85 to 97% porosity, pore size 5 microns to 2000 microns, and a Shore A hardness of the 4A to 16A, 00 and a Shore hardness value of from 4500 to 6500 . 在至少一个实施方案中,例如,聚合物组合物可包含按聚合物组合物的重量计70%的PLLA和按聚合物组合物的重量计30%的PCL,并具有按体积计90%的孔隙度、100微米至1000微米的孔尺寸、和4A至16A的肖氏A硬度值、以及4500至6500的肖氏00硬度值。 In at least one embodiment, for example, the polymer composition may comprise a polymer composition, by weight 70% by weight of PLLA and the polymer composition, 30% of the PCL, and having a porosity of 90% by volume degree, pore size 100 microns to 1000 microns, and a Shore a hardness of the 4A to 16A, 00 and a Shore hardness value of from 4500 to 6500. 在至少一个实施方案中,例如,聚合物组合物可包含按聚合物组合物的重量计65 %的PGA和按聚合物组合物的重量计35 %的PCL,并具有按体积计93 %至95 %的孔隙度、10微米至100微米的孔尺寸、和4A至16A的肖氏A硬度值、以及4500至6500的肖氏00硬度值。 In at least one embodiment, for example, the polymer composition may comprise a polymer composition, by weight 65% by weight of PGA and a polymer composition of 35% of the PCL, and having 93% by volume to 95 % porosity, pore size of 10 microns to 100 microns, and a Shore a hardness of the 4A to 16A, 00 and a Shore hardness value of from 4500 to 6500.

[0298] 在各种情况下,聚合物组合物可包含药物活性剂。 [0298] In each case, the polymer composition may comprise a pharmaceutically active agent. 聚合物组合物可释放治疗有效量的药物活性剂。 The polymer composition can release a therapeutically effective amount of a pharmaceutically active agent. 在各种情况下,当聚合物组合物被解吸/吸收时药物活性剂可被释放。 In each case, when the polymer composition is desorption / absorption of the drug active agent may be released. 在各种情况下,药物活性剂可被释放到流体诸如流经聚合物组合物上方或穿过聚合物组合物的血液中。 In each case, the pharmaceutically active agent may be released into the flowing fluid, such as through the above polymer composition or polymer composition in blood. 药物活性剂的示例可包括但不限于止血剂和药物,例如血纤维蛋白、凝血酶和氧化再生纤维素(ORC);抗炎剂药物,例如双氯芬酸、阿司匹林、萘普生、舒林酸和氢化可的松;抗生素和抗微生物药物或抗微生物剂,例如三氯生、离子银、氨苄青霉素、庆大霉素、多粘菌素B、氯霉素;以及抗癌剂,例如顺铂、丝裂霉素、阿霉素。 Examples of pharmaceutically active agents may include, but are not limited to hemostatic agents and drugs such as fibrin, thrombin, and oxidized regenerated cellulose (the ORC); anti-inflammatory agent drugs, such as diclofenac, aspirin, naproxen, sulindac, and hydrogenated cortisone; antibiotics and antimicrobial agents or antimicrobial agents such as triclosan, silver ions, ampicillin, gentamicin, polymyxin B, chloramphenicol; and anticancer agents, such as cisplatin, wire mitomycin, doxorubicin.

[0299] 本文公开了用于改变组织厚度补偿件的各种方法。 [0299] Disclosed herein are various methods for changing tissue thickness compensator. 此类方法可用于改变例如与紧固件仓和/或外科紧固器械一起使用的任何合适的层。 Such methods can be used, for example, any suitable layer changes fastener cartridge for use with and / or surgical fastening instrument. 此类层可包含可使用任何合适的工艺形成的小于百分之百的致密组成。 Such layers may comprise any suitable process may be used to form a dense composition of less than one hundred percent. 例如,此类工艺可包括例如挤出、注模、织造、冻干、气体发泡和/或熔喷工艺。 For example, such processes can include, for example, extrusion, injection molding, weaving, freeze-dried, gas foaming and / or meltblown processes. 一些工艺可能产生泡沫,而其他工艺可能不产生泡沫;然而,在任何情况下,都可设想到将所有此类实施方案与本文所公开的所有实施方案一起使用。 Some processes may produce a foam, but other processes may not produce foam; however, in any case, be contemplated that all such embodiments be used with all embodiments disclosed herein.

[0300] 在各种实施方案中,参见图44至图46,外科紧固器械的端部执行器诸如端部执行器100可被构造成能够捕获、紧固和/或切入组织。 [0300] In various embodiments, referring to FIGS. 44 to 46, an end effector of a surgical fastening instrument, such as the end effector 100 may be configured to capture, fastening and / or cut tissue. 端部执行器100可包括紧固件仓110,并且另外包括击发构件140,该击发构件可被推进穿过紧固件仓110以将可移除地储存在钉仓110内的钉部署到捕获在端部执行器100内的组织中。 End effector 100 may include a fastener cartridge 110, and further includes a firing member 140, the firing of the fastener member can be advanced through staple cartridge 110 to be removably stored within the staple cartridge 110 is deployed to capture 100 within the tissue end effector. 在各种情况下,击发构件140可从近侧位置(图44)朝端部执行器100的远侧端部推进以同时部署钉并且横切组织。 In various circumstances, the firing member 140 can (FIG. 44) toward the distal end of the end effector 100 advanced to deploy the staples and transect the tissue from the proximal position. 然而存在这样的一些情况,其中可能不需要将击发构件140朝端部执行器100的远侧端部推进。 However, there are some such cases, may not be required where the distal end portion of the firing member 140 toward end effector 100 in advance. 例如,端部执行器100的紧固件仓110可为可移除的以及/或者可替换的,在紧固件仓110不定位在端部执行器100内的情况下,对于击发构件140而言可能不需要在端部执行器100内推进。 For example, end effector 110 of the fastener cartridge 100 may be and / or may alternatively be removable, and in the case where the fastener cartridge 110 is not positioned within the end effector 100, to firing member 140 made may not require advanced within end effector 100. 在击发构件140被推进穿过端部执行器100而无需紧固件仓定位在端部执行器100内的情况下,击发构件140的刀刃142可切入捕获在端部执行器100内的组织而无需同时紧固组织。 In the case where the end effector 100 without the fastener cartridge is positioned within the end effector 100 is advanced through the firing member 140, the firing member can be cut edges 142,140 tissue captured in end effector 100 and At the same time you do not need to fasten tissue. 类似地,在定位在端部执行器100内的紧固件仓已被预先使用,或延伸,并且紧固件中的至少一些已从紧固件仓部署的情况下,对于击发构件140而言可能不需要在端部执行器100内推进。 Similarly, the positioning has been previously used within the end effector 100 of the fastener cartridge, or extend, at least in some cases and the fastener from the deployed fastener cartridge, for purposes of firing member 140 may not require advanced within end effector 100. 在击发构件140被推进穿过端部执行器100同时预先延伸的紧固件仓定位在端部执行器100内的情况下,击发构件140的刀刃142可切入捕获在端部执行器内的组织而无需同时紧固组织。 In the case where the fastener cartridge 100 while the end effector extending pre-positioned within the end effector 100 is advanced through the firing member 140, the firing member can be cut into the cutting edge 142,140 to capture tissue within the end effector at the same time without having to fasten tissue. 在各种实施方案中,端部执行器100可包括一个或多个锁定系统,当紧固件仓不存在于端部执行器100内时以及/或者当定位在端部执行器100内的紧固件仓已至少部分地延伸时,该锁定系统可防止击发构件140朝远侧推进。 In various embodiments, end effector 100 may include one or more locking systems, when the fastener cartridge 100 is not present in the end effector, and / or when positioned within the end effector 100 immediately firmware cartridge has been partially extends, at least the locking system prevents the firing member 140 is advanced distally. 各种锁定系统在名称为“SURGICALSTAPLING INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT” 并且公布于2006年I 月24 日的美国专利6 ,988 ,649中有所公开。 Various locking systems in the name of "SURGICALSTAPLING INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT" and in 2006 I published May 24, US Patent 6, 988, 649 are disclosed. 名称为“SURGICAL STAPLING INSTRUMENT HAVING ASPENT CARTRIDGE LOCKOUT”的美国专利6,988,649的全部公开内容以引用方式并入本文。 The name "SURGICAL STAPLING INSTRUMENT HAVING ASPENT CARTRIDGE LOCKOUT" the entire disclosure of US Patent 6,988,649 is incorporated by reference herein.

[0301] 再次参见图44至图46,紧固件仓110可包括仓体和组织厚度补偿件120,其中对上文进行进一步描述,组织厚度补偿件120可抵靠由端部执行器100通过可移除地储存在仓体内的紧固件捕获的组织植入。 [0301] Referring again to FIGS. 44 to 46, the fastener cartridge 110 may include a cartridge body 120 and a tissue thickness compensator, wherein further to the above, the tissue thickness compensator 120 abut against the end effector 100 by removably stored in the cartridge body tissue fastener implantation captured. 组织厚度补偿件120可定位在仓体的顶部表面或平台上面,其中可移除地储存在限定于仓体中的钉腔内的钉180可由例如击发构件(诸如滑动件130和/或击发构件140)从钉腔射出。 Tissue thickness compensator 120 may be positioned on the top surface of the cartridge body or platform above, wherein the staples removably stored in the cartridge body 180 defines a cavity may be formed, for example, a staple firing member (such as 130 and / or firing member slider 140) emitted from the staple cavities. 在某些实施方案中,紧固件仓110还可包括驱动器,该驱动器被构造成能够支撑钉180并且传递滑动件130到钉180的运动,以便使钉180在未击发位置和击发位置之间运动。 In certain embodiments, the fastener cartridge 110 may further include a driver, the driver is configured to support a staple 180 and transmits the movement of the slider 130 of the staple 180, so that the staples 180 in the unfired position and a fired position motion. 在各种情况下,当钉180处于其未击发位置中时,钉180可至少部分地嵌入组织厚度补偿件120中,而在某些情况下,当钉180处于其未击发位置中时,钉180可将组织厚度补偿件120保持在仓平台上方的适当位置中。 In each case, when the staples 180 in their unfired position, the staple 180 may be at least partially embedded tissue thickness compensator 120, and in some cases, when the staples 180 in their unfired position, the staple 180 may be tissue thickness compensator 120 is held in place above the platform of the cartridge. 在将钉180部署到组织中之前,在组织厚度补偿件120相对于仓体和/或钉180运动的情况下,在一些情况下,组织厚度补偿件120可使钉180相对于其优选位置运动或远离其优选位置运动。 Before deploying the staple 180 into tissue, the tissue thickness compensator 120 with respect to the case where the cartridge body member and / or staple movement 180, in some cases, the tissue thickness compensator 120 allows the staple 180 with respect to its preferred position or preferably away from its position. 此外,在钉180被部署之前,在组织厚度补偿件120从仓110移除的情况下,仓110可能不再适合于其初始预期用途。 Further, prior to the staples 180 are deployed, in a case where the tissue thickness compensator 120 is removed from the cartridge 110, the cartridge 110 may no longer be suitable for its original intended purpose. 鉴于以上所述,如下文更详细地讨论,端部执行器100可包括锁定件,该锁定件可被构造成能够在钉180被部署之前,在组织厚度补偿件120从仓体移除或者变得至少部分地从仓体脱离的情况下防止击发构件140和/或滑动件130朝远侧推进以部署钉180。 In view of the above, as discussed in more detail below, end effector 100 may include a locking member, the locking member may be configured to be, removed tissue thickness compensator 120 before the member 180 is deployed from the staple cartridge or variations have at least partially preventing the case from the cartridge body 140 from the firing member and / or slide member 130 distally advanced to deploy the staples 180.

[0302] 再次参见图44至图46,组织厚度补偿件120可包括(一)被构造成能够由钉180捕获的主体121,以及(二)从主体121延伸的锁定销122。 [0302] Referring again to FIGS. 44 to 46, a tissue thickness compensator 120 may include (a) is configured to be captured by the staple 180 of main body 121, and (ii) a locking pin 121 extending from the body 122. 在各种情况下,当组织厚度补偿件120未从仓体平台上方的合适位置移除或基本上从该位置运动时,锁定销122可包括嵌入主体121中的第一端部123和定位在击发构件140和滑动件130中间的第二端部124。 In various circumstances, when the tissue thickness compensator 120 is not removed from the appropriate position above the platform body or the cartridge substantially moves from this position, the locking pin 122 may include an embedded first end portion 123 and 121 positioned in the main body 140 and the sliding member 130 intermediate the second end portion 124 of the firing member. 在这样的位置中,锁定销122的第二端部124可定位在限定在滑动件130上的肩部或架134和从击发杆140朝远侧延伸的突起144中间。 The second end portion 124 in such a position, the locking pin 122 may be positioned on the sliding member defining a shoulder or shelf 130 and the protrusion 134 extending distally from the intermediate firing rod 140,144. 换句话讲,当锁定销122定位在滑动件130和击发杆140中间时,锁定销122和滑动件130可协作以将击发杆140支撑在限定于紧固件仓110中的锁定肩部112上方的解锁位置中,使得当远侧击发力施加到击发杆140时,击发杆140可朝远侧推进滑动件130以击发钉180。 In other words, when the locking pin 122 is positioned in the sliding member 130 and the firing rod 140 intermediate the locking pin 122 and the slide member 130 may cooperate to define a firing rod 140 is supported in the fastener cartridge 110 is locking shoulder 112 above the unlocking position, so that when a distal force applied to firing of the firing rod 140, rod 140 can advance firing member 130 slidable distally to fire the staples 180. 当组织厚度补偿件120从仓110移除并且/或者基本上从相对于仓体的所需位置脱离时,主要参见图45,锁定销122可能不再定位在滑动件130和击发构件140中间,并且/或者可能不能够将击发构件140支撑在其解锁位置(图44)中。 When the thickness of tissue compensator and / or substantially from a desired position relative to the body from the cartridge, referring primarily to FIG. 45, the locking pin 122 may not be positioned at 130 and firing member 140 intermediate the slider 120 from the cartridge 110 is removed, and / or may not be firing member 140 can be supported in its unlocked position (FIG. 44). 在此类情况下,击发构件140可变得定位在锁定位置中,使得击发构件140的远侧推进被锁定肩部112防止。 In such cases, the firing member 140 may become positioned in a locked position, such that firing member 140 distally advance the locking shoulder 112 is prevented. 在至少一种这样的情况下,端部执行器100还可包括例如被构造成能够将击发构件140偏压到其锁定状态中的偏压构件,诸如弹簧。 In at least one such case, the end effector 100 may also include, for example, is capable of firing member configured to bias the biasing member 140 to its locked state, such as a spring. 在某些情况下,偏压构件可将击发构件140偏压成例如与滑动件130接触,而无需定位在其间的锁定销122,该锁定销可包括击发构件140的锁定位置。 In some cases, the biasing member 140 can be biased into contact with the firing member and the sliding member 130, for example, without having therebetween positioned at the lock pin 122, the locking pin member may include a firing lockout position 140.

