JP6483136B2 - Surgical staples and methods for making the same - Google Patents

Description

  The present invention relates to surgical instruments and surgical cutting and fastening instruments designed to cut and fasten tissue in various arrangements, fastener cartridges therefor, and surgical fasteners designed for use therewith. Concerning ingredients.

  Surgical staplers are often used to deploy staples into soft tissue to reduce or eliminate bleeding from the soft tissue, particularly when the tissue is being transected, for example. For example, a surgical stapler, such as an end cutter, can include an end effector that can be moved or articulated relative to the elongated shaft assembly. The end effector is often configured to secure soft tissue between the first jaw member and the second jaw member, and the first jaw member is configured to removably store staples. In many cases, the second jaw member includes an anvil. Such surgical staples can include a closure system for pivoting the anvil relative to the staple cartridge.

  As outlined above, the surgical stapler can be configured to pivot the anvil of the end effector relative to the staple cartridge to capture soft tissue therebetween. In various cases, the anvil can be configured to apply a clamping force to the soft tissue to securely hold the soft tissue between the anvil and the staple cartridge. However, if the surgeon is not satisfied with the position of the end effector, the surgeon typically activates the surgical stapler release mechanism to pivot the anvil to the open position and then reposition the end effector. There must be. Thereafter, the staple is typically deployed from the staple cartridge by a sled that traverses a channel in the staple cartridge, deforms the staple relative to the anvil, and secures the soft tissue layers together. The sled can engage a driver located between the staples and the sled to deploy the staples from the staple cartridge. In many cases, as is known in the art, staples are deployed in the form of a plurality of staple lines, or rows, in order to more accurately secure multiple layers of tissue together. Staples are typically deformed to “B” by the end effector anvil. The end effector may also include a cutting member, such as a knife, that is advanced between a plurality of staple rows to stap the soft tissue together after stapling multiple layers of soft tissue.

  Such surgical staplers and end effectors may be sized and configured to be inserted into a body cavity through a trocar or other access opening. The end effector is typically coupled to an elongate shaft that is sized to penetrate the trocar or opening. The elongate shaft assembly is often operably coupled to a handle that supports a control system and / or trigger that controls the operation of the end effector. In order to facilitate proper positioning and orientation of the end effector within the body, many surgical instruments are configured to facilitate articulation of the end effector relative to a portion of the elongate shaft.

  The above discussion is intended only to illustrate various aspects of the related art in the field of the present invention at that time and should not be construed as denying the scope of the claims.

The features and advantages of the present invention, as well as the manner in which they are realized, will become more apparent and a better understanding of the invention itself can be obtained by reference to the following description of embodiments of the invention in conjunction with the accompanying drawings. Will.
1 is a perspective view of a surgical instrument according to various embodiments of the present disclosure. FIG. FIG. 2 is an exploded perspective view of the handle assembly of the surgical instrument of FIG. 1 according to various embodiments of the present disclosure. FIG. 2 is an exploded perspective view of the end effector of the surgical instrument of FIG. 1 according to various embodiments of the present disclosure. FIG. 4 is a perspective view of the end effector staple cartridge of FIG. 3 in accordance with various embodiments of the present disclosure. FIG. 5 is a cross-sectional perspective view of the staple cartridge of FIG. 4 along the plane shown in FIG. 4 according to various embodiments of the present disclosure. FIG. 5 is a perspective view of a staple shown in the staple cartridge of FIG. 4 in accordance with various embodiments of the present disclosure. It is a front view of the staple of FIG. It is a rear view of the staple of FIG. It is a top view of the staple of FIG. It is a bottom view of the staple of FIG. It is a right view of the staple of FIG. FIG. 7 is a left side view of the staple of FIG. 6. FIG. 7 is a perspective view of the staple of FIG. 6. FIG. 4 is an elevational view of the staple of FIG. 6 and the end effector thread of FIG. 3 showing the distal end surface of the thread in contact with the initial drive surface of the staple, according to various embodiments of the present disclosure. FIG. 15 is a perspective view of the staple and sled of FIG. 14 showing the leading end surface of the sled that contacts the initial drive surface of the staple. FIG. 15 is an elevational view of the staple and sled of FIG. 14 showing the trailing end surface of the sled contacting the secondary drive surface of the staple, according to various embodiments of the present disclosure. FIG. 15 is a perspective view of the staple and sled of FIG. 14 showing the trailing end surface of the sled that contacts the secondary drive surface of the staple. FIG. 4 is a cross-sectional elevation view of the end effector of FIG. 3 illustrating the progress of staple firing from a staple cartridge in accordance with various embodiments of the present disclosure. FIG. 4 is a cross-sectional elevation view of the end effector of FIG. 3 illustrating the progress of staple firing from a staple cartridge in accordance with various embodiments of the present disclosure. FIG. 4 is a cross-sectional elevation view of the end effector of FIG. 3 illustrating the progress of staple firing from a staple cartridge in accordance with various embodiments of the present disclosure. FIG. 4 is a cross-sectional elevation view of the end effector of FIG. 3 illustrating the progress of staple firing from a staple cartridge in accordance with various embodiments of the present disclosure. FIG. 4 is a cross-sectional elevation view of the staple cartridge and sled of FIG. 3 showing the staple in an unfired position, according to various embodiments of the present disclosure. FIG. 23 is a cross-sectional perspective view of the cartridge and sled of FIG. 22 showing the staple in the unfired position shown in FIG. FIG. 23 is a cross-sectional elevation view of the cartridge and sled of FIG. 22 showing a proximal staple pair in a partially fired position and a remaining staple in an unfired position in accordance with various embodiments of the present disclosure. FIG. 23 is a cross-sectional perspective view of the cartridge and sled of FIG. 22 showing the proximal staple pair shown in FIG. 24 in a partially fired position and the remaining staple shown in FIG. 24 in an unfired position. FIG. 23 is a cross-sectional elevation view of the cartridge and sled of FIG. 22 showing a plurality of staple pairs in a partially fired position and a proximal staple pair in a partially deformed configuration, according to various embodiments of the present disclosure. FIG. 27 is a cross-sectional perspective view of the cartridge and sled of FIG. 22 showing a plurality of staple pairs in the partially fired position of FIG. 26 and a proximal staple pair of the partially deformed configuration shown in FIG. FIG. 23 is a cross-sectional elevation view of the cartridge and sled of FIG. 22 showing a plurality of staple pairs in a further firing position and a proximal pair of further modified configurations in accordance with various embodiments of the present disclosure. FIG. 23 is a cross-sectional perspective view of the cartridge and sled of FIG. 22 showing a plurality of staple pairs in the partially fired position shown in FIG. 28 and a proximal staple pair in the partially deformed configuration shown in FIG. FIG. 22 is a cross-section of the cartridge and sled of FIG. 22 showing a plurality of staple pairs in a partially deformed configuration and a proximal staple pair in a fully deformed configuration in a partially fired configuration according to various embodiments of the present disclosure. FIG. 30 of the cartridge and sled of FIG. 22 in the partially fired position shown in FIG. 30 and a plurality of pairs of staples in a partially deformed configuration and in the firing position shown in FIG. It is a cross-sectional perspective view. 6 illustrates a method of forming staples from a sheet of material according to various embodiments of the present disclosure. 6 illustrates a method of forming staples from a sheet of material according to various embodiments of the present disclosure. 6 illustrates a method of forming staples from a sheet of material according to various embodiments of the present disclosure. FIG. 33 is a perspective view of a staple formed from the method shown in FIGS. 32A-32C in accordance with various embodiments of the present disclosure. It is a top view of the staple of FIG. It is a front view of the staple of FIG. It is a side view of the staple of FIG. 1 is a perspective view of a staple according to various embodiments of the present disclosure. FIG. FIG. 38 is a plan view of the staple of FIG. 37. FIG. 38 is a front view of the staple of FIG. 37. FIG. 38 is a side view of the staple of FIG. 37. 1 is a perspective view of a staple according to various embodiments of the present disclosure. FIG. FIG. 42 is a plan view of the staple of FIG. 41. 42 is a front view of the staple of FIG. 41. FIG. 42 is a side view of the staple of FIG. 41. FIG. 1 is a perspective view of a staple cartridge according to various embodiments of the present disclosure. FIG. FIG. 46 is a cross-sectional perspective view of the staple cartridge of FIG. 45 taken along the plane shown in FIG. 45. FIG. 46 is a plan view of the staple cartridge of FIG. 45. 1 is a perspective view of a staple according to various embodiments of the present disclosure. FIG. FIG. 49 is a plan view of the staple of FIG. 48. FIG. 49 is a front view of the staple of FIG. 48. FIG. 49 is a side view of the staple of FIG. 48. 1 is a perspective view of a staple according to various embodiments of the present disclosure. FIG. FIG. 53 is a plan view of the staple of FIG. 52. FIG. 53 is a front view of the staple of FIG. 52. FIG. 53 is a side view of the staple of FIG. 52. FIG. 5 is a partial cross-sectional elevation view of the staple cartridge of FIG. 4 showing the staple in a partial firing position within the staple cavity, according to various embodiments of the present disclosure. FIG. 57 is a partial plan view of the staple cartridge of FIG. 56 showing the staple in the partially fired position shown in FIG. 56. FIG. 57 is a partial cross-sectional elevation view of the staple cartridge of FIG. 56 showing the staple in the partially fired position shown in FIG. FIG. 57 is a partial cross-sectional elevation view of the staple cartridge of FIG. 56 showing the staple in another partial firing position, according to various embodiments of the present disclosure. FIG. 59 is a partial plan view of the staple cartridge of FIG. 56 showing the staple in the partially fired position shown in FIG. 59. FIG. 59 is a partial cross-sectional elevation view of the staple cartridge of FIG. 56 showing the staple in the partially fired position shown in FIG. 59. FIG. 57 is a partial cross-sectional elevation view of the staple cartridge of FIG. 56 in a firing configuration and showing a deformed configuration of staples according to various embodiments of the present disclosure. FIG. 57 is a partial plan view of the staple cartridge of FIG. 56 showing the deformed configuration of staples in the firing position shown in FIG. 62. FIG. 57 is a partial cross-sectional elevation view of the staple cartridge of FIG. 56 showing the staple in a deformed configuration in the firing position shown in FIG. 62. 1 is an exploded perspective view of an end effector comprising a plurality of fasteners and a firing actuator configured to eject fasteners from the end effector according to various embodiments of the present disclosure. FIG. FIG. 66 is a plan view of a first portion of the fastener firing actuator of FIG. 65. FIG. 67 is an elevational view of the first portion of FIG. 66. FIG. 66 is a plan view of a second portion of the fastener firing actuator of FIG. 65. FIG. 69 is an elevational view of the second portion of FIG. 68. FIG. 66 is a cross-sectional view of the end effector of FIG. 65 showing the firing actuator in an unfired, unstretched state. FIG. 66 is a cross-sectional view of the end effector of FIG. 65 showing the firing actuator in an extended state. FIG. 66 is a cross-sectional view of the end effector of FIG. 65 showing the firing actuator in an extended, advanced state. FIG. 66 is a cross-sectional view of the end effector of FIG. 65 showing the end effector anvil in the open position and the firing actuator in an unfired, unstretched state. FIG. 66 is a cross-sectional view of the end effector of FIG. 65 showing the anvil in the closed position and the firing actuator in an unfired, unstretched state. FIG. 74 is a cross-sectional perspective view of the end effector of FIG. 65 exemplified in the configuration shown in FIG. 73. FIG. 66 is a cross-sectional view of the end effector of FIG. 65, exemplified by the configuration shown in FIG. FIG. 66 is a cross-sectional view of the end effector of FIG. 65 showing the firing actuator in the extended state and the knife member in the non-advanced position. FIG. 66 is a cross-sectional view of the end effector of FIG. 65 showing the firing actuator in an extended state and the knife member in an advanced position. FIG. 76 is a cross-sectional perspective view of the end effector of FIG. 65, exemplified in the configuration shown in FIG. 78. FIG. 66 is a partial cross-sectional view of the end effector of FIG. 65, illustrated in a fully fired state. FIG. 66 is a cross-sectional elevation view of the end effector of FIG. 65 illustrated in the configuration shown in FIG. FIG. 66 is a cross-sectional perspective view of the end effector of FIG. 65, exemplified by the configuration shown in FIG. FIG. 66 is a cross-sectional elevation view of the end effector of FIG. 65 showing the knife member in a retracted position. FIG. 66 is a cross-sectional perspective view of the end effector of FIG. 65, exemplified in the configuration shown in FIG. 83. FIG. 76 is a perspective view of the firing member of the end effector of FIG. 65, illustrated in the non-expanded configuration shown in FIG. 74. FIG. 76 is a perspective view of a firing member of the end effector of FIG. 65, illustrated in the extended configuration shown in FIG. 77. FIG. 66 is a perspective view of the firing member of the end effector of FIG. 65, illustrated in a configuration immediately prior to the full firing configuration shown in FIG. FIG. 66 is a perspective view of the firing member of the end effector of FIG. 65, illustrated in the fully firing configuration shown in FIG. 1 is a cross-sectional view of an end effector including a firing actuator configured to eject a fastener from a fastener cartridge, illustrated by a firing actuator in an unfired position. FIG. FIG. 90 is a cross-sectional view of the end effector of FIG. 89, exemplified by a firing member in a partial firing position. FIG. 90 is a plan view of a staple cartridge body of the end effector of FIG. 89. FIG. 92 is a perspective view of a firing actuator for use with the cartridge body of FIG. 91. FIG. 92 is a perspective view of the cartridge body of FIG. 91. FIG. 94 is a cross-sectional view of the cartridge body of FIG. 91 taken along line 94-94 of FIG. 93.

