JP6643249B2 - Fastener cartridge including a layer mounted on the fastener cartridge - Google Patents

Description

(Cross-reference of related applications)
This non-provisional application filed a 35 U.S.C. S. C. No. 61 / 980,349, filed Apr. 16, 2014, entitled "FASTENING INSTRUMENTS AND FASTENING CARTRIDGES FOR THE THEREWITH," filed Apr. 16, 2014, pursuant to §119 (e). Is incorporated herein by reference in its entirety.

  The present invention relates to stapling instruments and, in various embodiments, to a surgical stapling instrument for generating one or more rows of staples.

  The stapling instrument can include a pair of cooperating elongate jaw members, each jaw member can be adapted to be inserted into a patient and positioned against tissue to be stapled and dissected. . In various embodiments, one of the jaw members supports a staple cartridge containing at least two rows of laterally spaced staples therein, and the other jaw member aligns with the staple rows in the staple cartridge. An anvil having a defined staple forming pocket can be supported. Generally, the stapling instrument slides against the jaw members to continuously eject staples from the staple cartridge via a cam surface on the push bar and / or a cam surface on a wedge sled pushed by the push bar. It may further include a moveable push bar and knife blade. In at least one embodiment, the cam surface is pressed by the cartridge to press the staples against the anvil and form laterally spaced rows of deformed staples in tissue grasped between the jaw members. The staple driver may be configured to activate a plurality of staple drivers supported and associated with the staples. In at least one embodiment, the knife blade can follow the cam surface and cut the tissue along a line between the rows of staples. An example of such a stapling instrument is disclosed in U.S. Patent No. 7,794,475, entitled "SURGICAL STAPLES HAVING COMPRESIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STARPING INSTRUMENTS," which is incorporated herein by reference. , Incorporated herein by reference.

  The above discussion is merely intended to illustrate various aspects of the related art in the field of the invention at the time and should not be deemed to deny the claims.