[0303] 作为以上所述的结果,如果组织厚度补偿件120过早地从仓110移除,则仓110可变得不可操作。 [0303] As a result of the above, if the tissue thickness compensator 120 prematurely removed from the cartridge 110, the cartridge 110 may become inoperable. 在此类情况下,锁定销122可包括熔线,在击发构件140朝远侧推进之前,在组织厚度补偿件120被移除的情况下,该熔线使仓110停用。 In such cases, the locking pin 122 may include a fuse, prior to advance firing member 140 distally, in the case where the tissue thickness compensator 120 is removed, so that the fuse cartridge 110 is disabled. 在各种情况下,锁定销122可包括键,当键定位在滑动件130和击发构件140之间时,该键将仓110维持在解锁状态中,并且在击发构件140朝远侧推进之前,S卩,在击发构件140开始其击发行程之前,在组织厚度补偿件120从仓110移除的情况下允许仓110进入锁定状态中。 In each case, the locking pin 122 may include a key, when the key is positioned between the sliding member 130 and firing member 140, the key cartridge 110 is maintained in the unlocked state, and prior to firing member 140 is advanced distally, S Jie, prior to firing member 140 starts its firing stroke, the tissue thickness compensator 120 allows the cartridge 110 from the locked state into the cartridge case 110 removed. 当击发构件140处于其锁定状态中并且不能朝远侧推进时,击发构件140的刀刃142不能切入捕获在端部执行器100内的组织。 When the firing member 140 is in its locked state and can not be advanced distally, firing member 140 of the blade 142 can cut tissue captured in end effector 100. 此外,在此类情况下,击发构件140不能将滑动件130朝远侧推进以击发钉180。 Further, in such cases, the firing member 140 can not slide member 130 distally advance the staples 180 to fire. 因此,当组织厚度补偿件120未定位在或未适当地定位在仓110上时,组织厚度补偿件锁定件可防止捕获在端部执行器100内的组织被切入和缝合。 Therefore, when the tissue thickness compensator 120 is not properly positioned or is positioned in the cartridge 110, the tissue thickness compensator prevents the locking member to capture tissue within the end effector 100 is cut and sewn. 在组织厚度补偿件120被移除或脱离之前,在击发构件140朝远侧推进的情况下,击发构件140可完成端部执行器100的击发行程或其击发行程的至少一部分。 Before tissue thickness compensator 120 is removed or disengaged, when the firing member 140 is advanced distally, the firing stroke of firing member 140 can be completed end effector 100, or at least a portion of the firing stroke. 在此类情况下,滑动件130朝远侧推进,使得限定在滑动件130上的一个或多个斜坡132可提升钉180,并且击发构件140的刀刃142可切入组织厚度补偿件120和/或捕获在端部执行器100内的组织。 In such a case, the slide member 130 is advanced distally, such that the defined one or more ramps 130 slide member 132 may be lift pin 180, and firing member can be cut edges 142,140 tissue thickness compensator 120 and / or tissue captured in end effector 100. 在一些情况下,击发构件140可接触锁定销122并且在击发构件140朝远侧推进时使其移位离开。 In some cases, the firing member 140 may contact and displacing the locking pin 122 when firing member 140 away from advanced distally. 在此类情况下,锁定销122可为柔性的。 In such cases, the locking pin 122 may be flexible. 在各种情况下,锁定销122可由例如可生物吸收的材料和/或生物相容性材料构成。 In each case, the locking pin 122 may be formed of a material such as bioabsorbable and / or biocompatible material. 在某些情况下,击发构件140可在击发构件140朝远侧推进时切入锁定销122。 In some cases, the firing member 140 may be cut into the locking pin 122 when firing member 140 is advanced distally. 在任何情况下,一旦击发构件140已至少部分地推进,锁定销122的目的可能变得过时。 In any case, once the firing member 140 has been at least partially forward, the purpose of the locking pin 122 may become outdated. 换句话讲,组织厚度补偿件锁定件可用作初始检查以验证组织厚度补偿件存在于端部执行器内,并且一旦已完成初始检查,便可进行端部执行器的击发行程。 In other words, tissue thickness compensator locking member may be used as an initial check to verify that the firing stroke tissue thickness compensator member is present in the end, and once the initial check has been completed, can be an end effector.

[0304] 再次参见图47至图50,端部执行器200可包括砧座260,并且另外包括紧固件仓210,该紧固件仓包括仓体214和组织厚度补偿件220,其中对上文进行进一步描述,组织厚度补偿件220可抵靠由端部执行器200通过可移除地储存在仓体214内的紧固件捕获的组织植入。 [0304] Referring again to FIG. 47 to FIG. 50, the end effector 200 can include anvil 260 and cartridge 210 further includes a fastener, the fastener cartridge comprises a cartridge body 214 and the tissue thickness compensator 220, in which the be further described herein, the tissue thickness compensator 220 abut against the implant 200 by the end effector is removably stored within the tissue fastener cartridge body 214 captured. 组织厚度补偿件220可定位在仓体214的顶部表面或平台211上面,其中可移除地储存在限定于仓体214中的钉腔内的钉可由例如击发构件(诸如滑动件230和/或击发构件240)从钉腔射出。 Tissue thickness compensator 220 may be positioned on the top surface of the cartridge body 214 or the internet 211 above, wherein the removable member, for example, the firing may be stored in the cartridge body 214 defines a staple staple cavity (such as a slide member 230, and / or firing member 240) emitted from the staple cavities. 在某些实施方案中,紧固件仓210还可包括驱动器,该驱动器被构造成能够支撑钉并且传递滑动件230到钉的运动,以便使钉在未击发位置和击发位置之间运动。 In certain embodiments, the fastener cartridge 210 may further include a driver, the driver is configured to support a staple 230 and slide into the staple transfer movement, so that the staple firing position and movable between an unfired position. 在各种情况下,当钉处于其未击发位置中时,钉可至少部分地嵌入组织厚度补偿件220中,而在某些情况下,当钉处于其未击发位置中时,钉可将组织厚度补偿件220保持在适当位置中。 In each case, when the staples are in their unfired position, the staple may be at least partially embedded tissue thickness compensator 220, and in some cases, when the staples are in their unfired position, the staple can be tissue thickness compensator 220 is held in place. 在将钉部署到组织中之前,在组织厚度补偿件220相对于仓体214和/或钉运动的情况下,在一些情况下,组织厚度补偿件220可使钉相对于其优选位置运动或远离其优选位置运动。 Before deploying staples into tissue, in the case where the tissue thickness compensator 220 with respect to the cartridge body 214 and / or staple movement, in some cases, the tissue thickness compensator 220 allows the staple to its preferred position relative to or away from preferred position. 此夕卜,在钉被部署之前,在组织厚度补偿件220从仓210移除的情况下,仓210可能不再适合于其初始预期用途。 Bu this evening, before the staples are deployed, in a case where the tissue thickness compensator 220 is removed from the cartridge 210, the cartridge 210 may no longer be suitable for its original intended purpose. 鉴于以上所述,如下文更详细地讨论,端部执行器200可包括锁定件,该锁定件可被构造成能够在钉被部署之前,在组织厚度补偿件220从仓体214移除或者变得至少部分地从仓体脱离的情况下防止击发构件240和/或滑动件230朝远侧推进以部署钉。 In view of the above, as discussed in more detail below, end effector 200 may include a locking member, the locking member may be configured to be before the staples are deployed, the tissue thickness compensator 220 in the cartridge body 214 is removed or changed from have at least partially preventing the case from the cartridge body 240 from the firing member and / or slide member 230 distally advanced to deploy the staples.

[0305] 再次参见图44至图46,组织厚度补偿件220可包括(一)被构造成能够由钉捕获的主体221,以及(二)从主体221延伸的环或拴系件222。 [0305] Referring again to FIGS. 44 to 46, a tissue thickness compensator 220 may include (a) the body is configured to be able to be captured by the staple 221, and (ii) a ring extending from the body 221 or tether 222. 在各种情况下,主要参见图47,环222可包括至少部分地嵌入主体221中的端部以及在端部之间延伸的可与滑动件230可释放地接合的中间部分。 In each case, referring primarily to FIG. 47, the ring 222 may include at least partially embedded in an end portion of the body 221 and an end portion extending between the sliding member may be releasably engageable intermediate portion 230. 在某些情况下,环222可包括例如缝合线或柔性线。 In some cases, the ring 222 may comprise, for example, a suture or flexible wire. 在一些情况下,环222可由例如可生物吸收的材料和/或生物相容性材料构成。 In some cases, the ring 222 may be, for example, a bioabsorbable material and / or biocompatible material. 主要参见图48,滑动件230可包括纵向主体部分236、从主体部分236延伸的钩238,以及限定在主体部分236和钩238之间的狭槽237。 Referring primarily to FIG. 48, the sliding member 230 can comprise a longitudinal body portion 236, body portion 236 extending from the hook 238, and a slot defined between the body 236 and the hook portions 238,237. 如图48所示,当组织厚度补偿件220定位在仓平台211上方时,环222定位在狭槽237内,并且滑动件230和击发构件240处于未击发位置中。 48, when the tissue thickness compensator 220 when the cartridge is positioned above the platform 211, the ring 222 is positioned within the slot 237, and the slide member 230 and firing member 240 is in an unfired position. 另外如图48所示,从击发构件240延伸的远侧突起244抵靠限定在滑动件230上的支撑肩部234定位并且/或者定位在其上,该支撑肩部将击发构件240保持在解锁位置中,即保持在这样的位置中,在该位置中,当击发运动施加到击发构件240时,击发构件240的远侧运动将被限定在έ而部执彳丁器200中的锁定肩部212阻碍或至少基本上阻碍。 Also shown in Figure 48, 240 extends distally from firing member 244 abuts against the projections define a support member 230 on the slider shoulder 234 positioned and / or positioned thereon, the support shoulder firing member 240 remains in the unlocked position, i.e., held in such a position, in this position, 240 when the firing motion to the firing member, the distal movement of the firing member 240 is defined in the locking shoulder portion while executing left foot butoxy έ 200 212 at least substantially hinder or obstruct. 因此,当滑动件230将击发构件240保持在其解锁位置中时,参见图49,击发构件240将滑动经过锁定肩部212以将滑动件230朝远侧推进,击发可移除地储存在仓体214内的钉,并且用刀刃242切入组织厚度补偿件和定位在端部执行器200内的组织。 Thus, when the slide member 230 to the firing member 240 is held in its unlocked position, see FIG. 49, the firing member 240 will slide past the locking shoulder 212 to distally advance the slide member 230, the firing may be stored in a removable cartridge 214 within the staple and cut tissue thickness compensator member and positioned at the tissue within the end effector 200 with a knife edge 242. 如图49所示,当滑动件230朝远侧推进时,环222可滑动退出限定于滑动件230中的狭槽237。 As shown in FIG 49, when the slide member 230 distally advance, ring 222 slidably exit slot 237 defined in the slider 230.

[0306] 在组织厚度补偿件220从仓210移除或基本上从仓210的平台211上方的合适位置运动的情况下,现在参见图50,组织厚度补偿件220可将滑动件230朝远侧牵拉,使得击发构件240不再由滑动件230支撑。 [0306] 220 from the cartridge 210 or removed from the case where the substantially proper position above the platform 211 of the cartridge 210, referring now to FIG 50, a tissue thickness compensator 220 can slide member 230 distally tissue thickness compensator drawing, so that the firing member 240 is no longer supported by the slider 230. 更具体地,组织厚度补偿件220的定位在狭槽237内的环222可将滑动件230从其未击发位置朝远侧牵拉,使得支撑肩部234不再定位在击发构件240的远侧突起244下面。 More specifically, the positioning member 220 of the tissue thickness compensator 222 may slide within the slot 237 in the ring 230 from its unfired position pulled distally, such that no support shoulder 234 is positioned distally of the firing member 240 projection 244 below. 在此类情况下,击发构件240可向下移位到锁定位置中,其中击发构件240的远侧运动可被锁定肩部212妨碍。 In such cases, the firing member 240 may be displaced downwardly into the locking position, wherein the distal movement of the firing member 240 locking shoulder 212 may be hampered. 在某些情况下,端部执行器200还可包括可将击发构件240偏压到其锁定状态中的偏压构件,诸如弹簧。 In some cases, the end effector 200 may also include a firing member 240 may be biased to its locked state of the biasing member, such as a spring. 当击发构件240处于其锁定状态中时,击发构件240不能朝远侧运动以推进滑动件230,将钉从仓体210击发,以及/或者切入捕获在端部执行器200内的组织。 When the firing member 240 is in its locked state, the firing member 240 can not be moved distally to advance the slide member 230, the staple cartridge body 210 from the firing, and / or cut tissue captured in end effector 200. 虽然当组织厚度补偿件220从仓210移除时滑动件230可朝远侧推进,但在各种情况下,滑动件230可能不会充分地推进以从仓210部署钉。 The sliding member 230 can be advanced distally Although the compensator 220 when the thickness of the tissue removed from the cartridge 210, but in each case, the slider 230 may not be sufficiently advanced to deploy the staples from the cartridge 210. 当外科器械的使用者认识到击发构件240处于锁定状态中时,使用者可将钉仓210从端部执行器200移除并且将其替换为例如钉仓210,其中组织厚度补偿件220正确定位在平台211上方并且滑动件230尚未从其未击发位置朝远侧推进。 When the user of the surgical instrument to recognize the firing member 240 is in the locked state, the user can remove the cartridge 210 from the end effector 200 and replace the staple cartridge 210, where the tissue thickness compensator 220 is properly positioned above the platform 211 and the slider 230 from its unfired position has not been advanced distally. 可以设想到其他实施方案,其中钉仓不可从端部执行器移除,在此类实施方案中,在组织厚度补偿件从钉仓移除并且/或者击发构件进入锁定状态中的情况下,端部执行器可被完全替换。 It is contemplated that other embodiments, in which the cartridge is not removed from the end effector, in such embodiments, the tissue thickness compensator member is removed from the staple cartridge and / or the firing member into the locked state, the end of effector may be completely replaced.

[0307] 现在转到图51至图53,钉仓310可包括仓体314和可动地定位在仓体314内的滑动件330。 [0307] Turning now to FIGS. 51 through 53, staple cartridge 310 may include a cartridge body 314 and may be movably positioned within the cartridge body 314 of the sliding member 330. 类似于上文,仓体314可包括例如多个紧固件腔,诸如紧固件腔316,以及例如限定在其中的纵向狭槽,诸如刀狭槽318。 Similar to the above, the cartridge body 314 may comprise a plurality of fasteners, for example, chambers, such as a fastener cavity 316, and, for example a longitudinal slot defined therein, such as a knife slot 318. 滑动件330可包括可滑动地定位在刀狭槽318内的中心主体部分336以及从中心主体部分336延伸的钩338。 The sliding member 330 can include a center body slidably positioned within the knife slot 318 and a hook portion 336 extending from the central body 338 portion 336. 主要参见图51,仓310的组织厚度补偿件320可包括主体部分321以及从主体部分321延伸的扣件322,其中当滑动件330处于其未击发或未推进位置中时,扣件322可以可释放地保持在限定于钩338和中心主体部分336之间的狭槽337中。 Referring primarily to FIG. 51, a tissue thickness compensator 320 of the cartridge 310 may include a body portion 321 and a fastener 321 extending from the body portion 322, wherein when the slider 330 is in its unfired or advanced position, the fastener 322 may be releasably retained in the slots 337 defined between the hook portion 336 and 338 of the central body. 类似于上文,扣件322可包括安装在主体321内的端部323并且可从组织厚度补偿件320的主体321朝近侧延伸,其中在例如组织厚度补偿件320从仓体314移除的情况下,扣件322可将滑动件330朝远侧牵拉,使得限定在中心主体部分336中的支撑肩部334不再能够在其上支撑击发构件(诸如击发构件240),并且使得击发构件可进入锁定状态。 Similar to the above, fastener 322 may include an end portion mounted within the body 321 of the body 323 and is available from the thickness 321 of compensator 320 extends proximally tissue, such as tissue thickness compensator which member 320 is removed from the cartridge body 314 case, the fastener 322 may pull the slide member 330 distally, such that the central body portion 336 defined in the support shoulder 334 is no longer capable of supporting thereon a firing member (such as the firing member 240), and such that the firing member You may enter the locked state. 在各种情况下,外科器械的使用者可尝试将组织厚度补偿件320重新组装或重新定位在仓体314的平台311上方;然而,由于组织厚度补偿件320的重新定位将不会重置滑动件330,所以击发构件340将仍保持在锁定状态中。 In each case, the user may attempt a surgical instrument tissue thickness compensator 320 re-assembly or re-position over the platform 314 of the cartridge body 311; however, since the thickness of the tissue repositioning compensator 320 will not reset slide 330, the firing member 340 will remain in the locked state. 因此,此类布置可防止仓310在其已被篡改的情况下被使用。 Thus, such an arrangement prevents the cartridge 310 is used in a case where it has been tampered with.

