CN108289672A - 可压缩附属物及其制作方法 - Google Patents

可压缩附属物及其制作方法 Download PDF

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Publication number
CN108289672A
CN108289672A CN201680068224.3A CN201680068224A CN108289672A CN 108289672 A CN108289672 A CN 108289672A CN 201680068224 A CN201680068224 A CN 201680068224A CN 108289672 A CN108289672 A CN 108289672A
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China
Prior art keywords
pillar
compressible adjunct
compressible
fiber
patent application
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Granted
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CN201680068224.3A
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English (en)
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CN108289672B (zh
Inventor
M·J·温德里
F·E·谢尔顿四世
J·L·哈里斯
H·T·格尔德雷因
R·S·莫伊尔
S·M·康索尼
I·阿克拉姆
A·D·伊斯特
H·S·拉萨姆
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Ethicon Endo Surgery LLC
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Ethicon Endo Surgery LLC
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Priority claimed from US14/871,195 external-priority patent/US10307160B2/en
Application filed by Ethicon Endo Surgery LLC filed Critical Ethicon Endo Surgery LLC
Publication of CN108289672A publication Critical patent/CN108289672A/zh
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Abstract

本发明提供了一种可压缩附属物，其具有第一部分、第二部分和中间部分。所述中间部分设置在所述第一部分与所述第二部分之间。所述中间部分包括第一支柱、第二支柱和互连构件。所述第一支柱和所述第二支柱基本上在所述第一部分与所述第二部分之间延伸。所述互连构件被构造成能够至少接合所述第一支柱和所述第二支柱。当所述可压缩附属物被力压缩时，所述第一支柱被构造成能够挠曲第一挠曲量，并且所述第二支柱被构造成能够挠曲第二挠曲量。所述第一挠曲量不同于所述第二挠曲量。

Description

可压缩附属物及其制作方法
背景技术
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以及与其一起使用的钉仓。
附图说明
各种实施方案的特征在所附权利要求书中进行了详细描述。然而，通过结合如下附图参考以下说明可最好地理解关于操作的组织和方法的各种实施方案及其优点：
图1为外科缝合和切断器械的透视图，该外科缝合和切断器械包括柄部、从柄部延伸的轴、和延伸以包括砧座和钉仓的端部执行器；
图2为图1的外科缝合和切断器械的钉仓的楔形滑动件的透视图；
图3为图1的外科缝合和切断器械的拼合式刀和击发杆(“E形梁”)的透视图；
图4为钉仓和处于闭合位置的砧座的纵向剖视图，该钉仓包括刚性支撑部分和可压缩附属物，该图示出了钉在击发序列期间从未击发位置运动到击发位置；
图5为图4的砧座和钉仓的另一个剖视图，该图示出了完成击发序列后处于打开位置的砧座；
图6为根据至少一个实施方案的包括可压缩附属物的钉仓组件的局部透视图；
图6A为由至少一个钉抵靠组织植入的图6的附属物的局部透视图；
图6B为根据至少一个实施方案的由至少一个钉抵靠组织植入的另选可压缩附属物的局部透视图；
图7为根据至少一个实施方案的包括另选可压缩附属物的钉仓组件的局部透视图；
图8为根据至少一个实施方案的包括另选可压缩附属物的钉仓组件的局部透视图；
图9为根据至少一个实施方案的由至少一个钉抵靠组织植入的另选可压缩附属物的局部透视图；
图10为根据至少一个实施方案的包括另选可压缩附属物的钉仓组件的局部剖视图；
图11为根据至少一个实施方案的包括另选可压缩附属物的钉仓组件的局部剖视图；
图12为根据至少一个实施方案的包括另选可压缩附属物的钉仓组件的局部剖视图；
图13为根据至少一个实施方案的另选可压缩附属物的局部透视图；
图14为抵靠钉仓的仓平台定位的图13的可压缩附属物的透视图；
图15为根据至少一个实施方案的包括另选可压缩附属物的钉仓组件的透视图；
图16为根据至少一个实施方案的另选可压缩附属物的局部透视图；
图17为根据至少一个实施方案的可压缩附属物的局部透视图；
图18为图17的可压缩附属物的剖视图；
图19为图18的剖视图的细部图；
图20为根据至少一个实施方案的包括可压缩附属物的钉仓组件的透视图；
图21为图20的钉仓组件的不同透视图；
图22为图20的钉仓组件的不同透视图；
图23为根据至少一个实施方案的可压缩附属物的局部透视图；
图24为根据至少一个实施方案的钉仓组件的局部剖视图；
图25为根据至少一个实施方案的插入到钉仓的钉腔中的固定构件的局部剖视图；
图26为根据至少一个实施方案的可压缩附属物的局部剖视图；
图27为根据至少一个实施方案的可压缩附属物的局部剖视图；
图28为根据至少一个实施方案的由至少一个钉抵靠组织植入的另选可压缩附属物的局部透视图；
图29为处于未压缩状态的图28的可压缩附属物的局部剖视图；
图30为处于压缩状态的图29的局部剖视图；
图31为根据至少一个实施方案的包括另选可压缩附属物的钉仓组件的透视图；
图32为根据至少一个实施方案的包括另选可压缩附属物的钉仓组件的透视图；
图33为根据至少一个实施方案的包括植入式附属物的钉仓组件的局部透视图；
图34为由至少一个钉抵靠组织植入的图33的附属物的局部透视图；
图35为根据至少一个实施方案的植入式附属物的局部透视图；
图36为根据至少一个另选实施方案的植入式附属物的局部透视图；
图37为图36的植入式附属物的局部正视图；
图38A为根据至少一个实施方案的环结的细部图；
图38B为根据至少一个实施方案的由图35的附属物使用的环结的细部图；
图39为图35的植入式附属物的局部正视图；
图40为根据本文所述的至少一个实施方案的包括多根直立纤维的可压缩附属物的局部剖视图；
图41为根据本文所述的至少一个实施方案的包括多根直立纤维的可压缩附属物的局部剖视图；
图42为根据本文所述的至少一个实施方案的由至少一个钉抵靠组织植入的可压缩附属物的局部透视图；
图43为根据本文所述的至少一个实施方案的纤维的局部透视图；
图44为根据本文所述的至少一个实施方案的纤维的局部透视图；并且
图45为根据本文所述的至少一个实施方案的可压缩附属物的局部透视图。
在所述若干视图中，对应的参考符号指示对应的部件。本文所述的范例以一种形式示出了本发明的各种实施方案，且这种范例不应被解释为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人拥有以下美国专利申请，所述美国专利申请与本申请于同一日期提交且各自全文以引用方式并入本文：
名称为“IMPLANTABLE LAYER COMPRISING PLASTICALLY DEFORMED FIBERS”的美国专利申请序列号__________；代理人案卷号END7646USNP/150081；
名称为“IMPLANTABLE LAYER COMPRISING A CONSTRICTED CONFIGURATION”的美国专利申请序列号__________；代理人案卷号END7647USNP/150082；
名称为“TUBULAR ABSORBABLE CONSTRUCTS”的美国专利申请序列号__________；代理人案卷号END7648USNP/150083；
名称为“IMPLANTABLE ADJUNCT COMPRISING BONDED LAYERS”的美国专利申请序列号__________；代理人案卷号END7649USNP/150084；
名称为“COMPRESSIBLE ADJUNCTS WITH BONDING NODES”的美国专利申请序列号__________；代理人案卷号END7650USNP/150085；
名称为“COMPRESSIBLE ADJUNCT WITH INTERMEDIATE SUPPORTING STRUCTURES”的美国专利申请序列号__________；代理人案卷号END7651USNP/150086；
名称为“COMPRESSIBLE ADJUNCT WITH CROSSING SPACER FIBERS”的美国专利申请序列号__________；代理人案卷号END7652USNP/150087；
名称为“COMPRESSIBLE ADJUNCT WITH LOOPING MEMBERS”的美国专利申请序列号__________；代理人案卷号END7653USNP/150088；
名称为“WOVEN CONSTRUCTS WITH INTERLOCKED STANDING FIBERS”的美国专利申请序列号__________；代理人案卷号END7654USNP/150089；
名称为“METHOD FOR APPLYING AN IMPLANTABLE LAYER TO A FASTENERCARTRIDGE”的美国专利申请序列号__________；代理人案卷号END7656USNP/150091；
名称为“COMPRESSIBLE ADJUNCT WITH ATTACHMENT REGIONS”的美国专利申请序列号__________；代理人案卷号END7657USNP/150092；
名称为“PROGRESSIVELY RELEASABLE IMPLANTABLE ADJUNCT FOR USE WITH ASURGICAL STAPLING INSTRUMENT”的美国专利申请序列号__________；代理人案卷号END7658USNP/150093；以及
名称为“COMPRESSIBLE ADJUNCT ASSEMBLIES WITH ATTACHMENT LAYERS”的美国专利申请序列号__________；代理人案卷号END7659USNP/150094。
本申请的申请人还拥有在下文中标识的美国专利申请，这些美国专利申请各自全文以引用方式并入本文：
名称为“SURGICAL INSTRUMENTS WITH RECONFIGURABLE SHAFT SEGMENTS”的美国专利申请序列号12/894,311；现为美国专利号8,763,877；
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；现为美国专利号8,899,463；
名称为“JAW CLOSURE ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号12/894,327；现为美国专利号8,978,956；
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；现为美国专利号9,113,864；
名称为“IMPLANTABLE FASTENER CARTRIDGE HAVING A NON-UNIFORMARRANGEMENT”的美国专利申请序列号12/894,338；现为美国专利号8,864,007；
名称为“IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER”的美国专利申请序列号12/894,369；现为美国专利申请公布2012/0080344；
名称为“IMPLANTABLE FASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS”的美国专利申请序列号12/894,312；现为美国专利号8,925,782；
名称为“SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE”的美国专利申请序列号12/894,377；现为美国专利号8,393,514；
名称为“SURGICAL STAPLING INSTRUMENT WITH COMPACT ARTICULATION CONTROLARRANGEMENT”的美国专利申请序列号12/894,339；现为美国专利号8,840,003；
名称为“SURGICAL STAPLING INSTRUMENT WITH A VARIABLE STAPLE FORMINGSYSTEM”的美国专利申请序列号12/894,360；现为美国专利号9,113,862；
名称为“SURGICAL STAPLING INSTRUMENT WITH INTERCHANGEABLE STAPLECARTRIDGE ARRANGEMENTS”的美国专利申请序列号12/894,322；现为美国专利号8,740,034；
名称为“SURGICAL STAPLE CARTRIDGES WITH DETACHABLE SUPPORT STRUCTURES”的美国专利申请序列号12/894,350；现为美国专利申请公布2012/0080478；
名称为“IMPLANTABLE FASTENER CARTRIDGE COMPRISING BIOABSORBABLELAYERS”的美国专利申请序列号12/894,383；现为美国专利号8,752,699；
名称为“COMPRESSIBLE FASTENER CARTRIDGE”的美国专利申请序列号12/894,389；现为美国专利号8,740,037；
名称为“FASTENERS SUPPORTED BY A FASTENER CARTRIDGE SUPPORT”的美国专利申请序列号12/894,345；现为美国专利号8,783,542；
名称为“COLLAPSIBLE FASTENER CARTRIDGE”的美国专利申请序列号12/894,306；现为美国专利号9,044,227；
名称为“FASTENER SYSTEM COMPRISING A PLURALITY OF CONNECTED RETENTIONMATRIX ELEMENTS”的美国专利申请序列号12/894,318；现为美国专利号8,814,024；
名称为“FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND AN ALIGNMENTMATRIX”的美国专利申请序列号12/894,330；现为美国专利号8,757,465；
名称为“FASTENER SYSTEM COMPRISING A RETENTION MATRIX”的美国专利申请序列号12/894,361；现为美国专利号8,529,600；
名称为“FASTENING INSTRUMENT FOR DEPLOYING A FASTENER SYSTEMCOMPRISING A RETENTION MATRIX”的美国专利申请序列号12/894,367；现为美国专利号9,033,203；
名称为“FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND A COVER”的美国专利申请序列号12/894,388；现为美国专利号8,474,677；
名称为“FASTENER SYSTEM COMPRISING A PLURALITY OF FASTENER CARTRIDGES”的美国专利申请序列号12/894,376；现为美国专利号9,044,228；
名称为“SURGICAL STAPLER ANVIL COMPRISING A PLURALITY OF FORMINGPOCKETS”的美国专利申请序列号13/097,865；现为美国专利申请公布2012/0080488；
名称为“TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER”的美国专利申请序列号13/097,936；现为美国专利号8,657,176；
名称为“STAPLE CARTRIDGE COMPRISING A VARIABLE THICKNESS COMPRESSIBLEPORTION”的美国专利申请序列号13/097,954；现为美国专利申请公布2012/0080340；
名称为“STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN ACOMPRESSIBLE PORTION THEREOF”的美国专利申请序列号13/097,856；现为美国专利申请公布2012/0080336；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING DETACHABLE PORTIONS”的美国专利申请序列号13/097,928；现为美国专利号8,746,535；
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；现为美国专利号8,864,009；
名称为“STAPLE CARTRIDGE COMPRISING AN ADJUSTABLE DISTAL PORTION”的美国专利申请序列号13/097,948；现为美国专利号8,978,954；
名称为“OMPRESSIBLE STAPLE CARTRIDGE ASSEMBLY”美国专利申请序列号13/097,907；现为美国专利申请公布2012/0080338；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING PORTIONS HAVINGDIFFERENT PROPERTIES”的美国专利申请序列号13/097,861；现为美国专利号9,113,865；
名称为“STAPLE CARTRIDGE LOADING ASSEMBLY”的美国专利申请序列号13/097,869；现为美国专利号8,857,694；
名称为“COMPRESSIBLE STAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS”的美国专利申请序列号13/097,917；现为美国专利号8,777,004；
名称为“STAPLE CARTRIDGE COMPRISING A RELEASABLE PORTION”的美国专利申请序列号13/097,873；现为美国专利号8,740,038；
名称为“STAPLE CARTRIDGE COMPRISING COMPRESSIBLE DISTORTION RESISTANTCOMPONENTS”的美国专利申请序列号13/097,938；现为美国专利号9,016,542；
名称为“STAPLE CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR”的美国专利申请序列号13/097,924；现为美国专利申请公布2012/0083835；
名称为“SURGICAL STAPLER WITH FLOATING ANVIL”的美国专利申请序列号13/242,029；现为美国专利号8,893,949；
名称为“CURVED END EFFECTOR FOR A STAPLING INSTRUMENT”的美国专利申请序列号13/242,066；现为美国专利申请公布2012/0080498；
名称为“STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK”的美国专利申请序列号13/242,086；现为美国专利号9,055,941；
名称为“STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK ARRANGEMENT”的美国专利申请序列号13/241,912；现为美国专利号9,050,084；
名称为“SURGICAL STAPLER WITH STATIONARY STAPLE DRIVERS”的美国专利申请序列号13/241,922；现为美国专利申请公布2013/0075449；
名称为“SURGICAL INSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATINGMULTIPLE ACTUATION MOTIONS”的美国专利申请序列号13/241,637；现为美国专利号8,789,741；