Various features of the embodiments described herein are set forth with particularity in the appended claims. However, various embodiments, both for mechanism and method of operation, together with their advantages, can be understood by the following description in conjunction with the accompanying drawings, in which:
FIG. 2 is an elevation view of a surgical stapling instrument. FIG. 2 is a cross-sectional view of the end effector of the surgical stapling instrument of FIG. 1 along line 2-2 of FIG. 1. FIG. 2 is a sectional perspective view of the end effector of FIG. 1. FIG. 2 is a cross-sectional view of the end effector of FIG. 1 illustrating staples contained therein in an unfired configuration; FIG. 5 illustrates the staple of FIG. 4 in a firing configuration. FIG. 2 illustrates the end effector of FIG. 1 being used to stap and cut tissue. FIG. 9 is a perspective view of a staple cartridge according to at least one embodiment, comprising a plurality of ridges extending from the cartridge body. FIG. 8 is a detailed view of the staple cartridge of FIG. 7. FIG. 8 is a sectional view of the staple cartridge of FIG. 7. FIG. 8 is a detailed view illustrating staples positioned within a staple cavity defined in the staple cartridge of FIG. 7. FIG. 9 is a partial perspective view of a staple cartridge according to at least one alternative embodiment, comprising a plurality of lateral ridges extending from the cartridge body. FIG. 9 is a partial perspective view of a staple cartridge according to at least one alternative embodiment, comprising a plurality of lateral ridges extending from the cartridge body. FIG. 15 is a partial perspective view of a staple cartridge according to at least one alternative embodiment, comprising a plurality of ridges surrounding a proximal end and a distal end of a staple cavity opening defined in the cartridge body. FIG. 15 is a partial perspective view of a staple cartridge according to at least one alternative embodiment, comprising a plurality of ridges surrounding a proximal end and a distal end of a staple cavity opening defined in the cartridge body. FIG. 14 is a partial perspective view of a staple cartridge according to at least one alternative embodiment, comprising a plurality of notched ridges extending from the cartridge body. FIG. 14 is a partial perspective view of a staple cartridge according to at least one alternative embodiment, comprising a plurality of notched ridges extending from the cartridge body. FIG. 4 is a perspective view of a pyramidal notch according to at least one embodiment. FIG. 4 is a perspective view of a frusto-conical notch according to at least one embodiment. FIG. 9 is a perspective view of a triangular nick according to at least one embodiment. FIG. 9 is a partial perspective view of a staple cartridge according to at least one alternative embodiment, comprising a plurality of ridges completely surrounding a staple cavity opening defined in the cartridge body. FIG. 9 is a partial perspective view of a staple cartridge according to at least one alternative embodiment, comprising a plurality of ridges completely surrounding a staple cavity opening defined in the cartridge body. FIG. 14 is a perspective view of a staple cartridge according to at least one alternative embodiment, comprising a plurality of longitudinal ridges extending from the cartridge body. FIG. 18 is a detailed view of the staple cartridge of FIG. 17. FIG. 9 is a perspective view of a surgical instrument having an interchangeable shaft assembly operably coupled. FIG. 20 is an exploded view of the replaceable shaft assembly and surgical instrument of FIG. 19. FIG. 21 is an exploded view of a portion of the surgical instrument of FIGS. 19 and 20. FIG. 22 is another exploded view showing a portion of the interchangeable shaft assembly and surgical instrument of FIGS. 19-21. FIG. 9 is a perspective view of a staple cartridge positioned within an end effector of a surgical instrument according to at least one embodiment, wherein the staple cartridge includes a plurality of ridges extending from a cartridge body of the staple cartridge. FIG. 4 is an elevation view of a staple according to at least one embodiment. FIG. 25 is an elevational view of the staple of FIG. 24 positioned within a staple cavity in a staple cartridge. FIG. 4 is an elevation view of a staple according to at least one embodiment. FIG. 5 is an elevation view of an asymmetric staple according to at least one embodiment. FIG. 9 is an elevation view of another asymmetric staple according to at least one embodiment. FIG. 9 is an elevation view of another asymmetric staple according to at least one embodiment. FIG. 4 is an elevation view of the staple illustrated in a partially deformed state. FIG. 31 is an elevational view of the staple of FIG. 30 in a completely deformed state. FIG. 3 is a bottom perspective view of an elongated channel. FIG. 6 is a cross-sectional perspective view of another elongated channel. FIG. 34 is another cross-sectional view of the elongated channel of FIG. 33 showing the cutting head schematically. FIG. 35 is a bottom view of the elongated channel of FIGS. 33 and 34. FIG. 9 is a bottom view of another elongated channel. FIG. 9 is a bottom view of another elongated channel. FIG. 9 is a bottom view of another elongated channel. FIG. 9 is a bottom view of another elongated channel. FIG. 7 is a partial side view of the elongated channel and the cutting head, showing the elongated channel in cross-section, omitting a portion of the surgical staple cartridge for clarity, the cutting head in the unlocked position and ready for firing. State. FIG. 41 is another partial side view of the elongate channel and cutting head of FIG. 40 with the cutting head biased to a locked position. FIG. 4 is a perspective view of an embodiment of a cutting head and firing bar. FIG. 9 is a perspective view of another end effector and shaft arrangement. FIG. 44 is another perspective view of the end effector and shaft arrangement of FIG. 43, with a portion of the outer shaft omitted for clarity. FIG. 9 is a partial side view of another end effector and shaft arrangement. FIG. 9 is a partial side elevational view of the end effector arrangement, with the elongated channel omitted for clarity. FIG. 4 is a top view of an embodiment of an anvil. FIG. 9 is a top view of another anvil embodiment. FIG. 9 is a cross-sectional view of an end effector of a surgical instrument according to at least one embodiment, comprising a staple cartridge including a stepped cartridge deck. FIG. 50 is the same cross-sectional view as that shown in FIG. 49, illustrating the height of the various gaps between the stepped cartridge deck and the opposing anvil. FIG. 5 is an elevation view of an asymmetric staple according to at least one embodiment. FIG. 9 is an elevation view of another asymmetric staple according to at least one embodiment. FIG. 9 is an elevation view of another asymmetric staple according to at least one embodiment. FIG. 4 is a perspective view of a staple thread according to at least one embodiment. FIG. 54 is a top view of the staple thread of FIG. 53. FIG. 24 is a partial top view of the staple cartridge of FIG. 23 illustrating the staple sled of FIG. 53 in a proximal, unfired position. FIG. 24 is a partial cross-sectional perspective view of the staple cartridge of FIG. 23. FIG. 24 is a partial rear perspective view of the staple cartridge of FIG. 23. FIG. 54 is a perspective view of the staple thread of FIG. 53. FIG. 24 is a perspective view of the distal end of the staple cartridge of FIG. 23. FIG. 24 is a perspective view of a protrusion extending from the staple cartridge of FIG. 23. FIG. 9 is a perspective view of a staple cartridge according to at least one embodiment, including a pattern of ridges extending from a deck of the staple cartridge. FIG. 57 is a detailed view of the ridge pattern and staple cartridge deck of FIG. 56. FIG. 9 is a partial perspective view of a staple cartridge according to at least one embodiment, including a pattern of ridges extending from a deck of the staple cartridge. FIG. 6 is a partial perspective view of a staple cartridge according to at least one embodiment, including a pattern of protrusions defined in a deck of the staple cartridge. FIG. 60 is a detailed view of a protrusion shown in FIG. 59. FIG. 4 is a partial perspective view of a staple cartridge according to at least one embodiment, including a pattern of domes extending from a staple cartridge deck. FIG. 63 is a detailed view of the dome shown in FIG. 61. FIG. 9 is a partial perspective view of a protrusion extending from a deck of a staple cartridge according to at least one embodiment. FIG. 3 is an exploded perspective view of a surgical staple cartridge and a cartridge cover. FIG. 65 is a cross-sectional view of the staple cartridge and cartridge cover of FIG. 64 with the cartridge cover mounted on the staple cartridge. FIG. 9 is a perspective view of an anvil of a surgical stapling instrument according to at least one embodiment, including an extending protrusion. FIG. 67 is a detailed view of a protrusion shown in FIG. 66. FIG. 9 is a partial perspective view of an anvil of a surgical stapling instrument according to at least one embodiment, including an extending protrusion. A first array of protrusions having a first height adjacent to a first row of staple pockets, a second array of protrusions having a second height adjacent to a second row of staple pockets, FIG. 9 is a cross-sectional view of the anvil of a surgical stapling instrument according to at least one embodiment, and including a third array of protrusions having a third height adjacent a third row of staple pockets. FIG. 9 is a perspective view of a staple cartridge according to at least one embodiment, including a protrusion extending from a stepped deck surface of the staple cartridge. FIG. 71 is a detailed view of the distal end and protrusions of the stepped deck surface of FIG. 70. FIG. 71 is a detailed view of the proximal end and protrusions of the stepped deck surface of FIG. 70. FIG. 9 is a perspective view of a staple cartridge according to at least one embodiment, including a protrusion extending from a stepped deck surface of the staple cartridge. FIG. 3 is a partial perspective view of a staple cartridge according to at least one embodiment. FIG. 9 is a cross-sectional view of an end effector of a surgical stapling instrument according to at least one embodiment, comprising a plurality of deployable tissue engaging members. FIG. 14 is a cross-sectional view of an end effector of a surgical stapling instrument according to at least one embodiment, comprising a plurality of protrusions extending from a stepped cartridge deck surface. FIG. 5 is a cross-sectional view of a cartridge deck of a staple cartridge and a protrusion extending from the deck configured to support staples as the staples are deployed from the staple cavity, according to at least one embodiment. FIG. 13 is a cross-sectional view of a cartridge deck of another staple cartridge and a protrusion extending from the deck configured to support staples as the staples are deployed from the staple cavities, according to at least one embodiment. A partial plane of a deck of a staple cartridge including a protrusion extending from the deck configured to support staples removably stored within a staple cavity defined in the staple cartridge according to at least one embodiment. FIG. According to at least one embodiment, a first protrusion configured to support a first leg of a staple removably positioned within a staple cavity, and configured to support a second leg of the staple. FIG. 10 is a partial cross-sectional view of the staple cartridge, including a second projected portion. FIG. 9 is a perspective view of a distal end of a staple cartridge including a deck, a plurality of staple cavities defined in the deck, and protrusions extending from the set of decks, according to at least one embodiment. In accordance with at least one embodiment, a deck, a plurality of staple cavities defined within the deck, and a plurality of protrusions extending from the deck surrounding some ends of the staple cavities but not others. FIG. 7 is a partial perspective view of the staple cartridge including a portion. In accordance with at least one embodiment, a deck, a plurality of staple cavities defined in the deck, and a plurality of protrusions extending from the deck surrounding one end of the staple cavity but not the other. FIG. 7 is a partial perspective view of the staple cartridge including a portion. FIG. 4 is a partial cross-sectional view of a staple cartridge according to at least one embodiment, including a deck and a plurality of staple cavities defined within the deck, a staple cavity extending between a proximal end and a distal end of the staple cartridge. An array of staples including a set of staples positioned therein and an array of protrusions including various combinations of heights extending from a deck extending between a proximal end and a distal end of the staple cartridge. including. FIG. 4 is a partial cross-sectional view of a staple cartridge deck and a protrusion extending from the deck, wherein the protrusion is made of a flexible material and is shown in an uncompressed state, according to at least one embodiment. FIG. 85B is a partial cross-sectional view of the staple cartridge deck and protrusion of FIG. 85A, illustrating the protrusion in a partially compressed state. FIG. 85B is a partial cross-sectional view of the staple cartridge deck and protrusion of FIG. 85A illustrating the protrusion in a compressed state. FIG. 4 is a partial cross-sectional view of a staple cartridge including a cartridge body made of a flexible material according to at least one embodiment, shown in an unbent state. FIG. 86B is a partial cross-sectional view of the staple cartridge of FIG. 86A, shown in a bent state. FIG. 4 is a perspective view of an anvil including a plurality of protrusions extending from the anvil, according to at least one embodiment. FIG. 89 is a detailed view of a portion of the anvil of FIG. 87. FIG. 9 is a partial perspective view of an anvil including a plurality of protrusions extending from the anvil, according to at least one embodiment. FIG. 4 is a perspective view of an assembly including a staple driver and a mobile pocket dilator, according to at least one embodiment. FIG. 90 is an exploded view of the assembly of FIG. 90. FIG. 90 is a cross-sectional perspective view of a staple cartridge utilizing the assembly of FIG. 90, shown in an undeployed state. FIG. 93 is a cross-sectional elevation view of the staple cartridge of FIG. 92 illustrating the assembly of FIG. 90 in an expanded state and the assembly of FIG. 90 in an undeployed state; FIG. 3 is a top view of the surgical staple driver. FIG. 95 is a perspective view of the surgical staple driver of FIG. 94. FIG. 9 is a perspective view of another surgical staple driver. FIG. 5 is a top view of a staple driver pocket within a portion of a surgical staple cartridge. FIG. 9 is an elevational view of an anvil according to at least one embodiment, the anvil including protrusions having different heights extending therefrom. FIG. 9 is a perspective view of a fastener cartridge according to at least one embodiment. FIG. 100 is a plan view of the fastener cartridge of FIG. 99. FIG. 100 is a partial perspective view of the proximal end of the fastener cartridge of FIG. 99. FIG. 100 is a partial plan view of the proximal end of the fastener cartridge of FIG. 99.

  Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set forth herein illustrate, in one form, various embodiments of the invention, and such exemplifications are not to be construed as limiting the scope of the invention in any manner.

The applicants of the present application possess the following patent applications, filed on even date herewith, each of which is incorporated herein by reference.
U.S. Patent Application No. _____________, entitled "FASTENER CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENT CONFIGURATIONS", Attorney Docket No. END7460USNP / 140136,
U.S. Provisional Patent Application No. __________________________________________, entitled "FASTENER CARTRIDGE COMPRISING FASTENER CAVITIES INCLUDING FASTENER CONTROL FEATURES," Attorney Docket Number END7461USNP / 140137,
U.S. Patent Application No. _____________, entitled "END EFFECTOR COMPRISING AN ANVIL INCLUDING PROJECTIONS EXTENDING THEREFROM", Attorney Docket Number END7462USNP / 140138,
U.S. Patent Application No. ____________, entitled "SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZING ARRANGEMENTS", Attorney Docket No. END7463USNP / 140139,
U.S. Patent Application No. _____________, entitled "SURGICAL END EFFECTORS WITH FIRING ELEMENT MONITORING ARRANGEMENTS", Attorney Docket No. END7464USNP / 140140,
U.S. Patent Application No. ____________, entitled "FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS", Attorney Docket No. END7465USNP / 140141,
U.S. Patent Application No. ____________, entitled "FASTENER CARTRIDGE COMPRISING DEPLOYABLE TISSUE ENGAGING MEMBERS", Attorney Docket No. END7466USNP / 140142,
U.S. Patent Application No. _____________, Title "FASTENER CARTRIDGE COMPRISING TISSUE CONTROL FEATURES", Attorney Docket No. END7467USNP / 140143, and U.S. Patent Application No. ______________________________________________________________ / 140144.