[0308] 在各种情况下,再次参见图51至图53,从滑动件330和/或狭槽337的中心部分336延伸的限定在其间的钩338的至少一部分可延伸到平台311上方。 [0308] In each case, referring again to FIGS. 51 to 53, from the center of the sliding member 330 and / or slots 337 may be defined extending portion 336 extends upward to the platform 311 at least a portion of the hook 338 therebetween. 在某些情况下,从滑动件330和/或狭槽337的中心部分336延伸的限定在其间的钩338的至少一部分可延伸到刀狭槽318上方。 In some cases, the center of the sliding member 330 and / or slots 337 defined therebetween over at least a portion of the hook 338 may extend into the knife slot 318 extending portion 336. 在此类实施方案中,当组织厚度补偿件320被组装到仓体314时,扣件322可易于滑动到狭槽337中。 In such embodiments, when the tissue thickness compensator 320 to 314 is assembled, fastener cartridge body 322 may slide easily into the slot 337. 在某些情况下,扣件322可定位在仓体314的平台表面311上方或抵靠其定位。 In some cases, the fastener 322 may be positioned above the platform surface 314 or 311 against the cartridge body positioned. 在各种情况下,主要参见图53,仓体314可包括限定在其中的凹陷部或凹坑319,当滑动件330处于其未击发或未推进位置中时,钩338可定位在所述凹陷部或凹坑内。 In each case, referring primarily to FIG. 53, the cartridge 314 may include a recess defined therein or recesses 319, when the slide member 330 or advancing in their unfired position, the hooks 338 may be positioned in the recess the inner portion or pit. 在这样的实施方案中,钩338的顶部可被定位在平台表面311下方。 In such an embodiment, the top of the hooks 338 may be positioned below the platform surface 311. 在各种情况下,凹坑319还可包括限定在凹坑319的远侧端部中的一个或多个倾斜表面313,并且从平台表面311向下延伸。 In each case, it may further include a dimple 319 defines a dimple at the distal end 319 or more inclined surfaces 313 and 311 extending downwardly from the platform surface. 在一些情况下,当滑动件330朝远侧推进时,扣件322可邻接倾斜表面313,在此类情况下,钩338然后可与扣件322分离。 In some cases, when the slide member 330 distally advance, fastener 322 may be inclined abutment surface 313, in such a case, the hooks 338 may then be separated from the fastener 322. 在各种情况下,凹陷部319可被构造成能够有利于在组织厚度补偿件320被组装到仓体314时将扣件322组装到滑动件330。 In each case, the recessed portion 319 may be configured to be able to facilitate tissue thickness compensator 320 is assembled to the cartridge body 314 when the fastener 322 is assembled to the slider 330. 在各种实施方案中,狭槽337可纵向地延伸并且可包括闭合的远侧端部和开放的近侧端部,其中扣件322可从开放的近侧端部滑动到狭槽337中。 In various embodiments, the slot 337 may extend longitudinally and may include a distal end and an open proximal end closed, wherein the slidable fastener 322 from the open proximal end 337 into the slot. 在组织厚度补偿件320没有过早地从仓314移除或脱离的情况下,滑动件330可朝远侧推进,使得扣件322穿过其远侧端部离开狭槽337并且使得限定在滑动件330上的斜坡332可将钉从钉仓310射出。 In the case where the tissue thickness compensator 320 does not prematurely removed or disengaged from the cartridge 314, the sliding member 330 can be advanced distally, such that the fastener 322 passes through the distal end thereof away from the slot 337 in the slide and is defined such that 332 on the ramp member 330 may be emitted 310 staples from the staple cartridge.

[0309] 在各种情况下,可使用至少一种粘合剂将组织厚度补偿件粘附到滑动件。 [0309] In each case, the adhesive may be used at least one member is adhered to the tissue thickness compensator slide. 在此类情况下,组织厚度补偿件和滑动件之间的粘合剂附接可足够强以允许组织厚度补偿件在组织厚度补偿件从仓移除的情况下将滑动件朝远侧牵拉。 In such cases, the adhesive attachment between tissue thickness compensator contact member and the slider can be strong enough to allow the tissue thickness compensator element in the case where the tissue thickness compensator removed from the cartridge will pull the slide member distally . 当滑动件被击发构件朝远侧推进作为击发行程的一部分时,组织厚度补偿件和滑动件之间的粘合剂附接可能失败,从而允许滑动件相对于组织厚度补偿件朝远侧滑动。 When the slider member is advanced distally fired as part of the firing stroke, the adhesive attachment between tissue thickness compensator contact member and the slider may fail, thereby allowing the slide member relative to the tissue thickness compensator slide distally. 在各种情况下,组织厚度补偿件可使用热熔接工艺和/或热成形工艺结合到滑动件。 In various circumstances, tissue thickness compensator using thermal fusion process and / or thermoforming processes bound to the slider. 在此类情况下,组织厚度补偿件和滑动件之间的结合可足够强以允许组织厚度补偿件在组织厚度补偿件从仓移除的情况下将滑动件朝远侧牵拉。 In such cases, the bond between the tissue thickness compensator member and the slider can be strong enough to allow the tissue thickness compensator element in the case where the tissue thickness compensator removed from the cartridge will pull the slide member distally. 当滑动件被击发构件朝远侧推进作为击发行程的一部分时,组织厚度补偿件和滑动件之间的结合可能失败,从而允许滑动件相对于组织厚度补偿件朝远侧滑动。 When the slider member is advanced distally fired as part of the firing stroke, the thickness of the bond between the tissue and the slide member compensator may fail, thereby allowing the slide member relative to the tissue thickness compensator slide distally.

[0310] 在一些情况下,例如,环、扣件和/或标签可与组织厚度补偿件一体形成。 [0310] In some cases, e.g., rings, fasteners and / or tags may be formed integrally with the tissue thickness compensator. 在各种情况下,例如,环、扣件和/或标签可包括与组织厚度补偿件一体的材料。 In various circumstances, e.g., rings, fasteners and / or integrally with the tag may include tissue thickness compensator material. 在一些情况下,可将附加的层附接到组织厚度补偿件。 In some cases, additional layers may be attached to the tissue thickness compensator. 在各种情况下,该层可包括与滑动件接合的安装部分。 In each case, the layer may include a mounting portion engaged with the sliding member.

[0311] 现在转到图54,类似于上文,滑动件430可包括中心主体部分436,并且另外包括多个斜坡432,所述斜坡被构造成能够例如将可移除地储存在仓体内的钉射出。 [0311] Turning now to FIG. 54, similar to the above, the sliding member 430 may include a central body portion 436, and further includes a plurality of ramp 432, the ramp is configured to be removable, for example, stored in the cartridge body nail shot. 同样类似于上文,主体部分436可包括从其延伸的钩438,其中狭槽437可限定在主体部分436和钩438之间。 Also similar to the above, the body 436 may include a hook portion 438 extending therefrom, wherein the slot may be defined between portion 437 and a hook 438 on the body 436. 在某些情况下,狭槽437可包括闭合的远侧端部437a和开放的近侧端部437d。 In some cases, the slots 437 may include a closed distal end 437a and an open proximal end portion 437d. 在各种情况下,狭槽437还可包括沿第一方向延伸的第一部分437b以及沿第二方向延伸的第二部分437c。 In each case, it may further include a slot 437 extending in a first direction along a first portion and a second portion 437b 437c extending in a second direction. 在某些情况下,第一部分437b可沿纵向轴线延伸并且第二部分437可沿横向于纵向轴线的第二轴线延伸。 In some cases, the first portion 437b may extend along a longitudinal axis and a second portion 437 extending along a second axis transverse to the longitudinal axis. 在至少一种此类情况下,第二部分437c可相对于第一部分437b成角度延伸。 At least one such case, the second portion 437c relative to the first portion 437b extends at an angle.

[0312] 现在转到图55至图58,滑动件组件530可包括第一部分535,并且另外包括第二部分536,该第二部分可相对于第一部分535在解锁位置(图55和图57)和锁定位置(图56和图58)之间运动。 [0312] Turning now to FIGS. 55 to FIG. 58, the slide assembly 530 may include a first portion 535, and further includes a second portion 536, the second portion is movable relative to the first portion 535 in the unlocked position (FIGS. 55 and 57) and a locking position (FIGS. 56 and 58) between the movement. 第一部分535可包括(一)被构造成能够在纵向狭槽(诸如限定在钉仓510中的刀狭槽518)内滑动的中心部分,以及(二)被构造成能够将可移除地储存在仓510内的钉射出的多个斜坡532。 The first portion 535 may include (a) is configured to be in a longitudinal slot (knife slot 510 in staple cartridge 518 such as defined) slidable within the central portion, and (ii) capable of being configured to removably store 510 within the staple cartridge 532 emitted from the plurality of ramps. 第一部分535的中心部分可包括限定在其中的第一狭槽533a和第二狭槽533b。 A central portion 535 may include a first portion defining therein a first slot 533a and second slot 533b. 第一狭槽533a和第二狭槽533b可被构造成能够接收分别从第二部分536延伸的销531a和531b。 A first slot 533a and second slot 533b can be configured to be able to receive a pin 531a extending from the second portion 536 and 531b. 第一销531a可被构造成能够在第一狭槽533a内滑动,并且第二销531b可被构造成能够在第二狭槽533b内滑动,以便允许第二部分536相对于第一部分535旋转。 The first pin 531a may be configured to be slidable within a first slot 533a, 531b and the second pin may be configured to be slidable within the second slot 533b, the second portion 536 so as to allow relative rotation of the first portion 535. 在各种情况下,第一销531a可紧密地接收在第一狭槽533a内,使得第一狭槽533a可约束第一销531a沿第一路径的运动,并且类似地,第二销531b可紧密地接收在第二狭槽533b内,使得第二狭槽533b可约束第二销531b沿第二路径的运动。 In each case, the first pin 531a may be closely received within a first slot 533a, 533a so that the first slot 531a may constrain movement of the first pin along the first path, and similarly, the second pin 531b may be tightly received within a second slot 533b, so that the second slot 533b may restrict movement of the second pin along a second path 531b. 主要参见图57,滑动件组件530的第二部分536可包括被构造成能够在刀狭槽518内滑动的臂,其中臂可包括限定在其近侧端部上的支撑肩部534以及限定在其远侧端部上的钩538。 Referring primarily to FIG. 57, the slide assembly 530 may include a second portion 536 configured to be slidable within knife slot 518 arm, wherein the arm may include defining at its proximal end 534 and a support shoulder defined hook 538 on its distal end. 类似于上文,支撑肩部534可被构造成能够在滑动件组件530处于近侧未击发位置中并且组织厚度补偿件220例如在仓510的平台表面511上方或抵靠其定位时将击发构件240支撑在例如解锁位置中。 Similar to above, the support shoulder 534 can be configured to be a thickness of compensator 530 in a proximal, unfired position in the tissue and the slide assembly 220 in the cartridge 510, for example, the platform surface 511 or the firing member positioned over against 240 supported, for example unlocked position. 同样类似于上文,钩538可被构造成能够可释放地保持组织厚度补偿件220的环222,使得在组织厚度补偿件220从仓体移除并且/或者基本上相对于仓体移位的情况下,环222可牵拉到第二部分536上以将第二部分536枢转到其锁定位置中,如图58所示。 Also similar to the above, the hook 538 can be configured to releasably hold the tissue thickness compensator ring members 222,220, such that the tissue thickness compensator 220 is removed from the cartridge body and / or substantially displaced with respect to the cartridge body case, the ring 222 may be pulled into the second portion 536 to second portion 536 to pivot to its locked position, shown in Figure 58. 在第二部分536的此类锁定位置中,支撑肩部534可不再支撑击发构件240的远侧突起244,并且击发构件240可向下落入其锁定位置中。 In such a second portion 536 of the locking position, the support shoulder 534 can no longer support a firing member 240 distally protrusion 244, and the firing member 240 may fall down in its locked position. 如图58所示,第二部分536到其锁定位置中的旋转可使支撑肩部534朝远侧运动并且/或者向下运动远离击发构件240。 58, the second rotating portion 536 to its locked position can support shoulder 534 to move distally and / or away from the firing member 240 moves downwardly. 同样如图58所示,击发构件240可包括从其相对侧延伸的锁541,该锁可被构造成能够在击发构件240处于其锁定位置中时邻接锁定肩部212。 Also as shown, the firing member 240 can include lock 541 extending from opposite sides, the lock 58 can be configured to be capable of firing member 240 abuts the locking shoulder 212 is in its locked position. 当击发构件240被滑动件组件530保持在其解锁位置中时,锁541可不接触锁定肩部212并且击发构件240可被推进穿过仓510。 When the firing member 240 is sled assembly 530 is held in its unlocked position, lock 541 may not contact the locking shoulder 212 and firing member 240 can be advanced through the cartridge 510.

[0313] 在各种情况下,如上所述,钉驱动滑动件的一部分可延伸到仓体的平台表面上方。 [0313] In various circumstances, as described above, the sliding portion of the staple driving member may extend above the deck surface of the cartridge body. 例如,再次参见图52和图54,例如滑动件330 (图52)的钩338和/或滑动件430的钩438可延伸到平台表面上方。 For example, referring again to FIGS. 52 and 54, such as a sliding member 330 (FIG. 52) of the hook 338 and / or the sliding member 430 hooks 438 may extend above the deck surface. 在此类情况下,钩338和/或钩438可在平台表面上方朝远侧平移,并且在一些情况下,接触抵靠平台表面定位或定位在平台表面上方的组织厚度补偿件。 In such cases, the hooks 338 and / or hooks 438 may be translated distally over the deck surface, and in some cases, the contact surface is positioned against the tissue thickness compensator or positioning platform member above the deck surface. 在某些情况下,钩338和/或钩438可将组织厚度补偿件向上提升远离仓体并且有利于将组织厚度补偿件从仓逐渐释放。 In some cases, the hook 338 and / or 438 may hook the tissue thickness compensator member is lifted upward away from the cartridge body and facilitate tissue thickness compensator gradually released from the cartridge. 例如,钩338和/或钩438可开始于组织厚度补偿件的近侧端部并且朝组织厚度补偿件的远侧端部运动,以便最初提升组织厚度补偿件的近侧端部,并且然后将其逐渐提升远离仓平台直到组织厚度补偿件的远侧端部最终提升远离仓体。 For example, a hook 338, and / or hooks 438 may begin at the proximal end of the tissue thickness compensator and the motion towards the distal end tissue thickness compensator so as to enhance the initial tissue thickness compensator proximal end member, and then which is gradually increased until the final lifting distal end tissue thickness compensator cartridge body remote from the cartridge away from the internet. 在其他情况下,如下文进一步更详细地讨论,对于滑动件的接触组织厚度补偿件的部分可能优选的是向下偏转并且/或者以其他方式在滑动件朝远侧推进时不干扰组织厚度补偿件。 In other cases, as discussed further below in more detail, for a tissue-contacting portion of the thickness of the sliding member compensator may be preferable to deflect downward and / or otherwise does not interfere with tissue when the thickness compensator slide member advanced distally pieces.