名称为“SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE ENDEFFECTOR”的美国专利申请序列号13/241,629；现为美国专利申请公布2012/0074200；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OFCAPSULES”的美国专利申请序列号13/433,096；现为美国专利申请公布2012/0241496；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF LAYERS”的美国专利申请序列号13/433,103；现为美国专利申请公布2012/0241498；
名称为“EXPANDABLE TISSUE THICKNESS COMPENSATOR”的美国专利申请序列号13/433,098；现为美国专利申请公布2012/0241491；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING A RESERVOIR”的美国专利申请序列号13/433,102；现为美国专利申请公布2012/0241497；
名称为“RETAINER ASSEMBLY INCLUDING A TISSUE THICKNESS COMPENSATOR”的美国专利申请序列号13/433,114；现为美国专利申请公布2012/0241499；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING AT LEAST ONEMEDICAMENT”的美国专利申请序列号13/433,136；现为美国专利申请公布2012/0241492；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING CONTROLLED RELEASE ANDEXPANSION”的美国专利申请序列号13/433,141；现为美国专利申请公布2012/0241493；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING FIBERS TO PRODUCE ARESILIENT LOAD”的美国专利申请序列号13/433,144；现为美国专利申请公布2012/0241500；
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；现为美国专利申请公布2012/0241501；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING RESILIENT MEMBERS”的美国专利申请序列号13/433,155；现为美国专利申请公布2012/0241502；
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；现为美国专利申请公布2012/0248169；
名称为“TISSUE THICKNESS COMPENSATORS”的美国专利申请序列号13/433,167；现为美国专利申请公布2012/0241503；
名称为“LAYERED TISSUE THICKNESS COMPENSATOR”的美国专利申请序列号13/433,175；现为美国专利申请公布2012/0253298；
名称为“TISSUE THICKNESS COMPENSATORS FOR CIRCULAR SURGICAL STAPLERS”的美国专利申请序列号13/433,179；现为美国专利申请公布2012/0241505；
名称为“ADHESIVE FILM LAMINATE”的美国专利申请序列号13/763,028；现为美国专利申请公布2013/0146643；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING CAPSULES DEFINING ALOW PRESSURE ENVIRONMENT”的美国专利申请序列号13/433,115；现为美国专利申请公布2013/0256372；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISED OF A PLURALITY OFMATERIALS”的美国专利申请序列号13/433,118；现为美国专利申请公布2013/0256365；
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；现为美国专利申请公布2013/0256382；
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；现为美国专利申请公布2013/0256368；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OFMEDICAMENTS”的美国专利申请序列号13/433,129；现为美国专利申请公布2013/0256367；
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，现为美国专利号7,669,746；
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；现为美国专利申请公布2007/0194082；
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；
名称为“SURGICAL STAPLING DEVICE WITH STAPLE DRIVERS OF DIFFERENTHEIGHT”的美国专利申请序列号11/711,975；现为美国专利申请公布2007/0194079；
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；
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；
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，现为美国专利号7,934,630；
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，现为美国专利号8,636,187；
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；现为美国专利申请公布2011/0290851；
名称为“ROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS”的美国专利申请序列号13/369,629，现为美国专利号8,800,838；
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；
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；
名称为“LAYER OF MATERIAL FOR A SURGICAL END EFFECTOR”的美国专利申请序列号13/766,325；现为美国专利申请公布2013/0256380；
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；现为美国专利申请公布2013/0256383；
名称为“LAYER COMPRISING DEPLOYABLE ATTACHMENT MEMBERS”的美国专利申请序列号13/763,094；现为美国专利申请公布2013/0256377；
名称为“END EFFECTOR COMPRISING A DISTAL TISSUE ABUTMENT MEMBER”美国专利申请序列号13/763,106；现为美国专利申请公布2013/0256378；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING CHANNELS”的美国专利申请序列号13/433,147；现为美国专利申请公布2013/0256369；
名称为“SURGICAL STAPLING CARTRIDGE WITH LAYER RETENTION FEATURES”的美国专利申请序列号13/763,112；现为美国专利申请公布2013/0256379；
名称为“ACTUATOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM AFASTENER CARTRIDGE”的美国专利申请序列13/763,035；现为美国专利申请公布2013/0214030；
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；现为美国专利申请公布2013/0221063；
名称为“FASTENER CARTRIDGE COMPRISING A RELEASABLE TISSUE THICKNESSCOMPENSATOR”的美国专利申请序列号13/763,048；现为美国专利申请公布2013/0221064；
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；现为美国专利申请公布2014/0097227；
名称为“FASTENER CARTRIDGE COMPRISING A RELEASABLY ATTACHED TISSUETHICKNESS COMPENSATOR”的美国专利申请序列号13/763,065；现为美国专利申请公布2013/0221065；
名称为“STAPLE CARTRIDGE COMPRISING A RELEASABLE COVER”的美国专利申请序列号13/763,021；现为美国专利申请公布2014/0224686；
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；现为美国专利申请公布2013/0256383；
名称为“LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES”的美国专利申请序列号13/763,095；现为美国专利申请公布2013/0161374；
名称为“IMPLANTABLE ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES”的美国专利申请序列号13/763,147；现为美国专利申请公布2013/0153636；
名称为“MULTIPLE THICKNESS IMPLANTABLE LAYERS FOR SURGICAL STAPLINGDEVICES”的美国专利申请序列号13/763,192；现为美国专利申请公布2013/0146642；
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；现为美国专利申请公布2013/0153641；
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；现为美国专利申请公布2013/0146641；
名称为“STAPLE CARTRIDGE COMPRISING A COMPRESSIBLE PORTION”的美国专利申请序列号13/763,037；现为美国专利申请公布2014/0224857；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING TISSUE INGROWTHFEATURES”的美国专利申请序列号13/433,126；现为美国专利申请公布2013/0256366；
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；现为美国专利申请公布2013/0256373；
名称为“FASTENER CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATORINCLUDING OPENINGS THEREIN”的美国专利申请序列号13/851,703；现为美国专利申请公布2014/0291382；
名称为“TISSUE THICKNESS COMPENSATOR COMPRISING A CUTTING MEMBER PATH”的美国专利申请序列号13/851,676；现为美国专利申请公布2014/0291379；
名称为“FASTENER CARTRIDGE ASSEMBLIES”的美国专利申请序列号13/851,693；现为美国专利申请公布2014/0291381；
名称为“FASTENER CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATORAND A GAP SETTING ELEMENT”的美国专利申请序列号13/851,684；现为美国专利申请公布2014/0291380；
名称为“STAPLE CARTRIDGE INCLUDING A BARBED STAPLE”的美国专利申请序列号14/187,387，现为美国专利申请公布2014/0166724；
名称为“STAPLE CARTRIDGE INCLUDING A BARBED STAPLE”的美国专利申请序列号14/187,395，现为美国专利申请公布2014/0166725；
名称为“STAPLE CARTRIDGE INCLUDING A BARBED STAPLE”的美国专利申请序列号14/187,400，现为美国专利申请公布2014/0166726；
名称为“IMPLANTABLE LAYERS AND METHODS FOR ALTERING IMPLANTABLE LAYERSFOR USE WITH SURGICAL FASTENING INSTRUMENTS”的美国专利申请序列号14/187,383，现为美国专利申请公布2015/0238185；
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14/187,386，现为美国专利申请公布2015/0239180；
名称为“IMPLANTABLE 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14/187,390，现为美国专利申请公布2015/0238188；
名称为“IMPLANTABLE LAYER ASSEMBLIES”的美国专利申请序列号14/187,389,现为美国专利申请公布2015/0238187；
名称为“IMPLANTABLE LAYERS COMPRISING A PRESSED REGION”的美国专利申请序列号14/187,385，现为美国专利申请公布2015/0238191；
名称为“FASTENING SYSTEM COMPRISING A FIRING MEMBER LOCKOUT”的美国专利申请序列号14/187,384，现为美国专利申请公布2015/0238186；
名称为“IMPLANTABLE LAYERS FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/827,856；
名称为“IMPLANTABLE LAYERS FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/827,907；
名称为“IMPLANTABLE LAYERS FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/827,932；
名称为“MALLEABLE BIOABSORBABLE POLYMER ADHESIVE FOR RELEASABLYATTACHING A STAPLE BUTTRESS TO A SURGICAL STAPLER”的美国专利申请序列号14/667,874；
名称为“ADJUNCT MATERIALS AND METHODS OF USING SAME IN SURGICALMETHODS FOR TISSUE SEALING”的美国专利申请序列号14/300,954；
名称为“DRUG ELUTING ADJUNCTS AND METHODS OF USING DRUG ELUTINGADJUNCTS”的美国专利申请序列号14/840,613；
名称为“METHOD FOR CREATING A FLEXIBLE STAPLE LINE”的美国专利申请序列号14/498,145；以及
名称为“IMPLANTABLE ADJUNCT SYSTEMS FOR DETERMINING ADJUNCT SKEW”的美国专利申请序列号14/865,306。
本文列出了许多具体细节，以提供对说明书中所述和附图中所示的实施方案的整体结构、功能、制造和用途的透彻理解。没有详细描述熟知的操作、部件和元件，以免使说明书中描述的实施方案模糊不清。读者将会理解，本文所述和所示的实施方案为非限制性示例，从而可认识到，本文所公开的特定结构和功能细节可为代表性和例示性的。在不脱离权利要求的范围的情况下，可对这些实施方案进行变型和改变。
术语“包括”(以及“包括”的任何形式，诸如“包括(comprises)”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、或设备的元件具有那些一个或多个特征，但不限于仅具有那些一个或多个特征。
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。术语“近侧”是指最靠近临床医生的部分，并且术语“远侧”是指远离临床医生定位的部分。还应当理解，为简洁和清楚起见，本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”等空间术语。然而，外科器械在许多方向和位置中使用，并且这些术语并非限制性的和/或绝对的。
提供各种示例性装置和方法以用于执行腹腔镜式和微创外科手术操作。然而，读者将容易理解，本文所公开的各种方法和装置可用于多种外科手术和应用中，包括例如与开放式外科手术结合。继续参阅本具体实施方式，读者将进一步理解，本文所公开的各种器械能够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。器械的工作部分或端部执行器部分可直接插入患者体内或者可通过具有工作通道的进入装置插入，外科器械的端部执行器和细长轴可通过所述工作通道推进。
外科缝合系统可包括轴和从轴延伸的端部执行器。端部执行器包括第一钳口和第二钳口。第一钳口包括钉仓。钉仓能够插入到第一钳口中并且能够从第一钳口移除；然而，设想到其中钉仓不能够从第一钳口移除或至少能够易于从第一钳口替换的其他实施方案。第二钳口包括被构造成能够使从钉仓射出的钉变形的砧座。第二钳口能够相对于第一钳口围绕闭合轴线枢转；然而，可设想到其中第一钳口能够相对于第二钳口枢转的其他实施方案。外科缝合系统还包括被构造成能够允许端部执行器相对于轴旋转或进行关节运动的关节运动接头。端部执行器能够围绕延伸穿过关节运动接头的关节运动轴线旋转。设想了不包括关节运动接头的其他实施方案。
钉仓包括仓体。仓体包括近侧端部、远侧端部和在近侧端部与远侧端部之间延伸的平台。在使用中，钉仓定位在待缝合的组织的第一侧上，并且砧座定位在组织的第二侧上。砧座朝向钉仓运动以将组织压缩并夹持抵靠平台。然后，能够移除地存储在仓体中的钉可部署到组织中。仓体包括限定于其中的钉腔，其中钉能够移除地存储在钉腔中。钉腔被布置成六纵向排。三排钉腔定位在纵向狭槽的第一侧上且三排钉腔定位在纵向狭槽的第二侧上。钉腔和钉的其他布置方式也是可以的。
钉由仓体中的钉驱动器支撑。驱动器能够在第一或非击发位置和第二或击发位置之间运动，以从钉仓射出钉。驱动器通过保持器保留在仓体中，保持器围绕仓体的底部延伸并且包括被构造成能够抓持仓体以及将保持器保持至仓体的弹性构件。驱动器能够通过滑动件在其非击发位置和击发位置之间运动。滑动件能够在与近侧端部相邻的近侧位置和与远侧端部相邻的远侧位置之间运动。滑动件包括多个斜坡表面，该斜坡表面被构造成能够朝向砧座在驱动器下方滑动以及提升驱动器，并且钉在驱动器上受到支撑。
除上述以外，滑动件还可通过击发构件朝远侧运动。击发构件被构造成能够接触滑动件并朝向远侧端部推动滑动件。限定于仓体中的纵向狭槽被构造成能够接收击发构件。砧座还包括被构造成能够接收击发构件的狭槽。击发构件还包括接合第一钳口的第一凸轮和接合第二钳口的第二凸轮。在击发构件朝远侧推进时，第一凸轮和第二凸轮可控制钉仓的平台和砧座之间的距离或组织间隙。击发构件还包括被构造成能够切入在钉仓和砧座中间捕集的组织的刀。希望刀定位成至少部分接近斜坡表面，使得钉先于刀被射出。
钉仓还可包括植入式层。植入式层被构造成能够在钉被相应的驱动器部署时连同组织被捕获在钉内。植入式层可包括支撑物、组织厚度补偿件、和/或其他助剂材料。组织厚度补偿件被构造成能够补偿组织特性的变化，诸如组织厚度例如沿钉线的变化。组织厚度补偿件可为可压缩的和弹性的。在使用中，组织厚度补偿件防止或限制缝合组织的过度压缩，同时有利于钉内和钉间的充分组织压缩。
钉仓的植入式层可以可剥离方式固定到钉仓的主体。例如，植入式层可利用可剥离粘合剂、至少一个附接插片、和/或其他附接特征结构以可剥离方式固定到钉仓的平台。除此之外或另选地，植入式层可以可剥离方式固定到第一钳口或第二钳口。植入式层可被定位到例如端部执行器的仓侧和/或端部执行器的砧座侧上。
植入式层可被构造成能够促进组织向内生长。在各种情况下，希望促进组织在植入式层中的向内生长以促进被处理组织(例如，缝合组织和/或切入组织)的愈合并且/或者加速患者的恢复。更具体地，组织在植入式层中的向内生长可降低外科部位处的炎症的发生率、范围和/或持续时间。组织在植入式层中和/或周围的向内生长可控制例如外科部位处的感染的扩散。血管尤其是白血细胞例如在植入式层中和/或周围的向内生长可抵抗植入式层及相邻组织中和/或周围的感染。组织向内生长还可促进异物(例如，植入式层和钉)被患者身体的接受，并且可降低患者身体拒绝异物的可能性。异物的拒绝可导致外科部位处的感染和/或炎症。