Applicants also own the following patent applications, filed March 1, 2013, each of which is incorporated herein by reference.
U.S. Patent Application No. 13 / 782,295, entitled "ARTICULABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS FOR SIGNAL COMMUNICATION",
U.S. patent application Ser. No. 13 / 782,323, entitled "ROTARY POWERED ARTICULATION JOINTS FOR SURGICAL INSTRUMENTS",
U.S. patent application Ser. No. 13 / 782,338, entitled "THUMWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INSTRUMENTS",
U.S. patent application Ser. No. 13 / 782,499, entitled "ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAY ARRANGEMENT,
U.S. patent application Ser. No. 13 / 782,460 entitled "MULTIPLE PROCESSOR MOTOR CONTROL FOR MODULAR SURGICAL INSTRUMENTS",
U.S. Patent Application No. 13 / 782,358, entitled "JOYSTICK SWITCH ASSEMBLYES FOR SURGICAL INSTRUMENTS",
U.S. patent application Ser. No. 13 / 782,481, entitled "SENSOR STRAIGHTENED END EFFECTOR DURING REMOVAL THROUGH TROCAR",
U.S. Patent Application No. 13 / 782,518, entitled "CONTROL METALDS FOR SURGICAL INSTRUMENTS WITH REMOABLE IMPLEMENT PORTIONS",
U.S. patent application Ser. No. 13 / 782,375, entitled "ROTARY POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEGREES OF FREEDOM", and U.S. patent application Ser. No. 13 / 782,536, entitled "SURGICAL INSTRUMENTSOFT."

Applicant also owns the following patent applications, filed March 14, 2013, each of which is incorporated herein by reference in its entirety:
U.S. patent application Ser. No. 13 / 803,097, titled "ARTICULABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE",
U.S. Patent Application No. 13 / 803,193, entitled "CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT",
U.S. Patent Application No. 13 / 803,053, entitled "INTERCHANGEABLE SHAFT ASSEMBLYES FOR US WITH A SURGICAL INSTRUMENT",
U.S. Patent Application No. 13 / 803,086, entitled "ARTICULABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK",
U.S. Patent Application No. 13 / 803,210, entitled "SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS",
U.S. Patent Application No. 13 / 803,148, entitled "MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT",
U.S. Patent Application No. 13 / 803,066, entitled "DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS",
U.S. Patent Application No. 13 / 803,117, entitled "ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS",
U.S. patent application Ser. No. 13 / 803,130, entitled "DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS", and U.S. patent application Ser. No. 13 / 803,159, entitled "METHOD AND SYSTEM FORMULATING INTERNATIONAL.

The applicant of the present application also owns the following patent applications, filed March 26, 2014, each of which is incorporated herein by reference in its entirety:
U.S. Patent Application No. 14 / 226,106, entitled "POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS",
U.S. Patent Application No. 14 / 226,099, entitled "STERILIZATION VERIFICATION CIRCUIT",
U.S. Patent Application No. 14 / 226,094, entitled "VERIFICATION OF NUMBER OF BATTERY EXCHANGES / PROCEDURE COUNT",
U.S. Patent Application No. 14 / 226,117, entitled "POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL",
U.S. Patent Application No. 14 / 226,075, entitled "MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES",
U.S. Patent Application No. 14 / 226,093, entitled "FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS",
U.S. Patent Application No. 14 / 226,116, entitled "SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION",
U.S. patent application Ser. No. 14 / 226,071, entitled "SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR",
U.S. Patent Application No. 14 / 226,097, entitled "SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS",
U.S. Patent Application No. 14 / 226,126, entitled "INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS",
U.S. Patent Application No. 14 / 226,133 entitled "MODULAR SURGICAL INSTRUMENT SYSTEM",
U.S. Patent Application No. 14 / 226,081, entitled "SYSTEMS AND METHODS FOR CONTROL A SEGMENTED CIRCUIT",
U.S. Patent Application No. 14 / 226,076, entitled "POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE PROTECTION",
U.S. Patent Application No. 14 / 226,111, entitled "SURGICAL STAPLING INSTRUMENT SYSTEM", and U.S. Patent Application No. 14 / 226,125, entitled "SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT".