[0314] 现在转向图59和图60,钉仓610可包括仓体614、可释放地保持到仓体614的组织厚度补偿件620,以及被构造成能够纵向横贯仓体614并且射出可移除地储存在仓体中的钉的滑动件630 ο滑动件630可包括具有限定在其上的多个斜坡表面的主要主体部分635、支撑肩部634,以及从主体部分635延伸的臂636。 [0314] Turning now to FIGS. 59 and 60, staple cartridge 610 may include a cartridge body 614, to releasably hold the tissue thickness compensator 614 of the cartridge body 620, and is configured to longitudinally traverse the cartridge body 614 and exits the removable slide stored in the cartridge body 630 of the nail 630 may include o slider 634, and an arm having a plurality of ramp surfaces defined on the main body portion 635, a support shoulder extending from the body portion 635,636. 在各种情况下,臂636可被组装到主要主体部分635。 In each case, the arm 636 may be assembled to the main body portion 635. 例如,臂636可包括例如嵌入主要主体部分635中的第一端部以及包括钩638的第二端部。 For example, the arm 636 may comprise, for example, embedded in the first end portion of the main body portion 635 and includes a second end portion 638 of the hook. 在各种情况下,臂636可包括从主要主体部分635延伸的悬臂梁。 In each case, the arm 636 may include a cantilever beam extending from the main body portion 635. 在某些情况下,臂636可由例如弹性和/或柔性的材料构成。 In some cases, the resilient arm 636 may be formed, for example, and / or flexible material. 类似于上文,狭槽637可限定在钩638和臂636之间,其可被构造成能够在滑动件630处于其近侧未击发位置中时可释放地保持组织厚度补偿件620的一部分。 Similar to the above, the slot 637 may be defined between the hook 638 and the arm 636, which can be configured to be releasably 630 at its proximal, unfired position in the holding portion of the tissue thickness compensator 620 in the slide member. 例如,在组织厚度补偿件620被拉离仓体614的情况下,组织厚度补偿件620可将滑动件630朝远侧牵拉远离击发构件,使得击发构件进入到锁定状态中。 For example, the tissue thickness compensator 620 is pulled away from the case of the cartridge body 614, tissue thickness compensator 620 may pull the slide member 630 distally away from the firing member, such that the firing member into the locked state.

[0315] 在各种情况下,对上文进行进一步描述,臂636的至少一部分(诸如钩638)可延伸到仓体614的平台表面611上方。 [0315] In various circumstances, further to the above described, at least a portion of the arm 636 (such as a hook 638) may extend above the deck surface 614 of the cartridge body 611. 在某些情况下,当滑动件630处于其近侧位置(图59)中时,臂636可与例如从组织厚度补偿件620延伸的环接合,并且在滑动件630朝远侧推进时,臂636可与环脱离接合。 In some cases, when the slide member 630 is in its proximal position (FIG. 59), the arms 636 may be engaged with the ring, for example, extending from the tissue thickness compensator 620, the sliding member 630 and advanced distally, the arms 636 may be disengaged from the ring. 在滑动件630朝远侧推进时,在某些情况下,臂636可接触组织厚度补偿件620的主体部分621并且向下挠曲。 When the slide member 630 distally advance, in some cases, the arm portion 636 may contact the body tissue thickness compensator 621 and 620 deflect downwardly. 在各种情况下,在滑动件630朝远侧推进时,偏转的臂636可在限定于仓体614中的纵向刀狭槽618内滑动。 In each case, the sliding member 630 when advanced distally, the deflection arms 636 can slide within the cartridge body 614 to define a longitudinal knife slot 618. 在一些情况下,参见图60,纵向狭槽618的远侧端部可由鼻壁或屋顶619限定,其中当滑动件630到达仓610的远侧端部617时,臂636可在鼻壁619下面滑动,使得端部执行器的击发行程可完成。 In some cases, referring to FIG. 60, a distal end portion of the longitudinal slot 618 may be defined nasal wall or roof 619, wherein when the distal end portion 610 of the cartridge 630 reaches the sliding member 617, the arm 636 may be below the nasal wall 619 slide, so that the end of the firing stroke may be completed. 在一些情况下,臂636可能不通过组织厚度补偿件620向下偏转或基本上向下偏转,其中当臂636到达纵向狭槽618的端部时,臂636可接触鼻壁618并且向下挠曲以便在其下滑动,如图60所示。 In some cases, the arm 636 may be deflected downwardly or substantially not deflected downwardly by tissue thickness compensator 620, wherein when the arm 636 reaches the end of longitudinal slot 618, the arm 636 may contact the nasal wall 618 and downwardly flexible Qu for sliding under it, as shown in FIG 60. 在各种情况下,作为结果,柔性臂636可允许击发行程完成并且滑动件630停放在仓的远侧端部处。 In various circumstances, as a result, the flexible arms 636 may allow a firing stroke is completed and the slider parked at the distal end 630 of the cartridge.

[0316] 现在转到图61,滑动件诸如滑动件组件730例如可包括主要主体部分735和可动臂736。 [0316] Turning now to FIG. 61, the sliding member such as a slide assembly 730 may comprise, for example, the main body portion 735 and the movable arm 736. 类似于上文,主要主体部分735可包括一个或多个钉驱动斜坡732以及被构造成能够将击发构件支撑在解锁位置中的支撑肩部734,如上所述。 Similar to the above, the main body portion 735 may include one or more staple drivers 732, and the ramp is configured to be supported in a firing member in the unlocking position support shoulder 734, as described above. 臂736可包括第一端部和第二端部,该第一端部可枢转和/或可旋转地安装到主要主体部分735,该第二端部包括被构造成能够与组织厚度补偿件可释放地接合的钩738,如上所述。 Arm 736 may comprise a first end and a second end, the first end portion pivotably and / or rotatably mounted to main body portion 735, the second end portion can be configured to include a tissue thickness compensator releasably engageable hook 738, as described above. 当滑动件组件730朝远侧推进时,钩738可从组织厚度补偿件分离;然而,钩738的上部表面可保持与组织厚度补偿件的底部表面接触。 When the slider assembly 730 is advanced distally, the hook 738 can be isolated from the tissue thickness compensator; however, the upper surface of the hook 738 may be held in contact with the bottom surface of the tissue thickness compensator. 在此类情况下,臂736可例如向下枢转到刀狭槽318中,以便在组织厚度补偿件下面滑动。 In such a case, the arm 736 may be pivoted down, for example, the knife slot 318 so as to slide in the tissue thickness compensator below. 更具体地,臂736可从升高或凸起的最上面位置(图61)枢转到降低或凹陷的位置。 More specifically, the arm 736 may (FIG. 61) pivoted to the lowered position from a raised or recessed or raised in the uppermost position. 在各种情况下,滑动件组件730还可包括例如被构造成能够将臂736偏压到其凸起位置中的弹性偏压构件,诸如弹簧731。 In each case, the slide assembly 730 may further comprise, for example, the arm is configured to be resilient biasing member 736 biased to its raised position, such as a spring 731. 当臂736已向下旋转到其降低位置中时,弹簧731可向臂736施加偏压力,该臂被传递到组织厚度补偿件中。 When the arm 736 has been rotated to the downward position, the spring 731 may apply a biasing force to arm 736 that reduces the thickness of the arm is transmitted to the tissue in the compensator. 在某些情况下,弹簧731可被定位在臂736和限定在主要主体部分735上的框架部分733中间。 In some cases, the spring 731 can be positioned intermediate arm portions 733 and 736 defined on the main body portion 735 of the frame. 在各种情况下,弹簧731可包括例如从臂736延伸的悬臂弹簧或片簧。 In each case, the spring 731 may comprise a cantilever spring or a leaf spring extending from the arm 736 for example. 当臂736向下推动时,悬臂弹簧可被构造成能够沿例如框架部分731挠曲和/或滑动。 When the arm 736 is pushed down, the cantilever spring may be configured to be along the frame portion 731, for example, flexing and / or sliding. 在各种实施方案中,主要主体部分735还可包括例如止动肩部739,该止动肩部可限制臂736的向上旋转或行进。 In various embodiments, the main body portion 735 may further comprise, for example, stop shoulder 739, the stop shoulder or to limit the upward travel of the rotary arm 736. 在任何情况下,类似于上文,臂736可被构造成能够在其接触屋顶619并且允许击发行程完成时向下旋转。 In any case, similar to the above, the arm 736 can be configured to be in contact with the roof 619 and permit its rotation downward stroke of the firing is completed.

[0317] 在各种情况下,钉可包括基部以及从基部延伸的一个或多个腿。 [0317] In various circumstances, the staples can include a base and one or more legs extending from the base. 在某些情况下,钉可包括具有第一端部和第二端部的基部、从第一端部延伸的第一腿,以及从第二端部延伸的第二腿。 In some cases, the staples can include a base having a first end and a second end portion, a first leg extending from the first end portion, and a second leg extending from the second end portion. 在一些情况下,钉可由包括第一腿、基部和第二腿的连续线形成。 In some cases, the staple may include a first leg, a second leg and a base portion formed of a continuous line. 连续线的第一端部可包括第一钉腿的尖端,并且连续线的第二端部可包括第二钉腿的尖端。 The first end portion may include a continuous wire tip of first leg and the second end portion may comprise continuous lines tip of the second staple leg. 一个此类钉,即钉800示于例如图62中。 Such a nail, i.e. the staple 800 shown in FIG. 62 for example. 钉800可包括基部802、从基部802的第一端部延伸的第一钉腿804,以及从基部802的第二端部延伸的第二钉腿804。 A staple 800 may include a base 802, a first leg extending from the first end portion 802 of the base 804, and a second leg extending from the second end portion 802 of the base 804. 第一钉腿804可包括第一尖端806,并且类似地,第二钉腿804可包括第二尖端806。 The first leg 804 may include a first tip 806, and similarly, the second leg 804 may include a second tip 806. 在各种情况下,尖端806可被构造成能够穿透组织,诸如示于例如图62中的组织T。 In each case, the tip 806 may be configured to be able to penetrate tissue, such as shown in FIG. 62, for example, the tissue T. 在一些情况下,尖端806可为锋利的,并且可通过例如模压工艺来形成。 In some cases, the sharp tip 806 may be, for example, and may be formed by a molding process. 在各种实施方案中,线可由例如钛和/或不锈钢构成。 In various embodiments, the line may be formed such as titanium and / or stainless steel.

[0318] 在各种实施方案中,钉800例如在其处于其未成形构型中时可为U形形状或至少基本上U形形状的。 [0318] In various embodiments, the staples 800 may be, for example, it is in a U-shape, or at least substantially U-shaped configuration in its unformed. 在此类实施方案中,钉800的腿804可彼此平行或至少基本上彼此平行。 In such embodiments, the legs 804 of the staples 800 may be parallel or at least substantially parallel to each other. 此夕卜,在此类实施方案中,腿804可垂直于或者至少基本上垂直于基部802。 Bu this evening, in such embodiments, the legs 804 may be perpendicular or at least substantially perpendicular to the base 802. 在某些实施方案中,钉800例如在其处于其未成形构型中时可为V形形状或至少基本上V形形状的。 In certain embodiments, the staples 800 may be for example, it is at least substantially V-shape or V-shape in its unformed configuration. 在此类实施方案中,钉800的腿804不是彼此平行的;相反,腿804可沿非平行方向延伸。 In such embodiments, the staple legs 800 to 804 are not parallel to each other; the contrary, the legs 804 may extend in non-parallel directions. 此外,在此类实施方案中,腿804中的一个或两个不垂直于基部802,其中腿804中的一个或两个可沿倾斜于基部802的方向延伸。 Further, in such embodiments, the legs 804, one or two non-perpendicular to the base 802, wherein one or both of the legs 804 may be inclined along the extending direction of the base 802. 在各种情况下,腿804可相对于钉的中心或中线向外延伸或张开。 In each case, the legs 804 may extend or flared outwardly relative to the center or midline of the staple. 在任何情况下,钉800可以可移除地储存在钉仓内,从钉仓射出以刺透组织,如图62所示,然后接触定位在组织的相对侧上的砧座。 In any case, the staples 800 can be removably stored within a staple cartridge, emitted from the staple cartridge to pierce tissue, as shown in FIG. 62, and the contact is positioned on the opposite side of the anvil tissue. 砧座可被构造成能够使钉800变形成任何合适的形状,诸如B形式构型,例如同样如图62所示。 Anvil can be configured to be able to deform the staples 800 in any suitable shape, such as in the form of configuration B, the same example shown in FIG. 62. 各种成形的钉构型诸如B形式构型可限定组织截留区域,诸如组织截留区域807,该组织截留区域被构造成能够将组织截留在钉内。 Various configurations such as forming staple form B configuration may define a tissue entrapment area, such tissue trapping region 807, the tissue trapping region is configured to be trapped within the staple tissue.

[0319] 如上所述,钉可以可移除地储存在限定于仓体中的腔内。 [0319] As described above, the staple may be removably stored in the cartridge body defining the cavity. 仓体810示于图63中,其可包括限定于其中的一个或多个钉腔812。 The cartridge body 810 shown in FIG. 63, which may include limited to one in which one or more staple cavities 812. 参见图63、图68和图69,每个钉腔812可包括第一端部814和第二端部814。 Referring to Figure 63, Figures 68 and 69, each staple cavity 812 may include a first end 814 and a second end portion 814. 在某些实施方案诸如包括纵向端部执行器的实施方案中,例如,第一端部814可包括钉腔812的近侧端部并且第二端部814可包括钉腔812的远侧端部。 In an embodiment the longitudinal end effector comprises certain embodiments, such as, for example, a first end portion 814 may include a proximal end portion of staple cavity 812 and the second end portion 814 may include a distal end 812 of staple cavities . 在各种情况下,钉可定位在钉腔812内,使得钉800的第一腿804定位在钉腔812的第一端部814中,并且第二腿804定位在第二端部814中。 In various circumstances, the staples may be positioned within staple cavities 812, such that the first leg 800 of staple 804 is positioned at the first end portion 814 of staple cavity 812, and a second leg 804 positioned at the second end portion 814. 在各种情况下,钉腔宽度可限定在钉腔812的端部814之间。 In various circumstances, the width of the staple cavity may be defined between the end portion 814 of the staple cavities 812. 钉的基部802可由基部宽度限定,该基部宽度等于或短于例如钉腔宽度。 Staple base 802 defined by the base width, the width of the base equal to or shorter than the staple cavity width. 在某些情况下,钉可具有可限定在钉腿804的尖端806之间的钉宽度。 In some cases, the staple may have a defined between the tip of the staple legs of the staples 806 804 width. 在一些实施方案中,钉宽度可等于钉腔宽度。 In some embodiments, the staples may be equal to the width of the staple cavity width. 在各种实施方案中,钉宽度可宽于钉腔宽度。 In various embodiments, the staples may be wider than the width of the staple cavity width. 在此类实施方案中,腿804可与钉腔812的端部814接触并且可在钉定位在钉腔812内时由端部814向内弹性偏压。 In such embodiments, the legs 804 may contact with the end portion of the staple cavities 814 and 812 from the end portion 814 may be resiliently biased inwardly in the staples 812 positioned within staple cavities. 当钉被向上提升出钉腔812时,腿804可在其从钉腔812出现时向外弹性地展开。 When the staples out of the staple cavities 812 is lifted upward, the leg 804 can elastically expand outward as it emerges from the staple cavities 812. 例如,钉可定位在钉腔812内,使得当钉处于其未击发或未提升位置中时,钉腿804的尖端806不延伸到仓体810的顶部表面或平台上方。 For example, the nail may be positioned within staple cavities 812, such that when the staples in their unfired position or when lifting, the tip of the staple legs 806 804 does not extend above the deck or top surface of the cartridge body 810. 在这样的位置中,尖端806可被定位成与仓体810的平台811齐平或凹陷到该平台下方。 In such a position, the tip 806 may be positioned to the cartridge body platform 811,810 to flush or recessed below the platform. 另选地,腿804的尖端806可至少部分地延伸到仓体810的平台811上方。 Alternatively, the tip of the legs 806,804 can extend at least partially above the platform 810 of the cartridge body 811. 在任何情况下,在钉向上提升时,钉尖端806可出现在平台811上方并且在腿804从腔812出现时向外展开。 In any case, when lifting up the staples, the staple tip 806 may occur over the internet 811 and deployed outwardly from the cavity 812 in the leg 804 occurs. 在钉的提升期间的某些时候,腿804可能不再与钉腔812的端部814接触,并且腿804可不再由钉腔812的侧壁向内偏压。 Some point during the lifting of the staple legs 804 may no longer be in contact with the end portion 814 of staple cavity 812, and 804 may not be biased by the legs of staple cavity 812 side walls inwardly.