转到附图，其中在若干附图中相似编号指示相似部件，图1示出了适于与植入式附属物诸如例如组织厚度补偿件一起使用的示例性外科缝合和切断器械8010。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。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。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。
在各种情况下，通过连接到细长轴8018的柄部8020操纵钉仓组件8012。柄部8020可包括用户控件，诸如，使细长轴8018和钉施用组件8012围绕轴8018的纵向轴线旋转的旋钮8030以及可在手枪式握持部8036前方枢转以闭合钉施用组件8012的闭合触发器8026。例如，当闭合触发器8026被夹紧时，闭合释放按钮8038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。
可在闭合触发器8026前方枢转的击发触发器8034使得钉施用组件8012同时切断和缝合被夹紧在其中的组织。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。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。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。
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“FASTENER CARTRIDGE 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。此外，通电的外科缝合和切断器械也可与本公开一起使用。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2009/0090763A1，该专利的全部公开内容以引用方式并入本文。
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8010一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。此外，击发组件9090的远侧部分处的E形梁9102可从钉施用组件8012击发钉以及在击发期间相对于细长钉通道8016定位砧座8014。E形梁9102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。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。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。
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。参见图4，钉仓(诸如钉仓10000)例如可与外科缝合和切断器械8010一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)。支撑部分10010可包括仓体和多个钉腔10012。钉10030例如可以能够移除地定位在每个钉腔10012中。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。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。
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。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。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。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。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。
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。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。一旦砧座8014已适当定位，则可部署钉10030，同样如图4所示。
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。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。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。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。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。
参见图5，当钉10030处于其未击发位置时，钉10030的钉腿10032可越过支撑部分10010延伸到补偿件10020中。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。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。
参见图6，示出了钉仓组件10。钉仓组件10包括可与外科缝合和切断器械8010一起使用的钉仓12。钉仓12在许多方面类似于钉仓10000。与钉仓10000类似，钉仓12包括容纳在限定于钉仓12中的多个腔或凹坑中的多个钉10030。另外，钉仓12的多个钉10030可在外科缝合和切断器械8010的击发序列中进行部署。
钉仓12还包括仓平台16和刀狭槽37(图14和图16)，所述刀狭槽37在切割刃9116被推进以切割由外科缝合和切断器械8010捕获的组织时容纳切割刃9116。滑动件10050穿过钉仓12的推进导致钉仓12的钉10030从其相应的凹坑以下述方式部署到组织中，所述方式与如上所述的从钉仓10000部署钉10030的方式相同或基本上相同。
再次参见图6，钉仓组件10还包括在许多方面类似于组织厚度补偿件10020的组织厚度补偿件或可压缩附属物11。可压缩附属物11抵靠仓平台16进行定位。可压缩附属物11附接到仓平台16。例如，可压缩附属物11可部分地熔融到仓平台16上并且随后通过冷却而重新固化，这导致可压缩附属物11粘结到仓平台16。也可采用各种附接特征结构来将可压缩附属物11附接到仓平台16。
可压缩附属物11包括被构造成能够定位成抵靠并且/或者附接到仓平台16的第一生物相容性层14以及被构造成能够定位成抵靠捕获在砧座8014与钉仓12之间的组织的第二生物相容性层15。第一生物相容性层14和第二生物相容性层15通过多个支撑构件或支柱19间隔开，所述多个支撑构件或支柱19在第一生物相容性层14与第二生物相容性层15之间延伸或直立放置，如图6所示。支柱19保持第一生物相容性层14与第二生物相容性层15之间的平均距离，所述平均距离由支柱19的平均高度(H)部分限定。
如图6所示，支柱19具有相同或至少基本上相同的高度(H)。另选地，在某些情况下，支柱19可具有不同的高度。此外，如图6所示，支柱19具有相同或至少基本上相同的横向横截面。另选地，支柱19可具有不同的横向横截面。在至少一种情况下，支柱19的横向横截面可沿着支柱19的高度(H)而变化。例如，支柱19可具有宽的中间部分和窄的端部部分。另选地，支柱19可具有窄的中间部分和宽的端部部分。另选地，支柱19可具有宽的中间部分、一个宽的端部部分、和一个窄的端部部分。另选地，支柱19可具有窄的中间部分，一个窄的端部部分，和一个宽的端部部分。
如图6所示，支柱19具有圆形或至少基本上圆形的横向横截面。另选地，支柱19中的一个或多个可具有非圆形的横向横截面。在至少一个示例中，支柱19中的一个或多个可具有椭圆形、三叶草形、新月形、或三角形的横向横截面。本公开设想到支柱19的横向横截面的其他形状。
一般来讲，支柱19的材料组成、高度、和/或横向横截面至少部分地控制其刚度或在压缩作用下弯曲的能力，这继而至少部分地控制可压缩附属物11的可压缩性。因此，支柱19可被构造成能够将可压缩附属物11的可压缩性调节到一个或多个期望值。可压缩附属物11的各个部分可包括例如具有不同刚度或可压缩性的支柱19。
当砧座8014相对于钉仓12运动到闭合位置时，柱19能够在施加到可压缩附属物11的压缩作用下弯曲。在外科缝合和切断器械8010的击发序列期间，支柱19的弹性允许可压缩附属物11适应各个组织部分具有不同组织厚度的组织(T)同时保持砧座8014与钉仓12之间的相同或至少基本上相同的平均距离。
如图6A所示，钉10030被击发到可压缩附属物11以及包括具有平均组织厚度(T1)的第一组织部分72和具有大于组织厚度(T1)的平均组织厚度(T2)的第二组织部分74的组织(T)中。已击发钉10030在其中限定空间以用于容纳捕获的可压缩附属物11和捕获的组织(T)。由已击发钉10030限定的空间至少部分地由已击发钉10030的高度(H3)限制，如图6A所示。所捕获的组织(T)的最终厚度和塌缩的可压缩附属物11的最终高度的总和等于或至少基本上等于已击发钉10030的高度(H3)。为了补偿所捕获组织(T)的厚度的变化，抵靠第二组织部分(T2)定位的可压缩附属物11的部分被压缩到最终高度(H2)，所述最终高度(H2)大于抵靠第一组织部分(T1)定位的可压缩附属物11的部分的最终高度(H1)。支柱19的弹性允许可压缩附属物11抵靠第二组织部分74比抵靠第一组织部分72被更大程度地压缩，这允许可压缩附属物11补偿由已击发钉10030限定的空间内的组织部分72和74的不同厚度。
当砧座8014朝其闭合位置运动时，砧座8014可接触组织T并对组织T和可压缩附属物11施加压缩力。支柱19的材料组成、孔隙率、频率、尺寸和/或取向可被定制以控制或调节可压缩附属物11的可压缩性。
在某些情况下，支柱19可为成角度的或倾斜的，以有利于响应于压缩力而沿第一方向诸如例如近侧方向(P)的有组织塌缩。然而在其他情况下，支柱19可为成角度的或倾斜的，以有利于响应于压缩力而沿不同于第一方向的第二方向诸如例如远侧方向(D)的有组织塌缩。在某些情况下，可压缩附属物11可包括成角度或倾斜以有利于沿第一方向弯曲的第一组支柱19和成角度或倾斜以有利于沿不同于第一方向的第二方向弯曲的第二组支柱19。在此类情况下，不同的弯曲方向可导致可压缩附属物11以无组织的方式弯曲。
参见图6，支柱19被取向成使得每个支柱19沿着或至少基本上沿着与第一生物相容性层14和第二生物相容性层15相交的横向轴线延伸。支柱19垂直于或至少基本上垂直于第一生物相容性层14和第二生物相容性层15。因此，支柱19彼此平行或至少基本上彼此平行地延伸。如图6所示，支柱19彼此间隔开并被布置成平行排。
在某些情况下，支柱19相对于第一生物相容性层14和/或第二生物相容性层15成角度或对角地取向。在某些情况下，支柱19按照预定义的模式诸如同心圆进行组织。在可压缩附属物11的特定部分内的支柱19的频率可影响(除了别的以外)此类部分的可压缩性。在某些情况下，支柱可被策略性性地集中在可压缩附属物11的某些部分中以例如在此类部分中提供更大的柱强度。在至少一种情况下，支柱19可集中在可压缩附属物11的下述部分中，所述部分被构造成能够在外科缝合和切断器械8010被击发时接收钉。另选地，支柱19可集中在可压缩附属物11的下述部分中，所述部分在外科缝合和切断器械8010被击发时不接收钉。在某些情况下，支柱19围绕外周边进行布置从而限定可压缩附属物11的侧壁，如图6所示。
支柱19中的每一个支柱包括在固定到第一生物相容性层14的第一端部部分18与和固定到第二生物相容性层15的第二端部部分20之间延伸的中间直立部分22。端部部分18和20可分别嵌入到第一生物相容性层14和第二生物相容性层15中。例如，端部部分18和20可分别针织或织造到第一生物相容性层14和第二生物相容性层15中。在某些情况下，端部部分18和20可利用热或溶剂分别焊接到第一生物相容性层14和第二生物相容性层15上。在某些情况下，端部部分18和20可分别胶合、钩挂和/或紧固到第一生物相容性层14和第二生物相容性层15。
如图6所示，第一生物相容性层14和第二生物相容性层15为织造层。在某些情况下，第一生物相容性层14和/或第二生物相容性层15可为针织层。在某些情况下，第一生物相容性层14和/或第二生物相容性层15可为泡沫层。在某些情况下，第一生物相容性层14和/或第二生物相容性层15可为膜层。
参照图6B，可压缩附属物61与组织(T)缝合在一起。可压缩附属物61包括被构造成能够被定位成抵靠和/或附接到钉仓12的仓平台16的第一生物相容性层64。环状构件69从第一生物相容性层64突起。环状构件69直接抵靠捕获在砧座8014和钉仓12之间的组织进行定位。另选地，可压缩附属物61可包括第二生物相容性层(如果存在的话)，并且环状构件69可保持生物相容性层之间的平均距离或间距。换句话讲，环状构件69可在第一生物相容性层64上方提升或升高第二生物相容性层。
第一生物相容性层64和/或第二生物相容性层可为织造层。在某些情况下，第一生物相容性层64和/或第二生物相容性层可为针织层。在某些情况下，第一生物相容性层64和/或第二生物相容性层可为泡沫层。在某些情况下，第一生物相容性层64和/或第二生物相容性层可为膜层。可利用一个或多个细长柔性构件诸如例如单丝和/或复丝纤维通过通过各种技术诸如例如编织和/或针织来形成一个或多个环状构件69。在至少一种情况下，细长柔性构件可例如穿入第一生物相容性层64中以形成环状构件69。
如图6B所示，环状构件69包括第一端部部分69a、第二端部部分69b、以及在第一端部部分69a和第二端部部分69b之间延伸的中间弯曲部分69c。端部部分69a和69b部分地嵌入和/或附接到第一生物相容性层64，同时中间弯曲部分69c通过第一端部部分69a和第二端部部分69b被提离第一生物相容性层64或与该层间隔开。环状构件69可具有相同的或至少基本上相同的高度。另选地，在某些情况下，环状构件69可具有不同的高度。
当存在第二生物相容性层时，环状构件69可定位在第一生物相容性层64与第二生物相容性层之间，并且中间弯曲部分69c可例如附接到第二生物相容性层。可采用多种附接技术诸如例如使用生物相容性胶来将第二生物相容性层固定到中间弯曲部分69c。在某些情况下，中间弯曲部分69c可与第二生物相容性层缝合在一起。
如图6B所示，第一生物相容性层64包括彼此间隔开的拴系岛62。拴系岛62被布置成平行的或至少基本上平行的排。每个拴系岛62由相交于拴系岛62处的环形构件69的第一端部部分69a和第二端部部分69b限定。在某些情况下，环状构件69的端部部分69a和69b可例如由彼此间隔开的两个拴系岛62接收。在某些情况下，仅单个端部部分69a或69b例如由拴系岛62接收。另选地，拴系岛62可被构造成能够接收例如端部部分69a和/或69b中的三个或更多个。拴系岛62可被构造成能够接收例如端部部分69a中的一个或多个而不接收端部部分69b中的任一个。
对上文进行进一步描述，环状构件69中的一个或多个包括从拴系岛62延伸的窄颈部部分63a和从窄颈部部分63a延伸的宽头部部分63b。在某些情况下，头部部分63b可抵靠第二生物相容性层进行定位。另选地，头部部分63b可抵靠组织(T)进行定位。
如图6B所示，环状构件69从第一生物相容性层64沿大致垂直的方向突起，这使得环构件69响应于通过被定位成抵靠可压缩附属物61的组织(T)传输的压缩力而以无组织的方式弯曲。在某些情况下，环状构件69可为成角度的或倾斜的，以有利于响应于压缩力而沿第一方向诸如例如近侧方向(P)的有组织塌缩。然而在其他情况下，环状构件69可为成角度的或倾斜的，以有利于响应于压缩力而沿不同于第一方向的第二方向诸如例如远侧方向(D)的有组织塌缩。在某些情况下，可压缩附属物61可包括成角度或倾斜以有利于沿第一方向弯曲的第一组环状构件69和成角度或倾斜以有利于沿不同于第一方向的第二方向弯曲的第二组环状构件69。在此类情况下，不同的弯曲方向可导致可压缩附属物69以无组织的方式弯曲。
参见图7，可压缩附属物31包括第一生物相容性层34和第二生物相容性层35，所述第二生物相容性层35为穿孔膜层，如下文更详细所述。可压缩附属物31在许多方面类似于可压缩附属物11。例如，可压缩附属物31包括多个支柱39，所述支柱39在许多方面类似于可压缩附属物11的支柱19。与支柱19不同，支柱39未被布置成平行排。支柱39被构造成能够彼此交叉，这可通过增加剪切负荷和/或压缩负荷下的抗塌缩性来改善可压缩附属物31的稳定性。
如图7所示，支柱39a被构造成能够与支柱39b交叉。支柱39a的第一端部部分38a与支柱39b的第二端部部分40b对齐，使得由第一端部部分38a和第二端部部分40b限定的第一横向轴线垂直于生物相容性层34和第二生物相容性层35。另外，支柱39b的第一端部部分38b与支柱39a的第二端部部分40a对齐，使得由第一端部部分38b和第二端部部分40a限定的第二横向轴线垂直于生物相容性层34和第二生物相容性层35。另外，支柱39a和39b的中间部分42a和42b可分别诸如例如通过焊接而彼此附接在一起。另选地，可允许中间部分42a和42b相对于彼此自由地运动。
在不同的布置中，某些支柱39可被构造成能够共用粘结波节或界面。如图7所示，支柱39c和支柱39d在粘结波节44处附接到第一生物相容性层34。支柱39c和39d从粘结波节44沿不同方向延伸，从而终止在第二生物相容性层35上的两个不同粘结波节46和48处。此外，支柱39e从粘结波节48延伸，从而终止在第一生物相容性层34上的粘结波节49处。支柱39c-39e在生物相容性层34和35之间的布置的重复可在两者间产生之字形模式。应当理解，三个或更多个支柱39可从一个粘结波节延伸或发出。
对上文进行进一步描述，可通过在膜中冲压孔50产生生物相容性层34和35的穿孔膜。孔50可改善可压缩附属物31中的组织向内生长。在某些情况下，在膜被制备之后产生孔50。例如，可利用溶剂或热来移除膜的部分以产生孔50。在其他情况下，可利用例如模具来制备具有孔50的膜。如图7所示，孔50被布置成排。此外，第一生物相容性层34的孔50与第二生物相容性层35的孔50对齐，以提供穿过可压缩附属物31的组织生长的路径。另选地，孔50可无归地定位。在至少一种情况下，孔50存在于生物相容性层34和35中的仅一者中。
参见图8，可压缩附属物51包括通过多个支撑或直立支柱或纤维59彼此间隔开的第一生物相容性层54和第二生物相容性层55。可压缩附属物51在许多方面类似于可压缩附属物11和31。例如，可压缩附属物51可抵靠钉仓12的仓平台16进行定位，如图8所示。可压缩附属物51包括纬编针织双面织物。在某些情况下，可压缩附属物51包括被构造成能够产生两个拴系层的两组互连成环的纤维。
可压缩附属物51包括以平行的或至少基本上平行的排延伸的多个环66。每个环66被定位在或开始于生物相容性层54和55中的一者处并且限定朝向生物相容性层54和55中的另一者延伸的两根直立纤维59。直立纤维59为成角度的或倾斜的，以有利于响应于通过抵靠第二生物相容性层55定位的组织(T)施加到第二生物相容性层55的压缩力而沿第一方向诸如例如近侧方向(P)的有组织塌缩。另选地，直立纤维59可为成角度的或倾斜的，以有利于响应于压缩力而沿与第一方向相反的第二方向诸如例如远侧方向(D)的有组织塌缩。另选地，可压缩附属物可包括成角度或倾斜以有利于沿第一方向弯曲的第一组直立纤维59和成角度或倾斜以有利于沿第二方向弯曲的第二组直立纤维59。不同的弯曲方向可导致可压缩附属物51以无组织的方式弯曲。
如图8所示，源自第二生物相容性层55的第一环66a限定第一对直立纤维59a，所述第一对直立纤维59a从第二生物相容性层55朝向第一生物相容性层54延伸。第一环66a保持由第二环66b限定的第二对直立纤维59b，所述第二对直立纤维59b也源自第二生物相容性层55。第二环66b相对于第一环66a被定位在远侧位置处。第二对直立纤维59b也朝向第一生物相容性层54延伸。所述模式以规则间隔进行重复。同样，源自第一生物相容性层54的类似环66限定从第一生物相容性层54朝向第二生物相容性层55延伸的成对直立纤维59。
可增加或减小两个连续的对直立纤维59之间的间距以分别增加或减小可压缩附属物51的可压缩性。一般来讲，可压缩附属物51的特定部分处的较多数量的直立纤维59对应于可压缩附属物51的此部分在压缩力下的较高稳定性。
第一生物相容性层54的环66被布置成平行的或至少基本上平行的排57a，并且第二生物相容性层55的环66被布置成与排57a间隔开的平行的或至少基本上平行的排57b。
参见图9，钉10030被击发到可压缩附属物51以及包括具有平均组织厚度(T1)的第一组织部分72和具有大于组织厚度(T1)的平均组织厚度(T2)的第二组织部分74的组织(T)中。已击发钉10030在其中限定空间以用于容纳捕获的可压缩附属物51和捕获的组织(T)。由已击发钉10030限定的空间至少部分地由已击发钉10030的高度(H3)限制，如图9所示。所捕获的组织(T)的最终厚度和塌缩的可压缩附属物51的最终高度的总和等于或至少基本上等于已击发钉10030的高度(H3)。为了补偿所捕获组织(T)的厚度的变化，抵靠第二组织部分(T2)定位的可压缩附属物51的部分被压缩到最终高度(H2)，所述最终高度(H2)大于抵靠第一组织部分(T1)定位的可压缩附属物51的部分的最终高度(H1)。直立纤维59的弹性允许可压缩附属物51抵靠第二组织部分74比抵靠第一组织部分72被更大程度地压缩，这允许可压缩附属物51补偿由已击发钉10030限定的空间内的组织部分72和74的不同厚度。直立纤维59的材料组成、孔隙率、频率、尺寸和/或取向可被定制以控制或调节可压缩附属物51的可压缩性。