Applicant also owns U.S. patent applications identified below, each of which is incorporated herein by reference in its entirety.
U.S. patent application Ser. No. 12 / 894,311 entitled "SURGICAL INSTRUMENTS WITH RECONFIGURE SHAFT SEGMENTS" (now U.S. Pat. Pub. No. 2012/0080496);
U.S. Patent Application No. 12 / 894,340, entitled "SURGITAL STAPLE CARTRIDGES SUPPORTING NON-LINEARLY ARRANGED STAPLES AND SURGICAL STAPLING INSTRUMENTS WITH COMMON STAFFLEG MONTH MONTH MONTH MONTH MOPS MONTH MOPS MONTH MOPS MONTH MOPS MONTH MONTH MOPS TO MONTH MONTH TO MONTH MOPS MONTH MOPS MONP
U.S. Patent Application No. 12 / 894,327, entitled "JAW CLOSURE ARRANGEMENTS FOR SURGICAL INSTRUMENTS" (now U.S. Patent Publication No. 2012/0080499);
U.S. patent application Ser. No. 12 / 894,351, entitled "SURGICAL CUTTING AND FASTENING INSTRUMENTS WITH SEPARATE AND DISTINCT FASTENER DEPLOYMENT AND TISSUE CUTTING SYSTEMS", now U.S. Pat.
U.S. patent application Ser. No. 12 / 894,338, entitled "IMPLANTABLE FASTENER CARTRIDGE HAVING A NON-UNIFORM ARRANGEMENT" (now U.S. Pat. Pub. No. 2012/0080481);
U.S. Patent Application No. 12 / 894,369, entitled "IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER" (now U.S. Patent Publication No. 2012/0080344);
U.S. Patent Application No. 12 / 894,312, entitled "IMPLANTABLE FASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS" (currently U.S. Patent Publication No. 2012/0080479);
U.S. Patent Application No. 12 / 894,377, titled "SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE" (now U.S. Patent No. 8,393,514);
U.S. patent application Ser. No. 12 / 894,339, entitled "SURGICAL STAPLING INSTRUMENT WITH COMPACT ARTICULATION CONTROL ARRANGEMENT" (currently U.S. Patent Publication No. 2012/0080500),
U.S. Patent Application No. 12 / 894,360, entitled "SURGICAL STAPLING INSTRUMENT WITH A VARIABLE STAPLE FORMING SYSTEM" (now U.S. Patent Publication No. 2012/0080484),
U.S. Patent Application No. 12 / 894,322, entitled "SURGICAL STAPLING INSTRUMENT WITH INTERCHANGEABLE STAPLE CARTRIDGE ARRANGEMENTS" (now U.S. Patent No. 8,740,034);
U.S. Patent Application No. 12 / 894,350, entitled "SURGICAL STAPLE CARTRIDGES WITH DETACHABLE SUPPORT STRUCTURES" (now U.S. Patent Publication No. 2012/0080478);
U.S. Patent Application No. 12 / 894,383, entitled "IMPLANTABLE FASTENER CARTRIDGE COMPRISING BIO ABSORBABLE LAYERS" (now U.S. Patent No. 8,752,699);
U.S. patent application Ser. No. 12 / 894,389, titled "COMPRESSABLE FASTENER CARTRIDGE" (now U.S. Pat. No. 8,740,037);
U.S. Patent Application No. 12 / 894,345, entitled "FASTENERS SUPPORTED BY A FASTENER CARTRIDGE SUPPORT" (now U.S. Patent Publication No. 2012/0080483);
U.S. Patent Application No. 12 / 894,306, entitled "COLLAPSABLE FASTENER CARTRIDGE" (now U.S. Patent Publication No. 2012/0080332),
U.S. Patent Application No. 12 / 894,318, entitled "FASTENER SYSTEM COMPRISING A PLURALITY OF CONNECTED RETENTION MATRIX ELEMENTS" (now U.S. Patent Publication No. 2012/0080480);
U.S. Patent Application No. 12 / 894,330, entitled "FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND AN ALIGNMENT MATRIX" (now U.S. Patent No. 8,757,465);
U.S. patent application Ser. No. 12 / 894,361, entitled "FASTENER SYSTEM COMPRISING A RETENTION MATRIX" (now U.S. Pat. No. 8,529,600);
U.S. patent application Ser. No. 12 / 894,367, titled "FASTENING INSTRUMENT FOR DEPLOYING A FASTENER SYSTEM COMPRISING A RETENTION MATRIX" (now U.S. Patent Publication No. 2012/0080485);
U.S. patent application Ser. No. 12 / 894,388, entitled "FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND A COVER" (now U.S. Pat. No. 8,474,677);
U.S. Patent Application No. 12 / 894,376, entitled "FASTENER SYSTEM COMPRISING A PLURALITY OF FASTENER CARTRIDGES" (now U.S. Patent Publication No. 2012/0080486);
U.S. patent application Ser. No. 13 / 097,865, entitled "SURGICAL STAPLELER ANVIL COMPRISING A PLURALITY OF FORMING POCKETS" (now U.S. Pat. Pub. No. 2012/0080488),
U.S. patent application Ser. No. 13 / 097,936, entitled "TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLLER" (now U.S. Pat. No. 8,657,176);
U.S. patent application Ser. No. 13 / 097,954, entitled "STAPLE CARTRIDGE COMPRISING A VARIABLE THICKNESS COMPRESIVE PORTION" (now U.S. Pat. Pub. No. 2012/0080340),
U.S. Patent Application Serial No. 13 / 097,856, entitled "STAPLE CARTRIDGE COMPRISING STAPLE POSITIONED WITHIN A COMPRESIVE PORTION THEREOF" (now U.S. Patent Publication No. 2012/0080336);
U.S. Patent Application No. 13 / 097,928, entitled "TISSUE THICKNESS COMPENSATOR COMPRISING DETACHABLE PORTIONS" (now U.S. Patent No. 8,746,535);
U.S. patent application Ser. No. 13 / 097,891, entitled "TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLLER COMPRISING AN ADJUSTABLE ANVIL" (currently U.S. Patent Publication No. 2012/0080489);
U.S. Patent Application Serial No. 13 / 097,948, entitled "STAPLE CARTRIDGE COMPRISING AN ADJUSTABLE DISTAL PORTION" (now U.S. Patent Publication No. 2012/00833836);
U.S. Patent Application No. 13 / 097,907, entitled "COMPRESSABLE STAPLE CARTRIDGE ASSEMBLY" (now U.S. Patent Publication No. 2012/0080338),
U.S. Patent Application No. 13 / 097,861, entitled "TISSUE THICKNESS COMPENSATOR COMPRISING PORTIONS HAVING DIFFERENT PROPERTIES" (now U.S. Patent Publication No. 2012/0080337);
U.S. Patent Application No. 13 / 097,869, entitled "STAPLE CARTRIDGE LOADING ASSEMBLY" (now U.S. Patent Publication No. 2012/0160721),
U.S. patent application Ser. No. 13 / 097,917, entitled "COMPRESSABLE STAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS" (now U.S. Pat. Pub. No. 2012/0083834);
U.S. patent application Ser. No. 13 / 097,873, entitled "STAPLE CARTRIDGE COMPRISING A RELEASEABLE PORTION" (now U.S. Pat. No. 8,740,038);
U.S. Patent Application No. 13 / 097,938, entitled "STAPLE CARTRIDGE COMPRISING COMPRESIBLE DISTORTION RESISTANT COMPONENTS" (now U.S. Patent Publication No. 2012/0080491),
U.S. Patent Application Serial No. 13 / 097,924, entitled "STAPLE CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR" (currently U.S. Patent Publication No. 2012/0083835);
U.S. Patent Application No. 13 / 242,029, entitled "SURGICAL STAPLER WITH FLOATING ANVIL" (now U.S. Patent Publication No. 2012/0080493);
U.S. Patent Application No. 13 / 242,066, entitled "CURVED END EFFECTOR FOR A STAPLING INSTRUMENT" (now U.S. Patent Publication No. 2012/0080498);
U.S. Patent Application No. 13 / 242,086, entitled "STAPLE CARTRIDGE INCLUDING COLLAPSIVE DECCK" (now U.S. Patent Publication No. 2013/0075450);
U.S. Patent Application No. 13 / 241,912, entitled "STAPLE CARTRIDGE INCLUDING COLLAPSABLE DECCK ARRANGEMENT" (currently U.S. Patent Publication No. 2013/0075448),
U.S. patent application Ser. No. 13 / 241,922, entitled "SURGICAL STAPLER WITH STATIONARY STAPLE DRIVERS" (now U.S. Pat. Pub. No. 2013/0075449);
U.S. patent application Ser. No. 13 / 241,637, entitled "SURGICAL INSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATION MULTIPLE ACTUATION MOTIONS" (now U.S. Pat. Pub. No. 2012/0074201);
U.S. Patent Application No. 13 / 241,629, entitled "SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR" (now U.S. Patent Publication No. 2012/0074200);
U.S. Application No. 13 / 433,096, entitled "TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF CAPSULES" (now U.S. Patent Publication No. 2012/0241496);
U.S. Application No. 13 / 433,103, entitled "TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF LAYERS" (currently U.S. Patent Publication No. 2012/0241498);
U.S. Application No. 13 / 433,098, entitled "EXPANDABLE TISSUE THICKNESS COMPENSATOR" (now U.S. Patent Publication No. 2012/0241491),
U.S. Application No. 13 / 433,102, entitled "TISSUE THICKNESS COMPENSATOR COMPRISING A RESERVOIR" (now U.S. Patent Publication No. 2012/0241497);
U.S. Application No. 13 / 433,114, titled "RETAINER ASSEMBLY INCLUDING A TISSUE THICKNESS COMPENSATOR" (currently U.S. Patent Publication No. 2012/0241499);
U.S. Application No. 13 / 433,136 entitled "TISSUE THICKNESS COMPENSATOR COMPRISING AT LEAST ONE MEDICAMENT" (now U.S. Patent Publication No. 2012/0241492);
U.S. Application No. 13 / 433,141, entitled "TISSUE THICKNESS COMPENSATOR COMPRISING CONTROL LED RELEASE AND EXPANSION" (now U.S. Patent Publication No. 2012/0241493);
U.S. Application No. 13 / 433,144 entitled "TISSUE THICKNESS COMPENSATOR COMPRISING FIBERS TO PRODUCE A RESILIENT LOAD" (now U.S. Patent Publication No. 2012/0241500);
U.S. Application No. 13 / 433,148, entitled "TISSUE THICKNESS COMPENSATOR COMPRISING STRUCTURE TO PRODUCE A RESILIENT LOAD" (now U.S. Patent Publication No. 2012/0241501);