Applicant also owns the following patent applications filed on the same day as the present application, the entire contents of each of which are incorporated herein by reference.
US patent application, “SURGICAL INSTRUMENTS WITH ARTULA TABLE SHARFT ARRANGEMENTS”, agent reference number END7343USNP / 130300.
US patent application, name "SURGICAL STAPLES AND STAPLE CARTRIDGES", agent serial number END7341USNP / 130301.
US patent application, “ARTICULABLE SURGICAL INSTRUMENTS WITH SEPARATE AND DISTINCT CLOSESING AND FIRING SYSTEMS”, Attorney Docket No. END7333USNP / 130322.
US patent application, “SURGICAL COUNTING AND STAPLING INSTRUMENTS WITH INDEPENDENT JAW CONTROL FEATURES”, Attorney Docket No. END7336USNP / 130303.
US patent application, name “SURGICAL STAPLES AND STAPLE CARTRIDGES”, agent serial number END7331 USNP / 130304.
US patent application, “SURGICAL STAPLES, STAPLE CARTRIDGES AND SURGICAL END EFFECTORS”, agent serial number END7332USNP / 130306.
US patent application, name “SURGICAL FASTENER”, Attorney Docket No. END 7338 USDP / 130307.
US patent application, name “FASTENER CARTRIDGE COMPRISING AN EXTENDABLE FIRING MEMBER”, attorney docket number END 7344 USNP / 130308.
US patent application, name “FASTENER CARTRIDGE COMPRISING A FIRING MEMBER CONFIGURED TO DIRECTLY ENGAGE AND EJECT FASTENERS FROM THE FASTENER CARTRIDGE”, agency number END 7339N.
US patent application, name “FASTENER CARTRIDGE COMPRISING A FIRING MEMBER INCLUDING FASTENER TRANSFER SURFACES”, Attorney Docket No. END7340USNP / 130310.
US patent application, “MODULAR SURGICAL INSTRUMENTS”, Attorney Docket No. END7342USNP / 130311.
US patent application, “SURGICAL CUTTING AND STAPLING INSTRUMENTS WITH ARTULATABLE END EFFECTORS”, Attorney Docket No. END7334USNP / 130312.
US patent application, “SURGICAL COUNTING AND STAPLING METHODS”, Attorney Docket No. END7330USNP / 130313.

  Certain exemplary embodiments are now described so that the principles of structure, function, manufacture, and application of the devices and methods disclosed herein may be comprehensively understood. One or more examples of these embodiments are illustrated in the accompanying drawings. Those skilled in the art will appreciate that the devices and methods specifically described herein and shown in the accompanying drawings are non-limiting exemplary embodiments, and that the scope of the various embodiments of the present invention is patentable. It will be understood that this is defined only by the claims. The features illustrated or described in connection with certain exemplary embodiments may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.

  Throughout this specification, references to “various embodiments,” “some embodiments,” “one embodiment,” or “embodiments,” and the like are specific for the particular embodiment described in connection with that embodiment. A feature, structure, or characteristic is meant to be included in at least one embodiment. Thus, throughout the specification, phrases such as “in various embodiments,” “in some embodiments,” “in one embodiment,” or “in an embodiment” appear. However, these are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or characteristics illustrated or described with respect to one embodiment are not limited, in whole or in part, with the features, structures, or characteristics of one or more other embodiments. May be combined. Such modifications and variations are intended to be included within the scope of the present invention.

  The terms “proximal” and “distal” are used herein with reference to the clinician operating the handle portion of the surgical instrument. The term “proximal” refers to the portion closest to the clinician, and the term “distal” refers to the portion that is remote from the clinician. It will be further understood that for convenience and clarity, spatial terms such as “vertical”, “horizontal”, “top”, “bottom” may be used herein with respect to the drawings. I will. However, surgical instruments are used in many directions and positions, and these terms are not intended to be limiting and / or absolute.

  Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, one of ordinary skill in the art will readily appreciate that the various methods and devices disclosed herein can be used in a number of surgical procedures and applications, including, for example, open surgery. As the “DETAILED DESCRIPTION OF THE INVENTION” herein is read, the various instruments disclosed herein can be used, for example, from natural orifices or from incisions or puncture holes formed in tissue. It will be further recognized by those skilled in the art that it can be inserted into the body by any method. The actuating or end effector portions of these instruments may be inserted directly into the patient's body, or access devices having working passages through which the end effector and elongate shaft of the surgical instrument can be advanced. May be inserted.

  1-3, the surgical instrument 100 includes a handle assembly 104, a shaft 114 extending from the handle assembly 104, and an end effector 120 extending from the shaft 114. obtain. Referring to FIG. 3, the staple cartridge 140 may be attached to the elongated channel 122 of the first jaw 123 of the end effector 120. In certain embodiments, the staple cartridge 140 can be, for example, disposable and / or replaceable. Additionally or alternatively, the staple cartridge 140 can be incorporated into the end effector 120, for example, and / or the end effector 120 can be disposable and / or replaceable. In various embodiments, surgical instrument 100 can be motor driven. For example, referring primarily to FIG. 2, the motor 106 may be located within the handle assembly 104. The handle assembly 104 of the surgical instrument 100 can also include a trigger 108. Actuation of the trigger 108 affects, for example, closure of the jaws 123, 124 of the end effector 120, firing of the staple 160 from the staple cartridge 140, and / or movement of the firing bar 156 and cutting element 158 through the end effector 120. Can do.

  Referring primarily to FIG. 3, the staple 160 may be releasably positioned within the staple cartridge 140. For example, the at least one sled 190 can move through the staple cartridge 140 to eject the staple 160 from the staple cartridge 140. A firing bar 156 having a cutting element or knife 158 may also be moved through the staple cartridge 140 to cut tissue captured between the end effector jaws 123, 124, for example. As shown in FIG. 3, the firing bar 156 and the cutting element 158 can move from a proximal position of the first jaw 123 to a distal position of the first jaw 123. In various embodiments, tissue located intermediate staple cartridge 140 and anvil 124 can be stapled by staple 160 and then cut by cutting element 158, for example. Referring primarily to FIGS. 4 and 5, the staple cartridge 140 may include a cartridge body 142 and a staple cavity 144 defined within the cartridge body 142. For example, a staple such as staple 160 may be removably located within staple cavity 144. In certain embodiments, each staple cavity 144 may removably store one staple 160. Each staple cavity 144 may have, for example, a proximal end 146 and a distal end 148, and the longitudinal sidewall 150 extends between the proximal end 146 and the distal end 148 of each staple cavity 144. Can exist. As described in further detail herein, proximal end 146, distal end 148, and / or longitudinal sidewall 150 of staple cavity 144 may guide staple 160 during deployment from staple cavity 144, and And / or support.

  With reference now to FIGS. 6-13, the staple 160 may include a base 162, a first staple leg 164 extending from the base 162, and a staple leg 166 extending from the base 162. The base 162 can have, for example, a proximal portion 168 and a distal portion 170, and an intermediate portion 172 of the base 162 can be located, for example, between the proximal portion 168 and the distal portion 170. As shown in FIGS. 6-13, the first staple leg 164 can extend from the proximal portion 168 of the base 162, and the second staple leg 166 can extend from the distal portion 170 of the base 162. Staple legs 164, 166 may include a tip 174 that may have, for example, a sharp or substantially sharp end. In various embodiments, the tip 174 may facilitate, for example, tissue penetration and / or tissue penetration. In certain embodiments, the staple legs 164, 166 can be, for example, sharp or substantially sharp, with an edge 176 that can facilitate, for example, tissue penetration and / or tissue penetration. May be included. In other embodiments, the staple legs 164, 166 can include rounded edges.

  Still referring to FIGS. 6-13, ramps 184, 186 may be located between staple legs 164, 166 and base 162. For example, the upper ramp 184 can extend between the staple legs 164, 166 and the base 162 and / or the lower ramp 186 extends between the staple legs 164, 166 and the base 162. obtain. Upon capture of tissue by the staple 160, the tissue may be compressed between the base 162 and the deformed staple legs 164, 166, and the ramps 184, 186 may contact the compressed tissue. In various embodiments, the ramps 184, 186 can, for example, compress the captured tissue and prevent, for example, the base 162 from unintentionally penetrating and / or cutting the captured tissue.

  In various embodiments, the base 162 of the staple 160 can be asymmetric with respect to the staple legs 174, 176. For example, referring primarily to FIG. 10, the first axis A may be defined between the first staple leg 174 and the second staple leg 176, and the base 162 is asymmetric with respect to the first axis A. possible. Base 162 may be non-linear, for example, and may include at least one lateral relief 178 that bends or curves away from axis A. The base 162 or at least a portion of the base 162 may be defined by the second axis B. The undulating portion 178 may include a straight region and / or a curved region, and may be generally non-parallel to the first axis A and the second axis B, for example. For example, the undulating portion 178 bends away from the first axis A, is curved, includes a straight portion, or a substantially straight portion, and bends toward the second axis B (FIG. 10), Can be curved.

  Still referring to FIG. 10, the center of mass (COM) of the staple 160 may be offset from the first axis A. In various embodiments, a portion of the base 162 can extend along the second axis B, which can be, for example, parallel or substantially parallel to the first axis A. For example, the intermediate portion 172 of the base portion 162 can be parallel or substantially parallel to the first axis A. The undulating portion 178 can be located, for example, between the proximal portion 168 and the intermediate portion 172, and another undulating portion 178 can be located, for example, between the distal portion 170 and the intermediate portion 172. The undulations 178 can, for example, offset the intermediate portion 172 of the base 162 laterally from the staple legs 164, 166 and from the first axis A. In certain embodiments, the staple legs 164, 166 can be located, for example, on a first surface defined by the first axis A, and the intermediate portion 172 of the base 162 is a second defined by the second axis B. It can be located on a surface. The second surface can be, for example, parallel to or substantially parallel to the first surface, and the center of mass (COM) of the staple 160 can be located between the first surface and the second surface. In such embodiments, the staple 160 may include a leg forming surface, for example, a surface defined by the first axis A that may be offset from the COM of the staple 160. For example, when the staple 160 is deformed, for example, a modified “B” shape may be formed, the staple legs 164, 166 may be non-coplanar and / or laterally from the intermediate portion 172 of the staple base 162. May be offset. In various cases, the formation of modified “B” staples may, for example, perform engagement, capture, compression, and / or impact on larger volumes of tissue. In addition, in certain cases, the formation of modified “B” staples can exert forces on engaged tissue, for example, in different directions and / or bifurcation directions. The modified “Type B” can define a tissue collection region that extends in three different directions. For example, a portion of the tissue collection region may be defined in two directions by legs 164 and 166, and another portion of the tissue collection region may be a third direction between the base 162 and the legs 164, 166. Can be defined.

  In various embodiments, the intermediate portion 172 of the staple base 162 can include a longitudinal guide surface 173. For example, as described in further detail herein, the longitudinal guide surface 173 is a staple cavity when, for example, staples 160 are fired and / or fired from the cartridge body 142 (FIGS. 4 and 5). 144 may slide and / or move in contact with guide surface 50 in FIGS. 4 and 5. In such an embodiment, the longitudinal guide surface 173 may balance and / or stabilize the staple 160 during deployment. Further, the intermediate portion 172 of the staple base 162 can include a tissue contacting surface 175 (FIG. 9), which can be flat or substantially flat, for example. In various cases, the tissue contacting surface 175 of the base 162 captures, which can result in a wide and / or smooth surface for applying and / or distributing pressure to the captured and / or compressed tissue. A flat surface for contacting tissue may be formed. In such embodiments, tissue rupture and / or trauma within the staple 160 may be reduced and / or minimized, for example.

  In various embodiments, the base 162 of the staple 160 can include one or more drive surfaces. For example, the base 162 can include an initial drive surface 180 and a secondary drive surface 182. Still referring to FIGS. 6-13, the proximal portion 168 of the base 162 can include, for example, an initial drive surface 180 and / or the intermediate portion 172 of the base 172 can include a secondary drive surface 182. For example, the proximal portion 168 can include a protrusion having a first drive surface 180. The protrusion of the first driving surface 180 may include, for example, a curved surface and / or an inclined surface. The secondary driving surface 182 may include a slope at the intermediate portion 172 of the base portion 162. For example, the secondary drive surface 182 can be located, for example, distal to the initial drive surface 180 and / or between the proximal portion 168 and the distal portion 170 of the base 162. The secondary drive surface 182 may include, for example, an inclined surface or plane, and may be inclined downward in the direction of the distal portion 170 (see FIGS. 7 and 8).

  Referring primarily to FIGS. 7 and 8, the staple midline M may be defined midway between the first staple leg 164 and the second staple leg 166. The staple midline M can, for example, bisect the staple 160 and penetrate the center of mass (COM) of the staple 160. In various embodiments, the secondary drive surface 182 can extend across the midline M. For example, the secondary drive surface 182 may extend along the middle portion 172 of the base 162 and may traverse from the proximal side of the midline M to the distal side of the midline M. In such an embodiment, as described in further detail herein, during deployment of the staple 160 through the thread 190, the bevel 192 of the thread 190 causes the midline M of the staple 160 during deployment of some staples. Staples 160 at and / or near the same may be driven. In various embodiments, the distal end of the secondary drive surface 182 can also include a staple overdrive 188, as further detailed herein. Referring primarily to FIG. 7, the staple overdrive 188 may include the lowest point of the middle portion 172 of the base 162, and in some embodiments, for example, the proximal portion 168 and / or the distal portion of the base 162. It can be aligned vertically with the lowest point of 170. In other embodiments, the staple overdrive 188 may be located vertically below or above the lowest point of the proximal portion 168 and / or the distal portion 170 of the base 162.