[0320] 在各种情况下,砧座可包括一个或多个凹坑,该凹坑被构造成能够在钉800从钉仓射出时接收钉腿804的尖端806。 [0320] In various circumstances, the anvil can comprise one or a plurality of dimples, the dimples are configured to receive a staple leg tip 806 804 800 when the staples are ejected from the staple cartridge. 砧座凹坑可被构造成能够例如将钉腿804向内朝彼此翻转或弯曲。 Anvil pockets may be configured to be, for example, staple legs 804 bend inwardly toward one another or inverted. 在其他情况下,砧座凹坑可被构造成能够例如将钉腿804向外远离彼此翻转或弯曲。 In other cases, the anvil dimple may be configured to be, for example, staple leg 804 bent outwardly away from one another or inverted. 然而,在一些情况下,钉的钉腿中的一个或多个可错过钉凹坑并且可能无法适当地变形。 However, in some cases, one or more of the staple legs can not miss the staple pocket and may be appropriately modified. 在某些情况下,钉腿中的一个或多个可能不接触砧座并且可能根本不变形。 In some cases, one or more staple legs may not be in contact with the anvil and may not even deformed. 在任一种情况下,钉可能不会将组织适当地捕获和/或保持在其组织截留区域内。 In either case, the staples may not properly capture the tissue and / or tissue remains trapped within its area. 此外,畸形或未成形的钉可能不能够向组织施加所需的压缩压力。 Furthermore, deformity or unformed staples may not be able to apply the required compressive pressure to the tissue. 在一些情况下,畸形或未成形的钉可能不保持在组织中并且可变得与组织脱离。 In some cases, deformity or unformed staples may not remain in the tissue and the tissue may become disengaged.

[0321] 再次参见图62,钉800和/或本文所公开的各种其他钉可包括从其延伸的一个或多个倒钩。 [0321] Referring again to FIG. 62, the staples 800 and / or disclosed herein may include a variety of other staple or more barbs extending therefrom. 在各种情况下,倒钩可被构造成能够接合捕获在钉内和/或围绕钉的组织。 In each case, the barbs may be configured to be engageable captured within the staples and / or tissue surrounding the nails. 在某些情况下,倒钩可有助于将钉保持在组织内,特别是当钉已成畸形或未成形时。 In some cases, the barbs may help to maintain the staples in the tissue, particularly when the staple or become deformed when the unformed. 钉800可包括从腿804中的一个或两个延伸的倒钩。 A staple 800 may include a barb 804 extending from the leg of one or two. 例如,每个腿804可包括从钉800的中心面向外的一个或多个倒钩808以及/或者朝例如钉800的中心面向内的一个或多个倒钩809。 For example, each leg 804 may include one or more from the outer staple 800 facing the center of the barbs 808 and / or one or more, for example, toward the center of the staple 800 facing barbs 809. 在某些情况下,倒钩808可延伸远离组织截留区域807并且/或者倒钩809可朝组织截留区域807延伸或延伸到组织截留区域中。 In some cases, the barbs 808 may extend away from the tissue entrapment area 807 and / or the barb 809 may extend toward the tissue or entrapment areas 807 extend into the area of ​​tissue entrapment. 如图62所示,钉800的钉腿804中的两个可包括倒钩808和倒钩809。 As shown in FIG. 62, two staple legs 804 of the staple 800 may include barbs 808 and barbs 809. 在一些情况下,钉腿804可包括倒钩808,但不包括倒钩809。 In some cases, the staple legs 804 may include barbs 808, 809 but does not include barbs. 钉820示于图63中,其包括倒钩808,但不包括倒钩809 ο在一些情况下,钉腿804可包括倒钩809,但不包括倒钩808。 Staple 820 shown in FIG. 63, which includes a barb 808, but does not include barbs 809 o In some cases, the staple legs 804 may include barbs 809, 808 but does not include barbs. 钉830,840,850,860和870分别示于图64、图65、图66、图67和图68中,其包括倒钩809,但不包括倒钩808。 Nail 830,840,850,860 and 870 are shown in FIG 64, FIG 65, FIG 66, FIG 67 and FIG 68, which includes barbs 809, 808 but does not include barbs. 在一些实施方案中,例如,钉的第一腿804可包括倒钩808,而钉的第二腿804可包括倒钩809。 In some embodiments, e.g., the first staple leg 804 may include barbs 808, and the second staple leg 804 may include barbs 809.

[0322] 在各种情况下,当钉处于未成形构型中时,钉的腿804和基部802可限定钉平面。 [0322] In various circumstances, when the staples in an unformed configuration, the staple legs 804 and base 802 may define a plane staple. 倒钩808可从此类钉平面内的腿804向外延伸。 Barb 808 may extend outwardly from staple leg 804 within such plane. 类似地,倒钩809可从此类平面内的腿804向内延伸。 Similarly, the barbs 809 may extend from the legs 804 inwardly within such plane. 在一些情况下,钉可包括相对于此类钉平面横向延伸的倒钩。 In some cases, the staples can include such staple with respect to the plane of barbs extending laterally. 可以设想到其他实施方案,其中腿804和基部802不位于或完全位于单个平面内。 It is contemplated that other embodiments, in which the legs 804 and the base 802 is not located or is located entirely within a single plane. 在此类实施方案中,倒钩可沿任何合适的方向延伸。 In such embodiments, the barbs may extend in any suitable direction. 在各种实施方案中,现在参见图67,钉诸如钉860例如可包括从基部802延伸的倒钩803。 In various embodiments, referring now to FIG. 67, for example, a staple, such as staple 860 includes a barb 803 extending from the base 802. 在各种情况下,倒钩803可向内朝钉860的组织截留区域807延伸。 In each case, the barbs 803 may extend inwardly toward the tissue entrapment area 807 of the staples 860. 在某些情况下,倒钩803可向外远离组织截留区域807延伸。 In some cases, the barbs 803 may extend outwardly away from the tissue entrapment area 807. 如图67所示,倒钩803可在由腿804和基部802限定的钉平面内延伸。 Shown in Figure 67, the barbs 803 may extend in a plane defined by the staple legs 804 and the base 802. 在某些情况下,倒钩803可相对于此类钉平面横向延伸。 In some cases, the barbs 803 extend laterally with respect to the plane of these nail. 各种示例性倒钩构型在下文中进一步详细地讨论。 Discussion of various exemplary barb configurations in further detail below.

[0323] 在各种情况下,钉腿804可包括沿其整个长度延伸的倒钩808的阵列。 [0323] In various circumstances, the staple legs along the array 804 may include a barb 808 extending the entire length thereof. 在一些情况下,钉腿804可包括沿小于其整个长度延伸的倒钩808的阵列。 In some cases, the staple legs 804 can comprise an array of barbs 808 along less than its entire length extending. 以举例的方式,参见图62,钉800的腿804各自包括沿小于腿804的整个长度延伸的倒钩808的阵列。 By way of example, referring to FIG legs 80 462, 800 each include an array of staples along the leg 804 is smaller than the overall length of barbs 808 extending therefrom. 类似地,参见图63,钉820的腿804各自包括沿小于腿804的整个长度延伸的倒钩808的阵列。 Similarly, referring to Figure 63, the staple legs 820 is less than 804 each comprise an array along the entire length of the barb 808 of the leg 804 extends. 参照钉800,例如,倒钩808的阵列可沿腿804中的每个从钉800的基部802朝腿804的尖端806延伸。 Referring to nail 800, e.g., an array of barbs 808 may each leg 804 extending from the base portion 802 of the staple 800 toward the tip of the leg of 806,804. 如图62所示,倒钩808的阵列可能不延伸到腿804的尖端806。 As shown in FIG. 62, barbs 808 may not extend the array to the legs 806,804 of the tip. 在各种情况下,倒钩808的阵列可沿例如腿804的长度的一半或大约一半延伸;然而,可使用倒钩阵列的任何合适的长度。 In each case, the barb 808 may extend along an array of, for example, one half or about half the length of the legs 804; however, any suitable length barbs array. 例如,倒钩808的阵列可沿小于腿804的长度一半或大于其长度的一半延伸。 For example, an array of barbs 808 along the leg 804 is smaller than half the length of or greater than half the length of the extension. 在一些实施方案中,倒钩808的阵列可沿腿804中的每个从腿804的尖端806朝基部802延伸。 In some embodiments, barbs 808 may each array extending in the leg 804 from the leg 802 towards the base of the tip 806 804. 在此类实施方案中,倒钩808的阵列可能不延伸到基部802。 In such embodiments, the barb 808 of the array may not extend to the base 802. 在一些实施方案中,腿804可包括倒钩808的阵列,其不延伸到腿804的尖端806或基部802。 In some embodiments, the legs 804 may include an array of barbs 808, which does not extend to the tip of the legs 806 or 804 of the base 802. 在某些实施方案中,腿804可包括倒钩808的多于一个阵列。 In certain embodiments, the legs 804 may include more than one array of barbs 808.

[0324] 在各种情况下,对上文进行进一步描述,钉腿804可包括沿其整个长度延伸的倒钩809的阵列。 [0324] In various circumstances, further to the above description, the staple legs 804 can comprise an array along the entire length thereof extending barb 809. 以举例的方式,参见图64,钉830的腿804各自包括沿腿804的整个长度延伸的倒钩809的阵列。 By way of example, 64, the staple legs 830 each include an array along the leg see FIG 804,804 extending the entire length of the barb 809. 在一些情况下,钉腿804可包括沿小于其整个长度延伸的倒钩809的阵列。 In some cases, the staple legs 804 can comprise an array of barbs 809 along less than its entire length extending. 以举例的方式,参见图65,钉840的腿804各自包括沿小于腿804的整个长度延伸的倒钩809的阵列。 By way of example, referring to Figure 65, the staple legs 804 each comprising 840 along the leg 804 is smaller than the length of the entire array of barbs 809 extending therefrom. 类似地,参见图68,钉870的腿804各自包括沿小于腿804的整个长度延伸的倒钩809的阵列。 Similarly, referring to Figure 68, the staple legs 870 is less than 804 each comprise an array along the entire length of the barb 809 of the leg 804 extends. 参照钉840,例如,倒钩809的阵列可沿腿804中的每个从钉840的基部802朝腿804的尖端806延伸。 Referring to nail 840, e.g., an array of barbs 809 may each extend along a leg 804 from the base 840 of the staple legs toward the tip 802 of 806,804. 如图65所示,倒钩809的阵列可能不延伸到腿804的尖端806。 Shown in Figure 65, the array of barbs 809 may not extend to the tip of the leg of 806,804. 在各种情况下,倒钩809的阵列可沿例如腿804的长度的一半或大约一半延伸;然而,可使用倒钩阵列的任何合适的长度。 In each case, the array may extend along a barb 809, for example, half the length of the leg 804 or about half; however, any suitable length barbs array. 例如,倒钩809的阵列可沿小于腿804的长度一半或大于其长度的一半延伸。 For example, an array of barbs 809 along the leg 804 is smaller than half the length of or greater than half the length of the extension. 在一些实施方案中,倒钩809的阵列可沿腿804中的每个从腿804的尖端806朝基部802延伸。 In some embodiments, barbs 809 may each array extending along the leg from the leg 804 towards the base of the tip 806 804 802. 在此类实施方案中,倒钩809的阵列可能不延伸到基部802。 In such embodiments, the barb 809 of the array may not extend to the base 802. 在一些实施方案中,如图66所示,腿804可包括倒钩809的阵列,其不延伸到腿804的尖端806或基部802。 In some embodiments, as shown in Figure 66, leg 804 may include an array of barbs 809, which does not extend to the tip of the legs 806 or 802 804 of the base portion. 在某些实施方案中,腿804可包括倒钩809的多于一个阵列。 In certain embodiments, the legs 804 may include more than one array 809 of the barb.

[0325] 各种倒钩构型示于图70至图73中,但任何合适的倒钩构型均可使用。 [0325] various barb configurations are shown in FIGS. 70 to 73, but any suitable configuration may be used barbs. 参见图70,钉腿804可包括例如至少一个倒钩809。 Referring to Figure 70, the staple legs 804 may include at least one barb 809. 在各种情况下,倒钩809可包括插脚。 In each case, the barbs 809 may include a pin. 插脚可包括可从钉腿804的周边805延伸的第一表面809a和第二表面809b。 Pins 809a of the first surface and the second surface 809b may comprise staple legs extending from the periphery of 805,804. 第一表面809a可包括例如倾斜表面、凸形表面和/或凹形表面。 The first surface 809a may comprise, for example, a surface, a convex surface, and / or the concave surface is inclined. 第二表面809b可包括例如平坦的或至少基本上平坦的表面。 The second planar surface 809b may comprise, for example, or at least substantially flat surface. 在各种情况下,第一表面809a和第二表面809b可会聚在例如边缘809c处。 In each case, a first surface 809a and second surface 809b may converge, for example, at the edge 809c. 倒钩809可使用任何合适的工艺形成。 Barbs 809 may be formed using any suitable process. 例如,倒钩809可使用冲压工艺形成。 For example, the barbs 809 may be formed using a stamping process. 在至少一个实施方案中,成形模具例如可用于冲击包括腿804的线的周边805,以便扰乱或干扰足够的材料来形成倒钩809。 In at least one embodiment, for example, mold 805 includes a peripheral impact wire legs 804, so as to disrupt or interfere with enough material to form barbs 809. 在各种情况下,倒钩可包括例如任何合适的尖头或毛刺。 In each case, the barbs may include any suitable pointed burrs. 在各种实施方案中,倒钩809可为锥形的。 In various embodiments, the barbs 809 may be tapered. 在各种情况下,倒钩809可包括与周边805相邻的基部,该基部比倒钩809的尖端厚。 In each case, the barbs 809 may include a base portion 805 adjacent the periphery of the base portion is thicker than the tip 809 of the barb.

[0326] 现在参见图68、图69、图71和图71A,钉腿804可包括例如至少一个倒钩879。 [0326] Referring now to FIG 68, FIG 69, FIG 71 and FIG 71A, the staple legs 804 may include at least one barb 879. 在至少一个实施方案中,倒钩879可围绕钉腿804的周边805的一部分延伸。 In at least one embodiment, the barbs 879 may extend around the periphery of the leg portion of the staple 805 804. 在各种情况下,倒钩879可包括可从钉腿804的周边805延伸的第一表面879a和第二表面879b。 In each case, the barbs 879 may include a first surface 879a and second surface 879b of the staple legs may extend from the periphery of 805,804. 第一表面879a可包括例如倾斜表面、凸形表面和/或凹形表面。 The first surface 879a may comprise, for example, a surface, a convex surface, and / or the concave surface is inclined. 第二表面879b可包括例如平坦的或至少基本上平坦的表面。 The second planar surface 879b may comprise, for example, or at least substantially flat surface. 在各种情况下,第一表面879a和第二表面879b可会聚在例如边缘879c处。 In each case, a first surface 879a and second surface 879b may converge, for example, at the edge 879c. 在各种情况下,边缘879c可为例如弓形的。 In each case, an edge 879c, for example, may be arcuate. 倒钩879可使用任何合适的工艺形成。 Barbs 879 may be formed using any suitable process. 例如,倒钩879可使用冲压工艺形成。 For example, the barbs 879 may be formed using a stamping process. 在至少一个实施方案中,成形模具例如可用于冲击包括腿804的线的周边805,以便扰乱或干扰足够的材料来形成倒钩879。 In at least one embodiment, for example, mold 805 includes a peripheral impact wire legs 804, so as to disrupt or interfere with enough material to form barbs 879. 主要参见图71A,包括腿804的线可由直径801限定,并且倒钩879可由比直径801大的直径限定。 Referring primarily to FIG. 71A, line 804 includes a leg 801 may be defined diameter, and the barbs 879 can be defined by a diameter larger than 801 diameter. 相应地,包括腿804的线可由半径限定,并且倒钩879可由比线半径大的半径限定。 Accordingly, the leg 804 includes a line defined by a radius, and the barbs 879 may be larger than a line defined radius. 在各种实施方案中,倒钩879可为锥形的。 In various embodiments, the barbs 879 may be tapered. 在各种情况下,倒钩879可包括与周边805相邻的基部,该基部比倒钩879的尖端厚。 In each case, the barbs 879 may include a base portion 805 adjacent the periphery of the base portion is thicker than the tip 879 of the barb.