U.S. Application No. 13 / 433,155, entitled "TISSUE THICKNESS COMPENSATOR COMPRISING RESILIENT MEMBERS" (now U.S. Patent Publication No. 2012/0241402);
U.S. Application No. 13 / 433,163, entitled "METHODS FOR FORMING TISSUE THICKNESS COMPENSATOR ARRANGEMENTS FOR SURGICAL STAPLERS" (now U.S. Patent Publication No. 2012/0248169);
U.S. Application No. 13 / 433,167, entitled "TISSUE THICKNESS COMPENSATORS" (now U.S. Patent Publication No. 2012/0241503),
U.S. Application No. 13 / 433,175 entitled "LAYERED TISSUE THICKNESS COMPENSATOR" (now U.S. Patent Publication No. 2012/0253298);
U.S. Application No. 13 / 433,179, entitled "TISSUE THICKNESS COMPENSATORS FOR CIRCULAR SURGICAL STAPLERS" (now U.S. Patent Publication No. 2012/0241505);
U.S. Application No. 13 / 763,028, entitled "ADHESIVE FILM LAMINATE" (currently U.S. Patent Publication No. 2013/0146643),
U.S. Application No. 13 / 433,115 entitled "TISSUE THICKNESS COMPENSATOR COMPRISING CAPSULES DEFINING A LOW PRESSURE ENVIRONMENT" (now U.S. Patent Publication 2013/0256372);
U.S. Application No. 13 / 433,118, titled "TISSUE THICKNESS COMPENSATOR COMPRISED OF A PLURALITY OF MATERIALS" (now U.S. Patent Publication 2013/0256365);
U.S. Patent Application No. 13 / 433,135, entitled "MOVABLE MEMBER FOR USE WITH TISSUE T HICKNESS COMPENSATOR" (currently U.S. Patent Publication No. 2013/0256382);
U.S. Application No. 13 / 433,140, entitled "TISSUE THICKNESS COMPENSATOR AND METHOD FOR MAKING THE SAME" (now U.S. Patent Publication 2013/0256368),
U.S. Application No. 13 / 433,129, entitled "TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF MEDICAMENTS" (now U.S. Patent Publication No. 2013/02563667),
U.S. Application No. 11 / 216,562 entitled "STAPLE CARTRIDGES FOR FORMING STAPLE HAVING DIFFERING FORMED STAPLE HEIGHT" (now U.S. Patent No. 7,669,746);
U.S. Application No. 11 / 714,049, entitled "SURGICAL STAPLING DEVICE WITH ANVIL HAVING STAPLE FORMING POCKETS OF VARYING DEPTHS" (now U.S. Patent Publication No. 2007/0194082);
U.S. Application No. 11 / 711,979, entitled "SURGICAL STAPLING DEVICES THAT PRODUCT FORMED STAPLES HAVING DIFFERENT LENGTHS" (now U.S. Patent No. 8,317,070);
U.S. Application No. 11 / 711,975, entitled "SURGICAL STAPLING DEVICE WITH STAPLE DRIVERS OF DIFFERENT HEIGHT" (currently U.S. Patent Publication No. 2007/0194079),
U.S. Application No. 11 / 711,977, entitled "SURGICAL STAPLING DEVICE WITH STAPLE DRIVER THAT SUPPORTS MULTIPLE WIRE DIAMETER STAPLES" (currently U.S. Patent No. 7,673,781);
U.S. Application No. 11 / 712,315 entitled "SURGICAL STAPLING DEVICE WITH MULTIPLE STACKED ACTUATOR WEDGE CAMS FOR DRIVING STAPLE DRIVERS" (now U.S. Patent No. 7,500,979).
U.S. Application No. 12 / 038,939, entitled "STAPLE CARTRIDGES FOR FORMING STAPLE HAVING DIFFERING FORMED STAPLE HEIGHT" (now U.S. Patent No. 7,934,630);
U.S. Application No. 13 / 020,263, entitled "SURGICAL STAPLING SYSTEMS THAT PRODUCT FORMED TAPLES HAVING DIFFERENT LENGTHS" (now U.S. Patent No. 8,636,187);
U.S. Patent Application No. 13 / 118,278, entitled "ROBOTICALLY-CONTROLLED SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS" (now U.S. Patent Publication No. 2011/029085).
U.S. Application No. 13 / 369,629, entitled "ROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS" (now U.S. Patent Publication No. 2012/0138660);
U.S. Application No. 12 / 695,359, entitled "SURGICAL STAPLING DEVICES FOR FORMING STAPLES WITH DIFFERENT FORMED HEIGHT" (now U.S. Patent No. 8,464,923);
U.S. application Ser. No. 13 / 072,923, entitled "STAPLE CARTRIDGES FOR FORMING STAPLE HAVING DIFFERING FORMED STAPLE HEIGHT" (now U.S. Pat. No. 8,567,656);
U.S. Application No. 13 / 766,325 entitled "LAYER OF MATERIAL FOR A SURGICAL END EFFECTOR" (now U.S. Patent Publication 2013/0256380);
U.S. Application No. 13 / 763,078, entitled "ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR" (now U.S. Patent Publication 2013/0256383),
U.S. Application No. 13 / 763,094, entitled "LAYER COMPRISING DEPLOYABLE ATTACHMENT MEMBERS" (now U.S. Patent Publication No. 2013/0256377);
U.S. Application No. 13 / 763,106, entitled "END EFFECTOR COMPRISING A DISTAL TISSUE ABUTMENT MEMBER" (currently U.S. Patent Publication 2013/0256378),
U.S. patent application Ser. No. 13 / 433,147, entitled "TISSUE THICKNESS COMPENSATOR COMPRISING CHANNELS" (now U.S. Pat. Pub. No. 2013/0256369);
U.S. application Ser. No. 13 / 763,112, entitled "SURGICAL STAPLING CARTRIDGE WITH LAYER RETENTION FEATURES" (now U.S. Pat. Pub. No. 2013/0256379),
U.S. Application No. 13 / 763,035, entitled "ACTUATOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM A FASTENER CARTRIDGE" (now U.S. Patent Publication No. 2013/0214030);
U.S. Application No. 13 / 763,042, entitled "RELEASEABLE TISSUE THICKNESS COMPENSATOR AND FASTENER CARTRIDGE HAVING THE SAME" (now U.S. Patent Publication No. 2013/0221063);
U.S. Application No. 13 / 763,048 "FASTENER CARTRIDGE COMPRISING A RELEASEABLE TISSUE THICKNESS COMPENSATOR" (currently U.S. Patent Publication No. 2013/0221064);
U.S. Application No. 13 / 763,054, "FASTENER CARTRIDGE COMPRISING A CUTTING MEMBER FOR RELEASING A TISSUE THICKNESS COMPENSATOR" (currently U.S. Patent Publication No. 2014/0097227).
U.S. Application No. 13 / 763,065 "FASTENER CARTRIDGE COMPRISING A RELEASEABLE ATTACHED TISSUE THICKNESS COMPENSATOR" (currently U.S. Patent Publication No. 2013/0221065);
U.S. Application No. 13 / 763,021, entitled "STAPLE CARTRIDGE COMPRISING A RELEASEABLE COVER"
U.S. Application No. 13 / 763,078, entitled "ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR" (now U.S. Patent Publication 2013/0256383),
U.S. Application No. 13 / 763,095, entitled "LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES" (currently U.S. Patent Publication No. 2013/0161374);
U.S. Application No. 13 / 463,147 entitled "IMPLANTABLE ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES" (now U.S. Patent Publication No. 2013/0292398);
U.S. Application No. 13 / 763,192 entitled "MULTIPLE THICKNESS IMPLANTABLE LAYERS FOR SURGICAL STAPLING DEVICES" (now U.S. Patent Publication No. 2013/0146642),
U.S. Application No. 13 / 763,161, titled "RELEASEABLE LAYER OF MATERIAL AND SURGICAL END EFFECTOR HAVING THE SAME" (now U.S. Patent Publication 2013/0153641),
U.S. Application No. 13 / 763,177, entitled "ACTUATOR FOR RELEASING A LAYER OF MATERIAL FROM A SURGICAL END EFFECTOR" (now U.S. Patent Publication 2013/0146641),
U.S. Application No. 13 / 763,037 entitled "STAPLE CARTRIDGE COMPRISING A COMPRESIVE PORTION",
U.S. Application No. 13 / 433,126, entitled "TISSUE THICKNESS COMPENSATOR COMPRISING TISSUE INGROWTH FEATURES" (now U.S. Patent Publication No. 2013/0256366);
U.S. Application No. 13 / 433,132 entitled "DEVICES AND METHODS FOR ATTACHING TISSUE THICKNESS COMPENSATING MATERIALS TO SURGICAL STAPLING INSTRUMENTS" (now U.S. Patent Publication No. 37/02/56).
U.S. Application No. 13 / 851,703, entitled "FASTENER CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR INCLUDING OPENINGS THEREIN",
U.S. Application No. 13 / 851,676, entitled "TISSUE THICKNESS COMPENSATOR COMPRISING A CUTTING MEMBER PATH",
U.S. Application No. 13 / 851,693, entitled "FASTENER CARTRIDGE ASSEMBLIES",
U.S. Application No. 13 / 851,684, entitled "FASTENER CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR AND A GAP SETTING ELEMENT",
U.S. Patent Application No. 14 / 187,387, entitled "STAPLE CARTRIDGE INCLUDING A BARBED STAPLE" (now U.S. Patent Publication No. 2014/0166724);
U.S. Patent Application No. 14 / 187,395, entitled "STAPLE CARTRIDGE INCLUDING A BARBED STAPLE" (now U.S. Patent Publication No. 2014/0166725);
U.S. Patent Application No. 14 / 187,400, entitled "STAPLE CARTRIDGE INCLUDING A BARBED STAPLE" (now U.S. Patent Publication No. 2014/0166726);
U.S. Patent Application No. 14 / 187,383 entitled "IMPLANTABLE LAYERS AND METHODS FOR ALTERING IMPLANTABLE LAYERS FOR US WITH SURGITAL FASTENING INSTRUMENTS",
U.S. Patent Application No. 14 / 187,386, entitled "IMPLANTABLE LAYERS AND METHODS FOR ALTERNATE ONE OR MORE PROPERTIES OF IMPLANTABLE LAYERS FOR USE WITH FASTENING INSTRUMENT,"
U.S. Patent Application No. 14 / 187,390, entitled "IMPLANTABLE LAYERS AND METHODS FOR MODIFYING THE SHAPE OF THE THE IMPLANTABLE LAYERS FOR USE WITH A SURGITAL INSTRUMENTAL FURNICAL INSTRUMENTS
U.S. Patent Application No. 14 / 187,389, entitled "IMPLANTABLE LAYER ASSEMBLIES",
U.S. Patent Application No. 14 / 187,385, entitled "IMPLANTABLE LAYERS COMPRISING A PRESSED REGION", and
U.S. Patent Application No. 14 / 187,384, entitled "FASTENING SYSTEM COMPRISING A FIRING MEMBER LOCKOUT".