参照图10-图12，各种可压缩附属物抵靠钉仓12的仓平台16进行定位。图10-图12的可压缩附属物在许多方面类似于可压缩附属物11、31和51。图10-图12的可压缩附属物进一步地通过由一根或多根直立纤维互连的粘结波节或界面来表征。例如，如图10所示，可压缩附属物81包括限定于第一生物相容性层84中的第一系列粘结波节84a-84e和限定于与第一生物相容性层84间隔开的第二生物相容性层85中的第二系列粘结波节85a-85e。间隔件纤维或直立纤维89从第一系列粘结波节84a-84e和/或第二系列粘结波节85a-85e延伸。
粘结波节84a-84e与对应的粘结波节85a-85e竖直地对齐或至少基本上对齐。此外，粘结波节84a-84e和粘结波节85a-85e分别被布置成或至少基本上布置成对应的排102和103。尽管在生物相容性层84和85中的每个生物相容性层中示出了仅一排粘结波节，但生物相容性层84和/或85可各自包括多排粘结波节或界面。
如图10所示，直立纤维89可包括经交织以形成网状结构的第一组直立纤维89a和第二组直立纤维89b。直立纤维89a大致沿循平行的或至少基本上平行的路径，所述路径相对于竖直轴线为沿近侧方向(P)成角度的或倾斜的。另一方面，直立纤维89b大致沿循平行的或至少基本上平行的路径，所述路径相对于竖直轴线为沿远侧方向(D)成角度的或倾斜的。
在从粘结波节诸如例如粘结波节85e延伸的纤维89a和89b之间限定角度α。例如，角度α为约10°至约160°范围内的任意角度。在某些情况下，角度α为例如约45°至约135°范围内的任意角度。在某些情况下，角度α为例如约60°至约110°范围内的任意角度。
如图10所示，直立纤维89b沿近侧方向(P)从粘结波节85a延伸到粘结波节84d。换句话讲，直立纤维89b连接排102中的第一位置处的粘结波节与排103中的第四位置处的粘结波节。因此，直立纤维89b与四根直立纤维89a交叉。在某些情况下，直立纤维89b可附接到由直立纤维89b交叉的四根直立纤维89a中的一个根或多根。
此外，直立纤维89a沿远侧方向(D)从粘结波节85e延伸到粘结波节84b。换句话讲，直立纤维89a连接排103中的第五位置处的粘结波节与排102中的第二位置处的粘结波节。因此，直立纤维89a与四根直立纤维89b交叉。在某些情况下，直立纤维89a可附接到由直立纤维89a交叉的四根直立纤维89b中的一个根或多根。直立纤维89a和89b的交叉改善了可压缩附属物81在压缩力和/或剪切力下的稳定性。
在某些情况下，直立纤维可在生物相容性层上的一排粘结波节中的第一位置处的粘结波节与不同生物相容性层上的一排粘结波节中的第二位置处的粘结波节之间延伸。在某些情况下，直立纤维可在生物相容性层上的一排粘结波节中的第一位置处的粘结波节与不同生物相容性层上的一排粘结波节中的第三位置处的粘结波节之间延伸。在某些情况下，直立纤维可在生物相容性层上的一排粘结波节中的第一位置处的粘结波节与不同生物相容性层上的一排粘结波节中的第五位置处的粘结波节之间延伸。各种其他位置处的各种粘结波节可由直立纤维89连接。在各种情况下，增加互连粘结波节之间的距离可降低可压缩附属物81的刚度。
参见图12，生物相容性层85的粘结波节81经由桥接构件92互连，所述桥接构件92在生物相容性层85的粘结波节之间延伸。如图12所示，桥接构件92在粘结波节85a和85b之间延伸。另一个桥接构件92在粘结波节85b和85c之间延伸。另外的桥接构件92可在生物相容性层85的同一排或不同排中的各个粘结波节之间延伸。
在某些情况下，生物相容性层84和85中的至少一个的粘结波节经由桥接构件92互连。在某些情况下，生物相容性层84和85中的至少一个的粘结波节彼此断开连接。如图10所示，第一生物相容性层84的粘结波节84a-84e彼此不直接连接。
参见图12，示出了可压缩附属物81’。可压缩附属物81’在许多方面类似于可压缩附属物81。此外，生物相容性层84和85的每对竖直对齐的粘结波节由一对直立纤维94连接。例如，一对直立纤维94在粘结波节85a与粘结波节84a之间延伸。直立纤维94改善了可压缩附属物81'在压缩力和/或剪切力下的稳定性。在某些情况下，仅一根直立纤维94在生物相容性层84和85的竖直对齐的粘结波节之间延伸。在某些情况下，三根或更多根直立纤维94在生物相容性层84和85的竖直对齐的粘结波节之间延伸。
参见图11，示出了可压缩附属物100。可压缩附属物100在许多方面类似于可压缩附属物81和81’。例如，可压缩附属物100包括具有粘结波节84a和84b的第一生物相容性层84'以及具有连接的粘结波节85a和85b的第二生物相容性层85'；然而，第一生物相容性层84'与第二生物相容性层85'偏置，使得第一生物相容性层84'的粘结波节84a和84b不与第二生物相容性层85'的粘结波节85a和85b竖直对齐。然而，在另选实施方案中，第一生物相容性层84'的粘结波节和第二生物相容性层85'的对应粘结波节可竖直对齐。
如图11所示，第一生物相容性层84'和第二生物相容性层85'之间的偏置导致在粘结波节84a和84b与粘结结点85a和85b之间延伸的直立纤维94'为成角度的或倾斜的，以有利于沿预定方向弯曲。例如，在图11所示的实施方案中，第一生物相容性层84'滞后于第二生物相容性层85'，这导致粘结波节85a例如位于粘结波节84a之前。因此，在粘结波节85a和84a之间延伸的直立纤维94'有利于沿远侧方向(D)弯曲。在粘结波节84b和85b之间延伸的直立纤维94'也为成角度的或倾斜的，以有利于沿远侧方向(D)弯曲。在另选实施方案中，直立纤维94'可取向成有利于沿近侧方向(P)弯曲。重复这种模式使得直立纤维对彼此平行或至少基本上彼此平行。在至少一个实施方案中，直立纤维94'中的一根或多根被取向成有利于沿近侧方向(P)弯曲并且直立纤维94'中的一根或多根被取向成有利于沿远侧方向(D)弯曲。直立纤维94'的弯曲方向可部分地基于被处理组织(T)的类型、位置和取向来选择。
再次参见图10和图12，生物相容性层84和85的外表面可被定制以适应各种钉仓平台和组织表面。例如，如图10-图12所示，生物相容性层84的粘结波节或界面彼此不直接连接，这允许生物相容性层84的附加柔韧性以适应例如阶梯式仓平台。在某些情况下，可压缩附属物的直立纤维可延伸超过生物相容性层以改变生物相容性层的外表面。
参见图13和图14，可压缩附属物110在许多方面类似于可压缩附属物11、31、51、81、81'和100。例如，可压缩附属物110可抵靠钉仓12的仓平台16进行定位。另外，可压缩附属物110包括在许多方面分别类似于可压缩层84、可压缩层85和直立纤维89的第一生物相容性层114、第二生物相容性层115和间隔件纤维或直立纤维119。
直立纤维119被构造成能够为可压缩附属物110提供结构支撑。相邻纤维部分119a和119b被构造成能够彼此交叉，如图13所示，以增加可压缩附属物110的稳定性。向可压缩附属物110施加压缩力可导致纤维部分119a和119b相对于彼此弯曲和/或偏移。
如图13-图16所示，可压缩附属物110和130包括被定位在可压缩附属物110的外周边处和/或在某些情况下被定位在各种其他中心位置处的构造块111。可压缩附属物110的构造块111包括一对纤维部分119a，所述一对纤维部分119a被构造成能够在限定于可压缩层114和115之间的中间距离处的平面上与一对纤维部分119b交叉。此外，四个纤维部分122限定构造块111的四个角。四个纤维部分122中的每个纤维部分沿着或至少基本上沿着横断生物相容性层114和115的竖直轴线延伸。在某些情况下，构造块111不包括竖直纤维部分。相邻构造块111共用公共纤维部分122。
如图13所示，交叉纤维部分119a和119b限定角度β，所述角度β可为例如约10°至约170°范围内的任意角度。在某些情况下，角度β可为例如约30°至约100°范围内的任意角度。在某些情况下，角度β可为例如约50°至约70°范围内的任意角度。
可压缩附属物110的直立纤维119还限定从第一生物相容性层114突起的抓握特征结构。抓握特征结构可为牵引环120的形式。如图13所示，两个纤维部分119a和119b在第一生物相容性层114的内表面116处相交于粘结波节或界面105，并且随后延伸穿过第一生物相容性层114以在第一生物相容性层114的外表面118上形成环120。纤维119可穿过第一生物相容性层114以形成若干环120。另选地，环120可独立于纤维119而形成于外表面118上。例如，可采用另一种纤维以在第一生物相容性层114上形成环120。如图13所示，环120与粘结波节或界面105对齐。另选地，在某些情况下，环120不与粘结波节105对齐。
如图13所示，环120被间隔开并且被布置成排123。环120可被定位在生物相容性层114的外周边处并且/或者在某些情况下被定位在在第一生物相容性层114上的各种其他位置处以提供相对于钉仓12的仓平台16的牵引力。
可控制第一生物相容性层114的特定部分处的环120的频率、位置、布置和/或尺寸以在第一生物相容性层114的该部分处实现相对于仓平台16的期望牵引程度。例如，如果在第一生物相容性层114的近侧部分处期望相对于仓平台16的附加牵引力，则可在第一生物相容性层114的外表面118的近侧部分上相比于外表面118的其余部分形成更多数量的牵引环120。
此外，仓平台还可包括例如附接部件，所述附接部件用于可释放地保持牵引环120以改善可压缩附属物110与仓平台16之间的牵引力。此外，第一生物相容性层114可被设计成包括用于热成形或粘结到仓平台16的特别致密部分。
与第一生物相容性层114类似，第二生物相容性层115也可包括用于向组织提供牵引力的抓握特征结构。例如，如图15和图16所示，可压缩附属物130包括在许多方面类似于牵引环120的牵引环140。牵引环140被定位在第二生物相容性层115的外表面138上。另选地，第二生物相容性层115的外表面138可为平滑的或至少基本上平滑的，并且/或者被处理以最小化组织向内生长和/或粘附性。
在各种情况下，生物相容性层114和115的抓握特征结构(包括环120和140)可被分别直接针织或织造到生物相容性层114和115上。在至少一种情况下，第一生物相容性层114和/或第二生物相容性层115可包括具有暴露的线的缎型编织物，所述线在第一方向上较长并且在与第一方向相交的第二方向上较短。缎型编织物可通过抵抗第二方向上的流动来增加牵引力。在各种情况下，生物相容性层114和115可由一根或多根复丝纤维针织而成，而直立纤维119包括单丝纤维。单丝纤维119可延伸超过生物相容性层114和115以形成环120和140。直立纤维119的延伸部可例如在生物相容性层114和115的针织模式的过程之间成环。
在各种情况下，生物相容性层114和115的抓握特征结构(包括环120和140)可为成角度的或倾斜的，以改善预定方向上的牵引力。例如，如图15和图16所示，环140沿近侧方向(P)略成角度或倾斜以抵抗邻近组织沿远侧方向(D)的流动。在另选实施方案中，环140可沿远侧方向(D)略成角度或倾斜以抵抗邻近组织沿近侧方向(P)的流动。在某些情况下，环140中的一些可沿近侧方向(P)成角度或倾斜并且环140中的一些可沿远侧方向(D)成角度或倾斜。在各种情况下，增加环140的高度可增加其对相邻组织的流动的抵抗力。
参见图14和图16，刀通道或狭槽137限定在每个可压缩附属物110和130的主体中。当可压缩附属物110和114抵靠钉仓12进行定位时，刀狭槽137与限定于钉仓12中的刀狭槽37对齐或至少基本上对齐。刀狭槽37和137被构造成能够在切割刃9116被推进以切割由外科缝合和切断器械8010捕获的组织时容纳切割刃9116。
可压缩附属物诸如例如可压缩附属物110和/或130可被制造为具有刀狭槽137。例如，刀狭槽137可在可压缩附属物的主体中织造或针织为具有减小纤维密度的局部薄区域。另选地，可在制造后的可压缩附属物中产生刀狭槽137。例如，可利用溶剂、热操作、模切操作、激光切割操作、超声切割操作或这些技术的组合来将刀狭槽137切割到可压缩附属物中。刀狭槽137有助于最小化可压缩附属物对切割刃9116的推进的阻力，这(除了别的以外)可改善切割刃9116的寿命并且/或者减小推进切割刃9116所需的力。
在某些情况下，刀狭槽137可将可压缩附属物分成两个完全分开的部分。另选地，如图17和图18所示，延伸于可压缩附属物150的两个部分150a和150b之间的刀狭槽137可被一个或多个桥接构件152中断，所述一个或多个桥接构件152被构造成能够拴系两个部分150a和150b。与可压缩附属物110和130类似，可压缩附属物150的部分150a和150b中的每一个包括能够抵靠仓平台16定位的第一生物相容性层114、能够抵靠所捕获的组织定位的第二生物相容性层115、以及在许多方面类似于直立纤维119的间隔件纤维或直立纤维179。
参见图17-图19，直立纤维179被构造成能够为可压缩附属物150提供结构支撑。相邻纤维部分179a和179b被构造成能够彼此交叉，如图17-图19所示，以增加可压缩附属物150在压缩力和/或剪切力下的稳定性。向可压缩附属物150施加压缩力可导致纤维部分179a和179b相对于彼此弯曲和或偏移。与可压缩附属物51(图9)类似，可压缩附属物150可适应各个部分具有不同厚度的组织。
参见图19，可压缩附属物150的生物相容性层114和115彼此平行地或至少基本上彼此平行地延伸。纤维部分179a、179b和172在生物相容性层114和115之间延伸以保持生物相容性层114和115之间的间距。纤维部分179a彼此平行或至少基本上彼此平行。纤维179a沿着或至少基本上沿着轴线171延伸，所述轴线171以角度α1与生物相容性层114和115相交。同样，纤维部分179b彼此平行或至少基本上彼此平行。纤维179b沿着或至少基本上沿着轴线173延伸，所述轴线173以角度α2与生物相容性层114和115相交。在某些情况下，角度α1和α2相同或至少基本上相同。
角度α1可为例如约10°至约170°范围的任意角度。在某些情况下，角度α1可为例如约30°至约100°范围内的任意角度。在某些情况下，角度α1可为例如约50°至约70°范围内的任意角度。本公开设想到角度α1的其他值。
角度α2可为例如约10°至约170°范围的任意角度。在某些情况下，角度α2可为例如约30°至约100°范围内的任意角度。在某些情况下，角度α2可为例如约50°至约70°范围内的任意角度。本公开设想到角度α2的其他值。
如图19所示，纤维部分179a和179b可彼此交叉，从而限定多个“X形”结构。粘结波节或界面175和178分别限定在相邻X形结构之间的生物相容性层115和114中。纤维部分179a和179b的端部在粘结波节175和178处相交。角度β限定在交叉纤维部分179a和179b之间。角度β可为例如约10°至约180°范围的任意角度。在某些情况下，角度β可为例如约30°至约100°范围内的任意角度。在某些情况下，角度β可为例如约50°至约70°范围内的任意角度。在至少一种情况下，角度β等于或至少基本上等于例如角度α1和/或角度α2。
此外，纤维部分172(包括纤维部分172a-172e)在生物相容性层114和115之间延伸。纤维部分172垂直于或至少基本上垂直于生物相容性层114和115。如图19所示，纤维部分172a沿着或至少基本上沿着轴线177延伸，所述轴线177以角度α3与生物相容性层114和115相交。角度α3可为例如约80°至约100°范围内的任意角度。在某些情况下，角度α3可为例如约85°至约95°范围内的任意角度。在某些情况下，角度α3可为例如约87°至约93°范围内的任意角度。本公开设想到角度α3的其他值。
此外，纤维部分172彼此间隔开。纤维部分172可彼此等间距或以任何其他合适的构型进行布置。如图19所示，纤维部分172c穿过由交叉纤维部分179a和179b限定的X形结构的交点174。纤维部分172d部分地穿过由交叉纤维部分179a和179b限定的X形结构的交点174。在某些情况下，两个或更多个纤维部分172可穿过或部分地穿过由交叉纤维部分179a和179b限定的X形结构的交点。在某些情况下，可利用生物相容性粘结介质诸如例如生物相容性胶在交点174中的一个或多个处产生粘结波节或界面。
参见图19，纤维部分172b被定位在交叉纤维部分179a和179b的X形结构的一侧，使得纤维部分172b与此类X形结构的交叉纤维部分179a和179b相交。在某些情况下，两个或更多个纤维部分172可相对于两个或更多个X形结构被定位成类似于纤维部分172b。
如图19所示，粘结波节175与粘结波节178竖直地对齐或至少基本上对齐。在某些情况下，纤维部分172可在竖直对齐的粘结波节175和178之间之间延伸，例如纤维部分172e。
参见图17和图18，桥接构件152在切割刃9116推进以切割由外科缝合和切断器械8010捕获的组织期间被切割刃9116切断。另选地，桥接构件152中的一个或多个可被定位在切割刃9116的路径之外，并且可在外科缝合和切断器械8010被击发之后继续拴系部分150a和150b。
参见图20-图22，可压缩附属物160的部分150a和150b经由桥接构件162拴系在一起。如图20所示，桥接构件162间隔开，以沿着刀狭槽137的长度在部分150a和150b之间提供分立的附接部件。桥接构件162中的一个或多个可在切割刃9116被推进以切割由外科缝合和切断器械8010捕获的组织时被切割刃9116切断。
如图21和图22所示，桥接构件162也被构造成能够将可压缩附属物160附接或拴系到钉仓12。桥接构件162的部分延伸穿过钉仓12的底部部分17中的切口或孔164以将可压缩附属物160固定到钉仓12。桥接构件162还可穿过刀狭槽37和137。当切割刃9116被推进以切割由外科缝合和切断器械8010捕获的组织时，桥接构件162可通过由切割刃9116的穿过所引起的剪切或切割动作而被切断以将部分150a和150b相互释放和/或从钉仓12释放。
如图21和图22所示，切口164形成于钉仓12的刀狭槽37的相对两侧上的分立位置处。在某些情况下，桥接构件162为例如缝合线的形式，所述缝合线穿过切口164以将可压缩附属物160附接到钉仓12。在某些情况下，切口164可由从钉仓12的底部部分17延伸的突起替换或与其结合使用。突起可被构造成能够保持桥接构件162的部分以将可压缩附属物160附接到钉仓12。其他附接部件可形成于钉仓12中以有利于通过桥接构件162将可压缩附属物160附接到钉仓12。
参见图23，桥接护套182可在可压缩附属物180的两个部分之间延伸。在图23中，桥接护套182已被切割刃9116切断。示出了可压缩附属物180的仅一个部分150a。另外，示出了保持附接到可压缩附属物180的部分150a的已切断的桥接护套182的一部分。切割刃9116沿着由纵向轴线AA限定的路径推进穿过刀狭槽37和137以切断桥接护套182。
在某些情况下，如图23所示，桥接护套182限定在可压缩附属物180的部分之间并且位于刀狭槽137的底部处。在此类情况下，桥接护套182可为在可压缩附属物180的两个部分之间延伸的第一生物相容性层114的一部分。另外，在此类情况下，当可压缩附属物180抵靠钉仓12的仓平台16定位时，桥接护套182将可压缩附属物180的刀狭槽137与钉仓12的刀狭槽37分开或至少部分地分开。
在其他情况下，桥接护套182限定在可压缩附属物180的部分之间并且位于可压缩附属物180的刀狭槽137的顶部处。在此类情况下，桥接护套182可为在可压缩附属物180的两个部分之间延伸的第二生物相容性层115的一部分。另外，在此类情况下，当可压缩附属物180抵靠钉仓12的仓平台16定位时，桥接护套182不将可压缩附属物180的刀狭槽137与钉仓12的刀狭槽37分开。相反，刀狭槽137和37定位在桥接护套182下方。在其他情况下，桥接护套182可例如穿过或至少基本上穿过限定在可压缩附属物180的生物相容性层114和115之间的平面在可压缩附属物180的部分之间延伸。
再次参见图23，可通过将桥接护套182拴系到钉仓16的底部部分17来将可压缩附属物180附接到钉仓16。例如，附接部件诸如缝合线可穿过桥接护套182和切口164以将桥接护套182拴系到钉仓12的底部部分。缝合线可被切割刃9116切断例如以从钉仓12逐渐地释放可压缩附属物180。通过使缝合线仅穿过刀狭槽137的底部处的桥接护套182来将可压缩附属物180附接到钉仓16可使得可压缩附属物180的其余部分能够自由地被压缩而不会失去缝合线中的附接张力。相同情况可例如通过使缝合线仅穿过第一生物相容性层114来实现。
参照图24和图25，可压缩附属物190抵靠钉仓12的仓平台16进行定位。可压缩附属物190在许多方面类似于可压缩附属物11、31、51、81、81'、100、110、130、150和/或180。例如，可压缩附属物190包括第一生物相容性层114、第二生物相容性层115、以及在生物相容性层114和115之间延伸的间隔件纤维或直立纤维199。
如图24所示，可压缩附属物190通过固定构件191固定到钉仓12，所述固定构件191包括从细长支撑构件194突起的可弯曲倒钩或突起192。可弯曲突起192被成形为类似于箭头，所述可弯曲突起192被构造成能够相对容易地刺入结构内但抵制从该结构的移除直到施加足够的力以使可弯曲突起192弯曲而远离细长支撑构件194。
可弯曲突起192被布置在细长支撑构件194的相对端部部分195和196上。在至少一个示例中，如图24所示，三个可弯曲突起192被定位在相对端部部分195和196中的每个端部部分上。相对端部部分195和196中的每个端部部分的可弯曲突起192在其间间隔开相等距离。多于或少于三个可弯曲突起192可被放置在相对端部部分195和196中的每个端部部分上。本公开设想到可弯曲突起192相对于细长支撑构件194的其他布置方式。