  In various embodiments, the drive surfaces 180, 182 of the staple 160 can be separate and separate. For example, the drive surfaces 180, 182 may be offset laterally and / or longitudinally such that the drive surfaces 180, 182 are separated and / or not adjacent. Each drive surface may be individual, for example. The initial drive surface 180 can overlap, for example, the first surface (see axis A in FIG. 10), and the secondary drive surface 182 can overlap, for example, the second surface (see axis B in FIG. 10). . In certain embodiments, the drive surfaces 180, 182 can be parallel. For example, the initial drive surface 180 can extend along the first axis A (FIG. 10) and the secondary drive surface 180 can extend along the second axis B (FIG. 10). In various embodiments, a lateral gap (FIGS. 10 and 11) having a width x may be defined between the initial drive surface 180 and the secondary drive surface 182, for example. In some embodiments, a longitudinal gap (FIG. 10) having a width y can be defined between the initial drive surface 180 and the secondary drive surface 182, for example. The initial drive surface 180 can be, for example, proximal of the secondary drive surface 182. Further, for example, a non-driving portion of the base such as the lower slope 186 of the undulating portion 178 between the proximal portion 168 and the intermediate portion 172 can separate the initial driving surface 180 and the secondary driving surface 182, for example. In various embodiments, the relief 178 may traverse between a first surface defined by axis A and a second surface defined by axis B, for example.

  Still referring to FIGS. 6-13, at least one of the drive surfaces 180, 182 of the staple 160 may be integrally formed with the staple 160. For example, the drive surfaces 180, 182 can be defined within the base 162 of the staple 160. Staple 160 may comprise a single piece that may, for example, integrally include drive surfaces 180, 182. The drive surfaces 180, 182 may comprise, for example, a single piece boundary surface, ie, an outer peripheral surface. In various cases, the staple 160 may be, for example, seamless and may not include any adhesive and / or overmold features, for example. Further, the base 162 and staple legs 164, 166 can be adjacent portions, and the base 162 can integrally define the drive surfaces 180, 182, for example. In certain cases, as described in further detail herein, staples 160 may be stamped or otherwise formed from a single sheet material, for example, may remain a single piece of material. . In various cases, the drive surfaces 180, 182 may comprise the surface or plane of the forming piece.

  Referring now to FIGS. 14-17, the sled 190 may drive the staple 160 from the cavity 144 in the cartridge body 142 (FIG. 3). In various cases, the sled 190 may directly contact the staple 160 and / or drive the staple 160 directly. For example, the sled 190 can include a beveled or inclined surface 192 that can contact at least one drive surface 180, 182 of the staple 160. As sled 190 moves relative to staple 160, ramp 192 may push drive surfaces 180, 182 to lift staple 160. In various embodiments, the slope of the slope 192 can vary along its length. For example, the ramp 192 can be designed to lift the staple 160 faster and / or slower during deployment of at least some staples. Further, the slope of the ramp 192 can be designed and / or selected based on the slope of the staple drive surfaces 180, 182. For example, ramp 192 may define a slope that is greater, less than and / or equal to the slope of initial drive surface 180 and / or secondary drive surface 182. The relationship between the slope of the slope 192 and the slopes of the drive surfaces 180 and 182 can affect, for example, the staple deployment speed.

  Still referring to FIGS. 14-17, the thread 190 may include at least one outer portion 191a, 191b. For example, the sled 190 can include a single outer portion, a pair of outer portions, and / or two or more outer portions. In various cases, each outer portion 191 a, 191 b may correspond to a row of staples 160 that are removably located on the cartridge body 142. As further shown in FIGS. 14-17, the outer portions 191a, 191b can be displaced in the longitudinal direction. For example, in certain embodiments, the first outer portion 191a lags behind the second outer portion 191b by a length difference of distance L, ie, follows (FIGS. 14 and 16). In other embodiments, the outer portions 191a, 191b can be longitudinally aligned, for example, and / or the second outer portion 191b can lag behind, ie follow, the first outer portion 191a. In embodiments where the sled 190 comprises a plurality of outer portions 191a, 191b, the intermediate portion 193 may connect and / or bridge the outer portions 191a, 191b, for example.

  Referring primarily to FIGS. 14-17, the sled 190 may move between the drive surfaces 180, 182 of the staple 160. In other words, the sled 190 may exert a driving force on, for example, the initial driving surface 180 of the staple 160 and then move to the second or secondary driving surface 182 of the staple 160 to exert the driving force. In certain embodiments, the sled sloping surface 192 can include a leading end surface 194 and a trailing end surface 196. The leading end surface 194 can be adjacent to and / or connected to the trailing end surface 196, for example, and the staple 160 can move smoothly between the leading end surface 194 and the trailing end surface 196. For example, the leading end surface 194 may contact the staple 160 and initiate the lifting of the staple 160, and the trailing end surface 196 may contact the staple 160 and subsequently lift the staple 160. In certain cases, the trailing end surface 196 can, for example, lift the staple 160 smoothly to disengage from and / or disengage from the leading end surface 194.

  Still referring to FIGS. 14-17, for example, the leading end surface 194 can be aligned with the initial drive surface 180 and the trailing end surface 196 can be aligned with the secondary drive surface 182. In operation, the tip surface 194 of the ramp 192 may initially contact the staple 160. For example, referring to FIGS. 14 and 15, the tip surface 194 can contact the initial drive surface 180 of the staple 160 as the sled 190 moves. The inclined front end surface 194 can exert a driving force on the initial driving surface 180. Thereby, the lifting of the base 162 of the staple 160 can be started. For example, as the staple 160 continues to move as the sled 190, which can be raised a first distance, ie, height, by the leading end surface 194, referring now to FIGS. 16 and 17, the trailing end surface 196 is, for example, 2 of the staple 160. The next drive surface 182 may be in contact engagement. The inclined front end surface 196 can exert a driving force on the secondary driving surface 182. This allows the base 162 of the staple 160 to continue to be lifted. For example, the staple 160 can be raised a second distance, or height, by the trailing end surface 196.

  In various cases, the trailing end surface 196 may lift and / or release the initial drive surface 180 from contact with the tip surface 194 of the ramp 192, for example. For example, the trailing end surface 196 may contact the secondary drive surface 182 and the staple 160 may be immediately lifted so that the primary drive surface 180 is released from drive contact with the leading end surface 194. In other embodiments, the leading end surface 194 can drive the initial driving surface 180 and the trailing end surface 196 can simultaneously drive the secondary driving surface to deploy at least some staples. As the sled 190 continues to move, the trailing end surface 196 can lift the base 162 out of the staple cavity 144 (FIGS. 4 and 5) and / or eject the staple 160 from the cartridge 140 (FIGS. 4 and 5). obtain. For example, the proximal portion of the rear end surface 196 can include a thread overdrive 198. In various embodiments, the thread overdrive 198 can extend from the staple cavity 144 and lift the staple overdrive 188, ie, the bottom of the intermediate portion 172 of the base 162 (see FIG. 7) away from the staple cavity 144. Can be put out.

  Deployment of a plurality of staples 160 according to an exemplary application of the present disclosure is shown in FIGS. In certain embodiments, multiple rows of staple cavities 144 can be defined in the cartridge body 142. For example, multiple rows of staple cavities 144 can be defined on the first side of cartridge slot 143 (FIG. 3), and multiple rows of staple cavities 144 can be defined on the second side of cartridge slot 143. FIGS. 18-21 show two rows of staples 160 positioned within the two rows of staple cavities 144 of the cartridge body 142. Still referring to FIGS. 18-21, staples 160a, 160c, and 160e may be located, for example, in a more inner row of staple cavities 144; Can be located in a row. In various embodiments, the first inner staple 160a may be located closer to the cartridge slot 143 than the first outer staple 160b. For example, the first inner staple 160a can be adjacent to the cartridge slot 143, and the first outer staple 160b can be, for example, intermediate the side of the first inner staple 160a and the cartridge body 142. In various embodiments, additional rows of staples 160 can be defined within the cartridge body 142. For example, at least one row of staples may be located midway between the first staple 160a and the cartridge slot 143, and / or at least one row of staples 160 may be located midway between the first outer staple 160b and the cartridge body 142, for example. Can do.

  Referring primarily to FIG. 18, when the sled 190 moves distally, the second outer portion 191b may contact the first inner staple 160a. The distal end surface 194 (FIGS. 14 to 17) of the second outer portion 191b can start lifting the first inner staple 160a, for example. Referring now to FIG. 19, as the sled 190 continues to move distally, for example, the rear end surface 196 (FIGS. 14-17) of the second outer portion 191b may continue to lift the first inner staple 160a, The inner staple 160a may be moved into contact with the anvil 152 of the end effector 120. In addition, the distal end surface 194 of the second outer portion 191b can move and contact the second inner staple 160c, for example. In various cases, the first outer portion 191a can contact the first outer staple 160b, for example, at the same time as the second outer portion 191b moves to contact the second inner staple 160c. In certain embodiments, the longitudinal lag or offset between the first outer portion 191a and the second outer portion 191b corresponds to the longitudinal distance between the first outer staple 160b and the second inner staple 160c. Can do. For example, the first outer portion 191a may lag behind the second outer portion 191b by a difference in length L (FIGS. 14 and 16), and the first outer staple 160b may be delayed from the second inner staple 160c by a difference in length L. It can be offset in the longitudinal direction. In such embodiments, the deployment of the first outer staple 160b and the second inner staple 160c can be, for example, simultaneous and / or synchronized.

  Referring now to FIG. 20, as the thread 190 continues, the rear end surface 196 of the second outer portion 191 b may continue to lift the first inner staple 160 a toward the anvil 152. A staple forming pocket 154 defined in the anvil 152 can capture the staple legs 164, 166 and can deform the first inner staple 160a. Further, for example, the second outer portion 191b can continue to lift the second inner staple 160c, and the first outer portion 191a can continue to lift the first outer staple 160b. Referring now to FIG. 21, the second outer portion 191b can fire the first inner staple 160 from the staple cavity 144 as the sled 190 continues to move distally. In various cases, the thread overdrive 198 (FIGS. 14-17), for example, lifts the staple overdrive 188 to remove the staple base 162 over the cartridge body 142. As the staple forming pocket 154 of the anvil 124 continues to form the first inner staple 160a, the second outer portion 191b may continue to lift the second inner staple 160c, for example, and the first outer portion 191a holds the first outer staple 160b. Can continue to lift. In addition, the second outer portion 191b can move and contact the inner staple 160e, for example, and the first outer portion 191a can contact the second outer staple 160d, for example. In various cases, similar to the above, the second outer staple 160d may be longitudinally offset from the third inner staple 160e by a difference in length L (FIGS. 14 and 16).

  As described herein, staples 160 can be fired continuously from cartridge 140. For example, as the sled 190 moves distally, the sled 190 may continuously fire staples 160 from the proximal portion of the cartridge body 142 toward the distal portion of the cartridge body 142. As described herein, the sled 190 may fire the first, more proximal inner staple 160a prior to firing the second, more distal inner staple 160c. In other embodiments, the sled 190 may move proximally to fire the staple 160 from the staple cartridge. In such an embodiment, the sled 190 may fire the staple 160 continuously from the distal portion of the staple cartridge 140 toward the proximal portion of the staple cartridge 140. Further, firing of the staples 160 from the staple cartridge 140 can be constant or synchronized. For example, the first outer staple 160b and the second inner staple 160c can be fired simultaneously and / or, for example, the second outer staple 160d and the third inner staple 160e can be fired simultaneously. For example, the longitudinal offset between the first outer portion 191a of the thread 190 and the second outer portion 191b of the thread 190 may cause the staple 160 in the first row of staple cavities and the second, different row of staple cavities. It may correspond to the longitudinal distance from the staple 160. In such embodiments, the deployment of staples 160 may be timed such that staples 160 in the first row of staple cavities are fired simultaneously with staples 160 in the second row of staple cavities. By adjusting or stabilizing the timing of staple deployment, the positioning and / or placement of tissue during firing may be improved. For example, a portion of tissue can be held in place by the end effector jaws 123, 124 (FIG. 3), which can be stapled simultaneously. However, in other cases, the offset between 191a and 191b may not be the same as the offset between staples in the staple row.

  22-31 further illustrate an exemplary embodiment of staple deployment. For example, the staples 160a, 160b, 160c, and 160d may be located on either side of the cartridge slot 140 and may be ejectable within the staple cavity 144 defined in the cartridge body 142. Referring primarily to FIGS. 22 and 23, staples 160a, 160b, 160c, and 160d may be unfired and sled 190 may be located proximal to cartridge body 142. The sled 190 may be aligned with a row of staple cavities 144 in the cartridge body 142. For example, the first thread 190 may be aligned with the staples 160 a, 160 c in the first inner row of staple cavities 144 and the staples 160 b, 160 d in the first outer row of staple cavities 144, and the second thread 190 may be aligned with the first of the staple cavities 144. Two inner rows of staples 160a, 160c and staple cavities 144 in the second outer row of staples 160b, 160d may be aligned. For example, the first outer portion 191 of each thread 190 can be aligned with the outer staples 160b, 160d, and the second outer portion 191b of each thread 190 can be aligned with the inner staples 160a, 160c.