  Numerous specific details are set forth in order to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments described herein and illustrated in the accompanying drawings. However, it will be apparent to one skilled in the art that embodiments may be practiced without such specific details. In other instances, well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described herein. It will be understood by those skilled in the art that the embodiments described and illustrated herein are non-limiting examples, and thus the specific structural and functional details disclosed herein may be exemplary and exemplary. Will be understood. Variations and changes thereto may be made without departing from the scope of the claims.

  Throughout this specification, references to "various embodiments," "some embodiments," "one embodiment," or "embodiments," etc., refer to particular embodiments described in connection with that embodiment. A feature, structure, or characteristic is meant to be included in at least one embodiment. Thus, the appearances of the phrase "in various embodiments," "in some embodiments," "in one embodiment," or "in one embodiment" may appear throughout the specification. , These do not necessarily all refer 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, without limitation, in whole or in part, with the features, structures, or characteristics of one or more other embodiments. May be combined. Furthermore, for brevity and clarity, spatial terms such as "vertical", "horizontal", "above", and "below" are used herein with reference to the illustrated embodiments. It will be appreciated that it gains. However, these terms are used to assist the reader and are not intended to be limiting and absolute.

  Referring to FIG. 1, a surgical staple and cutting instrument 10 can include a handle portion 12 that can be manipulated to position a mounting portion 14 within a surgical site. In various embodiments, mounting portion 14 can include an end effector 16 mounted on an elongate shaft 18. In various situations, the mounting portion 14 is dimensioned to be inserted into a surgical site via a trocar cannula (not shown), for example, to perform endoscopic or laparoscopic surgery. And can be configured. The end effector 16 can include an upper jaw or anvil 20 and a lower jaw 22 such that when the closure trigger 24 of the handle portion 12 is moved or pressed toward a pistol grip 26 of the handle portion 12, It can move between an open position and a closed position. In various embodiments, pressing the closure trigger 24 can advance the outer closure sleeve 28 of the elongate shaft 18, which contacts the anvil 20 and pivots the anvil 20 to its closed position. Can be. In certain situations, the surgeon may rotate mounting portion 14 about its longitudinal axis by twisting shaft rotation knob 30. In either case, for example, when the end effector 16 is inserted into the infused body cavity, the closure trigger 24 may be released, thereby biasing the anvil 20 open by a spring (not shown), It can be positioned relative to the target tissue. In various embodiments, the closure trigger 24 can be locked in its depressed state, and in at least one embodiment, the handle portion 12 can further be depressed to unlock the closure trigger 24. An apparatus 44 can be provided. When the anvil 20 and the lower jaw 22 are properly positioned relative to the tissue within the surgical site, the closure trigger 24 closes the anvil 20 and compresses the tissue against a staple cartridge 42 mounted on the lower jaw 22. Can be pressed again.

  When the anvil 20 is closed, the firing trigger 32 applies a firing force or motion to the firing member and pulls or pushes against the closing trigger 24 and the pistol grip 26 to advance the firing member from the unfired position. Can be. In various embodiments, the firing member can include a proximal firing rod 34 mounted on a distal firing bar 36. In at least one such embodiment, firing rod 34 and / or firing bar 36 may be supported within a frame 38 in shaft 18 that may extend between handle portion 12 and end effector 16. As a result of the firing motion applied to the firing member, firing bar 36 can be advanced distally within elongated staple cartridge channel 40 of lower jaw 22 and staple cartridge 42 located within cartridge channel 40. In various embodiments, referring to FIG. 2, the firing bar 36 can include a mounting portion 48 that is mounted on an E-beam 50 that can translate within the end effector 16. The E-beam 50 includes a vertical portion 52 that can pass through a narrow longitudinal anvil slot 58 that extends through a tissue contacting surface 60 in the anvil 20, a narrow vertical slot 62 in the staple cartridge 42, A narrow longitudinal channel slot 64 in the elongate staple channel 40 when 50 has been advanced distally. Referring now to FIGS. 2 and 3, anvil slot 58 can extend upwardly into anvil 20 and is sized to receive an upper pin 54 that extends laterally from vertical portion 52. A configured distal end that opens into a laterally enlarged longitudinal channel 66 may be provided. Similarly, channel slot 64 may extend downwardly into channel 40 and is dimensioned to receive one or more lower legs 70 extending laterally from vertical portion 52. A configured distal end that opens into a laterally enlarged longitudinal channel 68 may be provided.

  In various embodiments, in addition to the above, the E-beam 50 can further extend laterally from the vertical portion 52 and be configured to slide along the top surface of the bottom tray 74 of the staple cartridge 42. One or more intermediate pins 72 can be provided. In certain embodiments, intermediate pin 72 can be configured to seat staple cartridge 42 or to ensure that staple cartridge 42 remains seated in channel 40. A longitudinal firing recess 75 formed in the staple cartridge 42 on the bottom tray 74 is sized to translate the intermediate pin 72 through the staple cartridge 42. In various embodiments, the E-beam 50 translates through a vertical slot 62 in the staple cartridge 42 and can be configured to drive a wedge sled distally through the staple cartridge 42. A position drive surface 76 may be further provided. In certain embodiments, wedge threads 78 can be integrally formed within E-beam 50, but in other embodiments, wedge threads 78 can reside within staple cartridge 42, The drive surface 76 can make contact when the E-beam 50 is advanced distally. The vertical portion 52 of the E-beam 50 extends along the distal edge above the distal drive surface 76 and below the upper pin 54, which acts as the fixed tissue 46 when the tissue 46 is stapled. An existing cutting surface 80 may be further provided. Referring now to FIG. 4, the wedge sled 78 can be configured to engage one or more staple drivers 82 and drive the staple drivers 82 upward toward the anvil 20. In various embodiments, for example, the staples, such as staples 83, can be seated on staple driver 82 so that when staple driver 82 is lifted up, staples 83 can also be lifted up, and / or another As such, it can be supported. In at least one such embodiment, the staples 83 can also be positioned at least partially within staple cavities or pockets 84 in the staple cartridge body 85 of the staple cartridge 42, and when the staples 83 are lifted upward, the staples 83 Can contact the anvil 20 and can be ejected from the staple cavity 84. In at least one embodiment, referring again to FIG. 4, as described above, the bottom tray 74 is used to hold the staple driver 82 and the staples 83 in the staple cartridge 42 until the staples 83 are deployed from the staple cartridge. It can be mounted on the cartridge body 85.

  Referring now to FIGS. 5 and 6, during use, when the anvil 20 is closed on tissue, the tissue contacting surface 60 of the anvil 20 and the tissue contacting deck 90 of the staple cartridge 42 may cause the tissue 46 to reach an uncompressed thickness. The anvil 20 can be positioned on one side of the tissue 46 so that the anvil 20 can be compressed between 91 and a compressed thickness 92, and the bottom jaw 22 is positioned on the opposite side of the tissue 46. Can be positioned on top. To staple and sever tissue 46, wedge sled 78 is advanced distally within staple cartridge 42 to lift staple driver 82 toward anvil 20 and deform staples 83, as described above. can do. In various embodiments, each staple driver 82 can be configured to receive a base 87 of the staple 83 and releasably hold it in place, one or more defined therein. Slots. In at least one such embodiment, each staple 83 can include one or more staple legs 88 extending from a base 87, which staple legs 88 extend upwardly into a staple cavity 84. can do. In various embodiments, the tips of the staple legs 88 can be recessed against the deck or tissue contacting surface 90 of the cartridge body 85 when the staples 83 are in their unfired position. As the staples 83 are lifted upward by the driver 82, the tips of the staple legs 88 emerge from the staple cavities 84, penetrate the tissue 46, and contact an anvil forming pocket 89 located opposite the staple cavities 84. it can. The anvil forming pocket 89 can be configured to deform the staple 83 into any suitable shape, such as, for example, the B-shape shown in FIG. Once the staples 83 have been deployed, and referring now to FIG. 6, the cutting edge 80 can cut the tissue 46 into stapled portions 94.

  As described above, the jaw members of the end effector can be configured to apply a compressive force or force to the tissue to be stapled. In various situations, however, the tissue may be slippery, for example, and at least a portion of the tissue may slide relative to the jaw members. In certain situations, tissue may slide longitudinally out of the distal end of the end effector and / or in a direction perpendicular to the longitudinal direction out of the side of the end effector. . In some situations, portions of the tissue may be squeezed out of the distal end of the end effector and / or the sides of the end effector as the tissue is compressed. In various embodiments disclosed herein, the staple cartridge can be configured to prevent or at least reduce the likelihood of tissue located within the end effector moving relative to the end effector. One or more tissue retention features can be provided.