参照图24，采用两个固定构件191来将可压缩仓190的至少一部分固定到钉仓12。可采用多于或少于两个固定构件191来将可压缩仓190固定到钉仓12。如图24所示，固定构件191的端部部分195插入穿过生物相容性层114，而端部部分196穿过仓平台16插入到钉仓12的钉腔197中。钉10030被定位在钉腔197中。钉10030从钉腔197的部署被端部部分196阻挡或至少部分地阻挡。当钉10030从钉腔197部署时，钉10030将端部部分196从钉腔197推出，从而从钉仓12释放固定构件191。
其他固定构件191的端部部分196可在其相应钉10030的部署期间而从钉仓12的其他钉腔197逐渐地释放。因为在外科缝合和切断器械8010的击发序列期间，钉10030通过楔形滑动件9126(图4)的推进而从其相应的钉腔197逐渐地释放，所以可压缩附属物190的相应逐渐释放也通过楔形滑动件9126的推进来实现。基本上，具有插入到较近侧钉腔中的端部部分196的固定构件191在具有插入到较远侧钉腔中的端部部分196的固定构件191之前被释放。
可压缩附属物190的逐渐释放能够在仓平台16上的分立位置处保持可压缩附属物190与钉仓12之间的相对定位，直到此类位置处的钉10030从其相应的钉腔197被击发。当切割刃9116在外科缝合和切断器械8010的击发序列期间被推进时，固定构件191还抵制可能发生的可压缩附属物190的集拢。
参见图24，钉腔197处的固定构件191彼此平行地或至少基本上彼此平行地延伸。在至少一种情况下，钉腔197处的固定构件191可彼此交叉，从而限定例如“X”形状。
参见图24，细长支撑构件194的相对端部部分195和196中的每个端部部分上的最外侧可弯曲突起192可限定用于穿透结构的穿刺尖端。穿刺尖端可特别坚硬以有利于穿透到结构中。此外，可弯曲突起192的箭头形状可例如通过可弯曲突起192与直立纤维199的缠结来改善固定构件191与可压缩附属物190之间的附接稳定性。
参见图25，将固定构件191的细长支撑构件194的端部部分196插入钉仓12的钉腔197中。端部部分196包括四个可弯曲突起192，所述四个可弯曲突起192限定位于细长支撑构件194的第一侧上的从细长支撑构件194突起的附接部分192a以及位于细长支撑构件194的与第一侧相反的第二侧上的从细长支撑构件194突起的附接部分192b。附接部分192a在第一侧上与细长支撑构件194限定角度α1，而附接部分192b在第二侧上与细长支撑构件194限定角度α2。
在某些情况下，角度α1和/或角度α2可为例如约1°至约90°范围内的任意角度。在某些情况下，角度α1和或角度α2可为例如约30°至约70°范围内的任意角度。在某些情况下，角度α1和或角度α2可为例如约40°至约60°范围内的任意角度。在至少一种情况下，角度α1等于或至少基本上等于角度α2。在至少一种情况下，角度α1不同于角度α2。
如图25所示，可弯曲突起192各自包括从细长支撑构件194上的相同位置延伸的附接部分192a和192b。另选地，可弯曲突起192可包括附接部分192a和192b中的仅一者。在至少一种情况下，可弯曲突起192的附接部分192a和192b由从细长支撑构件194延伸的生物相容性纤维制成。在至少一种情况下，细长支撑构件194也可由生物相容性纤维制成。
在各种情况下，可压缩附属物的边缘可被构造成能够改善与钉仓12的仓平台16的附接并且/或者改善可压缩附属物的结构性能。如图17所示，可压缩附属物150的部分150a和150b的边缘151a和151b分别各自形成为外唇缘153，所述外唇缘153限定可压缩附属物150的外周边并且可附接到例如仓平台16。
在某些情况下，可在可压缩附属物的制造之后形成外唇缘。例如，可使可压缩附属物的生物相容性层的外周边经受热和/或压力以形成外唇缘。在某些情况下，可通过例如将可压缩附属物的生物相容性层的外周边编织或针织成限定外唇缘的联结结构来形成外唇缘。如图26所示，可通过例如将可压缩附属物200的生物相容性层114和115的外周边217和218分别针织成限定外唇缘203的联结结构来形成可压缩附属物200的外唇缘203。
联结可压缩附属物的生物相容性层的外周边可有助于稳定可压缩附属物和/或最小化压缩期间的剪切塌缩。然而，在某些情况下，期望保持可压缩附属物的生物相容性层的外周边之间的间距，以最小化可因修改而产生的可压缩附属物的外周边与中心之间的结构差异和/或其他差异。
参见图27，渐缩边缘212限定在可压缩附属物210中。可压缩附属物210包括侧向延伸超过第二生物相容性层215的第一生物相容性层214。另选地，可压缩附属物210可包括侧向延伸超过第一生物相容性层214的第二生物相容性层215。
生物相容性层214和215在许多方面类似于生物相容性层114和115。例如，第一生物相容性层214被构造成能够定位成抵靠并且/或者附接到仓平台16，并且第二生物相容性层215被构造成能够定位成抵靠捕获在砧座8014与钉仓12之间的组织。在至少一种情况下，通过移除或切除可压缩附属物210的一部分来形成可压缩附属物210的渐缩边缘212。切割平面可以预定角度进行，这取决于渐缩边缘212的期望锐度。
参见图28-图30，示出了可压缩附属物230。可压缩附属物230类似于本公开所述的其他可压缩附属物。例如，与可压缩附属物51(图9)类似，可压缩附属物230可补偿由钉10030结合可压缩附属物230捕获的组织(T)的厚度的变化。如图28所示，可压缩附属物230被构造成能够在组织部分72和74由钉10030结合可压缩附属物230捕获时适应具有组织部分72和74的组织(T)，所述组织部分72和74具有不同的组织厚度。
参见图28，可压缩附属物230包括定位在仓接触表面234与组织接触表面235之间的多个结构隔室236。结构隔室236中的一个或多个可沿着或至少基本上沿着可压缩附属物230的整个长度纵向地延伸。结构隔室236通常被壁包围，所述壁限定结构隔室236上的外周边。相邻结构隔室236可共用一个或多个壁。
参见图29，结构隔室236由六个壁限定并且包括六边形形状。在至少一种情况下，结构隔室236中的一个或多个可各自包括三个或更多个壁。可压缩附属物230的结构隔室236可包括相同数量的壁。另选地，第一组结构隔室236可包括第一数量的壁，而第二组结构隔室236可包括例如不同于第一数量的壁的第二数量的壁。在至少一种情况下，结构隔室236限定蜂窝形状，所述蜂窝形状可沿着或至少基本上沿着可压缩附属物230的整个长度的至少一部分纵向地延伸。
蜂窝形状改善了可压缩附属物230在压缩力和/或剪切力下的稳定性。此外，当砧座8014运动到与钉仓12相背对的闭合位置时，蜂窝形结构隔室236能够在施加到可压缩附属物230和抵靠第二生物相容性层215定位的组织(T)的压缩作用下弯曲。如图29和图30所示，蜂窝形结构隔室236被构造成能够在压缩力施加到可压缩附属物230时经历高度降低，这允许可压缩附属物230在组织部分72和74由钉10030结合可压缩附属物230捕获时适应具有组织部分72和74(具有不同的组织厚度)的组织(T)，如图28所示。
参照图29和图30，当砧座8014运动到与钉仓12相背对的闭合位置时，结构隔室236已响应于施加到可压缩附属物230的压缩力而经历从第一高度(H1)(如图29所示)到第二高度(H2)(如图30所示)的高度降低。高度降低可对应于抵靠该结构隔室236所在位置处的可压缩附属物230定位的所捕获组织(T)的厚度。换句话讲，组织部分的厚度越大，则位于抵靠该组织部分定位的可压缩附属物230的一部分处的结构隔室236的高度降低越大。
第二高度(H2)对第一高度(H1)的比率可为例如约0.05至约0.95的任意值。在某些情况下，第二高度(H2)对第一高度(H1)的比率可为例如约0.2至约0.7的任意值。在某些情况下，第二高度(H2)对第一高度(H1)的比率可为例如约0.3至约0.6的任意值。本公开设想到第二高度(H2)对第一高度(H1)的比率的其他值。
结构隔室236的壁可包括相同的或至少基本上相同的厚度。另选地，如图29所示，结构隔室236的壁可包括不同的厚度。一对相对壁242可包括第一厚度(T1)，一对相对壁244可包括第二厚度(T2)，并且一对相对壁246可包括第三厚度(T3)，其中第一厚度(T1)、第二厚度(T2)和/或第三厚度(T3)中的至少两个彼此不同。例如，如图29所示，壁242的第一厚度(T1)大于壁244的第二厚度(T2)并且大于壁246的第三厚度(T3)。
参见图28-图30，结构隔室236的壁242与第一生物相容性层234和第二生物相容性层235平行地或至少基本上平行地延伸。在某些情况下，结构隔室236的壁242可限定第一生物相容性层234的一部分。在某些情况下，结构隔室236的壁242可限定第二生物相容性层235的一部分。
如图28所示，可压缩附属物230的构造块包括五个结构隔室236，所述五个结构隔室236包括与其他四个结构隔室236共用壁的中央结构隔室236。可压缩附属物230的高度(H)可由共用壁244的两个结构隔室236的叠堆限定，如图29所示。另选地，可压缩附属物230的高度(H)可由两个四壁结构隔室237和延伸在结构隔室237之间的一个结构隔室236的叠堆限定，如图29所示。结构隔室236与结构隔室237中的每个结构隔室共用壁242。本公开设想到可压缩附属物230的结构壁的其他几何形状和布置方式。
各种附接件可附连或固定到本公开的可压缩附属物。附接件可由与可压缩附属物相同或至少基本上相同的材料制成。另选地，附接件可由与可压缩附属物不同的材料制成。在至少一种情况下，附接件可由与可压缩附属物相同的材料制成，但该材料被不同地处理以修改例如附接件的化学特性和/或物理特性中的一个或多个。
在至少一种情况下，可压缩附属物可比固定到可压缩附属物的附接件硬或软。较硬的附接件可提供期望的刚度以用于例如将附接件固定到仓平台。另选地，较软的附接件可例如与敏感组织产生较柔和的相互作用。在至少一种情况下，可压缩附属物可包括比固定到可压缩附属物的附接件的表面光滑或粗糙的表面。最终，附接件可被定制以结合可压缩附属物来执行各种功能。在各种情况下，附接件可为用于可压缩附属物的侧向附接件或端帽的形式。
参照图28-图30，侧向附接件250被附连或固定到可压缩附属物230。在至少一种情况下，可例如通过使用热或溶剂的焊接来将侧向附接件250固定到可压缩附属物230。侧向附接件250限定可压缩附属物230的渐缩边缘252。
此外，侧向附接件250可用于例如将可压缩附属物230附接到钉仓12的仓平台16。在至少一种情况下，可例如通过使用热或溶剂来将侧向附接件250焊接到仓平台16。本公开设想到用于将侧向附接件250固定到可压缩附属物230和/或仓平台16的其他技术。例如，侧向附接件250的拴系件254(图29)可固定到钉仓12和/或包绕在钉仓12周围。
可压缩附属物和/或侧向附接件可被构造成能够有利于组织向内生长。例如，如图28-图30所示，可压缩附属物230和侧向附接件250包括被构造成能够有利于组织向内生长到可压缩附属物230和侧向附接件250中的穿孔254。可在其中期望组织向内生长的区域中穿过可压缩附属物230和/或侧向附接件250选择性地产生穿孔254。
在各种情况下，可压缩附属物230和/或侧向附接件250可通过例如各种挤出技术来制造，并且穿孔254可被激光钻到例如可压缩附属物230和/或侧向附接件250的期望部分中。侧向附接件250可例如在挤出之后附接到可压缩附属物230。可通过将结构隔室诸如例如结构隔室236的壁制造为预定厚度在可压缩附属物230中实现定制的抗压缩性。不均一壁厚的模式可被挤出例如以调节可压缩附属物230内的结构隔室的柔韧性来实现所需的刚度，而无论可压缩附属物230的制造中所用的材料如何。
参见图31，示出了可压缩附属物260。可压缩附属物260包括抵靠钉仓12的仓平台16定位的第一生物相容性层114。此外，可压缩附属物260包括能够抵靠组织(T)定位的第二生物相容性层115。多个直立或间隔件壁262限定在生物相容性层114和115之间。直立壁262被构造成能够保持生物相容性层114和115之间的空间，如图31所示。此外，当砧座8014运动到与钉仓12相背对的闭合位置时，直立壁262能够在施加到可压缩附属物260和抵靠第二生物相容性层115定位的组织(T)的压缩作用下弯曲。
直立壁262附接到生物相容性层114和115，并且彼此间隔开。另选地，直立壁262可彼此拴系或附接在一起。直立壁262中的一些被布置成彼此平行或至少基本上平行。然而，其他直立壁262沿相交平面而延伸。
此外，直立壁262包括改善直立壁262的柔韧性的切口或间隙264。在至少一种情况下，直立壁262中的一个或多个可例如通过挤出而被制造为具有切口264。另选地，切口264可在直立壁262的制造完成之后产生。切口264可被策略性地定位以实现例如可压缩附属物260的期望柔韧性。
参见图32，可压缩附属物270包括抵靠钉仓12的仓平台16定位的第一生物相容性层114。可压缩附属物270不含第二生物相容性层。因此，组织(T)直接抵靠可压缩附属物270的多个间隔件壁或直立壁272进行定位。另选地，可压缩附属物270可包括位于直立壁272的相对侧上的第二生物相容性层。在此类情况下，组织(T)可抵靠第二生物相容性层进行定位。此外，当砧座8014运动到与钉仓12相背对的闭合位置时，直立壁272能够在施加到可压缩附属物270和抵靠直立壁272定位的组织(T)的压缩作用下弯曲。
直立壁272包括纵向壁272a和与纵向壁272a相交的横向壁272b。直立壁272包括中空的或至少基本上中空的框架，如图32所示。另选地，直立壁272可包括实心框架。在各种情况下，直立壁272包括例如三棱柱的形状。直立壁272包括三角形横截面。除了或取代三角形横截面，直立壁272可包括正方形、矩形和/或弯曲的横截面。如图32所示，纵向壁272a包括三角形的横向横截面并且横向壁272b包括三角形的纵向横截面。
纵向壁272a包括由第一生物相容性层114限定的基部276a和纵向延伸的顶端274a，所述顶端274a与相邻纵向壁272a的其他顶端274a平行或至少基本上平行。横向壁272b也包括由第一生物相容性层114限定的基部276b和横向延伸的顶端274b，所述顶端274b与相邻横向壁272b的其他顶端274b平行或至少基本上平行。
如图32所示，可压缩附属物272包括具有倒棱锥形状的结构隔室278。结构隔室278限定在两个平行的或至少基本上平行的壁272a与两个平行的或至少基本上平行的壁272b(与壁272a相交)之间。结构隔室278的基部280包括由相交壁272a和272b限定的四个角282。结构隔室278的顶点284限定在第一生物相容性层114处。每个结构隔室278从顶点284延伸并且终止于基部280处，如图32所示。
在各种情况下，本公开的可压缩附属物的第二生物相容性层诸如例如可压缩附属物110的第二生物相容性层115在可压缩附属物110抵靠钉仓12的仓平台16定位时为可见的。在各种情况下，可通过针织或印刷到第二生物相容性层上的图像、字词、符号和/或颜色来将特定信息传送给操作者。例如，针织线可用于显示刀行进长度，这可有助于操作者减少规程中所用的加载次数。针织线还可用于显示钉冠部的位置。此外，针织线也可用于提供有关与可压缩附属物一起使用的钉仓的信息，诸如例如钉高度。此外，针织线也可用于列出抵靠可压缩附属物定位被处理组织的最佳位置。
图33示出了包括植入式层4000的钉仓组件。钉仓组件还包括仓体12，所述仓体12包括支撑层4000的平台16。层4000包括由平台16支撑的底部部分4004以及顶部部分4005。底部部分4004和顶部部分4005由壁4009连接。壁4009侧向地延伸穿过层4000；然而，壁4009可沿任何合适的方向诸如例如纵向延伸。在至少一个实施方案中，仓体12包括被构造成能够接收切割构件的纵向狭槽，并且壁4009延伸横跨纵向狭槽。
壁4009在其间限定腔室4008。当将负荷施加到层4000时，腔室4008允许壁4009弯曲、挠曲和/或塌缩。壁4009挠曲的量取决于抵靠层4000夹持的组织的厚度。当组织被向下按压到层4000上时，层4000可与压贴层4000的组织的厚度相适配。换句话说，层4000可为组织厚度的局部变化提供局部适配，如图34所示。在各种情况下，壁4009在层4000中限定接缝。接缝可为例如侧向接缝和/或纵向接缝。接缝的布置方式可控制层4000的挠曲。
对上文进行进一步描述，层4000包括结构纤维4006和增强纤维4007。结构纤维4006被布置以形成底部部分4004、顶部部分4005和壁4009。在至少一种情况下，如图33所示，结构纤维4006被布置成在其间形成纵向接缝的纵向排。结构纤维4006形成柱或支柱，所述柱或支柱在底部部分4004和顶部部分4005之间延伸并连接这两个部分。增强纤维4007交织在底部部分4004、顶部部分4005和/或壁4009内。在至少一种情况下，增强纤维4007围绕结构纤维4006进行打结、成环和/或包绕。在各种情况下，增强纤维4007与结构纤维4006互锁。
增强纤维4007连接壁4009内的结构纤维4006。增强纤维4007将壁4009内的支柱保持或系结在一起以提供具有期望结构特性的壁4009。例如，具有较高密度的增强纤维4007的壁4009比具有较低密度的壁4009强固。类似地，底部部分4004和/或顶部部分4006内的增强纤维4007的密度可影响部分4004和/或4006的强度。
由于上文所述，壁4009内的结构支柱可一起挠曲和运动。此外，壁4009内的结构纤维支柱4006由于增强纤维4007而受到相邻结构纤维支柱2006的支撑。如图33所示，一个壁4009内的增强纤维4007不直接连接到相邻壁4009中的增强纤维4007然而，第一壁4009中的增强纤维4007可通过底部部分4004和/或顶部部分4006连接到第二壁4009中的增强纤维4007。在各种另选实施方案中，增强纤维4007可直接横跨并且连接相邻的壁4009。
结构纤维4006和增强纤维4007可在结界面处彼此附接。结界面可包括任何合适的结类型。使用的结界面的类型可影响层4000的刚度。例如，如果使用松散的结，则层4000可较不刚性或具有较低的弹性模量。另选地，如果使用紧密的结，则层4000可较硬或具有较高的弹性模量。层4000可采用任何合适的结的一种或多种类型。
对上文进行进一步描述，结构纤维4006和增强纤维4007之间的结可用于为层4000的不同部分选择性地提供不同的刚度或弹性模量。例如，可选择结构纤维4006与增强纤维4007之间的结的类型和/或结的频率以产生第一压缩区和第二压缩区。第一压缩区具有第一刚度，并且第二压缩区具有大于第一刚度的第二刚度。在至少一种情况下，第一压缩区与限定在平台12中的被构造成能够接收切割构件的纵向狭槽对齐并被定位在纵向狭槽之上，并且第二压缩区与限定在平台12中的钉腔对齐并被定位在钉腔之上。此类布置方式可有利于层4000的横断同时在抵靠组织捕获层4000的钉10030内提供期望的组织厚度补偿特性。在某些情况下，第一压缩区与平台12的近侧端部对齐，并且第二压缩区相对于第一压缩区被定位在远侧。在至少一种此类情况下，另一个第一压缩区相对于第二压缩区被定位在远侧。此类布置方式可有利于切割构件的切割行程开始和结束处的层4000的横断。
结构纤维4006包括第一横截面宽度或直径，并且增强纤维4007包括与第一横截面宽度不同的第二横截面宽度或直径。如图33和图34所示，结构纤维4006的横截面宽度比增强纤维4007的横截面宽度宽。在至少一种情况下，结构纤维4006的横截面宽度为例如增强纤维4007的横截面宽度的两倍。
结构纤维4006由第一材料构成并且增强纤维4007由不同于第一材料的第二材料构成。在至少一个实施方案中，结构纤维4006由第一聚合物材料构成并且增强纤维4007由第二聚合物材料构成，所述第二聚合物材料的弹性模量低于第一聚合物材料的弹性模量。在另选实施方案中，结构纤维4006由第一聚合物材料构成并且增强纤维4007由第二聚合物材料构成，所述第二聚合物材料的弹性模量高于第一聚合物材料的弹性模量。在某些实施方案中，结构纤维4006由多于一种聚合物材料构成并且/或者增强纤维4007由多于一种聚合物材料构成。在至少一个此类实施方案中，结构纤维4006和增强纤维4007彼此具有至少一种共用的材料和至少一种非共用的材料。
现在转到图35，植入式层4100包括顶部部分4105和支撑顶部部分4105的支柱壁4109。顶部部分4105包括由具有支柱壁4109的结构纤维4106互连的纵向结构或纤维4103。结构纤维4106以任何合适的方式围绕纵向纤维4103成环、包绕和/或打结。图38A和图38B公开了结构纤维4106互连到纵向纤维4103的两种示例性方式。
对上文进行进一步描述，图38A示出了双环状包绕。结构纤维4106包绕在第一纵向纤维4103周围，桥接到第二纵向纤维4103之上，并且包绕在第二纵向纤维4103周围。双环状结构纤维4106包括两个直立端部，所述直立端部包括腿或支柱，所述腿或支柱为支柱壁4109的部分。结构纤维4106的两个环包括闭环和/或至少一匝；然而，可设想到其中环各自包括围绕纵向纤维4103的一个圆形匝和/或多于一匝的另选实施方案。图38A的双环状包绕也可称为内双环。更具体地，结构纤维4106的支柱两者均穿过限定在相邻的第一和第二纵向纤维4103之间的间隙。在各种实施方案中，可使用外双环。
对上文进行进一步描述，图38B和图39示出了结构纤维4106，其包绕在第一纵向纤维4103周围，桥接到第二纵向纤维4103之上，并且包绕在第二纵向纤维4103周围。围绕第一纵向纤维4103的包绕包括开环；然而，可使用例如闭环和/或一匝或多匝。围绕第二纵向纤维4103的包绕包括一匝；然而，可使用例如圆形匝。类似于上文所述，图38B的结构纤维4106包括两个直立端部，所述直立端部包括腿或支柱，所述腿或支柱为支柱壁4109的部分。结构纤维4106的直立端部延伸穿过纵向纤维4103之间的不同间隙。