  Referring primarily to FIGS. 24 and 25, the first inner staple 160a can be moved to a partial firing position relative to the cartridge body 142 or lifted. For example, the second outer portion 191b of each sled 190 can move and engage the first inner staple 160a. The distal end surface 194 of the second outer portion 191b can lift the first inner staple 160a by a first distance. Subsequently, the trailing end surface 196 can move and engage the first inner staple 160a to further lift the first inner staple 160a. In various embodiments, for example, the distal movement of the sled 190 can be adjusted and the first inner staples 160a on either side of the slot 143 can be fired simultaneously. As the first inner staple 160a is lifted, a portion of each staple 160a may slide or move in contact with the longitudinal guide surface 150 of the staple cavity 144, the longitudinal guide surface 150 being referred to herein. As described in further detail, the torque generated by the sled 190 may be supported and / or balanced.

  Referring now to FIGS. 26 and 27, as the sled 190 continues to move relative to the cartridge 140, the sled 190 may move and engage the first outer staple 160b and the second inner staple 160c. In various cases, the thread 190 may contact the first outer staple 160b and the second inner staple 160c simultaneously. For example, the first outer portion 191a of the thread 190 can contact the first outer staple 160b, for example, when the second outer portion 191b of the thread 190 contacts the second inner staple 160c. Referring primarily to FIG. 27, the distal end surface 194 of the first outer portion 191a and the second outer portion 191b of the sled 190 can engage the initial drive surface 180 of the staples 160b, 160c, and the staple 160b relative to the cartridge body 142. , 160c. In addition, the rear end surface 196 of the second outer portion 191b of the sled 190 may continue to lift the first inner staple 160a, for example. As the first inner staple 160a continues to move out of the staple cavity 144, the anvil 152 (FIGS. 18-21) may begin to deform the first inner staple 160a. For example, the staple forming pocket 154 (FIGS. 18-21) may capture, rotate, and / or bend the legs 164, 166 of the first inner staple 160a. As described herein, the anvil 152 may, for example, transform the staple 160a into a modified “B-shape”.

  Referring now to FIGS. 28 and 29, as the sled 190 continues to move relative to the staple cartridge 140, the second outer portion 191b of the sled 190 may continue to lift the first inner staple 160a, for example, for example, an anvil 152. (FIGS. 18-21) may continue to deform the first inner staple 160a. In various cases, thread 190 may also continue to lift first outer staple 160b and second inner staple 160c. For example, the rear end surface 196 of the sled 190 can move to engage the secondary drive surface 182 of the first outer staple 160b and the second inner staple 160c, for example, the staple legs 164, 166 can be removed from the cartridge body 142. The staple base 162 may be lifted upward so as to continue to move toward.

  Referring now to FIGS. 30 and 31, as the sled 190 continues to move relative to the cartridge 140, the second outer portion 191b of the sled 190 may continue to lift the first inner staple 160a simultaneously. For example, the thread overdrive 198 (FIGS. 16 and 17) lifts the first inner staple 160a completely out of the cartridge body 142 so that the first inner staple 160a is fully ejected from the staple cartridge 140. obtain. In various cases, the anvil 152 (FIGS. 18-21) may continue to deform the first inner staple 160a, for example, when the first inner staple 160a is lifted completely out of the cartridge body 142, It can be completely deformed. In addition, the rear end surface 196 of the sled 190 may also continue to lift the first outer staple 160b and the second inner staple 160c simultaneously. For example, the rear end surface 196 of the first outer portion 191a can lift or drive the first outer staple 160b, and the rear end surface 196 of the second outer portion 191b can lift the second inner staple 160c, for example. Can be driven. Further, as the first outer staple 160b and the second inner staple 160c continue to move out of the staple cavity 144, the anvil 152 (FIGS. 18-21) deforms the first outer staple 160b and the second inner staple 160c. You can start. For example, the staple forming pocket 154 (FIGS. 18-21) may capture, rotate, and / or bend the legs 164, 166 of the first outer staple 160b and the second inner staple 160c. In various cases, the sled 190 may continue to move relative to the cartridge body 142 such that the first outer portion 191a and the second outer portion 191b of the sled 190 are staples 160 from adjacent and / or peripheral staple rows. Development may continue to be constant and / or timed. The sled 190 may continuously fire the staple 160 from the proximal portion of the staple cartridge 140 to the distal portion of the staple cartridge 140. In other embodiments, the sled 190 can move, for example, proximally and can fire the staples 160 continuously from the distal portion of the staple cartridge 140 toward the proximal portion of the staple cartridge 140. Further, in certain cases, the gap between the staple and the outer thread portion can affect, for example, asynchronous deployment of the staple.

Referring now to FIGS. 56-64, in various cases, the staple cavity 144 may guide the staple 160 as the sled 190 moves the staple 160 during firing. For example, in various cases, the tip surface 194 of the sled 190 can contact the initial drive surface 180 of the staple 160 and drive force D ₁ (FIG. 58) to the staple 160 via the initial drive surface 180 (FIGS. 56-58). ). The tip surface 194 may lift the staple 160 upward along a plane defined by the axis E (FIG. 57) and the axis F (FIG. 58). As shown in FIGS. 57 and 58, the center of mass (COM) of the staple can be offset from axes E and F, and in such an embodiment is exerted on the initial drive surface 180 in a plane defined by the axes E and F. Driving force D ₁ (FIG. 58) may generate torque T ₁ (FIG. 58). As described in further detail herein, the staple cavity 144 may include a longitudinal sidewall 150 between the proximal end 146 and the distal end 148 of the staple cavity 144. In certain embodiments, the staple cavity 144 can include a first sidewall 150a and a second sidewall 150b. Further, as described herein, the sidewalls 150a, 150b can resist twisting of the staple 160 during firing. For example, when the tip surface 194 of the sled 190 drives the initial drive surface 180 of the staple 160 along a plane defined by the axes E and F, the second side wall 150b causes the driving force D ₁ generated by the sled 190. Can counter counterclockwise torque T ₁ (FIG. 58) corresponding to. When the staple 160 is lifted a first distance by the tip surface 194 of the thread 190, the second sidewall 150b may guide and support the intermediate portion 172 of the staple base 162. For example, the flat surface 173 of the intermediate portion 172 of the staple base 162 can slide along and / or move in contact with the second side wall 150b.

Referring now to FIGS. 59-61, as the sled 190 moves between the initial drive surface 180 and the secondary drive surface 182, the rear end surface 196 of the sled 190 is secondary as described herein. A driving force D ₂ (FIG. 61) may be exerted on the staple 160 via the driving surface 182. In various cases, the trailing end surface 196 of the sled 190 can lift the base 162 of the staple 160 upward along a plane defined by the axis I (FIG. 60) and the axis J (FIG. 61). As shown in FIGS. 60 and 61, the center of mass (COM) of the staple may be offset from the plane defined by axes I and J, and in such an embodiment, the trailing end surface 196 of the sled 190 is on the secondary drive surface 182. The exerting driving force D ₂ (FIG. 61) can generate a torque T ₂ (FIG. 61). Comparing FIGS. 58 and 61, the driving force _{D 1} is applied to the staple 160 at the first side of the COM, the driving force _{D 2} is said to be applied at the opposite side of the COM. In various cases, for example, torque T ₁ can be in a first direction, T ₂ can be in a second direction, and the second direction can be the opposite of the first direction. When the trailing end surface 196 drives the secondary drive surface 182 of the staple 160 along the plane defined by the axes I and J, the first sidewall 150a can resist the clockwise torque T ₂ (FIG. 61). The first side wall 150a may guide and support the proximal end 168 and the distal end 170 of the staple base 162 when the staple 160 is lifted a second distance by the trailing end surface 194. For example, the proximal end 168 and the distal end 170 of the base 162 can slide along and / or move in contact with the first sidewall 150a.

  The reader will recognize that in certain embodiments, the various staples and / or features described herein with respect to the staple COM are equally applicable to the shape center of the staple. In various cases, for example, staples such as staple 160 may be composed of a single material and / or have a single composition. In such embodiments, the staple COM may correspond to the staple shape center. In other embodiments, staples can be composed of multiple materials and / or non-uniform compositions. For example, staples can be formed of multiple pieces and / or multiple materials that are welded and / or otherwise joined. In certain embodiments, at least two different sheets of material can be welded, for example, and the staples can be cut from a portion of the welded sheet comprised of the plurality of materials. In other embodiments, the at least two different material sheets can be layered, rolled and / or sealed, for example. Staples can be cut from a portion of a sheet composed of multiple materials. In such an embodiment, the staple COM may be offset from the staple shape center. For example, the staple COM may be offset laterally and / or longitudinally from the staple shape center.

As illustrated in FIGS. 58 and 61, the sled 190 may exert vertical driving forces D ₁ , D ₂ on the staple 160 during deployment. The reader will recognize that the driving force generated by sled 190 can also include a horizontal component. In various embodiments, the proximal end 146 and / or the distal end 148 of the staple cavity 144 can guide and support the staple legs 164, 166 when the staple 160 is lifted by the sled 190. In various embodiments, the proximal end 146 and / or the distal end 148 of the staple cavity 144 can balance the torque generated by the horizontal component of the driving force. For example, when the sled 190 moves distally, the distal end 148 of the staple cavity 144 may resist rotation and / or torque of the staple 160 during deployment. Referring now to FIGS. 62-64, the trailing end surface 196 may continue to lift the staple 160 out of the staple cavity 144. For example, the thread overdrive 198 can contact the staple overdrive 188 and lift the base 162 of the staple 160 out of the cartridge body 140.

  Referring now to FIGS. 45-47, for example, a staple cartridge, such as staple cartridge 240, may be attached to the elongated channel 122 (FIG. 3) of the end effector 120. For example, staples such as staple 160 may be releasably located on staple cartridge 240. For example, sled 190 (FIGS. 14-17) may move through staple cartridge 240 and eject staple 160 therefrom. In various cases, the staple cartridge 240 can include a cartridge body 242 and a staple cavity 244 defined in the cartridge body 242. Staple 160 may be removably positioned within staple cavity 244, for example. For example, each staple cavity 244 can removably store one staple 160. Further, each staple cavity 244 can have, for example, a proximal end 246 and a distal end 248, and the longitudinal sidewall 250 is between the proximal end 246 and the distal end 248 of the staple cavity 244. Can extend. Similar to the cavity 144 described herein, the proximal end 246, the distal end 248, and / or the longitudinal sidewall 250 may guide and / or support the firing staple 160. For example, the longitudinal side wall 250 can balance the torque exerted on the staple 160 by the movement of the sled 190. In various cases, the cavity 244 may also include a diagonal guide surface 251 between the sidewalls 250. For example, the proximal diagonal guide surface 251 a can extend between the proximal end 246 of the cavity 244 and the sidewall 250 of the cavity 244. In addition, or alternatively, the distal diagonal guide surface 251b may extend between the distal end 248 of the cavity 244 and the sidewall 250 of the cavity 244. The diagonal guide surfaces 251a, 251b may guide and / or indicate, for example, the reliefs 178 (FIGS. 6-13) of the staple 160 when the staple 160 is lifted within the staple cavity 244. For example, a portion of the relief 178 can pivot along and / or move along the diagonal guide surfaces 251a, 251b. In such an arrangement, the diagonal guide surfaces 251a, 251b can balance the torque exerted on the staple 160, for example.

  Referring now to FIGS. 32A-32C, for example, staples such as staple 160 may be cut, formed, and / or stamped from a material sheet, such as material sheet 130, for example. The material sheet 130 can be, for example, metal and can include, for example, stainless steel and / or titanium. In various cases, the material sheet 130 can be substantially flat and / or smooth. Further, in certain cases, the material sheet 130 may be bent, folded, undulated, and / or corrugated in various regions, such as the first region 134 and the second region 136, for example. The material sheet 130 can be bent using, for example, a punch and / or a stamping die. The flat or substantially flat portions 135a, 135b, and 135c of the material sheet 130 may be located in the middle of the regions 134, 136, for example. For example, the first region 134 may be in the middle of the flat portions 135a and 135b, and the second region 136 may be in the middle of the flat portions 135b and 135c, for example. In various cases, for example, the flats 135a and 135c can be coplanar and / or, for example, the flat 135b can be parallel to and / or substantially parallel to the flats 135a and / or 135c. It can be. Referring primarily to FIG. 32A, a plurality of flat sheets 130a, 130b, 130c, 130d, 130e, 130f may be laminated and then bent simultaneously in regions 134, 136. In other embodiments, the sheets 130a, 130b, 130c, 130d, 130e, 130f can be individually bent and then laminated, for example.

  In various cases, the staple 160 can be cut, formed, and / or stamped from the bent sheet 130. For example, referring primarily to FIG. 32B, the bent sheet 130 may be traced, etched, and / or cut of the staple profile 132. In the bent sheet 130, the staple contour 132 can be machined and / or laser cut, for example. In various cases, an electrical discharge machine (EDM) wire 138 may be used to cut the staple contour 132. Further, in certain cases, multiple laminated sheets 130 can be cut simultaneously. In certain embodiments, referring primarily to FIG. 32C, the staple contour 132 may form the boundary, or outer periphery, of the staple 160. For example, the staple profile 132 may form a staple 160 (FIGS. 6-13 and 33-36) and / or may form a staple having various features similar to the staple 160, for example. In various cases, a plurality of staple profiles 132 may be cut into the material sheet 130 and a plurality of staples 160 may be formed from a single material sheet 130. As shown in FIGS. 32B and 32C, the EDM wire 138 can penetrate a plurality of sheets of material 130 at a time and cut a plurality of staples 160 at a time. Although six sheets 130 are cut simultaneously by the EDM wire 138, any suitable number of sheets 130 can be cut simultaneously. For example, the wire 138 may cut less than six sheets 130 simultaneously, or more than six sheets 130 simultaneously.