[0327] 现在参见图72,钉腿804可包括例如至少一个倒钩889。 [0327] Referring now to FIG. 72, the staple legs 804 may include at least one barb 889. 在至少一个实施方案中,倒钩889可围绕钉腿804的整个周边805延伸。 In at least one embodiment, the barbs 889 may extend around the entire periphery of the staple legs to 805,804. 在各种情况下,倒钩889可包括可从钉腿804的周边805延伸的第一表面889a和第二表面889b。 In each case, the barbs 889 may include a first surface 889a and second surface 889b of the staple legs may extend from the periphery of 805,804. 第一表面889a可包括例如倾斜表面、凸形表面和/或凹形表面。 The first surface 889a may comprise, for example, a surface, a convex surface, and / or the concave surface is inclined. 第二表面889b可包括例如平坦的或至少基本上平坦的表面。 The second planar surface 889b may comprise, for example, or at least substantially flat surface. 在各种情况下,第一表面889a和第二表面889b可会聚在例如边缘889c处。 In each case, a first surface 889a and second surface 889b may converge, for example, at the edge 889c. 在各种情况下,边缘889c可为例如弓形的。 In each case, an edge 889c, for example, may be arcuate. 倒钩889可使用任何合适的工艺形成。 Barbs 889 may be formed using any suitable process. 例如,倒钩889可使用冲压工艺形成。 For example, the barbs 889 may be formed using a stamping process. 在至少一个实施方案中,成形模具例如可用于冲击包括腿804的线的周边805,以便扰乱或干扰足够的材料来形成倒钩889。 In at least one embodiment, for example, mold 805 includes a peripheral impact wire legs 804, so as to disrupt or interfere with enough material to form barbs 889. 包括腿804的线可由线直径限定,并且倒钩889可由比线直径大的直径限定。 Line 804 includes a leg wire diameter may be defined, and the barbs 889 may be defined by a diameter larger than the wire diameter. 相应地,包括腿804的线可由半径限定,并且倒钩889可由比线半径大的半径限定。 Accordingly, the leg 804 includes a line defined by a radius, and the barbs 889 may be larger than a line defined radius. 在各种实施方案中,倒钩889可为锥形的。 In various embodiments, the barbs 889 may be tapered. 在各种情况下,倒钩889可包括与周边805相邻的基部,该基部比倒钩889的尖端厚。 In each case, the barbs 889 may include a base portion 805 adjacent the periphery of the base portion is thicker than the tip 889 of the barb.

[0328] 现在参见图73,钉腿804可包括例如至少一个倒钩899。 [0328] Referring now to FIG. 73, the staple legs 804 may include at least one barb 899. 在各种情况下,倒钩899可包括插脚。 In each case, the barbs 899 may include a pin. 插脚可包括可从钉腿804的周边延伸的第一表面899a和第二表面899b。 Pins may include a first surface 899a surrounding the staple legs 804 extending from the second surface 899b. 第一表面899a可包括例如倾斜表面、凸形表面和/或凹形表面。 The first surface 899a may comprise, for example, a surface, a convex surface, and / or the concave surface is inclined. 第二表面899b可包括例如平坦的或至少基本上平坦的表面。 The second planar surface 899b may comprise, for example, or at least substantially flat surface. 在各种情况下,第一表面899a和第二表面899b可会聚在例如边缘899c处。 In each case, a first surface 899a and second surface 899b may converge, for example, at the edge 899c. 倒钩899可使用任何合适的工艺形成。 Barbs 899 may be formed using any suitable process. 例如,倒钩899可使用冲压工艺形成。 For example, the barbs 899 may be formed using a stamping process. 在至少一个实施方案中,成形模具例如可用于冲击包括腿804的线的周边,以便扰乱或干扰足够的材料来形成倒钩899。 In at least one embodiment, the mold can be used, for example, include a peripheral line of impact of the legs 804, so as to disrupt or interfere with enough material to form barbs 899. 在各种实施方案中,包括钉的线可包括一个或多个平坦侧面。 In various embodiments, includes a staple line may include one or more flat sides. 在至少一个实施方案中,线可包括例如相对的平坦侧面895。 In at least one embodiment, the line may include, for example, opposing flat sides 895. 在至少一个此类实施方案中,平坦侧面895可形成为圆柱形线。 In at least one such embodiment, the flat side surface 895 may be formed as a cylindrical wire. 在一些情况下,除了平坦侧面895之外,线可保持一个或多个圆柱形表面。 In some cases, in addition to the flat side 895 outside the line may hold one or more cylindrical surfaces. 在各种情况下,倒钩可包括例如任何合适的尖头或毛刺。 In each case, the barbs may include any suitable pointed burrs. 在各种实施方案中,倒钩899可为锥形的。 In various embodiments, the barbs 899 may be tapered. 在各种情况下,倒钩899可包括与腿804的周边相邻的基部,该基部比倒钩899的尖端厚。 In each case, the barbs 899 may include a base portion 804 adjacent the periphery of the legs, the base portion is thicker than the tip 899 of the barb.

[0329] 在各种情况下,钉的腿可限定钉平面。 [0329] In various circumstances, the staple legs of the staples may define a plane. 钉的基部可以或可以不定位在钉平面内。 The base may or may not be the staples positioned within the staple plane. 在任一种情况下,从腿和/或基部延伸的一个或多个倒钩可在钉平面内延伸以及/或者相对于钉平面平行地延伸。 , May extend in either case from the leg and / or one or more barbs extending from the base in the plane of the staple and / or a plane extending parallel relative to the staple. 在一些情况下,从腿和/或基部延伸的一个或多个倒钩可从钉平面向外延伸。 In some cases, it may extend outwardly from the plane from the staple legs and / or one or more barbs extending from the base. 从腿和/或基部延伸的一个或多个倒钩可相对于钉平面横向地延伸。 From the leg and / or one or more barbs extending from the base of the staple with respect to a plane extending transversely. 在各种情况下,倒钩可围绕钉腿周向地延伸。 In each case, the barbs may extend circumferentially around the circumference of the staple legs. 此类倒钩可在钉平面内延伸以及从钉平面向外延伸。 Such barbs may extend in the plane of the staple, and the staple extends outwardly from the plane. 在一些情况下,倒钩可围绕钉腿的整个周长延伸。 In some cases, the barbs may extend around the entire perimeter of the staple legs. 在某些情况下,倒钩可围绕钉腿延伸小于360度。 In some cases, the barbs may extend less than 360 degrees around the staple legs. 在钉平面内延伸的倒钩可易于控制钉平面内的组织。 Barbs extending in the plane of the staple can be easily controlled within a staple tissue plane. 从钉平面向外延伸的倒钩可易于控制钉平面之外的组织。 From the plane of the staple barbs extending outwardly beyond the tissue can be easily controlled staple plane. 钉和/或钉腿可包括在钉平面内延伸的一个或多个倒钩以及从钉平面向外延伸的一个或多个倒钩。 Nail and / or staple legs may include one or a plurality of barbs extending in the plane of the nail and one or more barbs extending outwardly from the plane of the staple.

[0330] 再次参见图62,从钉腿804延伸的倒钩可被构造成能够将钉腿804保持在组织内。 [0330] Referring again to FIG. 62, barbs 804 extending from the staple legs may be configured to staple legs 804 can be retained within the tissue. 如上所述,在某些情况下,钉腿804可通过砧座成畸形和/或未成形,并且由于从其延伸的一个或多个倒钩,钉腿804可仍然保持在组织内。 As described above, in some cases, the staple legs 804 can be deformed into and / or unformed by the anvil, and since one or more barbs extending therefrom, the staple legs 804 can remain within the tissue. 在各种情况下,倒钩可被构造成能够将组织截留在钉的组织截留区域内。 In each case, the barbs may be configured to be capable of trapping tissue in the tissue region entrapped nail. 在某些情况下,倒钩可被构造成能够抵靠基部802保持组织。 In some cases, the barbs may be configured to be able to hold the tissue against the base 802. 在此类情况下,倒钩可向组织施加压缩力或压力。 In such cases, the barbs may apply a compressive force or pressure to the tissue. 如上结合图70至图73所示的实施方案所述,倒钩可包括例如倾斜、凸形和/或凹形顶部表面,诸如表面809a,879a,889a和/或899a。 As described above in conjunction with FIGS. 70 to 73 shown in the embodiments, the barbs may include, for example, inclined, convex and / or concave top surface, such as surface 809a, 879a, 889a and / or 899a. 倒钩的顶部表面可被构造成能够有利于将钉腿804和倒钩插入组织中和/或插入穿过组织。 The top surface of the barbs may be configured to be able to facilitate the staple legs and barbs 804 inserted into the tissue and / or insertion through the tissue. 同样如上结合图70至图73所示的实施方案所述,倒钩可包括例如平坦或至少基本上平坦的底部表面,诸如表面809b,879b,889b和/或899b。 Also as described above in conjunction with the embodiment shown in FIGS. 70 to 73, the barbs may include at least a flat or substantially flat bottom surface, such as surface 809b, 879b, 889b and / or 899b. 倒钩的底部表面可被构造成能够抑制将倒钩和钉腿804从组织移除。 The bottom surface of the barbs may be configured to be capable of inhibiting the staple legs 804 and barbs removed from the tissue. 作为上述的结果,在某些情况下,倒钩的顶部表面可被构造成能够刺穿组织,而倒钩的底部表面可被构造成能够邻接组织。 As a result of the above, in some cases, the top surface of the barbs may be configured to pierce tissue, and a bottom surface of the barbs may be configured to abut tissue. 在各种情况下,钉腿804的尖端806可被构造成能够在组织中穿刺孔,而从其延伸的钉腿804和倒钩可被构造成能够弹性地展开孔,使得组织可在钉腿804被推动穿过组织时在倒钩周围流动并且流回到倒钩的底部表面下方。 In various circumstances, the tip of the staple legs 806,804 may be configured to be a puncture hole in the tissue, and the staple legs and barbs 804 extending therefrom can be configured to be elastically expand the hole, so that the tissue may be staple legs when flowing around the barb 804 is pushed through tissue and flows back below the bottom surface of the barbs.

[0331] 在某些实施方案中,第一倒钩可从钉的第一腿804延伸,并且第二倒钩可从钉的第二腿804延伸。 [0331] In certain embodiments, the first barb 804 may extend from the first leg of the staple, the staple and the second barb from the second leg 804 extends. 在各种情况下,第一倒钩和第二倒钩可位于基部802之间相同或至少基本上相同的距离。 In each case, the first barb and the second barb at the same or at least substantially the same distance between the base 802. 在某些情况下,第一倒钩和第二倒钩可距基部802相同或至少基本上相同的竖直距离定位。 In some cases, first barb and the second barb 802 may be from the same base or at least substantially the same vertical distance positioning. 如上所述,钉腿804可包括沿钉腿804的长度延伸的倒钩的阵列。 As described above, the staple legs 804 can comprise an array of barbs along the length of staple legs 804 extending therefrom. 在各种实施方案中,主要参见图62,钉可包括具有倒钩的第一阵列的第一腿804以及具有倒钩的第二阵列的第二腿804,其中倒钩的第一阵列和倒钩的第二阵列可被构造成能够协作地将钉保持在组织内。 In various embodiments, referring primarily to FIG. 62, a staple may include a first leg 804 having barbs first leg 804 and a second array having a second array of barbs, wherein the barbs of the first array and fall a second array of hooks can be configured to be cooperatively holding the staples in the tissue. 在各种实施方案中,来自第一阵列的倒钩和来自第二阵列的倒钩可包括被构造成能够在距例如基部802相同竖直距离处接合组织的一对倒钩。 In various embodiments, the barbs from the barb and the second array from the first array may comprise, for example, be configured to be able to engage tissue away from the base 802 at the same vertical distance from a pair of barbs. 在各种情况下,钉可包括多于一对倒钩。 In various circumstances, the staples can comprise more than one pair of barbs. 在某些情况下,倒钩对中的每对可被够造成在距基部802不同竖直距离处接合组织。 In some cases, each of the pair of barbs may be engaged enough to cause tissue 802 at a different vertical distance from the base. 在此类情况下,钉可适合以不同组织厚度使用。 In such cases, the staples may be adapted to use a different thickness of the tissue. 例如,当钉用于缝合薄的组织时,一对倒钩或小于所有的倒钩对可接合薄的组织。 For example, when the staples for stapling thin tissue, a pair of barbs or less than all of the barbs may engage a thin tissue. 如果钉用于缝合厚的组织,然而,附加的倒钩对或所有的倒钩对可接合组织。 If the thickness of the staples for stapling tissue, however, an additional or all of the barbs may engage barbs on the tissue. 在某些实施方案中,从腿804延伸的倒钩可以按照组织厚度或组织厚度的范围的方式布置,所述组织厚度由钉缝合。 In certain embodiments, the barbs may be arranged legs 804 extending from the range according to the thickness of tissue thickness or tissue embodiment, the thickness of the tissue by the suture staples. 例如,再次参见图62,倒钩808和809可沿腿804选择性地定位,使得其定位在捕获在钉内的组织内和/或与捕获在钉内的组织相邻定位。 For example, referring again to FIG. 62, barbs 808 and 809 may be selectively positioned 804 along the legs, such that it is positioned within the tissue captured within the staples and / or tissue captured within the staples positioned adjacent. 在某些情况下,钉腿804的通过砧座变形或与砧座接触的部分可不包括从其延伸的倒钩。 In some cases, deformed or partially in contact with the anvil 804 of the staple legs through the anvil may include barbs extending therefrom. 在至少一些情况下,从钉腿804的面向内的侧面延伸的倒钩的阵列可长于从钉腿804的面向外的侧面延伸的倒钩的阵列。 In at least some cases, an array of barbs extending from the inner side surface facing the staple legs 804 may be longer than an array of barbs extending from the sides of the outer face 804 of the staple legs. 在其他情况下,从钉腿804的面向内的侧面延伸的倒钩的阵列可短于从钉腿804的面向外的侧面延伸的倒钩的阵列。 In other cases, an array of barbs extending from the inner side surface of the staple legs 804 facing the array may be shorter than the barb extending from a side facing the outside of the staple legs 804. 在又一种情况下,从钉腿804的面向内的侧面延伸的倒钩的阵列可与从钉腿804的面向外的侧面延伸的倒钩的阵列一样长。 In a further aspect, the barbs from the array as staple legs extending barbs array of inwardly facing side 804 may extend from the outer side surface 804 of the staple legs oriented long.

[0332] 如上所述,如果钉腿804是畸形的以及/或者无意未成形的,则从钉腿804延伸的倒钩可有助于将钉保持在组织内。 [0332] As described above, if the staple legs 804 are deformed and / or unintentional unformed, from the staple legs 804 extending barbs may assist in holding the staples in the tissue. 然而,可设想到某些情况,其中包括本文所公开的倒钩中的一个或多个的钉被插入组织中并且保持有意未成形的。 However, some cases may be envisaged, including one barb disclosed herein or more staples are inserted into tissue and intentionally holding unformed. 在任何情况下,包括本文所公开的倒钩中的一个或多个的钉可用于缝合厚的组织。 In any case, disclosed herein includes a barb of one or more of the staples may be used for suturing tissue thickness. 更具体地讲,在一些情况下,在钉仓和砧座之间的厚和/或致密组织的存在以及/或者在钉内的厚和/或致密组织的存在可防止钉完全成形或闭合。 More specifically, in some cases, the presence in the presence of thick and / or dense tissue between the anvil and the staple cartridge and / or the thick and / or dense tissue to prevent the staples within the staple fully formed or closed. 例如,钉可能不完全闭合成B形式构型,或者钉可能不完全闭合。 For example, the staple may not be completely closed configuration to form B, or staples may not fully closed. 在此类情况下,未闭合的钉的倒钩可能抑制或防止组织被拉出例如钉。 In such a case, not closed staples barbs may inhibit or prevent the tissue from being pulled out, for example, staples. 沿钉腿的长度的延伸的倒钩的阵列可允许腿保持在组织中,而不管组织的厚度。 An array of barbs extending along the length of the staple legs may allow the legs held in the tissue, regardless of tissue thickness.