现在转到图36和图37，层4200包括纵向结构或纤维4103。层4200还包括结构纤维4206和增强纤维4107。增强纤维4107侧向地交织在纵向纤维4103内。结构纤维4206包绕在多根纵向纤维4013周围以形成壁4209。如图所示，每根结构纤维4206包绕在例如四根纵向纤维4103周围以形成壁4209。由于上文所述，每根结构纤维4206形成若干闭合的端部式环支柱，闭合的端部式环支柱支撑层4200的顶部部分4205。结构纤维4206的端部不支撑顶部部分4205；然而，可设想到其中结构纤维4206的端部包括结构支柱的另选实施方案。
本文所公开的实施方案可提供具有压缩和弯曲特性的有组织的纤维支架，所述纤维支架与另一个支架以形成沿多个取向具有压缩和弯曲特性的较大基质的方式交织在一起。可通过调节本文所公开的一种或多种特性来调节此类压缩和弯曲特性。基质的壁可限定大孔隙的阵列。在各种情况下，基质可具有双模态特性，其中在基质中的壁之间限定大孔隙并且在构成壁的纤维之间限定间隙空间。此类大孔隙和间隙空间可配合以促进组织向内生长和基质结合到主体中。
图40示出了组织厚度补偿件或可压缩附属物2000。可压缩附属物2000可与许多装置一起使用。在至少一个实施方案中，可压缩附属物2000可与外科缝合和切断器械8010一起使用。可压缩附属物2000可附接到钉仓的钉仓平台16。另选地，在某些情况下，可压缩附属物2000可附接到砧座8014。
参见图40，可压缩附属物2000在至少一个实施方案中被示为被组织T部分地压缩。当钉2002被外科缝合和切断器械8010击发并且成形时，在许多方面类似于钉10030的钉2002接合可压缩附属物2000。成形钉2002具有钉基部2004、第一钉腿2006、和第二钉腿2008。在本实施方案中，第一钉腿2006与组织T和可压缩附属物2000接合。
可压缩附属物2000包括具有组织接触界面2010的第一部分2012。当可压缩附属物2000被组织T接合时，组织接触界面2010接触组织T并与组织T相互作用。可压缩附属物2000包括具有仓界面2014的第二部分2016。在本实施方案中，仓界面2014能够可释放地附接到或定位在钉仓平台16或邻近其。
可压缩附属物2000包括定位在第一部分2012与第二部分2016之间的中间部分。中间部分包括多个直立纤维支柱2018和多根互连纤维2024。直立纤维支柱2018在第一部分/直立纤维支柱界面2020处接合第一部分2012。直立纤维支柱2018在第二部分/直立纤维支柱界面2022处接合第二部分2016。多根互连纤维2024在直立纤维支柱/互连纤维界面2026处接合多个直立纤维支柱2018。
第一部分2012和第二部分2016包含各种生物相容性材料。第一部分和第二部分2016、2016还可浸渍或涂覆有可有助于患者的恢复时间的各种试剂，诸如止血剂、抗菌剂、或抗微生物剂。第一部分2012可具有各种厚度和材料特性。在至少一个实施方案中，第一部分2012可具有各种密度和弹性以提供具有期望适应特性的第一部分2012。同样，第二部分2016可具有各种厚度和材料特性。在至少一个实施方案中，第二部分2016可具有各种密度和弹性以提供具有期望适应特性的第二部分2016。
直立纤维支柱2018包含一种或多种生物相容性材料。直立纤维支柱2018可为具有合适的拉伸强度和回弹力的弹性纤维。直立纤维支柱2018可具有均一的材料属性和特性；或者可改变材料属性和特性以提供具有期望适应特性的可压缩附属物2100。在至少一个实施方案中，直立纤维支柱2018可成排地对齐，并且每排可具有不同的材料特性。当与外科缝合器一起使用时，最靠近外科缝合器的刀狭槽或最接近切口定位的直立纤维支柱2018可具有更高的回弹力并且在直立纤维支柱2018弯曲或屈曲之前需要另外的力。这可在切口附近产生增大的压力，这可有利于患者的治疗。另选地，在某些情况下，最靠近外科缝合器的刀狭槽或最接近切口定位的直立纤维支柱2018可具有更高的弹性并且在直立纤维支柱2018弯曲或屈曲之前需要较小的力。
在其他实施方案中，直立纤维支柱2018的材料特性可从近侧到远侧有所变化，以为可压缩附属物2000提供期望的适应特性。多个直立纤维支柱2018可包括不同的密度和横截面面积或直径。当直立纤维支柱2018包括相对较高的密度或较大的横截面面积或直径时，实现直立纤维支柱2018的期望挠曲量所需的力可增加。类似地，当直立纤维支柱2018包括相对较低的密度或较小的横截面面积或直径时，实现期望挠曲量所需的力可减小。此外，可改变直立纤维支柱2018的密度和横截面面积或直径，以允许直立纤维支柱2018在力增加或可压缩附属物2000遇到具有不同厚度的组织T时具有不同的弯矩。在一个此类实施方案中，直立柱纤维2018可在较靠近第二部分2016的部分中具有较大的密度并且在较靠近第一部分2012的部分中具有较小的密度。这可允许可压缩附属物2000在另外的压缩力被施加时具有增加的回弹力，并且力和压缩分布随着可压缩附属物2000的位移和压缩而变化。
直立纤维支柱2018在第一部分/直立纤维支柱界面2020处接合第一部分2012。第一部分/直立纤维支柱界面2020可为摩擦或阻力关系中的一种，其中直立纤维支柱2018不固定地附接到第一部分2012。在其他实施方案中，直立纤维支柱2018能够在第一部分/直立纤维支柱界面2020处固定地或可释放地附接到第一部分2012。在至少一个实施方案中，直立纤维支柱2018可嵌入到第一部分2012中。在另选实施方案中，直立纤维支柱2018可附接、胶合、焊接、熔融、钩挂、织造、针织、或紧固到第一部分2012。
直立纤维支柱2018在第二部分/直立纤维支柱界面2022处接合第二部分2016。第二部分/直立纤维支柱界面2022可为摩擦或阻力关系中的一种，其中直立纤维支柱2018不固定地附接到第二部分2016。在其他实施方案中，直立纤维支柱2018能够在第二部分/直立纤维支柱界面2022处固定地或可释放地附接到第二部分2016。在至少一个实施方案中，直立纤维支柱2018可嵌入到第二部分2016中。在另选实施方案中，直立纤维支柱2018可附接、胶合、焊接、熔融、钩挂、织造、针织、或紧固到第二部分2016。
所述多根互连纤维2024包含一种或多种生物相容性材料。互连纤维2024可为具有合适的拉伸强度和回弹力的弹性纤维。互连纤维2024可具有均一的材料属性和特性；或者可改变材料属性和特性，以为可压缩附属物2000提供期望的适应特性。
在至少一个实施方案中，互连纤维2024可成排和成列地对齐以形成基质，并且每排和/或每列可具有不同的材料特性。当与外科缝合器一起使用时，最靠近外科缝合器的刀狭槽或切口定位的互连纤维2024可具有更高的回弹力，而较远离刀狭槽的互连纤维2024可具有更高的弹性。这可在切口附近产生增大的压力，这可有利于患者的治疗。另选地，在某些情况下，最靠近外科缝合器的刀狭槽或切口定位的互连纤维2024可具有更高的弹性，而较远离刀狭槽的互连纤维2024可具有更高的回弹力。
在其他实施方案中，互连纤维2024的材料特性可根据患者的需要而从近侧到远侧有所变化。互连纤维2024可包括不同的密度和横截面面积或直径。当使用包括相对较大的密度或较大的横截面面积或直径的互连纤维2024时，实现互连纤维2024的期望挠曲量所需的张力增加。类似地，当互连纤维2024包括较小的密度或较小的横截面面积或直径时，实现互连纤维2024的期望挠曲量所需的张力减小。此外，互连纤维2024的密度和横截面面积或直径可在钉仓12的近侧部分与钉仓12的远侧部分之间有所变化，以允许互连纤维2024在可压缩附属物2000遇到具有不同厚度的组织T时具有不同的物理特性和回弹力。
直立纤维支柱2018和互连纤维2024在直立纤维支柱/互连纤维界面2026处彼此接合。直立纤维支柱/互连纤维界面2026可为摩擦或阻力关系中的一种，其中直立纤维支柱2018不固定地附接到互连纤维2024。在其他实施方案中，直立纤维支柱2018能够在直立纤维支柱/互连纤维界面2026处固定地、可释放地、或可滑动地附接到互连纤维2024。在至少一个实施方案中，直立纤维支柱2018可嵌入到互连纤维2024中。在另选实施方案中，直立纤维支柱2018可附接、胶合、焊接、熔融、钩挂、织造、环状连接、或紧固到互连纤维2024。
互连纤维2024还可为每个直立纤维支柱2018和整个可压缩附属物2000产生另外的稳定性。再次参见图40，互连纤维2024在第一部分2012与第二部分2016之间间隔开。三根互连纤维2024以彼此基本上等距地间隔开的方式与每个直立纤维支柱2018接合；然而，可采用任何合适数量的互连纤维2024。在其他实施方案中，可增加互连纤维2024的数量，以增加直立纤维支柱2018的稳定性或增加回弹力和压缩可压缩附属物2000所需的力。在另一个实施方案中，可调节互连纤维2024的间距和数量，以提供具有期望适应特性的可压缩附属物2000。当互连纤维2024较靠近第二部分2016进行定位时，可压缩附属物2000在最靠近第二部分2016的可压缩附属物2000的部分中具有较高的刚度并且在最靠近第一部分2012的可压缩附属物2000的部分中具有较低的刚度。
参见图41，可压缩附属物2100在至少一个实施方案中被示为被组织T部分地压缩。当钉2102通过外科缝合器击发并且成形时，钉2102接合可压缩附属物2100。成形钉2102具有钉基部2104、第一钉腿2106、和第二钉腿2108。在本实施方案中，第一钉腿2106与组织T和可压缩附属物2100接合。
可压缩附属物2100包括具有组织接触界面2110的第一部分2112。当可压缩附属物2100接合组织T时，组织接触界面2110接触组织T并与组织T相互作用。可压缩附属物2100包括具有仓界面2114的第二部分2116。仓界面2114能够可释放地附接到或定位在钉仓平台16或邻近其。
可压缩附属物2100包括定位在第一部分2112与第二部分2116之间的中间部分。中间部分包括多个直立纤维支柱2118和互连纤维2124；然而，可使用任何合适数量的互连纤维2124。直立纤维支柱2118在第一部分/直立纤维支柱界面2120处接合第一部分2112。直立纤维支柱2118在第二部分/直立纤维支柱界面2122处接合第二部分2116。互连纤维2124在直立纤维支柱/互连纤维界面2126处接合多个直立纤维支柱2118。
第一部分2112和第二部分2116包含一种或多种生物相容性材料。第一部分和第二部分2112、2116还可浸渍或涂覆有可有助于患者的恢复时间的各种试剂，诸如止血剂、抗菌剂、或抗微生物剂。第一部分2112可具有各种厚度和材料特性。在至少一个实施方案中，第一部分2112可具有各种密度和弹性以提供具有期望适应特性的第一部分2012。同样，第二部分2116可具有各种厚度和材料特性。在至少一个实施方案中，第二部分2116可具有各种密度和弹性以提供具有期望适应特性的第二部分2016。
直立纤维支柱2118包含一种或多种生物相容性材料。直立纤维支柱2118可为具有合适的拉伸强度和回弹力的弹性纤维。直立纤维支柱2118可具有均一的材料属性和特性；或者可改变材料属性和特性以提供具有期望适应特性的可压缩附属物2100。在至少一个实施方案中，直立纤维支柱2118可成排地对齐，并且每排可具有不同的材料特性。当与外科缝合器一起使用时，最靠近外科缝合器的刀狭槽或最接近切口定位的直立纤维支柱2118可具有更大的回弹力并且在直立纤维支柱2118弯曲或屈曲之前需要另外的力。这可在切口附近产生增大的压力，这可有利于患者的治疗。另选地，在某些情况下，最靠近外科缝合器的刀狭槽或最接近切口定位的直立纤维支柱2118可具有更大的弹性并且在直立纤维支柱2118弯曲或屈曲之前需要较小的力。
在其他实施方案中，直立纤维支柱2118的材料特性可从近侧到远侧有所变化，以为可压缩附属物2100提供期望的适应特性。多个直立纤维支柱2118可包括不同的密度和横截面面积或直径。当直立纤维支柱2118包括相对较大的密度或较大的横截面面积或直径时，实现直立纤维支柱2118的期望挠曲量所需的力可增加。类似地，当直立纤维支柱2118包括相对较小的密度或较小的横截面面积或直径时，实现期望挠曲量所需的力可减小。此外，可改变直立纤维支柱2118的密度和横截面面积或直径，以允许直立纤维支柱2118在力增加或可压缩附属物2100遇到具有不同厚度的组织T时具有不同的弯矩。在一个此类实施方案中，直立柱纤维2118可在较靠近第二部分2116的部分中具有较大的密度并且在较靠近第一部分2112的部分中具有较小的密度。这可允许可压缩附属物2100在另外的压缩力被施加时具有增加的回弹力，并且力和压缩分布随着可压缩附属物2100的位移和压缩而变化。
直立纤维支柱2118在第一部分/直立纤维支柱界面2120处接合第一部分2112。第一部分/直立纤维支柱界面2120可为摩擦或阻力关系中的一种，其中直立纤维支柱2118不固定地附接到第一部分2112。在其他实施方案中，直立纤维支柱2118能够在第一部分/直立纤维支柱界面2120处固定地或可释放地附接到第一部分2112。在至少一个实施方案中，直立纤维支柱2118可嵌入到第一部分2112中。在另选实施方案中，直立纤维支柱2118可附接、胶合、焊接、熔融、钩挂、织造、针织、或紧固到第一部分2112。
直立纤维支柱2118在第二部分/直立纤维支柱界面2122处接合第二部分2116。第二部分/直立纤维支柱接合部2122可为摩擦或阻力关系中的一种，其中直立纤维支柱2118不固定地附接到第二部分2116。在其他实施方案中，直立纤维支柱2118能够在第二部分/直立纤维支柱界面2122处固定地或可释放地附接到第二部分2116。在至少一个实施方案中，直立纤维支柱2118可嵌入到第二部分2116中。在另选实施方案中，直立纤维支柱2118可附接、胶合、焊接、熔融、钩挂、织造、针织、或紧固到第二部分2116。
互连纤维2124包含一种或多种生物相容性材料。互连纤维2124可为具有合适的拉伸强度和回弹力的弹性纤维。互连纤维2124可具有均一的材料属性和特性；或者可改变材料属性和特性，以为可压缩附属物2100提供期望的适应特性。
在其他实施方案中，互连纤维2124的材料特性可朝近侧有所变化以提供期望的适应特性。互连纤维2124可包括不同的密度和横截面面积。
当使用包括相对较大的密度或较大的横截面面积或直径的互连纤维2124时，实现互连纤维2124的期望挠曲量所需的张力增加。类似地，当互连纤维2124包括较小的密度或较小的横截面面积或直径时，实现互连纤维2024的期望挠曲量所需的张力减小。此外，互连纤维2124的密度和横截面面积或直径可在钉仓12的近侧部分与钉仓12的远侧部分之间有所变化，以允许互连纤维2124在可压缩附属物2100遇到具有不同厚度的组织T时具有不同的物理特性和回弹力。
直立纤维支柱2118和互连纤维2124在直立纤维支柱/互连纤维界面2126处彼此接合。直立纤维支柱/互连纤维界面2126可为摩擦或阻力关系中的一种，其中直立纤维支柱2118不固定地附接到互连纤维2124。在其他实施方案中，直立纤维支柱2118能够在直立纤维支柱/互连纤维界面2126处固定地、可释放地、或可滑动地附接到互连纤维2124。在至少一个实施方案中，直立纤维支柱2118可嵌入到互连纤维2124中。在另选实施方案中，直立纤维支柱2118可附接、胶合、焊接、熔融、钩挂、针织、织造、环状连接或紧固到互连纤维2124。
互连纤维2124还可为整个可压缩附属物2100和每个直立纤维支柱2118产生另外的稳定性。再次参见图41，单根互连纤维2124在第一部分2112与第二部分2116之间间隔开。单根互连纤维2124基本上在直立纤维支柱2118的中点处接合每个直立纤维支柱2118。在其他实施方案中，可增加互连纤维2124的数量，以增加直立纤维支柱2118的稳定性或增加回弹力和压缩可压缩附属物2100所需的力。在另一个实施方案中，可调节互连纤维2124的间距以提供具有期望适应特性的可压缩附属物2100。当互连纤维2124较靠近第二部分2116进行定位时，可压缩附属物2100在最靠近第二部分2116的可压缩附属物2100的部分中具有较高的刚度并且在最靠近第一部分2112的可压缩附属物2100的部分中具有较小的刚度。
参见图41，界面2126可为滑动接头的形式，这允许互连纤维2124在直立纤维支柱2118之间滑动、运动和/或移位。这种特征结构允许直立纤维支柱2118自由地弯曲到不同的程度同时通过由互连纤维2124限定的滑动接头界面来保持与其他直立纤维支柱2118的联接接合。
参见图42，示出了可压缩附属物2200。可压缩附属物2200与具有多种组织厚度的组织T接合。组织T具有第一组织厚度T1和第二组织厚度T2。至少一根钉2202接合可压缩附属物2200。钉2202具有钉基部2204、以及从钉基部2204延伸的第一钉腿2206和第二钉腿2208。钉2202被成形并且第一钉腿2206和第二钉腿2208的一部分接合组织T和可压缩附属物2200。
可压缩附属物2200包括被构造成能够与相邻组织T相互作用的组织接触界面2210。可压缩附属物2200可与各种外科规程一起使用并且可用于外科缝合器或钉仓中。可压缩附属物2200包括可置于或固定地附接到钉仓12的平台16的仓界面2214。可压缩附属物2200可包括多个直立纤维支撑部分2214和可压缩附属物基部部分2216。多个直立纤维支撑部分2214可从可压缩附属物基部部分2216延伸。
可压缩附属物2200与具有多种厚度T1、T2的组织T接合。响应于组织厚度，可压缩附属物2200被压缩到第一压缩高度H1和第二压缩高度H2。在本实施方案中，可压缩附属物2200响应并适形于具有不同厚度的有关组织T。可压缩附属物2200包含一种或多种生物相容性材料。
直立纤维支撑部分2214可被适配并且被构造成能够具有各种材料特性。直立纤维支撑部分2214可具有各种密度、横截面面积和直径、以及孔隙率。直立纤维支撑部分2214可包括位于每个直立纤维支撑部分2214中的多根织造或扭绞纤维。这些单独纤维可具有各种密度、横截面面积和直径、以及孔隙率。每个直立纤维支撑部分2214包含至少两根扭绞纤维并且可固定地附接到可压缩附属物基部部分2214。另选地，直立纤维支撑部分2214能够可释放地或可滑动地附接到可压缩附属物基部部分2216。在至少一个实施方案中，直立纤维支撑部分2214可嵌入到可压缩附属物基部部分2216中。在另选实施方案中，直立纤维支撑部分2214可附接、胶合、焊接、熔融、钩挂、织造、针织、环状连接、或紧固到可压缩附属物基部部分2216。
在至少一个实施方案中，每个直立纤维支撑部分2214可包括扭绞或配合在一起的至少两根纤维。可调节扭绞纤维，以实现可压缩附属物2200的期望的回弹力和可压缩性。在至少一个实施方案中，直立纤维支撑部分2214的纤维可在靠近可压缩附属物基部部分2216的直立纤维支撑部分2214的一部分处更紧密地扭绞或缠绕。类似地，直立纤维支撑部分2214的纤维可在靠近组织接触界面2210的直立纤维支撑部分2214的一部分处更松散地扭扭绞或缠绕。直立纤维支撑部分2214的纤维的可变紧密度允许可压缩附属物2200的不同可压缩性。在另一个实施方案中，直立纤维支撑部分2214的纤维可被构造成能够在可压缩附属物2200遇到具有较大厚度的组织或直立纤维支撑部分2214遇到较大的阻力时松开扭绞或缠绕。
在另一个实施方案中，可调节和修改直立纤维支撑部分2214的轴向强度，以为可压缩附属物2200提供期望的适应特性。直立纤维支撑部分2214还可产生动态系统，其中直立纤维支撑部分2214的纤维可在组织接触界面2210附近松散并且在可压缩附属物基部部分2216附近压缩。动态系统允许可压缩附属物2200与具有不同厚度的组织动态地相互作用。当直立纤维支撑部分2214接合具有较大厚度的组织的一部分时，它们可自适应地调整以允许可压缩附属物2200的较大可压缩性。当直立纤维支撑部分2214接合具有较薄厚度的组织的一部分时，可压缩附属物2200可保持较高的刚性以补偿变化的组织厚度。针对具有变化厚度的组织进行调节的动态能力有助于促进正确的钉成形和压缩以固定所接合的组织T。
参见图43，示出了纤维2300。纤维2300可具有各种材料和物理特性并且可被制成不同的形状、尺寸和长度。如图43所示，纤维2300包括圆柱形或至少基本上圆柱形形状。在其他实施方案中，纤维2300可具有正方形、矩形、椭圆形、八边形或任何其他横向横截面形状。纤维2300可为柔性的和弹性的并且可用于制造本公开的各种可压缩附属物。纤维2300包含一种或多种生物相容性材料。
纤维2300的材料组成、高度、和/或横向横截面面积影响其刚度或在压缩作用下弯曲的能力。可调节纤维2300的刚度以将可压缩附属物的可压缩性调节到一个或多个期望值。
参见图44，示出了纤维2400。纤维2400已经受气体吸附工艺。气体吸附工艺使得纤维2400的纤维内部部分2406浸渍有多个纤维内孔2408。纤维2400的外纤维表面2402也可通过气体吸附工艺进行改变以包括多个外纤维表面孔2404。
通过气体吸附工艺的批量起泡包括选择待使用的基质或纤维2400。该方法还包括迫使高压下的气体进入纤维2400或基质。然后降低压力，因此被处理的纤维2400或基质可膨胀。膨胀纤维2400或基质可具有增加的孔隙率、减小的密度、和/或增大的横截面表面积和直径。气体吸附工艺相对于其他常规方法可为有利的，因为其允许在不需要化学溶剂的情况下调整或调节材料特性诸如例如纤维2400的硬度。
气体吸附批量起泡工艺可应用于各种基质。在至少一个实施方案中，气体吸附批量起泡法可应用于生物相容性聚合物膜，所述生物相容性聚合物膜可用作植入式装置或可压缩附属物。可迫使高压下的气体进入聚合物膜。然后可通过降低压力使聚合物膜膨胀成闭孔构造。聚合物膜可在不需要化学溶剂的情况下变为可压缩的闭孔结构。
用于气体吸附工艺的另一个期望基质包括熔喷非织造构造。在各种情况下，熔喷工艺包括通过孔口挤出熔融聚合物，并且通过高温/高速气体的作用使挤出物变细成为纤维，所述高温/高速气体将熔融聚合物从孔口附近吹扫到输送机或卷取筛上以形成纤维非织造构造。
熔喷非织造构造随着其厚度的增加而快速地增加刚度。在某些情况下，期望具有较大厚度而不具有刚度的伴随增加的可压缩附属物。这显示出熔喷工艺的限制。在某些情况下，可利用化学溶剂获得具有较大厚度和合适刚度的可压缩附属物。