  In various embodiments, referring now to FIGS. 7 and 8, a staple cartridge, such as, for example, staple cartridge 142, includes a cartridge body 185 and, for example, staples 187 (FIG. 9) positioned within cartridge body 185. And a plurality of staples. The cartridge body 185 can include a proximal end 141 and a distal end 143, the proximal end 141 can be configured to be inserted into a proximal end of a staple cartridge channel, and a distal end. 143 can be configured to be inserted into the distal end of the staple cartridge channel. In at least one embodiment, the cartridge body 185 can include a plurality of staple cavities 184, each of which can be configured to receive a staple 187 therein. In certain embodiments, although not shown, the staple cavity can include one or more staples positioned therein. In any case, the staple cavities 184 can be arranged in multiple rows within the cartridge body 185. More specifically, in at least one embodiment, the staple cavities 184 are, for example, in three rows of staples on a first side 145 of the cartridge body 185 and, for example, on a second side 147 of the cartridge body 185. In three rows of staples. In at least one such embodiment, the first side 145 and the second side 147 of the cartridge body 185 are separated by a knife slot 162, which can be configured to slidably receive a cutting member therein. be able to. In various other embodiments, the cartridge may include any other suitable number of staple rows, such as, for example, two staple rows or four staple rows on each side of the knife slot 162. Referring to FIG. 9, in various embodiments, the staple cartridge 142 further comprises a plurality of staple drivers 182 configured to support the staples 187 and / or eject the staples 187 from the staple cavities 184. Can be. In certain embodiments, each staple cavity 184 can include an open end or opening 110 in the deck 190 of the cartridge body 185 through which staples 187 can be ejected.

  In various embodiments, referring primarily to FIG. 8, staple cavities 184 can be arranged such that they are longitudinally staggered relative to one another. For example, the staple cavities 184 on the first side 145 of the cartridge body 185 can be located, for example, in the innermost row of staple cavities 184, the middle row of staple cavities 184, the outermost row of staple cavities 184. The staple cavities 184 in one row may not be aligned transversely with the staple cavities 184 in one or both of the other rows. In at least one embodiment, each staple cavity 184 can include a proximal end 111 and a distal end 112, wherein the proximal end 111 of each staple cavity 184 is more of the cartridge body 185 than the distal end 112. It can be located closer to the proximal end 141. Similarly, the distal end 112 of each cavity 184 can be located closer to the distal end 143 of the cartridge body 185 than to the proximal end 111. In various embodiments, the innermost row of staple cavities 184 is such that the distal end 112 of staple cavities 184 in the innermost row is distal to the distal end 112 of staple cavities 184 in the middle row of staple cavities 184. Can be positioned. Similarly, the outermost row of staple cavities 184 is positioned such that the distal end 112 of staple cavities 184 in the outermost row is distal to the distal end 112 of the staple cavities in the middle row of staple cavities 184. And so on. For example, the most distal staple cavities 184 in the innermost row can be located distally with respect to the most distal staple cavities 184 in the middle row, as well as the most distal staple cavities 184 in the outermost row. Can be positioned distal to the most distal staple cavity 184 in the middle row. In certain embodiments, the innermost staple cavities 184 and the outermost staple cavities 184 include, first, a distal end 112 of the innermost staple cavities 184 and a distal end of the outermost staple cavities 184. Aligned with the end 112, and secondly, the proximal end 111 of the inner staple cavity 184 can be aligned across each other such that it is aligned with the proximal end 111 of the outermost staple cavity 184. In various embodiments, each staple cavity 184 and their openings 110 can have the same, or at least approximately the same, configuration, and in at least one embodiment, the staple cavities 184 are within the staple rows. They may be equidistant from each other, or at least substantially equidistant.

  In various embodiments, referring again to FIGS. 7 and 8, the cartridge body 185 of the staple cartridge 142 can be configured to contact and compress target tissue, for example, ridges 113, 114, and 115. And one or more ridges. More specifically, referring now to FIG. 8A, the end effector anvil 120 can be closed to compress the tissue T against the staple cartridge 142, and in such a situation, the tissue contact deck 190 and The ridges 113, 114, and 115 extending therefrom can engage tissue. When the anvil 120 is closed, in certain circumstances, the anvil 120 applies tissue to the staple cartridge 142 such that the tissue first contacts the ridges 113, 114, and 115, and then contacts the cartridge deck 190. You can push it in. In other situations, the staple cartridge 142 can be positioned relative to the tissue such that the ridges 113, 114, and 115 contact the tissue before the tissue is contacted by the cartridge deck 190. In any case, upon contact with the tissue, the ridges 113, 114, and 115 may prevent or at least limit relative movement between the tissue and the staple cartridge 142. In certain embodiments, the ridges 113, 114, and 115 can extend upward from a flat, or at least substantially flat, cartridge deck 190, for example, to receive a portion of the tissue therein. One or more pockets or channels can be defined that can be configured such that the tissue is at least partially compressed between the anvil 120 and the ridges 113, 114, and 115. When done, it prevents relative movement of tissue in the longitudinal and / or transverse direction of the end effector. In various embodiments, as the ridges 113, 114, and 115 extend above the cartridge deck 190, the tissue positioned intermediate the anvil 120 and the ridges 113, 114, and 115 may be displaced by the anvil 120 and the cartridge deck. Before the tissue positioned intermediate to 190 can be compressed, it can be compressed. In some such situations, as a result, tissue positioned intermediate the anvil 120 and the ridges 113, 114, and 115 can be pre-compressed, i.e., intermediate the anvil 120 and the cartridge deck 190. Can be at least partially compressed before the other portion of the tissue located at is compressed. Due to this pre-compression, in various situations, portions of the tissue control or prevent the tissue from slipping out of the end effector before the tissue is fully compressed, as described in more detail below. be able to.

  In various embodiments, referring again to FIGS. 7 and 8, the ridge 113 extending from the cartridge deck 190 can extend around the proximal end 111 of the staple cavity opening 110. Similarly, the ridge 114 extending from the cartridge deck 190 can extend around the distal end 112 of the staple cavity opening 110. These proximal ridges 113 and distal ridges 114, in various embodiments, engage tissue located above and / or around the staple cavity 184 to compress and / or staple the tissue. Then, these portions of the tissue can be configured to be held in place. In other words, retaining tissue positioned over and / or surrounding staple cavity 184 can provide local control over the portion of tissue to be stapled, Relative movement between these portions of tissue and the staple cartridge 142 can be prevented or at least limited. In various embodiments, the ridges 113 and 114 can be located around the opening 110 of all or only some of the staple cavities 184. In at least one embodiment, the cartridge body may include ridges 113 and 114 surrounding only the staple cavities 184 in the outermost rows of the first and second sides 145 and 147. In such an embodiment, the ridges surrounding the outermost row of staple cavities 184 may be sufficient to prevent lateral movement of tissue within the end effector. In certain embodiments, the cartridge body includes a proximal ridge 113 surrounding the proximal end 111 of the most proximal staple cavity 184 and a distal ridge 114 surrounding the distal end 112 of the most distal staple cavity 184. May be provided. In such an embodiment, the ridge surrounding the most proximal and distal most staple cavities 184 may be sufficient to prevent longitudinal movement of tissue within the end effector.

  In various embodiments, in addition to the above, each proximal ridge 113 can include, for example, an arcuate or curved profile surrounding the proximal end 111 of the opening 110. The arcuate profile of each proximal ridge 113 can be defined by one radius of curvature, or one or more radii of curvature. Similarly, each distal ridge 114 may include, for example, an arcuate or curved profile surrounding the distal end 112 of the opening 110. The arcuate profile of each distal ridge 114 can be defined by one radius of curvature, or one or more radii of curvature. In certain embodiments, in addition to the above, each ridge 113 and 114 forms a pocket that can receive a portion of the tissue to be compressed, the portion of the tissue extending longitudinally relative to the staple cartridge 142. Movement in the direction and / or in the transverse direction can be prevented. In various embodiments, the staple cartridge 142 extends between and / or can connect between adjacent ridges 113 and 114 in adjacent rows of staple cavities 184 and / or the intermediate ridge 115. May be further provided. In at least one such embodiment, one or more ridges 113, 114, and 115 operably undulate over first side 145 or second side 147 of cartridge body 185. A ridge may be formed, and in at least one embodiment, the undulating ridge may extend between a central portion and a side portion of the cartridge body 142. In various embodiments, each undulating ridge may comprise a plurality of serpentine waves, for example, around the proximal and distal ends of the staple cavity 184. In various embodiments, each ridge 113, 114, and 115 can have a height defined from cartridge deck 190, and in certain embodiments, the height of each ridge 113, 114, and 115. The length can be uniform, or at least substantially uniform, over its length. In at least one embodiment, each ridge 113, 114, and 115 can have the same, or at least substantially the same height.