  For example, referring to FIGS. 32C and 33-36, the staple contour 132 may form, for example, a base 162 and / or staple legs 164, 166. Further, the staple profile 132 may include at least one integrally formed staple drive surface. For example, the staple profile 132 can include an initial drive surface 180 and / or a secondary drive surface 182. In other words, the initial drive surface 180 and / or the secondary drive surface 182 can be machined and / or formed simultaneously with the staple 160 being cut from the sheet of material 130. In certain cases, the bends or undulation regions 134, 136 (FIGS. 32A and 32B) of the sheet 130 can form the undulations 178 of the staple 160. Further, the outer flat portions 135a and 135c (FIGS. 32A and 32B) of the sheet 130 may correspond to the staple legs 164 and 166, and the intermediate flat portion 135b (FIGS. 32A and 32B) of the sheet 130 is, for example, the base 162. It can correspond to the intermediate part 172.

In various cases, the depth D ₁ (FIGS. 34 and 36) of the staple 160 may be determined by the depth of the material sheet 130. For example, the material sheet 130 can be selected based on its depth, and the staples 160 formed from the material sheet 130 can have the same depth as the material sheet 130. Further, the height H ₁ (FIG. 35) and width W ₁ (FIG. 35) of the base 162 and staple legs 164, 166 may be determined by the staple contour 132. In various cases, the staple profile 132 may cause a change in the height and / or width of the staple element along the length of each staple element. For example, the height H ₁ of the base 162 and / or the width W ₁ of the staple legs 164, 166 can vary along its length. Further, the taper profile 132 may define taper, step, and / or other changes. Accordingly, the shape of the staple 160 may be selected and / or manipulated based on the purpose, application, and / or design of the end effector 120 that may use the staple 160 and / or the staple 160.

Referring primarily to FIGS. 33-36, in various cases, the staple 160 is cut so that the height H ₁ of the base 162 is independent of and / or different from the depth D ₁ of the staple legs 164, 166. Can be done. For example, the depth _{D 1} of the staple legs 164 and 166 may correspond to the depth of the material sheet 130, the base 162 is, for example, independent of the depth _{D 1} of the depth and / or the corresponding leg of the sheet of material 130 It can be cut to proper height H ₁ obtained. The appropriate height H ₁ may be based on, for example, the purpose, application, and / or design of the end effector 120 (FIG. 3) that may use the staple 160 and / or the staple 160. Further, the height H ₁ of the base 162 can also vary along its length. For example, the height H ₁ may vary, for example, at and / or near the drive surface of the staple 160 and / or in the gusset between one of the staple legs 164, 166 and the base 162. The staple contour 132 may, for example, provide at least one taper and / or step along the length of the base 162. The staple contour 132 may comprise a taper or bevel that may form the secondary drive surface 182 of the base 162, for example. The slope of the secondary drive surface 182 can be selected, designed and implemented via the staple contour 132. In certain embodiments, the height H ₁ of the base 162 may be greater than the depth D ₁ of the staple legs 164, 166. In other embodiments, the height H ₁ of the base 162 can be less than or equal to the depth D ₁ of the staple legs 164, 166. By comparison, the shape of the staple formed from the bent wire can be constrained and / or limited based on the dimensions of the initial wire. For example, in a staple formed of wire, the height of the staple base typically corresponds to the width of the staple leg, and the width of the staple leg typically corresponds to the diameter of the wire. For example, the diameter of the wire can be modified by stretching and / or rolling, but acceptable modifications are limited and / or constrained by the volume of the material.

In various cases, the width W ₁ of the staple legs 164, 166 can also be independent of, for example, the depth D ₁ of the staple legs 164, 166 and the height H _{1 of the} base 162. Staple legs 164 and 166, for example, application of the end effector 120 that may be used to staple 160 and / or staple 160 (FIG. 3), based on the object, and / or design can be cut to the appropriate width _{W 1} . In certain embodiments, the staple legs 164, 166 can comprise, for example, different widths, and / or the width of the staple legs 164, 166 can be tapered, stepped, or other methods. Can vary along its length. For example, the staple legs 164, 166 may be tapered at the tip 174 to form a penetrating end or point.

  Referring now to FIGS. 37-40, the staple contour 232 is traced, cut, etched, and / or machined into the sheet of material 130 (FIGS. 32A and 32B), for example, staple 160 (FIGS. 33-36). Can be formed from the sheet of material 130. For example, the staple 260 may include a base 262 and staple legs 264, 266 extending from the base 262. In various embodiments, the staples 260 can include undulations 278 that correspond to the bends and / or undulation regions 134, 136 (FIGS. 32A and 32B) of the material sheet 130 on which the staples 260 are formed. obtain. In certain embodiments, the staple 260 may include an intermediate portion 272 between the reliefs 278, for example. Further, at least one drive surface 280, 282 may be formed along the outer periphery of the staple 260 via the staple contour 232.

Similar to the staple 160, the depth D ₁ of the staple leg 264 can correspond to the depth of the material sheet 130. Further, in various cases, the height H ₂ of the staple base 262 can be independent of the depth D ₁ of the staple legs 264, 266 and / or independent of the depth of the material sheet 130. For example, as shown in FIG. 37 to 40, the height _{H 2} of the staple base 262 is the height _H less than _a staple base 162 (Fig. 33-36), the depth _{D 2} of the staple legs 264, 266 , for example, equal to the depth _{D 1} of the staple legs 164 and 166. In various cases, the width _{W 2} of the staple legs 264 and 266 also can be independent of the depth _{D 2} of the staple legs 264, 266. The height H ₁ of the staple base 262 and the width W ₂ of the staple legs 264, 266 may be selected based on, for example, the purpose, application, and / or design of the staple 260 and / or end effector 120 (FIG. 3). .

  Referring now to FIGS. 41-44, the staple profile 332 is traced, cut, etched, and / or machined into the sheet of material 130 (FIGS. 32A and 32B), eg, staples 160 and 260 (FIGS. 33-33). A staple 360 similar to 40) may be formed from the sheet of material 130. For example, the staple 360 may include a base 362 and staple legs 364, 366 extending from the base 362. In various embodiments, the staple 360 can include a relief 378 that corresponds to the bend and / or relief regions 134, 136 (FIGS. 32A and 32B) of the material sheet 130 on which the staple 360 is formed. obtain. In certain embodiments, the staple 360 may include an intermediate portion 372 between the reliefs 378, for example. Further, at least one drive surface 380 and 382 may be formed along the outer periphery of the staple 360 via the staple contour 332.

Similar to the staples 160 and 260, the depth D ₃ of the staple legs 364 can correspond to the depth of the material sheet 130. Further, in various cases, the height H ₃ of the staple base 362 can be independent of the depth D ₃ of the staple legs 364, 366 and / or independent of the depth of the material sheet 130. For example, as shown in FIG. 41 to 44, the height _{H 3} of the staple base 362 is greater than the height _{H 1} of the staple base 162 (Fig. 33-36), the staple base 262 (FIG. 37 to 40) High is larger than _{H 2,} the depth _{D 3} of the staple legs 364, 366 may, for example, equal to the depth _{D 1} of the staple legs 164 and 166 is equal to the depth _{D 2} of the staple legs 264, 266. In various cases, the width W ₃ of the staple legs 364, 366 may also be independent of the depth D ₃ of the staple legs 364, 366. The height H ₃ of the staple base 362 and the width W ₃ of the staple legs 364, 366 may be selected based on, for example, the purpose, application, and / or design of the staple 360 and / or end effector 120 (FIG. 3). .

  Referring now to FIGS. 48-51, for example, staples such as staple 460 may be used in staple cartridges such as staple cartridge 140 (FIGS. 3-5) and / or staple cartridge 240 (FIGS. 45-47). Staple 460 may include a base 462 having a proximal portion 468 and a distal portion 470. The intermediate base 472 may be located between the proximal portion 468 and the distal portion 470, for example. As shown in FIGS. 48-51, the first staple leg 464 can extend from the proximal portion 468 of the base 462 and the second staple leg 466 can extend from the distal portion 470 of the base. In various cases, the staple legs 464, 466 can be, for example, cylindrical or substantially cylindrical, eg, tapered to penetrate tissue, and / or sharp edges or sharp points. A staple tip 474 may be included. In other embodiments, the staple legs 464, 466 can include, for example, a round and / or polygonal perimeter. The intermediate portion 472 of the staple base 462 can include a tissue contacting surface 473 that can be, for example, flat or substantially flat. In various cases, the staple 460 can be formed, for example, from a wire that is bent, twisted, and / or otherwise manipulated, such as, for example, staple legs 464, 466, and / or A staple base 462 may be formed. In various embodiments, the diameter of the wire can define the width and depth of the staple legs 464, 466, for example. In some embodiments, the wire can be stretched and / or rolled to modify the dimensions of the staple 460. In certain cases, the intermediate portion 462 of the wire base 462 can be formed and / or planarized to form the tissue contacting surface 473. In various cases, the base 462 can be two parallel or, for example, such that the tissue contacting surface 473 and the bottom 475 of the base 462 are flat or substantially flat and / or parallel or substantially parallel. It can be planarized between plates that are substantially parallel. Modifications to the base 162 may be constrained and / or limited, for example, by the volume of wire material.

  Still referring to FIGS. 48-51, staples 460 may include bevels and / or gussets. For example, the ramp 484 can extend between the first staple leg 464 and the base 462 and / or the ramp 484 can extend between the second staple leg 466 and the base 462. In certain embodiments, the ramp 484 may be, for example, with respect to a longitudinal axis G (FIG. 49) extending between the first staple leg 464 and the second staple leg 466 and / or the staple leg. It may be asymmetric with respect to a vertical axis H (FIG. 51) extending along the length of 464,466. The inclined surface 484 may extend in a direction away from the axis G and / or the axis H, for example. Thus, in certain embodiments, the middle portion 472 of the base 462 can be offset from the axis G and / or the axis H. For example, the center of mass of base 462 may be offset from the plane defined by axis G and axis H. In various cases, the offset intermediate portion 472 of the base 462 is for contacting the captured tissue, which can provide a wide and / or smooth surface for applying and / or distributing pressure to the captured tissue. Wide and / or flat surfaces can be formed. In such embodiments, tissue rupture and / or trauma within the staple 460 may be reduced and / or minimized. Further, similar to the staples 160, 260 and / or 360 described herein, the staple 460 can include a leg-forming surface, eg, a surface defined by the axis G and the axis H, such as , Offset from the center of mass of the base 462 of the staple 460.

  Referring now to FIGS. 52-55, for example, staples such as staple 560 may be used in staple cartridges such as, for example, staple cartridge 140 (FIGS. 3-5) and / or staple cartridge 240 (FIGS. 45-47). Staple 560 may include a base 562 having a proximal portion 568 and a distal portion 570. The intermediate base 572 can be located, for example, between the proximal portion 568 and the distal portion 570. As shown in FIGS. 52-55, the first staple leg 564 can extend from the proximal portion 568 of the base 562 and the second staple leg 566 can extend from the distal portion 570 of the base 562. In certain embodiments, the intermediate portion 572 of the base 560 is parallel and / or substantially parallel to, for example, an axis C (FIG. 53) defined between the first staple leg 564 and the second staple leg 566. It may extend along axis D (FIG. 53), which may be parallel.

  In various cases, the staple legs 564, 566 can be, for example, cylindrical or substantially cylindrical, eg, tapered to penetrate tissue, and / or sharp edges or points. A staple tip 574 may be included. In various cases, the staple 560 can be formed from a wire. For example, the wire may be bent, twisted, and / or otherwise manipulated to form staple 560. With further reference to FIGS. 52-55, the wire can be manipulated at the bends 579a, 579b, 579c, and / or 579d. For example, the staple base 562 can include a corner 578 that can be, for example, relative to the intermediate portion 572 of the staple base 562 and / or between the first staple leg 564 and the second staple leg 566. Can be oriented at an angle with respect to an axis C defined in FIG. In various embodiments, the wires forming staple 560 can be curved at 579b between corner 578a and intermediate portion 572, which can be curved, for example, at 579a between first staple leg 564 and corner 578a. May be curved at 579c between the intermediate portion 572 and the corner 578b and / or curved at 579d between the corner 578b and the second staple leg 566. For example, the intermediate portion 572 of the base 562 can be laterally offset from the axis C (FIG. 53) extending between the first staple leg 564 and the second staple leg 566.