参见图45，在无需化学溶剂的情况下制备出具有较大厚度和合适刚度的可压缩附属物2500。通过熔喷工艺制备可压缩附属物2500，这产生具有多根纤维2501的熔喷非织造中间基质。通过气体吸附工艺进一步地处理熔喷非织造中间基质以产生合适的刚度。通过利用气体吸附工艺进一步地处理熔喷非织造基质，可使中间基质膨胀并且可将密度、可压缩性和/或孔隙率调节到期望的参数。
熔喷非织造中间基质利用熔喷工艺制备。可采用其他合适的技术来制备用于气体吸附工艺的合适基质。在至少一种情况下，可使用电纺工艺。在至少一种情况下，可通过针织、编织或任何其他合适的工艺制备基质。
可通过气体吸附工艺来修改本公开的一个或多个可压缩附属物，以将它们的密度、可压缩性和/或孔隙率调节到期望的参数。可通过气体吸附工艺来修改本公开的可压缩附属物的各种支柱、间隔件纤维、直立纤维和/或环状构件以将它们的密度、可压缩性和/或孔隙率调节到期望的参数。
参见图45，气体吸附工艺可导致外纤维表面2502形成外纤维表面孔2504。此外，气体吸附工艺可使得纤维内部部分2506浸渍有多个纤维内孔2508。通过气体吸附工艺，中间基质可膨胀体积，同时降低密度并增加基质的孔隙率。组合工艺的一些潜在有益效果可包括更大的组织向内生长到向可压缩附属物2500中，这归因于通过结合熔喷工艺和气体吸附工艺实现的较大的孔隙率。如图45所示，可压缩附属物2500包括通过熔喷工艺在纤维2501之间产生的多个孔2510以及通过气体吸附工艺在各个纤维2501内的产生的孔。
一旦可压缩附属物2500被成形为具有期望的特性，就可进行进一步的处理。在至少一个实施方案中，可将多个可压缩附属物2500进行层合，以增加整个构造的厚度或增加不同的材料特性。在至少一种实施方案中，可使用由不同材料制成或具有不同孔隙率和密度的可压缩附属物2500。在一个示例中，较靠近组织界面的密度和孔隙率可较大，以允许较大的组织向内生长。多个可压缩附属物可通过熔融、紧固、胶合、针织、编织、钩挂、以及其他附接技术进行附接。
可通过利用各种物质涂覆或嵌入可压缩附属物2500来到进一步地增强可压缩附属物2500。在至少一个实施方案中，可有利的是利用止血剂、抗菌剂或抗微生物剂涂覆或浸渍可压缩附属物2500。
所公开的各种实施方案包括附接到钉仓并且/或者定位在钉仓上的辅助件。应当理解，此类教导内容适用于辅助件附接到外科器械的砧座并且/或者定位在砧座上的实施方案。事实上，设想到其中第一辅助件附接到仓并且/或者定位在仓上并且第二辅助件附接到砧座并且/或者定位在砧座上的实施方案。
本公开的可压缩附属物可抵靠钉仓的仓平台诸如例如钉仓12的仓平台16进行定位。在至少一种情况下，可压缩附属物可在将钉仓加载到外科器械诸如例如外科缝合和切断器械8010(图1)上之前抵靠钉仓的仓平台进行定位。另选地，可压缩附属物可在钉仓已加载到外科缝合和切断器械上之后抵靠钉仓的仓平台进行定位。可使用加载单元来将可压缩附属物设置到钉仓的仓平台上。加载单元可包括各种附接特征结构和/或布置特征结构以用于抵靠仓平台操纵和定位可压缩附属物。一旦可压缩附属物抵靠仓平台被正确地定位，加载单元就可释放可压缩附属物。
对上文进行进一步描述，可压缩附属物可抵靠仓平台进行定位而不附接到钉仓。另选地，可压缩附属物可在钉仓加载到外科缝合和切断器械中之前或之后附接到钉仓。例如，可压缩附属物可部分地熔融到仓平台上并且随后通过冷却而重新固化，这导致可压缩附属物粘结到仓平台。也可采用各种附接特征结构来将可压缩附属物附接到钉仓，诸如例如缝合线、条带、倒钩和/或其他机械附接机构。
实施例
实施例1-一种与包括钉仓的外科器械一起使用的可压缩附属物，其中所述可压缩附属物包括第一生物相容性层、与所述第一生物相容性层间隔开的第二生物相容性层、以及在所述第一生物相容性层与所述第二生物相容性层之间延伸的多个支撑支柱。
实施例2-根据实施例1所述的可压缩附属物，其中所述支撑支柱中的每个支撑支柱包括附接到所述第一生物相容性层的第一端部部分和附接到所述第二生物相容性层的第二端部部分。
实施例3-根据实施例2所述的可压缩附属物，其中所述第一端部部分和所述第二端部部分限定与所述第一生物相容性层和所述第二生物相容性层相交的横向轴线。
实施例4-根据实施例3所述的可压缩附属物，其中所述横向轴线与所述第一生物相容性层限定第一角度，其中所述横向轴线与所述第二生物相容性层限定第二角度，并且其中所述第一角度和所述第二角度选自约80°至约100°的范围。
实施例5-根据实施例2、3、或4所述的可压缩附属物，其中所述第一端部部分织造到所述第一生物相容性层中。
实施例6-根据实施例2、3、4、或5所述的可压缩附属物，其中所述第一端部部分焊接到所述第一生物相容性层。
实施例7-根据实施例1、2、3、4、5、或6所述的可压缩附属物，其中所述多个支撑支柱包括第一支撑支柱和与所述第一支撑支柱交叉的第二支撑支柱。
实施例8-根据实施例1、2、3、4、5、6、或7所述的可压缩附属物，其中所述第一生物相容性层和所述第二生物相容性层中的至少一个包括织造基质。
实施例9-根据实施例1、2、3、4、5、6、7、或8所述的可压缩附属物，其中所述第一生物相容性层和所述第二生物相容性层中的至少一个包括针织基质。
实施例10-根据实施例1、2、3、4、5、6、8、或9所述的可压缩附属物，其中所述第一生物相容性层和所述第二生物相容性层中的至少一个包括膜。
实施例11-根据实施例1、2、3、4、5、6、8、9、或10所述的可压缩附属物，其中所述第二生物相容性层包括被构造成能够抓握组织的外表面。
实施例12-根据实施例11所述的可压缩附属物，其中所述外表面包括多个抓握特征结构，并且其中所述抓握特征结构中的每个抓握特征结构与所述外表面限定锐角。
实施例13-根据实施例1、2、3、4、5、6、8、9、10、11、或12所述的可压缩附属物，其中所述第一生物相容性层具有比所述第二生物相容性层大的密度。
实施例14-根据实施例1、2、3、4、5、6、8、9、10、11、12、或13所述的可压缩附属物，还包括主体部分和至少部分地围绕所述主体部分的外边缘，其中所述主体部分具有比所述外边缘大的厚度。
实施例15-根据实施例14所述的可压缩附属物，其中所述外边缘为渐缩的。
实施例16-根据实施例14或15所述的可压缩附属物，其中所述外边缘包括从所述第一生物相容性层延伸的第一外边缘部分和从所述第二生物相容性层延伸的第二外边缘部分，其中所述第一外边缘部分和所述第二外边缘部分联结成连续的侧向部分，所述连续的侧向部分被构造成能够接合所述第一生物相容性层和所述第二生物相容性层。
实施例17-根据实施例1、2、3、4、5、6、8、9、10、11、12、13、14、15、或16所述的可压缩附属物，还包括被构造成能够接收用于切割由所述外科器械捕获的组织的刀的刀狭槽，其中所述刀狭槽限定两个侧部，并且其中所述刀在所述两个侧部之间穿过。
实施例18-根据实施例17所述的可压缩附属物，还包括在所述两个侧部之间延伸的拴系件，其中所述刀被构造成能够切割所述拴系件以分开所述两个侧部。
实施例19-一种与外科缝合器械一起使用的钉仓组件，其中所述钉仓组件包括钉仓，所述钉仓包括仓平台和多个钉，所述仓平台包括外表面。所述钉仓组件还包括能够抵靠所述外表面定位的可压缩附属物，其中所述可压缩附属物包括：面向组织的生物相容性层；能够抵靠所述外表面定位的面向平台的生物相容性层，其中所述面向组织的生物相容性层与所述面向平台的生物相容性层间隔开；以及与所述面向组织的生物相容性层和所述面向平台的生物相容性层相交的间隔件纤维，其中所述间隔件纤维被构造成能够在所述面向平台的生物相容性层之上提升所述面向组织的生物相容性层。
实施例20-一种与包括钉仓的外科器械一起使用的可压缩附属物，其中所述可压缩附属物包括第一生物相容性层、与所述第一生物相容性层间隔开的第二生物相容性层、以及互连所述第一生物相容性层和所述第二生物相容性层的细长柔性构件，其中所述细长柔性构件被构造成能够形成在所述第一生物相容性层与所述第二生物相容性层之间直立的多个支撑结构。
实施例21-一种与外科缝合器械一起使用的钉仓组件，其中所述钉仓组件包括钉仓，所述钉仓包括仓平台和多个钉。所述钉仓组件还包括能够抵靠所述仓平台定位的可压缩附属物，其中所述钉能够被部署到抵靠所述可压缩附属物捕获的组织中，并且其中所述可压缩附属物包括具有第一部分的第一生物相容性层、具有第二部分的第二生物相容性层、以及在所述第一部分与所述第二部分之间延伸的交叉间隔件纤维。
实施例22-一种与外科缝合器械一起使用的钉仓组件，其中所述钉仓组件包括钉仓，所述钉仓包括仓平台和多个钉。所述钉仓组件还包括能够抵靠所述仓平台定位的可压缩附属物，其中所述钉能够被部署到抵靠所述可压缩附属物捕获的组织中，并且其中所述可压缩附属物包括面向组织的层，所述面向组织的层包括第一粘结波节和第二粘结波节，所述第二粘结波节与第一粘结波节被布置在第一排中。所述可压缩附属物还包括面向平台的层，其中所述面向组织的层与所述面向平台的层间隔开，并且其中所述面向平台的层包括与所述第一粘结波节竖直对齐的第三粘结波节和与所述第二粘结波节竖直对齐的第四粘结波节，其中所述第四粘结波节与所述第三粘结波节被布置在第二排中。所述可压缩附属物还包括在所述第一粘结波节与所述第四粘结波节之间延伸的第一间隔件纤维和在所述第二粘结波节与所述第三粘结波节之间延伸的第二间隔件纤维，其中所述第一间隔件纤维与所述第二间隔件纤维交叉。
实施例23-根据实施例22所述的钉仓组件，其中所述第一排平行于所述第二排。
实施例24-根据实施例22或23所述的钉仓组件，其中所述第一排还包括位于所述第一粘结波节与所述第二粘结波节之间的第五粘结波节。
实施例25-根据实施例24所述的钉仓组件，还包括互连所述第一粘结波节与所述第五粘结波节的第一纤维部分。
实施例26-根据实施例24或25所述的钉仓组件，还包括互连所述第二粘结波节与所述第五粘结波节的第二纤维部分。
实施例27-根据实施例22、23、24、25、或26所述的钉仓组件，其中所述第二排还包括位于所述第三粘结波节与所述第四粘结波节之间的第六粘结波节。
实施例28-根据实施例27所述的钉仓组件，还包括互连所述第三粘结波节与所述第六粘结波节的第三纤维部分。
实施例29-根据实施例27或28所述的钉仓组件，还包括互连所述第四粘结波节与所述第六粘结波节的第四纤维部分。
实施例30-根据实施例27、28、或29所述的钉仓组件，其中所述第五粘结波节与所述第六粘结波节竖直对齐。
实施例31-一种与外科缝合器械一起使用的钉仓组件，其中所述钉仓组件包括钉仓，所述钉仓包括仓平台和多个钉，所述仓平台限定近侧端部和远侧端部。所述钉仓组件还包括能够抵靠所述仓平台定位的可压缩附属物，其中所述钉能够被部署到抵靠所述可压缩附属物捕获的组织中，并且其中所述可压缩附属物包括面向组织的层，所述面向组织的层包括第一粘结波节和第二粘结波节，所述第二粘结波节与第一粘结波节被布置在第一排中。所述可压缩附属物还包括面向平台的层，其中所述面向组织的层与所述面向平台的层间隔开，并且其中所述面向平台的层包括第三粘结波节和第四粘结波节，其中所述第四粘结波节与所述第三粘结波节被布置在第二排中。所述可压缩附属物还包括从所述第一粘结波节延伸到所述第三粘结波节的第一间隔件纤维、从所述第一粘结波节沿近侧方向朝向所述面向平台的表面延伸的第二间隔件纤维、以及从所述第一粘结波节沿远侧方向朝向所述面向平台的表面延伸的第三间隔件纤维。所述可压缩附属物还包括从所述第二粘结波节延伸到所述第四粘结波节的第四间隔件纤维。
实施例32-根据实施例31所述的钉仓组件，还包括从所述第二粘结波节沿所述近侧方向朝向所述面向平台的表面延伸的第五间隔件纤维。
实施例33-根据实施例31或32所述的钉仓组件，还包括从所述第二粘结波节沿所述远侧方向朝向所述面向平台的表面延伸的第六间隔件纤维。
实施例34-根据实施例33所述的钉仓组件，其中所述第六间隔件纤维与所述第二间隔件纤维交叉。
实施例35-根据实施例31、32、33、或34所述的钉仓组件，还包括从所述第一粘结波节延伸到所述第三粘结波节的第七间隔件纤维。
实施例36-根据实施例31、32、33、34、或35所述的钉仓组件，还包括从所述第二粘结波节延伸到所述第四粘结波节的第八间隔件纤维。
实施例37-根据实施例31、32、33、34、35、或36所述的钉仓组件，其中所述第一粘结波节与所述第三粘结波节竖直对齐。
实施例38-根据实施例31、32、33、34、35、36、或37所述的钉仓组件，其中所述第二粘结波节与所述第四粘结波节竖直对齐。
实施例39-一种与外科缝合器械一起使用的钉仓组件，其中所述钉仓组件包括钉仓，所述钉仓包括仓平台和多个钉，所述仓平台限定近侧端部和远侧端部。所述钉仓组件还包括能够抵靠所述仓平台定位的可压缩附属物，其中所述钉能够被部署到抵靠所述可压缩附属物捕获的组织中，并且其中所述可压缩附属物包括面向组织的层和面向平台的层，其中所述面向组织的层与所述面向平台的层间隔开，并且其中所述面向平台的层包括外表面和内表面。所述可压缩附属物还包括：从所述面向组织的层朝向所述内表面延伸的第一间隔件纤维；从所述面向组织的层朝向所述内表面延伸的第二间隔件纤维，其中所述第一间隔件纤维和所述第二间隔件纤维延伸穿过所述面向平台的层；以及由所述第一间隔件纤维和所述第二间隔件纤维在所述外表面上限定的环。
实施例40-根据实施例39所述的钉仓组件，其中所述第一间隔件纤维和所述第二间隔件纤维在所述面向平台的层处相交。
实施例41-根据实施例39或40所述的钉仓组件，还包括从所述面向组织的层延伸的第三间隔件纤维，其中所述第三间隔件纤维与所述第一间隔件纤维和所述第二间隔件纤维在所述面向平台的层处相交。
实施例42-一种与包括钉仓的外科器械一起使用的可压缩附属物，其中所述可压缩附属物包括生物相容性层和从所述生物相容性层突起的多个生物相容性环状构件。所述生物相容性环状构件中的每个生物相容性环状构件包括附接到所述生物相容性层的第一端部部分、附接到所述生物相容性层的第二端部部分、以及在所述第一端部部分与所述第二端部部分之间延伸的中间弯曲部分，其中所述中间弯曲部分比所述第一端部部分和所述第二端部部分远离所述生物相容性层。
实施例43-根据实施例42所述的可压缩附属物，还包括与所述生物相容性层间隔开的另一个生物相容性层。
实施例44-根据实施例43所述的可压缩附属物，其中所述多个生物相容性环状构件定位在所述生物相容性层与所述另一个生物相容性层之间。
实施例45-根据实施例43或44所述的可压缩附属物，其中所述中间弯曲部分附接到所述另一个生物相容性层。
实施例46-根据实施例43、44、或45所述的可压缩附属物，其中所述另一个生物相容性层包括织造层。
实施例47-根据实施例42、43、44、45、或46所述的可压缩附属物，其中所述生物相容性层包含彼此间隔开的多个拴系岛，并且其中所述拴系岛中的每个拴系岛由所述生物相容性环状构件中的至少一个的所述第一端部部分和所述第二端部部分限定。
实施例48-根据实施例47所述的可压缩附属物，其中所述拴系岛被布置成平行排。
实施例49-根据实施例42、43、44、45、46、或47所述的可压缩附属物，其中生物相容性环状构件中的每个生物相容性环状构件包括宽头部部分和在所述宽头部部分与所述生物相容性层之间延伸的窄颈部部分。
实施例50-根据实施例42、43、44、45、46、47、或48所述的可压缩附属物，其中所述生物相容性环状构件中的每个生物相容性环状构件由纤维构成。
实施例51-根据实施例50所述的可压缩附属物，其中所述纤维为复丝纤维。
实施例52-根据实施例42、43、44、45、46、47、48、49、50、或51所述的可压缩附属物，其中所述生物相容性环状构件被构造成能够响应于压缩力而以无组织的方式弯曲。
实施例53-根据实施例42、43、44、45、46、47、48、49、50、或51所述的可压缩附属物，其中所述生物相容性环状构件被构造成能够响应于压缩力而以有组织的方式弯曲。
实施例54-一种与包括钉仓的外科器械一起使用的可压缩附属物，其中所述可压缩附属物包括：第一生物相容性层，所述第一生物相容性层包括被布置成多个第一排的第一纤维环；与所述第一生物相容性层间隔开的第二生物相容性层，其中所述第二生物相容性层包括被布置成与所述多个第一排间隔开的多个第二排的第二纤维环；以及从所述第一纤维环中的每个第一纤维环朝向所述第二生物相容性层延伸的一对第一纤维部分。所述可压缩附属物还包括从所述第二纤维环中的每个第二纤维环朝向所述第一生物相容性层延伸的一对第二纤维部分。
实施例55-根据实施例54所述的可压缩附属物，其中所述第一纤维部分为倾斜的，以有利于响应于压缩力而沿第一方向弯曲。
实施例56-根据实施例55所述的可压缩附属物，其中所述第二纤维部分为倾斜的，以有利于响应于所述压缩力而沿所述第一方向弯曲。
实施例57-根据实施例54、55、或56所述的可压缩附属物，其中所述第一纤维部分和所述第二纤维部分被构造成能够响应于压缩力而以无组织的方式弯曲。
实施例58-根据实施例54、55、或56所述的可压缩附属物，其中所述第一纤维部分和所述第二纤维部分被构造成能够响应于压缩力而以有组织的方式弯曲。
实施例59-一种与外科缝合器械一起使用的钉仓组件，其中所述钉仓组件包括钉仓，所述钉仓包括仓平台和多个钉，所述仓平台限定近侧端部和远侧端部。所述钉仓组件还包括能够抵靠所述仓平台定位的可压缩附属物，其中所述可压缩附属物包括第一生物相容性层和与所述第一生物相容性层间隔开的第二生物相容性层。所述第二生物相容性层包括：第一纤维环；从所述第一纤维环朝向所述第一生物相容性层延伸的一对第一纤维部分；位于所述第一纤维环近侧的第二纤维环，其中所述一对第一纤维部分穿过所述第二纤维环；以及从所述第二纤维环朝向所述第一生物相容性层延伸的一对第二纤维部分。
实施例60-根据实施例59所述的钉仓组件，其中所述第二生物相容性层包括：位于所述第二纤维环近侧的第三纤维环，其中所述一对第二纤维部分穿过所述第三纤维环；以及从所述第三纤维环朝向所述第一生物相容性层延伸的一对第三纤维部分。
实施例61-根据实施例59或60所述的钉仓组件，其中所述第二层为针织层。
实施例62-一种钉仓组件，所述钉仓组件包括：仓体，所述仓体包括平台和限定在所述平台中的多个钉腔；能够移除地存储在所述钉腔中的多根钉；以及定位在所述钉腔之上的植入式层，其中所述植入式层包括被编织成顶部表面、底部表面和在所述顶部表面与所述底部表面之间延伸的支柱壁的结构纤维以及交织在所述支柱壁内的增强纤维。
实施例63-根据实施例62所述的钉仓组件，其中所述增强纤维交织在所述顶部表面和所述底部表面内。
实施例64-根据实施例62或63所述的钉仓组件，其中所述增强纤维围绕所述结构纤维成环。
实施例65-根据实施例62、63、或64所述的钉仓组件，其中所述植入式层包括第一压缩区和第二压缩区，所述第一压缩区包括位于所述增强纤维与所述结构纤维之间的第一密度的环，所述第二压缩区包括位于所述增强纤维与所述结构纤维之间的第二密度的环，其中所述第二密度大于所述第一密度。
实施例66-根据实施例65所述的钉仓组件，其中所述仓体还包括被构造成能够接收切割构件的纵向狭槽，其中所述第一压缩区与所述纵向狭槽对齐，并且其中所述第二压缩区与所述钉腔对齐。
实施例67-根据实施例62、63、64、65、或66所述的钉仓组件，其中所述仓体包括近侧端部和远侧端部，其中所述第一压缩区与所述近侧端部对齐，并且其中所述第二压缩区相对于所述第一压缩区被定位在远侧。
实施例68-根据实施例62、63、64、65、66、或67所述的钉仓组件，其中所述仓体还包括被构造成能够接收切割构件的纵向狭槽，并且其中所述支柱壁延伸横跨所述纵向狭槽。
实施例69-根据实施例62、63、64、65、66、67、或68所述的钉仓组件，其中每个所述结构纤维包括在所述仓体的近侧端部与远侧端部之间延伸的纵向接缝。
实施例70-根据实施例62、63、64、65、66、67、68、或69所述的钉仓组件，其中每个所述增强纤维包括延伸穿过支柱壁的侧向接缝。
实施例71-根据实施例62、63、64、65、66、67、68、69、或70所述的钉仓组件，其中所述结构纤维由第一材料构成，并且其中所述增强纤维由不同于所述第一材料的第二材料构成。
实施例72-根据实施例62、63、64、65、66、67、68、69、70、或71所述的钉仓组件，其中所述增强纤维与所述结构纤维打结在一起。
实施例73-根据实施例62、63、64、65、66、67、68、69、70、71、或72所述的钉仓组件，其中所述植入式层包括第一压缩区和第二压缩区，所述第一压缩区包括位于所述增强纤维与所述结构纤维之间的第一密度的结，所述第二压缩区包括位于所述增强纤维与所述结构纤维之间的第二密度的结，其中所述第二密度大于所述第一密度。
实施例74-一种钉仓组件，所述钉仓组件包括：仓体，所述仓体包括平台和限定在所述平台中的多个钉腔；存储在所述钉腔中的多根钉；以及定位在所述钉腔之上的植入式层，其中所述植入式层包括由交织纤维构成的互连结构壁以及限定在所述结构壁之间的凹坑。
实施例75-根据实施例74所述的钉仓组件，其中所述结构壁由结构纤维和增强纤维构成，所述结构纤维被编织成顶部表面、底部表面、和在所述顶部表面与所述底部表面之间延伸的支柱壁，所述增强纤维交织在所述支柱壁内。
实施例76-根据实施例75所述的钉仓组件，其中所述增强纤维围绕所述结构纤维成环。
实施例77-根据实施例75或76所述的钉仓组件，其中所述植入式层包括第一压缩区和第二压缩区，所述第一压缩区包括位于所述增强纤维与所述结构纤维之间的第一密度的环，所述第二压缩区包括位于所述增强纤维与所述结构纤维之间的第二密度的环，其中所述第二密度大于所述第一密度。
实施例78-根据实施例77所述的钉仓组件，其中所述仓体还包括被构造成能够接收切割构件的纵向狭槽，其中所述第一压缩区与所述纵向狭槽对齐，并且其中所述第二压缩区与所述钉腔对齐。
实施例79-根据实施例77或78的钉仓组件，其中所述仓体包括近侧端部和远侧端部，其中所述第一压缩区与所述近侧端部对齐，并且其中所述第二压缩区相对于所述第一压缩区被定位在远侧。
实施例80-根据实施例75、76、77、78、或79所述的钉仓组件，其中所述结构纤维由第一材料构成，并且其中所述增强纤维由不同于所述第一材料的第二材料构成。
实施例81-根据实施例75、76、77、78、79、或80所述的钉仓组件，其中所述仓体还包括被构造成能够接收切割构件的纵向狭槽，并且其中所述结构壁延伸横跨所述纵向狭槽。