[0333] 可设想到各种实施方案,其中至少一个带倒钩的钉诸如带倒钩的钉800例如可移除地储存在钉仓诸如图10至图12所示的钉仓22000内。 [0333] Various embodiments may be envisaged, wherein the at least one barbed barbed staples, such as staples, for example, 800 is removably stored within a staple cartridge, such as staple cartridge shown in FIG. 10 to FIG 1,222,000. 可设想到其中钉仓仅包括带倒钩的钉的某些实施方案,同时设想到使用带倒钩的钉和不带倒钩的钉的其他实施方案。 Wherein the staple cartridge may be contemplated to include only certain embodiments of barbed staples, while use is contemplated to barbed staples and other embodiments without barbed staples. 例如,第一行钉可包括带倒钩的钉,而第二行钉可包括不带倒钩的钉。 For example, the first row of staples can include a barbed nails, staples and the second row may include a barbed staple is not. 在一些情况下,储存在钉仓内的钉可具有相同或基本上相同的未成形高度。 In some cases, the staples stored within the staple cartridge may have the same or substantially the same height unformed. 至少参照U形形状和/或V形形状的钉,例如,钉的未成形高度可被限定为钉的基部的底部和钉腿的尖端之间的竖直距离。 Referring least U-shape and / or the V-shape of the nail, e.g., unformed staple height can be defined vertical distance between the tip and the bottom of the base of the staple legs of the staples. 在钉被插入钉仓中之前,在钉可移除地储存在钉仓内时,以及/或者在钉抵靠砧座变形之前,可采取此类测量。 Before the staples are inserted into the staple cartridge, the staples removably stored within a staple cartridge, and / or prior to deformation against the anvil, the staple can be taken against such measurements. 在一些情况下,在钉仓中布置在第一排中的带倒钩的钉可具有第一未成形高度,并且在钉仓中布置在第二排中的带倒钩的钉可具有第二未成形高度。 In some cases, the staples in a first row of barbed arrangement may have a first height in the unformed staple cartridge, the staple cartridge and arranged in a second row of staples may have a barbed second unformed height. 在钉仓中的第三排中的带倒钩的钉可具有第一未成形高度、第二未成形高度或第三未成形高度。 In the third row of the staple cartridge of barbed unformed staples may have a height of a first, second, or third height unformed unformed height. 第一行、第二行和/或第三行的带倒钩的钉可被定位在限定于钉仓中的刀狭槽的相同侧上或刀狭槽的相对侧上。 The first row, second row barbed staples and / or the third row can be positioned on the same side of the knife slot defined within the staple cartridge or on opposite sides of the knife slot. 在使用中,可移除地储存在钉仓中的带倒钩的钉可被成形为相同成形高度或不同成形高度。 Barbed nails, in use, may be stored in a removable staple cartridge may be shaped to the same height or different shaped molding height. 钉的成形高度可被定义为在其已抵靠砧座变形之后钉的总竖直距离。 The staple forming height may be defined in which has arrived after deformation against the staple anvil total vertical distance. 至少参照已变形成B形式的钉,例如,可在钉的基部的底部和钉腿的最上部分之间测量钉的成形高度。 Referring B has been deformed at least in the form of a staple, for example, formed height of the staples can be measured between the uppermost portion of the staple legs and the bottom of the base of the nail. 在一些情况下,在钉仓中布置在第一排中的带倒钩的钉可变形成第一成形高度,并且在钉仓中布置在第二排中的带倒钩的钉可变形成第二成形高度。 In some cases, the staple cartridge is arranged in a first row of barbed staple forming height forming a first variable, and is arranged in the second row of staples is formed of a variable barbed staple cartridge two forming height. 在钉仓中的第三排中的带倒钩的钉可具有第一成形高度、第二成形高度或第三成形高度。 In the staple cartridge in the third row of staples may have a barbed forming a first height, the height of the second or the third shaped forming height. 第一排、第二排和/或第三排的带倒钩的钉可被定位在限定于钉仓中的刀狭槽的相同侧上或钉仓的相对侧上。 The first row, second row, and / or third row of the barbed staple can be positioned on the same side of the knife slot defined within the staple cartridge or on opposite sides of the staple cartridge. 如读者将理解的,示于图10至图12中的钉已变形成不同成形高度。 As the reader will appreciate, it is shown in FIGS. 10 to 12 are formed of different staple forming heights has changed. 带倒钩的钉800例如可用于形成具有不同成形高度的钉排的钉仓和/或缝合器械中。 Barbed staple 800, for example, be used to form staples having different formed heights of the rows of the staple cartridge and / or stapling instrument. 第一排的带倒钩的钉800可变形为第一成形高度,并且第二排的带倒钩的钉800可变形为第二成形高度。 The first row of barbed staples 800 may be deformed into a first forming height, and the second row 800 may be barbed staple deformed into a second forming height. 在各种情况下,第三排的带倒钩的钉800可变形为第三成形高度。 In each case, the third row 800 may be a barbed staple deformed into a third forming height. 在一些情况下,变形为不同高度的带倒钩的钉800可开始于相同或基本上相同的未成形高度。 In some cases, the height of the deformed barbed staples 800 may begin at a different identical or substantially identical unformed height. 在某些情况下,变形为不同成形高度的带倒钩的钉800可开始于不同未成形高度。 In some cases, the deformation of different heights forming a barbed staple 800 may start at different heights unformed. 各种结构可用于使钉成形为不同成形高度。 Various structures may be used to make different shaped staple forming height. 例如,支撑钉的可动驱动器可在相对于砧座的不同距离处支撑钉。 For example, the support may be movable staple drive the staples may be supported at different distances with respect to the anvil. 在一些情况下,砧座可包括具有不同深度的钉成形凹坑。 In some cases, the anvil can include a staple forming pockets of different depths. 在各种情况下,钉驱动器可包括支架,该支架被构造成能够支撑钉的基部并且向上朝限定于砧座中的成形凹坑推动钉。 In various circumstances, the staple driver may include a bracket base configured to support a staple and is defined upwardly toward the anvil forming pockets push the staple. 钉的成形高度可通过支架的底部表面和成形凹坑的顶部表面之间的距离来确定。 The staple forming height can be obtained by a bottom surface of the stent and the distance between the top surface of the pits formed is determined. 公布于2012年11月27日的名称为“SURGICAL STAPLINGDEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS” 的美国专利8,317,070以引用方式全文并入。 Published November 27, 2012, entitled "SURGICAL STAPLINGDEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS" US Patent No. 8,317,070 is incorporated by reference. 在某些情况下,钉仓的平台可包括阶梯式表面,如图1所示。 In some cases, the staple cartridge may include a stepped surface of the platform, as shown in FIG. 第一排的钉腔可限定于第一阶梯中,并且第二排的钉腔可限定于第二阶梯中,其中第一阶梯和第二阶梯可彼此竖直地偏移。 A first row of staple cavities may be limited to the first step, and the second row of staple cavities may be defined in a second step, wherein the first step and second step may be vertically offset from each other. 例如,第一阶梯可竖直地定位在砧座上方,或者比第二阶梯更靠近砧座定位。 For example, the first step may be positioned vertically above the anvil or anvil is positioned closer than the second step. 在某些情况下,壁可定位在第一阶梯和第二阶梯之间。 In some cases, the wall may be positioned between the first step and the second step. 在一些情况下,钉仓的平台可包括第一阶梯、竖直地定位在第一阶梯上方的第二阶梯,以及竖直地定位在第二阶梯上方的第三阶梯。 In some cases, the staple cartridge may include a first step a platform, positioned vertically above the second step of the first step, and is positioned vertically above the second step of the third step. 可设想到各种实施方案,其中钉仓的平台包括任何合适数目的阶梯以及在阶梯之间的任何合适数目的壁。 Various embodiments may be contemplated, wherein the staple cartridge includes a stepped platform and any suitable number of any suitable number of walls between the step. 例如,第一排的钉腔可限定于第一阶梯中,第二排的钉腔可限定于第二阶梯中,并且/或者第三排的钉腔可限定于第三阶梯中。 For example, a first row of staple cavities may be defined in a first step, the second row of staple cavities may be defined in a second step, and / or the third row of staple cavities may be defined in a third step. 例如,第一行的钉腔可包括具有第一未成形高度的钉,第二排的钉腔可包括具有第二未成形高度的钉,并且/或者第三排的钉腔可包括具有第三未成形高度的钉。 For example, the first row of staple cavities may include a first unformed staple height, a second row of staples having a cavity may comprise a second height unformed staples, and / or the third row of staple cavities may comprise a third unformed height of the staple. 可设想到各种实施方案,其中钉仓包括具有不同未成形高度的任何合适数目的钉排。 Various embodiments may be contemplated, wherein the staple cartridge include any suitable number of different heights of unformed staple rows. 例如,第一排钉腔中的钉可变形为第一成形高度,第二排钉腔中的钉可变形为第二成形高度,并且/或者第三排钉腔可变形为第三成形高度。 For example, a first row of staple cavities in a first staple forming height can be deformed, in the second row of staple cavities may be deformed to a second staple forming height, and / or third rows of staple cavities may be deformed to a third forming height. 可设想到各种实施方案,其中钉仓包括变形为不同成形高度的任何合适数目的钉排。 Various embodiments may be contemplated, wherein a staple cartridge comprising a shaped deformed into any suitable number of different height rows of staples. 除了具有不同成形钉高度之外或代替具有不同钉高度,缝合器械的端部执行器可具有不同组织间隙。 In addition to having different formed staple heights or replaced with different staple heights, end stapling instrument may have different tissue gap. 例如,通常参见图10和图11,间隙可被限定在钉仓的仓平台表面22011和砧座的砧座组织压缩表面10063之间。 For example, see generally FIG. 11 and FIG. 10, a gap may be defined between the surface of the staple cartridge 22011 cartridge deck and the anvil tissue compression surface of the anvil 10,063. 该间隙可被构造成能够接收组织T。 The gap may be configured to be able to receive the tissue T. 该间隙也可被构造成能够接收组织厚度补偿件;然而,带倒钩的钉可以或者可以不与组织厚度补偿件一起使用,并且相对于带倒钩的钉提供的讨论可适用于任一种情况。 This gap may also be configured to be able to receive tissue thickness compensator; however, barbed staple may or may not be used with the tissue thickness compensator, and is applicable to any discussion with respect to barbed staples provided Happening. 在任何情况下,读者将理解,砧座组织压缩表面10063是阶梯式的。 In any case, the reader will understand, anvil tissue compression surface 10063 is stepped. 砧座组织压缩表面10063包括竖直地定位在第二部分上方的第一部分。 10063 anvil tissue compression surface comprises a first portion positioned vertically above the second portion. 当端部执行器的砧座和钉仓处于闭合状态时,如图11所示,第一间隙距离限定在砧座组织压缩表面10063的外部部分和仓平台表面22011之间,并且第二不同的间隙距离限定在砧座组织压缩表面10063的内部部分和仓平台表面22011之间。 When the end effector of the anvil and a staple cartridge in the closed state, as shown in FIG. 11, the first gap distance is defined between 22,011 anvil and cartridge tissue compression portion of the outer surface 10063 of the platform surface, and a second different 22011 gap distance is defined between the anvil portion and the inner tissue compression surfaces 10063 of the cartridge deck. 第一间隙距离被示为大于第二间隙距离,但是第一间隙距离有可能短于第二间隙距离。 A first gap larger than the second distance is shown as gap distance, but there is a first gap distance may be shorter than the second gap distance. 以较短间隙距离压缩在砧座和钉仓之间的组织可比以较大间隙距离的组织更受压缩。 Compress the tissue with a short gap distance between the anvil and the staple cartridge than the larger gap distance is more compressed tissue. 例如,带倒钩的钉800的倒钩可不同地接合组织,这取决于组织定位在较短组织间隙还是较大组织间隙内。 For example, barbed staple barbs 800 engage the tissue may be different, depending on the tissue positioned within the tissue gap is larger the shorter the interstitial space. 更具体地,压缩在较短组织间隙内的组织可在其从端部执行器释放之后寻求比压缩在较大组织间隙内的组织更加重新展开,并且带倒钩的钉的倒钩可抑制或抵抗该重新展开,这取决于其构型和/或在倒钩上的位置。 More specifically, compress the tissue in a relatively short space of tissue may seek to re-expand more than the compression in large interstitial tissue after release from the end effector, and barbed spikes or barbs inhibit the resistance to re-open, depending on its configuration and / or location on the barb. 在其他情况下,倒钩可被构造成能够和/或定位成不抑制或抵抗组织的重新展开。 In other cases, the barbs may be configured to enable and / or positioned so as not to inhibit or resist reopening tissue. 如读者将理解的,砧座组织压缩表面10063是阶梯式的,并且仓平台表面是平坦或至少基本上平坦的,并且因此,限定在端部执行器内的组织间隙的差值随阶梯式砧座表面的高度而变化。 As the reader will appreciate, the anvil surface 10,063 tissue compression is stepped, and the cartridge deck surface is flat, or at least substantially flat and therefore, the gap defining the difference tissue within the end effector with the stepped anvil height of the seat surface varies. 可设想到其他实施方案。 Other embodiments may be envisaged. 例如,砧座组织压缩表面可为平坦或至少基本上平坦的,并且仓平台表面可为阶梯式的。 For example, the anvil tissue compression surfaces may be flat, or at least substantially flat and the cartridge deck surface may be stepped. 在其他情况下,砧座组织压缩表面和仓平台表面可均为阶梯式的。 In other cases, the anvil and cartridge tissue compression surface of the platform surface are stepped. 在任何情况下,不同间隙距离可限定在砧座组织压缩表面和仓平台表面之间。 In any case, the gap distance may be defined in different anvil surface and the tissue compressed between the cartridge deck surface. 虽然两个间隙距离已在图10和图11中示出,但是可能多于两个间隙距离,诸如三个间隙距离。 Although both the gap distance is shown in FIG. 10 and FIG. 11, the gap distance may be more than two, such as three gap distance. 参照图10和图11,第一纵向排的成形凹坑可布置在端部执行器的具有第一组织间隙距离的第一部分内,并且第二纵向排的成形凹坑可布置在端部执行器的具有不同于第一组织间隙距离的第二组织间隙距离的第二部分内。 Referring to FIGS. 10 and 11, a first longitudinal row of forming pockets may be disposed at the end of the first tissue having a gap distance within a first portion and a second longitudinal row forming pockets may be disposed at the end a second portion having a second tissue gap distance is different from the first tissue gap distance. 在一些情况下,端部执行器可包括第三纵向排的成形凹坑,其布置在端部执行器的具有不同于第一组织间隙距离和第二组织间隙距离的第三组织间隙距离的第三部分内。 In some cases, the end effector may include a third dimple forming longitudinal rows, which are arranged with a first gap distance different from the third tissue gap distance of the first tissue and second tissue gap distance at the end of in three parts. 在某些情况下,端部执行器可包括第三纵向排的成形凹坑,其布置在端部执行器的具有与第一组织间隙距离或第二组织间隙距离相同的组织间隙距离的第三部分内。 In some cases, the end effector may include a third dimple forming longitudinal rows, which are arranged with a third gap distance or the second tissue gap between the first tissue from the same tissue in the gap distance of the end effector section inside. 读者将理解,端部执行器可具有不同组织间隙距离和/或不同成形钉高度。 The reader will appreciate that the end effector may have different interstitial distances and / or different staple forming heights. 端部执行器可以具有一者、另一者,或两者兼有。 The end effector may have one, the other, or both. 在某些情况下,较短成形钉高度可与较短组织间隙距离相关联,而较大成形钉高度可与较大组织间隙距离相关联。 In some cases, a shorter staple forming height of the tissue may be associated with a shorter gap distance, and the larger staple forming height associated with larger interstitial distance. 在其他情况下,较短成形钉高度可与较大组织间隙距离相关联,而较大成形钉高度可与较短组织间隙距离相关联。 In other cases, a shorter staple forming height associated with larger tissue gap distance, and the larger staple forming height associated with interstitial shorter distance. 对上文进行进一步描述,钉在其未成形状态中可具有U形形状构型。 Further to the above described, the staple in its unformed state may have a U-shape configuration. U形形状的钉可包括基部和从基部延伸的两个钉腿,其中钉腿沿平行的方向延伸到彼此。 U-shaped staple may include a base and two legs extending from the base of the staple, wherein the staple legs extend in a direction parallel to one another. 另外对上文进行进一步描述,钉在其未成形状态中可包括V形形状构型。 In addition to the above described further, the staple in its unformed state may include a V-shaped configuration. V形形状构型可包括基部和从基部延伸的两个钉腿,其中钉腿沿不平行的方向延伸。 V-shape configuration may include a base and two staple legs extending from the base, which extends along a direction not parallel to staple leg. 本文所述的各种实施方案在线性端部执行器和/或线性紧固件仓的上下文中描述。 The various embodiments described herein the linear portion of the end effector and / or the context described linear fastener cartridge. 此类实施方案及其教导内容可应用于非线性端部执行器和/或非线性紧固件仓,诸如圆形和/或波状外形端部执行器。 Such embodiments and teachings may be applied to the nonlinear end effector and / or non-linear fastener cartridge, such as a circle and / or a contoured end effector. 例如,包括非线性端部执行器的各种端部执行器在2011年2月28日提交的名称为“SURGICALSTAPLING INSTRUMENT”的美国专利申请序列号13/036,647 (现为美国专利申请公布2011/0226837)中有所公开,该专利据此以引用方式全文并入。 For example, the name of a non-linear end various end in February 28, 2011 entitled "SURGICALSTAPLING INSTRUMENT" US Patent Application Serial No. 13 / 036,647 (now US Patent Application Publication 2011/0226837 ) are disclosed in, which is hereby incorporated by reference in its entirety. 另外,2012年9月29日提交的名称为“STAPLE CARTRIDGE”的美国专利申请序列号12/893,461 (现为美国专利申请公布2012/0074198)据此以引用方式全文并入。 In addition, the name of September 29, 2012, filed as "STAPLE CARTRIDGE" US Patent Application Serial No. 12 / 893,461 (now US Patent Application Publication 2012/0074198) hereby incorporated by reference. 2008年2月15日提交的名称为“END EFFECTORS FOR ASURGICAL CUTTING AND STAPLING INSTRUMENT” 的美国专利申请序列号12/031,873 (现为美国专利7,980,443)也据此以引用方式全文并入。 Name February 15, 2008 entitled "END EFFECTORS FOR ASURGICAL CUTTING AND STAPLING INSTRUMENT" US Patent Application Serial No. 12 / 031,873 (now US Patent 7,980,443) is also hereby incorporated by reference. 2010年12月7日公布的名称为“SURGICALINSTRUMENT HAVING RECORDING CAPABILITIES” 的美国专利7,845,537的全部公开内容以引用方式并入本文。 Name December 7, 2010 published as "SURGICALINSTRUMENT HAVING RECORDING CAPABILITIES" the entire disclosure of US Patent 7,845,537 is incorporated by reference herein. 2011年5月27日提交的名称为“SURGICAL STAPLING INSTRUMENTS WITHROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS” 的美国申请序列号13/118,241 (现为美国专利申请公布2012/0298719)的全部公开内容以引用方式并入本文。 Name May 27, 2011 entitled "SURGICAL STAPLING INSTRUMENTS WITHROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS" The entire disclosure of US application (now US Patent Application Publication 2012/0298719) serial number 13 / 118,241, incorporated herein by reference .