  In various embodiments, the diameter of the wire can define, for example, the width and depth of the staple legs 564, 562 and / or the staple base 562. In some embodiments, the wires and / or portions thereof can be stretched and / or rolled to modify the dimensions of staples 560 and / or the elements of staples 560. Further, the wire may include a round and / or polygonal perimeter. In certain embodiments, the wire can be cut at an angle to form staple tips 574, for example. Similar to staples 160, 260 and / or 460 described herein, staple 560 may include a leg-forming surface, eg, a surface defined by axis C, which is the base of staple 560, for example. May be offset from the center of mass of 562;

  In addition to the above, referring now to FIG. 65, an end effector, such as, for example, end effector 120, can be positioned on the opposite side of staple cartridge 240 in addition to staple cartridge 240 located in elongate channel 122. Anvil 124. In various cases, the cartridge 240 is configured to slidably receive a plurality of staple cavities 244, fasteners such as staples 460 located within each staple cavity 244, and a knife 158 therein. A longitudinal slot 243. While the staple 460 is shown in connection with the embodiment shown in FIG. 65, any suitable staple or fastener, such as the staple 160, can be used in this embodiment. Referring generally to FIGS. 73 and 74, the end effector 120 may extend from a shaft 114 that may include a closure tube 115. As the closure tube 115 advances distally, the closure tube 115 contacts the anvil 124 and can rotate the anvil 124 between an open position (FIG. 73) and a closed position (FIG. 74). When the anvil 124 is closed, the knife 158 can be advanced distally to transversely incise the tissue captured between the anvil 124 and the cartridge 240. In certain end effectors disclosed herein, the cartridge located within the end effector 120 may further include a fastener firing actuator, such as a sled 190, which is pushed distally by the knife 158, The staples are deployed from the cartridge at the same time that the knife 158 cuts through the tissue. With respect to the embodiment shown in FIG. 65, the staple cartridge may include a fastener firing actuator, such as, for example, a sled assembly 790, which is advanced distally with or in parallel with the knife 158 to the cartridge 240. Staples 460 can be fired from. For example, the stapler shaft 114 may include a firing bar 157 configured to advance the knife 158 and, in addition, a pusher bar 159 configured to advance the sled assembly 790. The firing bar 157 and pusher bar 159 may advance simultaneously, but in various cases, these operations are timed so that the initial distal movement cannot overlap with each other, as described in further detail below. obtain. In addition to the initial relative movement between firing bar 157 and pusher bar 159, sled assembly 790 may include two or more portions that can move relative to each other, as will also be described in further detail below. .

  Referring primarily to FIGS. 66-69, the thread assembly 790 may include a first thread portion 792 and a second thread portion 793. The first thread portion 792 may include an inner slope portion 791a and an outer slope portion 791b. As shown in FIGS. 66 and 67, the outer slope 791b is located outside the inner slope 791a. The outer slope 791b also extends distally with respect to the inner slope 791a. Similarly, the second thread portion 793 can include an inner slope portion 794a and an outer slope portion 794b. As shown in FIGS. 68 and 69, the outer slope 794b is located outside the inner slope 794a. The outer bevel 794b also extends distally relative to the inner bevel 794a. In various cases, the inner bevel 791a may be configured to lift or at least partially lift the inner staple row, while the outer bevel 791b lifts or at least partially lifts the outer staple row. Can be configured to lift. As shown primarily in FIG. 67, the inner bevel 791a and the outer bevel 791b may include bevels such as bevels 795a and 795, respectively, which slide under the staples in the inner and outer staple rows, respectively. obtain. The slopes 795a and 795b of the inner slope 791a and the outer slope 791b can be configured to lift the staples from the unfired position to at least the partially fired position. In various cases, the slopes 795a and 795b of the inner slope 791a and the outer slope 791b can include, for example, at least one slope, a curved surface, an actuation surface, and / or a convex surface, respectively.

  In addition to the above, the inner slope 794a of the second thread portion 793 may include an inner slope 796a, and similarly, the outer slope 794b of the second thread portion 793 may include an outer slope 796b. In various cases, the inner slope 795a of the first thread portion 792 is configured to cooperate with the inner slope 796a of the second thread portion 793 to lift the staples in the inner staple row from the unfired position to the fully fired position. Can be done. More specifically, the inner bevel 791a can lift the staples in the inner staple row from an unfired position to a partially fired position, for example, then the inner bevel 794a staples from its partially fired position to a fully fired position. Get up. In such a situation, the lifting operation of the staples in the inner staple row is started by the inner slope portion 791a of the first thread portion 792, moves to the inner slope 796a of the second slope portion 793, and then the second slope portion 793. Can be completed by. Similarly, the inner bevel 795b of the first thread portion 792 can be configured to cooperate with the inner bevel 796b of the second thread portion 793 to lift the staples in the outer staple row from the unfired position to the fully fired position. . More specifically, the outer bevel 791b can lift the staples in the outer staple row from an unfired position to a partially fired position, for example, then the outer bevel 794b staples from its partially fired position to a fully fired position. Get up. In such a situation, the lifting operation of the staples in the outer staple row is started by the inner slope portion 791b of the first thread portion 792, moves to the outer slope 796b of the second slope portion 793, and then the second slope portion 793. Can be completed by. The firing or lifting operation of the staples in the inner staple row may be completed when the top 798 of the inner bevel 794a passes under the staples. Similarly, the firing or lifting operation of the staples in the outer staple row may be completed when the top 798 of the outer ramp 794b passes under the staples.

  Referring again to FIG. 65, the thread assembly 790 may include a plurality of first thread portions 792 and / or a plurality of second thread portions 793. In various cases, the thread assembly 790 includes a first set of thread portions including a first thread portion 792 and a second thread portion 793, and a second set of threads including a first thread portion 792 and a second thread portion 793. And a portion. In certain cases, the second set of thread portions may constitute a first set of mirror images. In order to simplify the description of the thread assembly 790 herein, only one set of thread sections will be referred to. However, the reader should be aware that the description associated with the operation of a set of thread sections can also be applied to the simultaneous operation of any suitable number of sets of thread sections.

  In addition to the above, the outer staple row of cartridge 240, ie, the row furthest from channel 243, may guide the inner staple row, ie, the row closest to channel 243. In other words, the deformation of the staples in the outer row may begin before, or at least slightly before, the deformation of the laterally adjacent staples in the inner row. In other cases, the outer staple row of cartridge 240, ie, the row furthest from channel 243, can lag behind the inner staple row, ie, the row closest to channel 243. In other words, the deformation of the staples in the inner row may begin before, or at least slightly before, the deformation of the laterally adjacent staples in the outer row. Further, although two staple rows are disclosed on either side of the channel 243 defined in the cartridge 240, other embodiments have more than two staple rows, such as three staple rows, on both sides of the channel 243. I think that exists. In such an embodiment, the sled assembly deploys additional rows of staples at the same time as the inner staple rows, simultaneously with the outer staple rows, and / or at successive stages relative to the inner and outer staple rows. Can be configured.

  As described above, the first thread portion 792 is movable with respect to the second thread portion 793 of the thread assembly 790. Referring now to FIGS. 70-72, the sled assembly 790 is movable between an initial unfired configuration (FIG. 70) and a second, extended configuration (FIGS. 71 and 72). Referring primarily to FIG. 70, in the initial unfired configuration of the sled assembly 790, the first sled portion 792 is folded or retracted relative to the second portion 793. In at least one such case, the distal end of the first thread portion 792 may not extend beyond the distal end of the second thread portion 793. Although not shown, in other cases, the distal end of the first threaded portion 792 may be displaced by the distal end of the second threaded portion 793 when the first threaded portion 792 is folded within the second portion 793. May extend beyond. With further reference to FIG. 70, the reader will further recognize that the staple 460 is in an unfired position when the staple 460 has not yet been lifted toward the anvil 124. Comparing FIGS. 70 and 71, the reader will notice that the first thread portion 792 extends relative to the second thread portion 793. In such a situation, the distal end of the first thread portion 792 is located distal to the distal end of the second thread portion 793. The initial movement of the first sled portion 792 from the unfired position to the extended position thereof may include one or more staples 460 on the inner sloping surface 791a and / or the outer sloping surface 791b of the first sled 792. Can be positioned below. In other configurations, the movement of the first sled portion 792 from its initial, unfired position to its extended position may involve one or two or more staples 460 on the inner bevel 791a and / or outer bevel 791b. Can be positioned below. In any case, as shown in FIG. 71, the extension of the first thread portion 792 may at least partially lift the at least one staple 460 toward the anvil 124 and / or lift the at least one staple 460 into the anvil 124. Or at least partially deformed by contact. In certain cases, the extension of the first thread portion 792 may cause the at least one staple 460 to contact the anvil 124 and be fully lifted or fully deformed. In various cases, the second thread portion 793 may not advance distally when the first thread portion 792 moves to its extended position, but in certain circumstances, the first thread portion 792 may not be advanced to its extended position. When moving toward, at least some distal movement of the second thread portion 793 may occur.

  71 and 72, it may be noted that the first thread portion 792 and the second thread portion 793 have been advanced distally to lift the staple 460 toward the anvil 124. The first thread portion 792 and the second thread portion 793 may then be advanced to the distal end of the end effector 120 to complete the firing stroke of the end effector 120, which will be described in further detail below. In any case, the initial progress of the sled assembly 790 during the firing stroke of the end effector 120 is shown in FIGS. FIG. 70 shows sled assembly 790 in a retracted, unfired position. FIG. 71 shows the sled assembly 790 in an extended, partially fired position. FIG. 72 shows the sled assembly 790 in an extended, fired position. As outlined above, pusher bar 159 may move distally to advance sled assembly 790 through the progress shown in FIGS. Referring to FIG. 70, pusher bar 159 is shown in an initial, unfired position and is in contact with the proximal end of first thread portion 792. In various embodiments, the pusher bar 159 can include a contact flange 155 extending from its distal end that can engage the first threaded portion 792. Still referring to FIG. 70, the pusher bar 159 may not contact the second thread portion 793 when the pusher bar 159 is in its initial, unfired position. As pusher bar 159 advances distally, pusher bar 159 moves first thread portion 792 distally until contact flange 155 contacts the proximal end of second thread portion 793, as shown in FIG. Can be. As described above, it is this relative movement between the first thread portion 792 and the second thread portion 793 that causes the thread assembly 790 to expand. Thereafter, pusher bar 159 may move distally to simultaneously advance first and second threaded portions 792 and 793 distally, as shown in FIG.

  As described above, the end effector 120 may be configured to perform tissue stapling and transverse incision simultaneously. Referring again to FIG. 65, the end effector 120 may include a firing member or knife bar 156 that includes a knife blade 158 configured to transect tissue when the knife bar 156 is advanced distally. Referring again to FIGS. 70 and 71, the initial distal movement of the push bar 159 may not be transmitted to the knife bar 156. In other words, when the sled assembly 790 moves between its retracted position (FIG. 70) and its extended position (FIG. 71), the knife bar 156 may remain stationary or not move substantially. In such a situation, relative movement between pusher bar 159 and knife bar 156 may occur at least during the initial portion of the end effector firing stroke. Comparing FIGS. 74 and 77, it can be said that, first, pusher bar 159 is advanced distally, extending sled assembly 790, and second, knife bar 156 is not advanced distally. Note in particular the proximal end of knife bar 156 and pusher bar 159. More specifically, pusher bar 159 may include a drive pin 759 extending therebetween that extends through a drive slot 757 defined in drive bar 157 extending proximally from knife bar 156. Exists. As shown in FIG. 74, when pusher bar 159 is in its proximal unfired position, drive pin 759 is located at the proximal end of drive slot 757. As shown in FIG. 77, when pusher bar 159 is advanced distally, drive pin 759 may slide distally within drive slot 757 until drive pin 759 reaches the distal end of drive slot 757. . In such a position, sled 790 is fully extended and knife bar 156 has not yet been advanced distally with pusher bar 159. As shown in FIGS. 78 and 79, when drive pin 759 contacts the distal end of drive slot 757, pusher bar 156 and knife bar 159 may both move distally.

  In addition to the above, knife bar 156 may include flanges 153 and 155 that may be configured to engage anvil 124 and staple cartridge channel 123, respectively. As shown in FIG. 77, when the knife bar 156 is in a proximal, non-advanced position, the flange 153 can be located proximal to the slot 121 defined in the anvil 124. In such a position of the knife bar 156, the flange 155 may or may not be located in a slot defined in and / or outside the cartridge channel 123. As knife bar 156 is advanced distally, flange 153 may enter anvil slot 121 and flange 155 may be located within the cartridge channel slot. In such a situation, the knife bar 156 may set a gap, or tissue gap distance, between the anvil 124 and the staple cartridge located within the cartridge channel 123. In various cases, knife bar 156 may control the formation height and / or compression of tissue within end effector 120 as knife bar 156 is advanced distally.

  The above arrangement in which the pusher bar 159 moves the sled assembly 790 before the pusher bar 159 advances the knife 158 can be advantageous in many situations. For example, it is often desirable for tissue to be stapled prior to incision. Thus, the formation of staples results in or substantially results in a transverse incision of the tissue with knife bar 156. The staggered deployment of the sled 790 and knife bar 156 can facilitate such relative progression between stapling and tissue dissection. Further, the sled 790 is compactly stored within the end effector 120 in a retracted, unfired configuration to allow for a reduction in the proximal-to-distal length, or longitudinal length, of the end effector 120. obtain. In other words, a sled assembly that may initiate a firing stroke at least in a partially folded state may require less longitudinal space. Further, due to the longitudinal extensibility of the thread assembly 790, the staple lifting surface of the thread assembly 790 may be longer, for example, it may include a bevel angle that is shallower than a single thread, ie, not acute. In other words, the mechanical length of the thread assembly 790 may be improved due to the longer longitudinal length available for the slant of the thread assembly 790.