实施例82-根据实施例75、76、77、78、79、80、或81所述的钉仓组件，其中所述结构壁包括在所述仓体的近侧端部和远侧端部之间延伸的纵向接缝。
实施例83-根据实施例82所述的钉仓组件，其中所述结构壁还包括横向于所述纵向接缝延伸的侧向接缝。
实施例84-一种钉仓组件，所述钉仓组件包括：仓体，所述仓体包括平台和限定在所述平台中的多个钉腔；存储在所述钉腔中的多根钉；以及定位在所述钉腔之上的植入式层，其中所述植入式层包括顶部部分、底部部分以及在所述顶部部分与所述底部部分之间交织的壁。
实施例85-一种可压缩附属物，所述可压缩附属物包括第一部分、第二部分和中间部分，其中所述中间部分设置在所述第一部分与所述第二部分之间，并且其中所述中间部分包括：第一支柱；第二支柱；其中所述第一支柱和所述第二支柱基本上在所述第一部分与所述第二部分之间延伸；和互连构件，其中所述互连构件被构造成能够至少接合所述第一支柱和所述第二支柱，其中当所述可压缩附属物被力压缩时，所述第一支柱被构造成能够挠曲第一挠曲量并且所述第二支柱被构造成能够挠曲第二挠曲量，并且其中所述第一挠曲量不同于所述第二挠曲量。
实施例86-根据实施例85所述的可压缩附属物，其中所述互连构件固定地接合所述第一支柱和所述第二支柱。
实施例87-根据实施例85或86所述的可压缩附属物，其中所述互连构件滑动地接合所述第一支柱和所述第二支柱。
实施例88-根据实施例85、86、或87所述的可压缩附属物，其中所述第一支柱具有第一横截面直径，其中所述第二支柱具有第二横截面直径，并且其中所述第一直径不同于所述第二直径。
实施例89-根据实施例88所述的可压缩附属物，其中所述第一横截面直径大于所述第二横截面直径，并且其中所述第二挠曲量大于所述第一挠曲量。
实施例90-根据实施例85、86、87、88、或89所述的可压缩附属物，其中所述第一支柱具有第一密度，其中所述第二支柱具有第二密度，并且其中所述第一密度不同于所述第二密度。
实施例91-根据实施例90所述的可压缩附属物，其中所述第一密度大于所述第二密度，并且其中所述第二挠曲量大于所述第一挠曲量。
实施例92-根据实施例85、86、87、88、89、90、或91所述的可压缩附属物，其中所述第一支柱具有第一横截面直径，其中所述第二支柱具有第二横截面直径，其中所述互连构件具有第三横截面直径，并且其中所述第一横截面直径和所述第二横截面直径不同于所述第三横截面直径。
实施例93-根据实施例85、86、87、88、89、90、91、或92所述的可压缩附属物，其中所述第一支柱具有第一密度，其中所述第二支柱具有第二密度，其中所述互连构件具有第三密度，并且其中所述第一密度和所述第二密度不同于所述第三密度。
实施例94-根据实施例85、86、87、88、89、90、91、92、或93所述的可压缩附属物，其中所述第一支柱包括第一端部、第二端部和中间部分，其中所述第一端部接合所述第一部分，其中所述第二端部接合所述第二部分，并且其中所述互连构件接合所述中间部分。
实施例95-一种可压缩附属物，所述可压缩附属物包括基部部分和多个支柱，其中所述多个支柱构成第一支撑件，所述第一支撑件包括第一支柱和第二支柱，其中所述第一支柱和所述第二支柱接合所述基部部分，并且其中所述第一支柱和所述第二支柱互连。所述多个支柱还构成第二支撑件，所述第二支撑件包括第三支柱和第四支柱，其中所述第三支柱和所述第四支柱接合所述基部部分，其中所述第三支柱和所述第四支柱互连，其中当所述可压缩附属物被力压缩时，所述第一支撑件被构造成能够挠曲第一挠曲量并且所述第二支撑件被构造成能够挠曲第二挠曲量，并且其中所述第一挠曲量不同于所述第二挠曲量。
实施例96-根据实施例95所述的可压缩附属物，其中所述第一支撑件包含第一材料，并且其中所述第二支撑件包含第二材料，并且其中所述第一材料不同于所述第二材料。
实施例97-根据实施例95或96所述的可压缩附属物，其中所述第一支撑件具有第一平均密度，并且其中所述第二支撑件具有第二平均密度，并且其中所述第一平均密度不同于所述第二平均密度。
实施例98-根据实施例97所述的可压缩附属物，其中所述第一平均密度大于所述第二平均密度，并且其中所述第二挠曲量大于所述第一挠曲量。
实施例99-根据实施例95、96、97、或98所述的可压缩附属物，其中所述第一支柱具有第一横截面直径，其中所述第二支柱具有第二横截面直径，并且其中所述第一直径不同于所述第二直径。
实施例100-根据实施例95、96、97、98、或99所述的可压缩附属物，其中所述第一支柱具有第一横截面直径，其中所述第二支柱具有第二横截面直径，其中所述第三支柱具有第三横截面直径，并且其中所述第四支柱具有第四横截面直径。
实施例101-根据实施例100所述的可压缩附属物，其中所述第一直径不同于所述第三直径，并且其中所述第二直径不同于所述第四直径。
实施例102-根据实施例95、96、97、98、99、100、或101所述的可压缩附属物，其中所述第一支撑件具有第一平均高度，其中所述第二支撑件具有第二平均高度，并且其中所述第一高度不同于所述第二高度。
实施例103-根据实施例102所述的可压缩附属物，其中所述第一平均高度大于所述第二平均高度并且所述第一挠曲量大于所述第二挠曲量。
实施例104-根据实施例95、96、97、98、99、100、101、102、或103所述的可压缩附属物，其中所述第一支柱和所述第二支柱织造在一起，并且其中当所述可压缩附属物被压缩时，所述第一支柱和所述第二支柱被构造成能够部分地退绕。
实施例105-一种制备具有期望厚度的纤维可压缩构造的方法，其中所述方法包括下述步骤：一，制备包括小于期望厚度的厚度的生物相容性熔喷非织造基质，其中所述生物相容性熔喷非织造基质包括多根纤维；以及二，对所述生物相容性熔喷非织造基质应用气体吸附工艺以将所述厚度修改为所述期望厚度。
实施例106-根据实施例105所述的方法，其中应用所述气体吸附工艺的所述步骤包括将高压气体施加到所述生物相容性熔喷非织造基质。
实施例107-根据实施例105或106所述的方法，其中制备所述生物相容性熔喷非织造基质的所述步骤包括挤出聚合物，通过高温和高速气体的作用使所述挤出物变细成为纤维，并且收集所述纤维以形成纤维非织造织物。
实施例108-根据实施例105、106、或107所述的方法，其中应用气体吸附工艺的所述步骤包括：一，将高压气体施加到所述生物相容性熔喷非织造基质；以及二，降低所述气体的压力。
在各种情况下，本公开的可压缩附属物中的一个或多个由一种或多种生物相容性材料构成。可压缩附属物可包含聚合物组合物。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。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。在各种情况下，聚合物组合物可包括具有均一孔形态或梯度孔形态(即，小孔尺寸在整个泡沫厚度上沿着一个方向逐渐增加变成大孔)的多孔结构。
在各种情况下，可压缩附属物具有多孔形态，该多孔形态表现出梯度结构，诸如例如，在一个表面上是小孔，而在另一表面上是较大的孔。此类形态对于组织向内生长或止血行为而言更为理想。另外，梯度还可与变化的生物吸收剖面相组合。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。
在各种情况下，聚合物组合物可包含药物活性剂。聚合物组合物可释放治疗有效量的药物活性剂。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。在各种情况下，药物活性剂可被释放到流体诸如例如流经聚合物组合物上方或穿过聚合物组合物的血液中。
下述专利的全部公开内容据此以引用方式并入本文：
公布于1995年4月4日的名称为“ELECTROSURGICAL HEMOSTATIC DEVICE”的美国专利5,403,312；
公布于2006年2月21日的名称为“SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”的美国专利7,000,818；
公布于2008年9月9日的名称为“MOTOR-DRIVEN SURGICAL CUTTING ANDFASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK”的美国专利7,422,139；
公布于2008年12月16日的名称为“ELECTRO-MECHANICAL SURGICAL INSTRUMENTWITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”的美国专利7,464,849；
公布于2010年3月2日的名称为“SURGICAL INSTRUMENT HAVING AN ARTICULATINGEND EFFECTOR”的美国专利7,670,334；
公布于2010年7月13日的名称为“SURGICAL STAPLING INSTRUMENTS”的美国专利7,753,245；
公布于2013年3月12日的名称为“SELECTIVELY ORIENTABLE IMPLANTABLEFASTENER CARTRIDGE”的美国专利8,393,514；
名称为“SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利申请序列号11/343,803；现为美国专利号7,845,537；
提交于2008年2月14日的名称为“SURGICAL CUTTING AND FASTENING INSTRUMENTHAVING RF ELECTRODES”的美国专利申请序列号12/031,573；
提交于2008年2月15日的名称为“END EFFECTORS FOR A SURGICAL CUTTING ANDSTAPLING INSTRUMENT”的美国专利申请序列号12/031,873(现为美国专利7,980,443)；
名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT”的美国专利申请序列号12/235,782，现为美国专利8,210,411；
名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117，现为美国专利8,608,045；
2009年12月24日提交的名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENTWITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY”的美国专利申请序列号12/647,100；现为美国专利号8,220,688；
提交于2012年9月29日的名称为“STAPLE CARTRIDGE”的美国专利申请序列号12/893,461，现为美国专利号8,733,613；
提交于2011年2月28日的名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号13/036,647，现为美国专利号8,561,870；
名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利申请序列号13/118,241，现为美国专利9,072,535；
2012年6月15日提交的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING A FIRING DRIVE”的美国专利申请序列号13/524,049；现为美国专利号9,101,358；
提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,025，现为美国专利申请公布2014/0263551；
提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,067，现为美国专利申请公布2014/0263552；
提交于2006年1月31日的名称为“SURGICAL CUTTING AND FASTENING INSTRUMENTWITH CLOSURE TRIGGER LOCKING MECHANISM”的美国专利申请公布2007/0175955；以及
提交于2010年4月22日的名称为“SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”的美国专利申请公布2010/0264194，现为美国专利8,308,040。
虽然本文已结合某些公开的实施方案描述了装置的各种实施方案，但也可实施对这些实施方案的许多修改和变型。另外，在公开了用于某些部件的材料的情况下，也可使用其他材料。此外，根据多种实施方案，单个部件可被替换为多个部件，并且多个部件也可被替换为单个部件，以执行给定的一种或多种功能。上述具体实施方式和下述权利要求旨在涵盖所有此类修改和变型。
本文所公开的装置可被设计成在单次使用后废弃，或者其可被设计成能够使用多次。然而无论是哪种情况，该器械都可在至少使用一次后经过修复再行使用。修复可包括拆卸装置、清洁或更换具体部件以及后续重新组装的其中任意几个步骤的组合。具体地，所述装置可拆卸，而且可以任意组合选择性地更换或移除所述装置的任意数目的特定零件或部件。在清洁和/或替换特定部件后，可对所述装置进行重新组装，以便随后在修复设施处使用或就在外科手术之前由外科小组人员使用。本领域的技术人员将会理解，修复装置可利用各种技术来进行拆卸、清洁/替换和重新组装。此类技术的使用以及所得的修复装置均在本申请的范围内。
仅以举例的方式，可在外科手术之前对本文所述的方面进行处理。首先，可以获得新的或用过的器械，并且根据需要进行清洁。然后，可对器械进行消毒。在一种灭菌技术中，将所述器械放置在密闭且密封的容器(诸如，塑料或TYVEK袋)中。然后可将容器和器械置于可穿透所述容器的辐射场，例如γ辐射、X射线或高能电子。辐射可以杀死器械上和容器中的细菌。消毒后的器械随后可被存放在无菌容器中。密封容器可将器械保持处于无菌状态，直至在医疗设施中将该容器打开。还可使用本领域已知的任何其他技术对装置进行消毒，所述技术包括但不限于β或γ辐射、环氧乙烷或蒸汽。
尽管本发明已被描述为具有示例性设计，但可在本公开的实质和范围内进一步修改本发明。因此，本专利申请旨在涵盖使用本发明的一般原理的本发明的任何变型、用途或改型。
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提出的现有定义、陈述或其他公开材料相冲突的范围内并入本文。因此，并且在必要的程度下，本文明确列出的公开内容代替以引用方式并入本文的任何冲突材料。据称以引用方式并入本文但与本文列出的现有定义、陈述或其他公开材料相冲突的任何材料或其部分，将仅在所并入的材料与现有的公开材料之间不产生冲突的程度下并入。

Claims (24)

1.一种可压缩附属物，包括：
第一部分；
第二部分：和
中间部分，其中所述中间部分设置在所述第一部分与所述第二部分之间，并且其中所述中间部分包括：
第一支柱；
第二支柱，其中所述第一支柱和所述第二支柱基本上在所述第一部分与所述第二部分之间延伸；以及
互连构件，其中所述互连构件被构造成能够至少接合所述第一支柱和所述第二支柱，其中当所述可压缩附属物被力压缩时，所述第一支柱被构造成能够挠曲第一挠曲量，并且所述第二支柱被构造成能够挠曲第二挠曲量，并且其中所述第一挠曲量不同于所述第二挠曲量。
2.根据权利要求1所述的可压缩附属物，其中所述互连构件固定地接合所述第一支柱和所述第二支柱。
3.根据权利要求1所述的可压缩附属物，其中所述互连构件滑动地接合所述第一支柱和所述第二支柱。
4.根据权利要求1所述的可压缩附属物，其中所述第一支柱具有第一横截面直径，其中所述第二支柱具有第二横截面直径，并且其中所述第一直径不同于所述第二直径。
5.根据权利要求4所述的可压缩附属物，其中所述第一横截面直径大于所述第二横截面直径，并且其中所述第二挠曲量大于所述第一挠曲量。
6.根据权利要求1所述的可压缩附属物，其中所述第一支柱具有第一密度，其中所述第二支柱具有第二密度，并且其中所述第一密度不同于所述第二密度。
7.根据权利要求6所述的可压缩附属物，其中所述第一密度大于所述第二密度，并且其中所述第二挠曲量大于所述第一挠曲量。
8.根据权利要求1所述的可压缩附属物，其中所述第一支柱具有第一横截面直径，其中所述第二支柱具有第二横截面直径，其中所述互连构件具有第三横截面直径，并且其中所述第一横截面直径和所述第二横截面直径不同于所述第三横截面直径。
9.根据权利要求1所述的可压缩附属物，其中所述第一支柱具有第一密度，其中所述第二支柱具有第二密度，其中所述互连构件具有第三密度，并且其中所述第一密度和所述第二密度不同于所述第三密度。
10.根据权利要求1所述的可压缩附属物，其中所述第一支柱包括：
第一端部；
第二端部；和
中间节段，其中所述第一端部接合所述第一部分，其中所述第二端部接合所述第二部分，并且其中所述互连构件接合所述中间节段。
11.一种可压缩附属物，包括：
基部部分；和
多个支柱，其中所述多个支柱包括：
第一支撑件，所述第一支撑件包括：
第一支柱；和
第二支柱，其中所述第一支柱和所述第二支柱接合所述基部部分，并且其中所述第一支柱和所述第二支柱互连；和第二支撑件，所述第二支撑件包括：
第三支柱；和
第四支柱，其中所述第三支柱和所述第四支柱接合所述基部部分，其中所述第三支柱和所述第四支柱互连，其中当所述可压缩附属物被力压缩时，所述第一支撑件被构造成能够挠曲第一挠曲量，并且所述第二支撑件被构造成能够挠曲第二挠曲量，并且其中所述第一挠曲量不同于所述第二挠曲量。
12.根据权利要求11所述的可压缩附属物，其中所述第一支撑件包含第一材料，并且其中所述第二支撑件包含第二材料，并且其中所述第一材料不同于所述第二材料。
13.根据权利要求12所述的可压缩附属物，其中所述第一支撑件具有第一平均密度，并且其中所述第二支撑件具有第二平均密度，并且其中所述第一平均密度不同于所述第二平均密度。
14.根据权利要求13所述的可压缩附属物，其中所述第一平均密度大于所述第二平均密度，并且其中所述第二挠曲量大于所述第一挠曲量。
15.根据权利要求11所述的可压缩附属物，其中所述第一支柱具有第一横截面直径，其中所述第二支柱具有第二横截面直径，并且其中所述第一直径不同于所述第二直径。
16.根据权利要求11所述的可压缩附属物，其中所述第一支柱具有第一横截面直径，其中所述第二支柱具有第二横截面直径，其中所述第三支柱具有第三横截面直径，并且其中所述第四支柱具有第四横截面直径。
17.根据权利要求16所述的可压缩附属物，其中所述第一直径不同于所述第三直径，并且其中所述第二直径不同于所述第四直径。
18.根据权利要求11所述的可压缩附属物，其中所述第一支撑件具有第一平均高度，其中所述第二支撑件具有第二平均高度，并且其中所述第一高度不同于所述第二高度。
19.根据权利要求18所述的可压缩附属物，其中所述第一平均高度大于所述第二平均高度，并且所述第一挠曲量大于所述第二挠曲量。
20.根据权利要求11所述的可压缩附属物，其中所述第一支柱和所述第二支柱织造在一起，并且其中当所述可压缩附属物被压缩时，所述第一支柱和所述第二支柱被构造成能够部分地退绕。
21.一种制备具有期望厚度的纤维可压缩构造的方法，其中所述方法包括下述步骤：
制备包括小于期望厚度的基质厚度的生物相容性熔喷非织造基质，其中所述生物相容性熔喷非织造基质包括多根纤维；以及
对所述生物相容性熔喷非织造基质应用气体吸附工艺以将所述基质厚度修改为所述期望厚度。
22.根据权利要求21所述的方法，其中应用所述气体吸附工艺的所述步骤包括将高压气体施加到所述生物相容性熔喷非织造基质。
23.根据权利要求21所述的方法，其中制备所述生物相容性熔喷非织造基质的所述步骤包括：
挤出聚合物；
通过高温和高速气体的作用使所述挤出物变细成为纤维；以及
收集所述纤维以形成纤维非织造织物。
24.根据权利要求21所述的方法，其中应用气体吸附工艺的所述步骤包括：
将高压气体施加到所述生物相容性熔喷非织造基质；以及降低所述气体的压力。
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US14/871,057 US20170086829A1 (en) 2015-09-30 2015-09-30 Compressible adjunct with intermediate supporting structures
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US14/871,153 US10524788B2 (en) 2015-09-30 2015-09-30 Compressible adjunct with attachment regions
US14/871,078 US10561420B2 (en) 2015-09-30 2015-09-30 Tubular absorbable constructs
US14/871,056 US10478188B2 (en) 2015-09-30 2015-09-30 Implantable layer comprising a constricted configuration
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US14/871,071 US10433846B2 (en) 2015-09-30 2015-09-30 Compressible adjunct with crossing spacer fibers
US14/871,119 US10285699B2 (en) 2015-09-30 2015-09-30 Compressible adjunct
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