[0334]可将本文所公开的装置设计为单次使用后即进行处理,或者可将它们设计为可多次使用。 [0334] The device may be designed as disclosed herein is processed after a single use, or they can be designed to be used multiple times. 然而无论是哪种情况,该装置都可在至少使用一次后经过修复再行使用。 In either case, however, the device can be used at least once after repairing any further. 重新修复可包括以下步骤中的任意组合:拆卸该装置、然后清洗或更换特定零件、以及随后重新组装。 Reconditioning can include any combination of Re of the following steps: disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. 具体地,该装置可以拆卸,并且可以任意组合选择性地置换或移除任意数目的特定部件或零件。 In particular, the device can be disassembled, and any combination selectively replaced or removed in any number of particular pieces or parts. 清洗和/或更换特定零件后,该装置可以在修复设施处重新组装以便随后使用,或者在即将进行外科手术前由外科团队重新组装。 Upon cleaning and / or replacement of particular parts, the device can be reassembled at a reconditioning facility for subsequent use, or by a surgical team immediately prior to a surgical procedure. 本领域的技术人员应当理解,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。 Those skilled in the art will appreciate that the device can be restored using a variety of techniques for disassembly, cleaning / replacement, and reassembly. 此类技术的用途以及所得的重新修复装置均在本发明的范围内。 Use of such techniques, and the resulting reconditioned device, are again within the scope of the present invention.

[0335] 优选的是,将在手术前处理本文所述的发明。 [0335] Preferably, the invention described herein will be processed before surgery. 首先,获取新的或用过的器械,并根据需要进行清洗。 First, obtain a new or used instrument, and clean as necessary. 然后可对器械进行灭菌。 The instrument may then be sterilized. 在一种灭菌技术中,将该器械放置在闭合且密封的容器中,诸如塑料或TYVEK袋中。 In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. 然后将容器和器械放置在可穿透该容器的辐射场诸如γ辐射、X-射线或高能电子中。 The container and instrument are then placed in a field of radiation that can penetrate the container, such as γ irradiation, X- rays, or high-energy electrons. 辐射杀死器械上和容器中的细菌。 The radiation kills bacteria on the instrument and in the container. 然后可将灭菌后的器械储存在无菌容器中。 The sterilized instrument can then be stored in the sterile container. 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。 The sealed container keeps the instrument sterile until it is opened up in the medical facility.

[0336]以引用方式全文或部分地并入本文的任何专利、公布或其他公开材料均仅在所并入的材料不与本公开所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。 [0336] by reference in entirety or in part, any patent, publication, or other disclosure material herein are incorporated only in the incorporated material does not present disclosure with existing definitions claim, statements, or other disclosure material conflicts range incorporation of this article. 因此,并且在必要的程度下,本文明确阐述的公开内容取代以引用方式并入本文的任何冲突材料。 Accordingly, and in the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. 任何以引用方式并入本文但与本文所述的现有定义、陈述或其他公开材料相冲突的任何材料或其部分,仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入本文。 Any of any material incorporated by reference herein, but is described herein with existing definitions, statements, or other disclosure material conflicts or portions thereof, not only the conflict between that incorporated material and the existing disclosure material incorporated herein by next degree.

[0337]尽管本发明已被描述为具有示例性的设计,但还能够在本公开的实质和范围内对本发明进行修改。 [0337] While the invention has been described as having an exemplary design, but it is also possible to modify the invention within the spirit and scope of the present disclosure. 因此本申请旨在涵盖采用本发明一般原理的任何变型、用途或修改型式。 This application is therefore intended to cover any variations uses, uses, or adaptations of the principles of the general version of the invention. 另外,本申请旨在涵盖本发明所属领域中属于已知或惯有实践范围内的与本公开不同的此类型式。 Further, this application is intended to cover in the field of the invention is a known or customary with the present disclosure within the different versions of such a practice range.

Claims (21)

1.一种用于改变组织厚度补偿件的方法,所述方法包括以下步骤: 获得包括表面的组织厚度补偿件,其中所述表面至少部分地由具有玻璃化转变温度和熔融温度的材料构成; 将所述表面加热到高于所述玻璃化转变温度且低于所述熔融温度的温度; 操纵所述表面; 使所述经操纵的表面冷却到低于所述玻璃化转变温度;以及释放所述表面。 1. A method for changing tissue thickness compensator member, said method comprising the steps of: obtaining a tissue thickness compensator comprises a surface member, wherein said surface is at least partially converted material having a glass transition temperature and melting temperature of the composition; the surface is heated to a temperature above the glass transition temperature and lower than the said melting temperature; said actuating surface; the manipulated surface cooled to below the glass transition temperature; and releasing the said surface.
2.根据权利要求1所述的方法,其中获得所述组织厚度补偿件的步骤包括以下步骤: 获得包括玻璃化转变温度和熔融温度的生物相容性聚合物; 将所述生物相容性聚合物溶解于溶剂中以产生溶液;以及冻干所述溶液。 2. The method according to claim 1, wherein the step of obtaining the tissue thickness compensator comprises the steps of: obtaining a biocompatible polymer comprises a glass transition temperature and melt temperature; the biocompatible polymeric It was dissolved in a solvent to produce a solution; and lyophilizing said solution.
3.根据权利要求1所述的方法,其中操纵所述表面的步骤包括将至少一个压缩力施加到所述表面。 3. The method according to claim 1, wherein the step of manipulating said surface comprises at least one compression force is applied to the surface.
4.根据权利要求1所述的方法,其中操纵所述表面的步骤包括将至少一个拉力施加到所述表面。 4. The method according to claim 1, wherein the step of manipulating said surface comprises at least a tension is applied to the surface.
5.根据权利要求1所述的方法,还包括将所述经操纵的表面主动地冷却到低于所述玻璃化转变温度的步骤。 The method according to claim 1, further comprising the manipulated actively cooled to a surface of the step below the glass transition temperature.
6.—种与外科缝合器一起使用的定制组织厚度补偿件,其中所述定制组织厚度补偿件通过包括以下步骤的过程制备: 获得包括熔融温度的组织厚度补偿件; 获得包括接触表面的表面改性剂; 将所述接触表面加热到至少等于所述组织厚度补偿件的所述熔融温度的温度; 使所述组织厚度补偿件的表面与经加热的所述接触表面接合;以及移除所述表面改性剂。 6.- three customizable tissue thickness compensator for use with a surgical stapler, wherein the tissue thickness custom compensator prepared by a process comprising the steps of: obtaining a tissue thickness compensator comprises melting temperature; obtaining a surface modification comprising contacting surface agent; and at least said contact surface is heated to a temperature equal to the melting temperature of the tissue thickness compensator member; the surface of the contact with the heated surface of the tissue thickness compensator engagement member; and removing the surface modifiers.
7.根据权利要求6所述的定制组织厚度补偿件,其中获得所述组织厚度补偿件的步骤包括以下步骤: 获得包括玻璃化转变温度和熔融温度的生物相容性聚合物; 将所述生物相容性聚合物溶解于溶剂中以产生溶液;以及冻干所述溶液。 7. Customizing tissue thickness compensator according to claim 6, wherein the step of obtaining the tissue thickness compensator comprises the steps of: obtaining a biocompatible polymer comprises a glass transition temperature and melt temperature; the biological compatible polymer dissolved in a solvent to produce a solution; and lyophilizing said solution.
8.根据权利要求6所述的定制组织厚度补偿件,其中接合所述组织厚度补偿件的所述表面的步骤包括将至少一个压缩力施加到所述表面。 Step 8. The customized tissue thickness compensator according to claim 6, wherein the engaging surface of the tissue thickness compensator comprises at least one compression force is applied to the surface.
9.根据权利要求6所述的定制组织厚度补偿件,其中所述过程还包括将所述组织厚度补偿件的所述表面和所述表面改性剂的经加热的所述接触表面之间的接合维持足以熔融所述表面的时间段。 Between the customized according to the tissue thickness compensator 6, wherein said process further comprises contacting the surface to claim the heated surface of the tissue thickness compensator member and said surface modifier maintaining the engagement period sufficient to melt the surface.
10.根据权利要求6所述的定制组织厚度补偿件,其中所述过程还包括主动地冷却所述组织厚度补偿件的步骤。 10. Custom tissue thickness compensator according to claim 6, wherein said process further comprises the step of actively cooling the tissue thickness compensator member.
11.根据权利要求6所述的定制组织厚度补偿件,其中所述表面改性剂包括被构造成能够加热所述接触表面的加热元件。 11. The customized tissue thickness compensator according to claim 6, wherein the surface modifier is configured to be heated comprises contacting the surface of the heating element.
12.—种用于制备与外科缝合器一起使用的生物相容性泡沫的方法,所述方法包括以下步骤: 获得包括玻璃化转变温度和熔融温度的生物相容性聚合物; 将所述生物相容性聚合物溶解于溶剂中以产生溶液; 冻干所述溶液以产生生物相容性泡沫; 将所述生物相容性泡沫加热到高于所述玻璃化转变温度且低于所述熔融温度的温度; 将空间创建器插入所述生物相容性泡沫中; 使所述生物相容性泡沫冷却到低于所述玻璃化转变温度;以及移除所述空间创建器。 12.- method for the preparation of biocompatible foam for use with a surgical stapler, said method comprising the steps of: obtaining a biocompatible polymer comprises a glass transition temperature and melt temperature; the biological compatible polymer dissolved in a solvent to produce a solution; lyophilizing the solution to produce biocompatible foam; the biocompatible foam is heated to above the glass transition temperature and below the melting temperature; and the space creating the biocompatible foam is inserted; the biocompatible foam is cooled to below the glass transition temperature; and removing the space creator.
13.根据权利要求12所述的方法,其中所述空间创建器包括能够插入所述生物相容性泡沫中的中心梁。 13. The method according to claim 12, wherein said space creator can be inserted into said central beam comprises a biocompatible foam.
14.根据权利要求12所述的方法,其中所述空间创建器包括能够插入所述生物相容性泡沫中的多个突起。 14. The method according to claim 12, wherein said space creator comprises a plurality of biocompatible foam can be inserted in the projection.
15.根据权利要求14所述的方法,其中所述多个突起被布置成排。 15. The method according to claim 14, wherein said plurality of projections are arranged in a row.
16.根据权利要求14所述的方法,其中所述多个突起包括多个销,其中所述空间创建器包括表面,并且其中所述多个销中的每个销从所述表面平行于彼此延伸。 16. The method according to claim 14, wherein said plurality of projections comprises a plurality of pins, wherein said space creator comprises a surface, and wherein each of the plurality of pins from the pin surface parallel to each extend.
17.根据权利要求16所述的方法,其中所述多个销中的所述每个销从所述表面沿垂直于所述表面的轴线延伸。 17. The method according to claim 16, wherein said plurality of pins each pin extends perpendicular to the axis direction from the surface of the surface.
18.根据权利要求12所述的方法,还包括将所述生物相容性泡沫主动地冷却恢复到低于所述玻璃化转变温度的步骤。 18. The method according to claim 12, further comprising the biocompatible foam returns to step actively cooled below the glass transition temperature of the.
19.一种用于改变生物相容性泡沫的方法,所述方法包括以下步骤: 获得包括熔融温度的生物相容性泡沫; 将空间创建器加热到至少等于所述生物相容性泡沫的所述熔融温度的温度; 将所述空间创建器插入所述生物相容性泡沫中; 使所述生物相容性泡沫冷却到低于所述熔融温度;以及移除所述空间创建器。 19. A method for changing a biocompatible foam, said method comprising the steps of: obtaining a biocompatible foam comprising melting temperature; heated to create a space at least equal to the biocompatible foam said melting temperature; the space creating the biocompatible foam is inserted; the biocompatible foam is cooled to below the melting temperature; and removing the space creator.
20.根据权利要求19所述的方法,其中所述空间创建器包括能够插入所述生物相容性泡沫中的中心梁。 20. The method according to claim 19, wherein said space creator can be inserted into said central beam comprises a biocompatible foam.
21.根据权利要求19所述的方法,其中所述空间创建器包括能够插入所述生物相容性泡沫中的多个突起。 21. A method according to claim 19, wherein said space creator comprises a plurality of biocompatible foam can be inserted in the projection.
CN201580020868.0A 2014-02-24 2015-01-21 Implantable layers and methods for altering implantable layers for use with surgical fastening instruments CN106413577A (en)

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