  Referring now to FIGS. 80-82, the sled assembly 790 and knife bar 156 may be advanced distally toward the distal end of the end effector 120 to complete the firing stroke of the end effector 120. As the sled 790 approaches the distal end of the end effector 120, in various cases, the first sled portion 792 contacts the distal end 245 of the staple cartridge, against the second sled portion 793, and / or the second. The thread portion 793 can be retracted. More specifically, the distal end 245 may prevent distal movement of the first thread portion 792, while the second thread portion 793 is relative to the first thread portion 792 to complete the firing stroke. Move distally. In various cases, the second sled portion 793 may be advanced distally until it contacts the distal end 245 of the staple cartridge, while in other cases, the firing stroke may cause the second sled portion 793 to move distally. It may be completed before contacting 245. In any case, in the embodiment where the distal flange 155 of the pusher bar 159 pushes the first thread portion 792 and the second thread portion 793 toward the distal end of the end effector 120, the first thread portion 792 is When the first thread portion 792 reaches the distal end, the engagement with the pusher bar 159 is released so that the pusher bar 159 can push the second thread portion 793 against the first thread portion 792. Good. In at least one such case, primarily referring to FIG. 77, the distal end of the staple cartridge may cause the first threaded portion 792 to move to the anvil 124 such that the pusher bar 159 can slide under the first threaded portion 792. A boss 241 may be included that may be configured to lift upwardly toward. In such a situation, the first thread portion 792 can disengage the second thread portion 793 and the pusher bar 159 so as to be operable. In various cases, as described above, the boss 241 is positioned and arranged such that the first thread portion 792 is lifted upward after deployment of all staples in the staple cartridge and / or movement to the second thread portion 793. obtain. Further, in addition to the above, the distal end of the staple cartridge is configured to lift a first boss 241 configured to lift the first thread portion 792 and a further first thread portion 792. 2 bosses 241. In various cases, the boss 241 can be configured to lift the first thread portion 792 simultaneously and synchronously. In some cases, the boss 241 can be configured to continuously lift the first thread portion 792.

  Referring now to FIGS. 85-88, FIG. 85 shows the sled assembly 790 in an initial, unfired configuration. In addition to the above, the pusher bar 159 contacts the proximal end 789 of the first threaded portion 792, and the proximal end 789 of the first threaded portion 792 is proximal to the second threaded portion 793, as shown in FIG. The first thread portion 792 can be pushed distally until it is flush with the end 787. At this time, the first thread portion 792 can be fully extended with respect to the second thread portion 793. The pusher bar 156 can then push the proximal end 787 and the proximal end 789 simultaneously to advance the sled assembly 790 distally. As also mentioned above, referring now to FIG. 87, the first thread portion 792 can be stopped, for example, by the distal end 245 of the staple cartridge and lifted upward by the boss 241 of the staple cartridge. At such time, as shown in FIG. 88, the first thread portion 792 can be raised relative to the second thread portion 793 and the distal flange 155 so that the second thread portion 793 can fold the thread assembly 790. In addition, the first threaded portion 792 can slide at least partially under it. Comparing FIGS. 87 and 88, the second thread portion 793 moves closer to the ledge 788 defined on the bottom surface of the first thread portion 792, and the distal end 789 of the first thread portion 792 It can be said that it is no longer aligned with the distal end 787 of the portion 793.

  After completion of the firing stroke, referring now to FIGS. 83 and 84, the knife bar 156 and pusher bar 159 may be retracted proximally. In various cases, knife bar 156 can be pulled proximally by pusher bar 159. More specifically, pusher bar 159 may be retracted proximally relative to knife bar 159 until drive pin 759 contacts the proximal end of drive slot 759. At such time, the pusher bar 159 may pull the knife bar 156 proximally until the flange 153 of the knife bar 156 is no longer located in the slot 121 of the anvil 124. Thereafter, the anvil 124 may move to the open position when the closure tube 115 is pulled proximally. In certain cases, the staple cartridge may comprise a replaceable staple cartridge. In such a case, the used staple cartridge can be removed from the cartridge channel 122 and, if necessary, an unused staple cartridge can be positioned within the cartridge channel 122 to make the surgical instrument reusable. .

  83 and 84, the folded sled assembly 790 may be left at the distal end of the end effector 120 when the knife bar 156 and pusher bar 159 are retracted. When removing a used staple cartridge from the cartridge channel 122, the folded sled assembly 790 may be removed from the end effector 120 along with the cartridge. In certain cases, all staple cartridges may not be used before pusher bar 159 and knife bar 156 are retracted. In such a case, the sled assembly 790 may only be partially advanced within the staple cartridge and may not be folded back to the unstretched configuration. Then, when the staple cartridge is removed from the cartridge channel 123, some of the staples are still in the staple cavity.

  As described herein, a firing actuator, i.e., a sled and / or stapling instrument, of a staple cartridge is configured to lift or deploy staples between an unfired position and a fired position. Or may include two or more inclined surfaces. For example, the sled may include a first sloping surface configured to deploy the first staple row, a second sloping surface configured to deploy the second staple row, and the like. Each inclined surface includes an adjacent surface that is configured to engage each staple in the corresponding staple row and lift the staple until it contacts the anvil located on the opposite side of the staple cartridge and fully deforms. obtain. The adjacent surfaces that define each inclined surface may include any suitable number of undulations, such as, for example, one or more straight surfaces and / or one or more curved surfaces. In various cases, the adjacent surface can directly engage each staple in the corresponding staple row and remain engaged with the staples in that row as it moves from its unfired position to its fully fired position. possible. After the staple has reached its fully fired position, the ramp may disengage from the staple. This arrangement may be possible, for example, with a thread having a relatively movable element, such as a thread assembly 790, and / or a thread that is not composed of a relatively movable element, such as, for example, a thread composed of a single piece of material.

  In various cases, the firing actuator, or sled, may comprise one, two or more ramps, each ramp comprising two or more cooperating drive surfaces. For example, referring now to FIG. 92, the sled 890 can include a first sloping surface 891a that includes an initial, or first, driving surface 895a and a second, or final, driving surface 896a. The initial drive surface 895a and the final drive surface 896a of the first inclined surface 891a can be configured to cooperatively lift the staples in the first staple row between the unfired position and the fired position. As the sled 890 moves distally through the staple cartridge, referring to FIGS. 89-92, the initial drive surface 895a, for example, contacts the staple 160 and pulls the staple 160 from its unfired position (FIG. 89). It can be lifted to the firing position (FIG. 90). The sled 890 can then be advanced distally so that the final drive surface 896a can lift the staple 160 between its partially fired position and its fully fired position. In various cases, the initial drive surface 895a may contact the initial drive surface 180 of the staple 160 to lift the staple 160 to its partially fired position, with the final drive surface 896a being on the second drive surface 182 of the staple 160. Upon contact, the staple 160 may be lifted to its final firing position. In such a case, the staple 160 may move from the initial drive surface 895a to the final drive surface 896a to complete its deployment, or firing. Referring to FIG. 92, the deployment, or firing, of the staple 160 may be completed once the top 898 of the first ramped surface 891a has passed under the second drive surface 182 of the staple 160.

  In addition to the above, referring again to FIG. 92, the initial drive surface 895a and the final drive surface 896a of the first ramp 891 can be configured to cooperatively deploy the staples in the first staple row. The thread 890 may include additional ramps to deploy additional staple rows. For example, the thread 890 can include a second ramped surface 891b with an initial drive surface 895b and a final drive surface 896b that can be configured to cooperatively deploy the staples in the second staple row. In various cases, the thread 890 deploys staples in a third inclined surface similar to the first inclined surface 891a and a staple in the fourth staple row, eg, configured to deploy the staples in the third staple row. It may further include any suitable number of inclined surfaces, such as a fourth inclined surface similar to the second inclined surface 891b. In any case, the drive surfaces of the inclined drive surfaces such as, for example, drive surfaces 895a, 895b, 896a, and 896b may include any suitable configuration, such as, for example, a linear profile and / or a curved profile. Still referring to FIG. 92, the first inclined surface 891a may include a transition drive surface 897a intermediate the initial drive surface 895a and the final drive surface 896a. Similarly, the second inclined surface 891b may include a transfer driving surface 897b between the initial driving surface 895b and the final driving surface 896b. In various cases, the transfer drive surface may include a transfer portion between one drive surface and another drive surface. In some cases, the transfer drive surface may comprise, for example, a surface that drives the initial drive surface 180 and the second drive surface 182 of the staple 160 simultaneously. In various cases, the ramp may include any suitable number of drive surfaces.

  In various cases, in addition to the above, the initial drive surface 895a may be located outward from the final drive surface 896a. In certain cases, the initial drive surface 895a and the final drive surface 896a may be connected to each other. In other cases, the initial drive surface 895a and the final drive surface 896a may not be connected to each other. In various cases, the initial drive surface 895a can be defined by a first height and the final drive surface 896a can be defined by a second height that is higher than the first height. In certain cases, the initial drive surface 895a can be defined along a first longitudinal axis and the final drive surface 896a can be defined along a second longitudinal axis. In certain cases, the first longitudinal axis and the second longitudinal axis may be parallel. In some cases, the initial drive surface 895a can be defined by a first plane and the final drive surface 896a can be defined by a second plane parallel to the first plane. In other cases, the first longitudinal axis and the second longitudinal axis may be non-parallel. In some cases, the first longitudinal axis and the second longitudinal axis may extend in a converging direction. In other cases, the first longitudinal axis and the second longitudinal axis may extend in a direction that does not converge. In various cases, in addition to the above, the transition drive surface 897a of the first inclined surface 891a can be defined along an axis that is parallel to the first longitudinal axis and / or the second longitudinal axis. In certain cases, the transfer drive surface 897a may be defined along an axis that is not parallel to the first longitudinal axis and / or the second longitudinal axis. In various cases, in addition to the above, the transition drive surface 897a of the first inclined surface 891a can be defined along a plane that is parallel to the first surface and / or the second surface. In some cases, the transfer drive surface 897a may be coplanar with the initial drive surface 895a and / or the final drive surface 896a. In certain cases, the transfer drive surface 897a may be defined in a different plane than the first surface and / or the second surface. In various cases, in addition to the above, the transfer drive surface 897a can connect the initial drive surface 895a to the final drive surface 896a.

  The above considerations relating to the inclined surface 891a, the initial drive surface 895a, the final drive surface 896a, and the transfer drive surface 897a are also applicable to, for example, the inclined surface 891b, the initial drive surface 895b, the final drive surface 896b, and the transfer drive surface 897b. The same may apply.

  In various cases, in addition to the above, the first inclined surface 891a may be parallel to the second inclined surface 891b. In other cases, the first inclined surface 891a may not be parallel to the second inclined surface 891b. In various cases, the first inclined surface 891a can be defined by a first height and the second inclined surface 891b can be defined by a second height. In some cases, the first height may be the same as the second height. In such a case, the first staple row formed by the first inclined surface 891a and the second staple row formed by the second inclined surface 891b can be formed at the same height. In other cases, the first height may be different from the second height. In such a case, the first staple row formed by the first inclined surface 891a and the second staple row formed by the second inclined surface 891b can be formed at different heights. The entire disclosure of US Pat. No. 8,317,070, issued on November 27, 2012, entitled “SURGICAL STAPLING DEVICES THAT PRODUCE FORMEDIA STAPLES HAVING DIFFERENT LENGTHS” is incorporated herein by reference.

  As noted above, the sled can directly drive and deploy staples and / or any other suitable fasteners stored within the cartridge. In other words, the sled can be in direct contact with the staples and the drive is not in the middle of the sled and staples. Such an arrangement is different from an arrangement including a plurality of driving units for supporting staples. In such an arrangement, the sled engages the drive to lift the staples. In these arrangements, the drive is often configured to eject the staples completely from the stored staple cavities. More specifically, the drive is configured to lift the staples such that when the staples are in the fully fired position, the staples are fully positioned above the staple cartridge, i.e. above the deck. To fully lift the staples above the staple cartridge deck, the drive may also be lifted at least partially above the deck. Such an arrangement can be characterized as a staple overdrive. Many teachings described herein include embodiments that include one or more threads that drive the staples directly, as well as one or more threads that drive the staples. The present invention can be applied to an embodiment including a plurality of driving units driven by the motor. For example, although the thread 890 is described in connection with an embodiment that drives the staple 160 directly, the thread 890 is also used in an embodiment that includes a drive configured to deploy the staple from the staple cavity. Can be done. In such an embodiment, each drive is engaged by a first drive surface similar to the first drive surface 180 and, for example, a final drive surface 896a, configured to be engaged by, for example, an initial drive surface 895a. A second drive surface similar to the second drive surface 182 configured to be combined may be included.

  In the embodiments disclosed herein where the staples are driven directly by the sled, i.e. without using a drive, in addition to the above, the staples can be fully lifted above the deck by the sled itself, i.e. over Can be driven. Referring now to FIGS. 91-94, the sled 890 is configured to extend partially above the deck surface 141 of the cartridge 142. More specifically, when the inclined surfaces 891a and 891b pass through and / or between the cavities 144, for example, when ejecting the staple 160 from the staple cavities 144, the top 898 and the second inclined surface of the first inclined surface 891a. The top 898 of the surface 891b can extend above the deck surface 141. In such a situation, the thread 890 is configured to extend partially above the staple cavity opening defined in the deck surface 141. In various cases, the cartridge 142 may further comprise a plurality of covers 145 located in and / or aligned with the rows of staple cavities 144. For example, the cover 145 may be located midway between adjacent staple cavities 144 in the staple cavity row. In certain cases, the cover 145 may be located proximal and / or distal to the staple cavity 144. In various cases, referring primarily to FIG. 94, the top 898 of the ramp 891 can pass under the cover 145. In such a case, each cover 145 may include a bottom surface, such as an arched bottom surface 147, configured to allow the inclined surface 891 to pass thereunder. Still referring to FIG. 94, the cartridge 142 is adapted to receive, for example, a first longitudinal slot 149 configured to slidably receive a first inclined surface 891a therein and a second inclined surface 891b. A second longitudinal slot 149 configured. In various cases, cartridge 142 may include a plurality of longitudinal slots 149 configured to receive sloping surfaces of sled 890. In certain cases, the longitudinal slot 149 can be defined by a cover 145 and a staple cavity 144. In some situations, each longitudinal slot 149 may correspond to a longitudinal row of staple cavities 144, and the longitudinal slots 149 are stapled as outlined above, with the inclined surfaces passing through the longitudinal slots 149 outlined above. The staple cavities 144 may be disposed within the staple cavity rows that are in communication with each other so that they can pass through the cavities 144.

  In various cases, the deck of cartridges may be configured to directly contact and / or support the tissue to be fastened. In certain circumstances, the cartridge assembly is disclosed in US patent application Ser. No. 12 / 894,369, entitled “IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER” (current US Patent Application Publication No. 2012/0080344, filed Sep. 30, 2010). ), US patent application No. 13 / 097,856, “STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN COMPRESIBLE PORTION THEREOF” (current US Patent Application Publication Nos. 2012/0080336, April 29, 2011) Patent application No. 13 / 242,066, name “CURVED END EFFECTOR” OR A STAPLING INSTRUMENT "disclosed in (now U.S. Patent Application Publication No. 2012/0080498, September 23, 2011 filed), for example, may include a layer positioned on the deck, such as tissue thickness compensator. No. 12 / 894,369, name “IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER” (current US Patent Application Publication No. 2012/0080344, filed September 30, 2010), US Patent Application No. 13/097 , 856, the title “STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A COMPRESIBLE PORTION THEREOF” (current US Patent Application Publication No. 2012/0080336, filed April 29, 2011), and US Patent Application No. 13/24 , “CURVED END EFFECTOR FOR A STAPLING INSTRUMENT "The entire disclosure of (now U.S. Patent Application Publication No. 2012/0080498, September 23, 2011 filed) are incorporated herein by reference. In various cases, referring again to FIG. 93, the deck 141 and cover 145 can be configured to directly contact tissue. In such a situation, the cover 145 may extend above the deck 141, so that the deck 141 and cover 145 may have a non-uniform support surface. In various cases, the cover 145 may apply additional pressure to tissue located directly above and / or adjacent to each longitudinal row of staples. This additional pressure may move fluid present in the tissue away from the staple line before, during, and / or after the staple forming process. As a result, better staple formation and / or staple retention within the tissue may be promoted. The cover 145 may also be configured to grasp tissue located between the staple cartridge and the anvil, particularly along the staple line where staple formation occurs. The cover may also be configured to support the staples as the staples are ejected from the staple pocket and to locally control the staple forming process. US patent application Ser. No. 12 / 893,461, “STAPLE CARTRIDGE” (current US Patent Application Publication No. 2012/0074198, filed Sep. 29, 2010) and US Patent Application No. Mar. 27, 2013 No. 13 / 851,676, the entire disclosure of the name “TISSUE THICKNESS COMPENSATOR COMPRISING A CUTTING MEMBER PATH” is incorporated herein by reference.

  As described above, primarily referring to FIGS. 58, 61, and 64, for example, a staple cavity, such as staple cavity 144, guides staples, such as staple 160, when raised between an unfired position and a fired position. A first sidewall 150a and a second sidewall 150b may be included that may be configured. In various cases, the side walls 150a, 150b may be configured and arranged such that the entire staple 160 is positioned intermediate the side walls 150a, 150b when the staple 160 is in its unfired position. In other situations, referring primarily to FIGS. 22-31, the sidewall 150 of the staple cavity 144 is located in the middle of the sidewall 150 with less than the entire staple 160 when the staple 160 is in its unfired position. It may be constituted as follows. For example, the base 162 of the staple 160 in the outermost row of staple cavities 144 defined within the cartridge body 142 may not be supported by at least one of the side walls 150 when the staple 160 is in its unfired position. Good. However, when the staple 160 is lifted upward, the base 162 of the staple 160 may be supported by both of the side walls 150. 93 and 94, for example, a portion of the staple cavity 144 of the cartridge 142, such as the cavity 144a, may only support both sides of the base 162 at the end of the lifting operation. In any case, the side walls of the staple cavity 144 defined in the cartridge body 142 may not fully support the staple 160 in its unfired position, but referring again to FIGS. The cartridge channel 123 may at least partially support the staple 160. In other words, the cartridge body 142 and the cartridge channel 123 may cooperate to define the staple cavity 144 to support and / or surround the staple 160 through the lifting operation of the staple 160. For example, the cartridge body 142 and the cartridge channel 123 may cooperate to support and / or surround the staple 160 when the staple 160 is in its unlifted position. In some situations, at some point during the lifting operation of the staple 160, the cartridge channel 123 does not support and / or surround the staple 160. In such a situation, the cartridge body 142 may fully support the staple 160 during the remaining lifting operation. In at least one embodiment, the cartridge channel 123 and the cartridge body 142 may cooperate to support the staple 160 during half or about half of the lifting operation. In other embodiments, the cartridge channel 123 and the cartridge body 142 may cooperate to support the staple 160 for shorter or longer than half of the lifting operation. In some cases, the cartridge body 142 and the cartridge channel 123 may cooperate to support and / or surround the staple 160 throughout the lifting operation of the staple 160.

  Various embodiments described herein are described in the context of a linear end effector and / or a linear fastener cartridge. Such embodiments and their teachings may be applied to nonlinear end effectors and / or nonlinear fastener cartridges, such as, for example, circular and / or undulating end effectors. For example, various end effectors, including non-linear end effectors, are disclosed in US patent application Ser. No. 13 / 036,647 filed Feb. 28, 2011, entitled “SURGICAL STAPLING INSTRUMENT” (current US Patent Application Publication No. 2011/0226837). ), Which is incorporated herein by reference in its entirety. In addition, US patent application Ser. No. 12 / 893,461, filed Sep. 29, 2012, entitled “STAPLE CARTRIDGE”, current US Patent Application Publication No. 2012/0074198, is incorporated herein by reference. The entirety is incorporated herein. US patent application Ser. No. 12 / 031,873, filed Feb. 15, 2008, entitled “END EFFECTORS FOR A SURGICAL CUTING AND STAPLING INSTRUMENT”, current US Patent No. No. 7,980,443 is also hereby incorporated by reference in its entirety. The entire disclosure of US Pat. No. 7,845,537, issued December 7, 2010, entitled “SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”, is incorporated herein by reference. Reference is made to the entire disclosure of US Patent Application No. 13 / 118,241, entitled “SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS” (currently US Patent Application Publication No. 2012/0298719, filed May 27, 2011). Is incorporated herein by reference.

  The devices disclosed herein can be designed to be discarded after a single use or can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Such readjustment may include any combination of equipment disassembly steps, subsequent cleaning steps or replacement of specific parts, and subsequent reassembly steps. In particular, the device can be disassembled and any number of the particular parts or parts of the device can be selectively replaced or removed in any combination. After cleaning and / or replacing certain parts, the device can be reassembled at a reconditioning facility or by a surgical team immediately prior to a surgical procedure for later use. One skilled in the art will appreciate that reconditioning of the device can utilize various techniques of disassembly, cleaning / replacement, and reassembly. Such techniques, and the use of the resulting reconditioned device, are all within the scope of the present invention.

  Preferably, the invention described herein will be processed before surgery. First, obtain a new or used instrument and clean it if necessary. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic bag or a TYVEK bag. The container and instrument are then placed in a radiation facility that can penetrate the container, such as gamma rays, X-rays, and high energy electron beams. Radiation kills bacteria on the instrument or in the container. The sterilized instrument can then be stored in a sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.

  Any patent publication or other disclosure that is incorporated herein by reference in its entirety or in part is intended to be incorporated by reference into its current definitions, descriptions, or other disclosures described in this disclosure. To the extent that they do not contradict each other. Accordingly, to the extent necessary, the disclosure expressly set forth herein shall supersede any conflicting literature incorporated herein by reference. Any references, or portions thereof, which are incorporated herein by reference but are inconsistent with the existing definitions, descriptions, or other disclosures described herein, It shall be incorporated only to the extent that no contradiction arises with the disclosure content of.

  While this invention has been described as having an exemplary design, the present invention may be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Furthermore, this application is intended to cover such departures from the present disclosure as known or customary in the field to which this invention pertains.

Embodiment
(1) surgical staples,
A first leg;
A second leg;
A non-linear base,
A first drive surface;
A second drive surface offset laterally from the first drive surface;
A surgical staple, comprising: a non-linear base comprising a undulation in the middle of the first drive surface and the second drive surface.
(2) The surgical staple according to embodiment 1, wherein the first drive surface is flush with the first leg and the second leg.
(3) The surgical staple according to embodiment 1, wherein the second drive surface is laterally offset from the first leg and the second leg.
4. The surgical staple of embodiment 1, wherein the second drive surface further comprises a flat surface.
(5) The surgical of embodiment 1, wherein the non-linear base further comprises a proximal portion, the first leg extends from the proximal portion, and the proximal portion further comprises the first drive surface. Staple.

(6) The surgical staple according to embodiment 5, wherein the proximal portion further comprises a protrusion.
The surgical staple according to claim 1, wherein the base, the first leg, and the second leg define a single piece.
(8) surgical staples,
A base with an integral drive surface;
A first leg extending from the base;
A second leg extending from the base,
Surgical staples wherein a staple midline bisects the base intermediate the first leg and the second leg and the integral drive surface extends across the staple midline .
9. The surgical staple of embodiment 8, wherein the integral drive surface further comprises an inclined surface.
The surgical staple according to claim 8, wherein the first leg and the second leg are located on a side surface of the integral drive surface.

The surgical staple of embodiment 10, wherein the integral drive surface is laterally offset from the first leg and the second leg.
12. The surgical staple of embodiment 8, wherein the integral drive surface comprises a first integral drive surface and the base further comprises a second integral drive surface.
The surgical staple according to claim 12, wherein the second integral drive surface is laterally aligned with the first leg and the second leg.
The surgical staple according to claim 12, wherein the second integral drive surface is proximal to the integral drive surface.
15. The surgical staple of embodiment 12, wherein a gap is defined between the second integral drive surface and the integral drive surface.

(16) surgical staples,
Legs with overall leg depth, and
A surgical staple comprising: a base having an overall base height, wherein the base height is independent of the leg depth, and the leg and the base define a seamless single piece.
(17) The surgical staple according to embodiment 16, wherein the base height is larger than the leg depth.
The surgical staple of embodiment 16, wherein the base further comprises at least one integral drive surface.
(19) A surgical staple punched from a sheet of material, wherein the surgical staple comprises
A first leg having a first cross section;
A second leg having a second cross section;
A surgical staple, comprising: a base having a base cross section, wherein the base cross section is different from the first cross section and the second cross section.
(20) The first leg includes a first flat surface formed from the flat surface of the material sheet, and the second leg includes a second flat surface formed from the flat surface of the material sheet, The surgical staple of embodiment 19, wherein the first flat surface and the second flat surface are coplanar.

21. The surgical staple of embodiment 20, wherein the base comprises a base flat surface formed from the flat surface of the material sheet, and the base flat surface and the first flat surface are not coplanar. .
(22) a surgical fastener formed from a sheet of material,
A first leg;
A second leg, wherein the first leg and the second leg define a leg plane, and the first leg has a first leg height and a first leg in the leg plane. A second leg defining a part depth, wherein the second leg defines a second leg height and a second leg depth in the leg plane;
A base part that seamlessly connects the first leg part and the second leg part, wherein the base part comprises a base height greater than the first leg part depth and the second leg part depth; and A surgical fastener comprising:
(23) An end effector for use with a surgical instrument,
A channel with side walls;
A cartridge body located in the channel;
A fastener cavity at least partially defined by the channel and the cartridge body;
An end effector comprising: a fastener removably stored within the fastener cavity.

Claims (6)

A surgical staple,
A first leg;
A second leg;
A non-linear base,
A first drive surface;
A second drive surface offset laterally from the first drive surface;
A non-linear base comprising a undulation in the middle of the first drive surface and the second drive surface ;
When the surgical staple is located in a surgical instrument, the first leg and the second leg extend upward from the nonlinear base;
The second drive surface is located distal to the first drive surface, and the first drive surface is located below a proximal end of the second drive surface in the vertical direction, The two driving surfaces are inclined downward from the proximal side to the distal side of the second driving surface,
The inclined portion of the drive member that moves the surgical staple upward contacts the first drive surface to move the surgical staple upward, and then contacts the second drive surface to move the surgical staple. A surgical staple adapted to move the surgical staple further upward .   The surgical staple according to claim 1, wherein the first drive surface is coplanar with the first leg and the second leg. Said second drive surface, wherein the first leg and the offset from the second leg in the lateral direction, surgical staple according to claim 1.   The surgical staple according to claim 1, wherein the non-linear base further comprises a proximal portion, the first leg extends from the proximal portion, and the proximal portion further comprises the first drive surface. The surgical staple according to claim 4 , wherein the proximal portion further comprises a protrusion. The surgical staple according to claim 1, wherein the nonlinear base, the first leg, and the second leg define a single piece.

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