  In various embodiments, as described above, the staple cavity defined in the staple cartridge body can include a staple positioned therein, wherein the entire staple is when the staple is in its unfired position. It can be located on the top of the cartridge deck or below the tissue contacting surface. In certain other embodiments, at least a portion of the staples, such as, for example, the tips of the staple legs, can extend above the top surface of the cartridge deck or the tissue contacting surface when the staples are in their unfired position. it can. In some such embodiments, the tip of the staple may protrude from the deck and may become trapped on tissue as the staple cartridge is inserted into the surgical site. In at least one embodiment, referring now to FIG. 9, for example, the ridges 113 and 114 that extend above the tissue contacting cartridge deck 190 are such that they extend above the cartridge deck 190 in the unfired position. When it does, the staple legs 183 of the staple 187 can be at least partially surrounded and protected. Although ridges 113 and 114 may not extend completely around each opening 110, in various embodiments, tissue is compressed against staple cartridge 142 and / or staple 187 is inserted into staple cartridge 142. The proximal ridge 113 may sufficiently surround one of the staple leg tips so that the tip of the staple leg does not contact tissue before being ejected from the The tip of another staple leg may be sufficiently surrounded. In at least one embodiment, the tips of the staple legs may be located below the upper surface 116 of the ridges 113 and 114. In certain embodiments, the tips of the staple legs may lie in a common plane with the upper surface 116 of the ridges 113 and 114. In various embodiments, staples having a higher staple height, for example, as a result of the protection provided by the ridges 113 and 114, are used without the staple tips protruding from the staple cartridge 142 in their unfired position. be able to. In certain embodiments, referring again to FIG. 9, the ridges 113 and 114 can extend or increase the length by which the staple legs 183 of the staple 187 can be controlled and / or supported. In at least one such embodiment, each ridge 113 and 114 can extend or increase the length that staple legs 183 are supported on its three sides. Such embodiments may, for example, prevent or at least reduce the likelihood of staple legs 183 buckling when the staple legs are inserted through dense tissue, such as bronchial tissue.

  In various embodiments, referring again to FIG. 4, the cartridge body 85 comprises a cavity 84 defined therein, a slot 62, and a channel 86, which may, for example, reduce the strength of the cartridge body 85. Can be. In various situations, particularly when, for example, the cartridge body 85 is compressed by the anvil 20, the cartridge body 85 may deflect as a result of the load applied thereto. In at least one such embodiment, for example, the portion of the cartridge deck 90 that extends across the channel 86 may be particularly thin and may be particularly susceptible to deflection and / or breakage. In certain embodiments, referring again to FIGS. 7 and 8, the ridges 113, 114, and / or 115 can be configured to strengthen and / or stiffen the cartridge body 185. In at least one such embodiment, for example, the ridges 113 and 114 may extend around the opening 110 to strengthen and / or stiffen the portion of the cartridge body 185 surrounding the staple cavity 184. it can. In certain embodiments, the ridges 115 may include a channel defined within the cartridge body 185, for example, such that the ridges 115 may strengthen and / or stiffen the cartridge body 185 surrounding the channel 86. It can extend transversely over 86 or the like. In various other embodiments, the cartridge body 185 can include any suitable number and configuration of ridges extending therefrom to achieve the advantages described herein.

  In various embodiments, the staple cartridge body 185 can be comprised of, for example, a plastic, metallic, and / or ceramic material. Some such materials include liquid crystal polymers (eg, Vectra), thermoplastic polymers (eg, polycarbonate), ABS, Noryl, polyamide (nylon), polyethersulfone, polyetherimide (eg, Ultem), and / or , Can include a polymer blend of two or more of the foregoing thermoplastic polymers, and in various embodiments, the cartridge body 185 can be formed, for example, by injection molding. Some such materials include thermoset polymers (e.g., thermoset polyester), cast-in steel nets (e.g., 17-4PH, etc.), and / or metal injection molded stainless steel nets (e.g., 17-4PH). Etc.). In at least one such embodiment, the ridges 113, 114, and / or 115 can be formed integrally with the cartridge deck 190 of the cartridge body 185. In certain embodiments, the ridges 113, 114, and / or 115 can be attached to the cartridge deck 190, for example, by at least one adhesive.

  In various embodiments, and referring now to FIG. 12, for example, a staple cartridge, such as staple cartridge 342, includes a cartridge body 385, a plurality of staple cavities 384 defined within cartridge body 385, and each of staple cavities 384. And a staple positioned within. In certain embodiments, the cartridge body 385 includes a first side 345 comprising a first group of staple cavities 384, a second side 347 comprising a second group of staple cavities 384, and a cartridge deck 390. May be further provided. In various embodiments, the cartridge body 385 can further include a plurality of ridges 315 extending from a cartridge deck 390 that can be intermediately positioned adjacent to the staple cavities 384 in the row of staple cavities 384. In at least one embodiment, each ridge 315 can comprise, for example, a cross or X-shaped configuration. In at least one such embodiment, for example, each ridge 315 includes a V-shaped portion 313 that can at least partially surround the proximal end 311 of the staple cavity opening 310, and, in addition, another staple cavity opening And a V-shaped portion 314 that can at least partially surround the distal end 312 of the portion 310. In certain embodiments, only the outermost row of staple cavities 384 in the cartridge body 385 may be at least partially surrounded by the ridge 315. In certain other embodiments, referring now to FIG. 13, the staple cartridge body 385 'comprises a ridge 315 at least partially surrounding the openings 310 of all staple cavities 384 in the cartridge body. Can be. In each case, in various embodiments, each ridge 315 compresses and controls tissue positioned against staple cartridge 342 as described above, and staple legs of the staple extending over deck 390. Can be surrounded.

  In various embodiments, referring now to FIG. 16, for example, a staple cartridge, such as staple cartridge 542, includes a cartridge body 585, a plurality of staple cavities 584 defined within cartridge body 585, and each of staple cavities 584. And a staple positioned within. In certain embodiments, the cartridge body 585 includes a first side 545 comprising a first group of staple cavities 584, a second side 547 comprising a second group of staple cavities 584, and a cartridge deck 590. May be further provided. In various embodiments, the cartridge body 585 can further include a plurality of ridges 515 extending from the cartridge deck 590, each ridge 515 completely surrounding or encompassing the staple cavity opening 510. it can. As shown in FIG. 16, some cavity openings 510 in the cartridge body 585 may not be surrounded by the ridges 515, while in various alternative embodiments, see now FIG. 16A. Then, any cavity opening 510 in the cartridge body 585 'may be surrounded by the ridge 515. Various embodiments are contemplated, in which the cartridge body includes a first group of staple cavities 584 surrounded by ridges 515 and a second group of staple cavities 584 not surrounded by ridges 515. A staple having a higher staple height may be positioned within the first group of staple cavities 584, such that no higher or lower staples protrude from the staple cartridge 542. Staples having a staple height may be positioned within the second staple cavity 584. In at least one such embodiment, for example, the cartridge body can be configured to utilize high staples in one row of staple cavities 584 and lower staples in another row of staple cavities 584. In certain embodiments, the ridges 515 may be, for example, such that higher staples may be utilized in the outermost row of staple cavities 584 and lower staples may be utilized in the innermost and / or middle rows. , All of the staple cavities 584 in the outermost row of staple cavities 584 in the cartridge body can be surrounded.

  In various embodiments, referring now to FIG. 14, for example, a staple cartridge, such as staple cartridge 442, includes a cartridge body 485, a plurality of staple cavities 484 defined within cartridge body 485, and each of staple cavities 484. And a staple positioned within. In certain embodiments, the cartridge body 485 includes a first side 445 comprising a first group of staple cavities 484, a second side 447 comprising a second group of staple cavities 484, and a cartridge deck 490. May be further provided. In various embodiments, the cartridge body 445 can include a plurality of ridges 415 extending from the cartridge deck 490, and each ridge 415 can further include a plurality of notches or an array thereof. In use, the anvil may be utilized to position the tissue relative to the notch so that the tissue matches the contour of the notch. In various embodiments, each ridge 415 can comprise a plurality of pyramidal or diamond-shaped notches, for example, at least partially surrounding one or more staple cavity openings 410, In one embodiment, the pyramid-shaped notch may project upward from cartridge deck 490. In at least one embodiment, each pyramid-shaped notch can include four triangular sides that can merge together to form a sharp protrusion. In certain embodiments, referring to FIG. 15A, the pyramid-shaped notches of the ridge 415 can be truncated, with the top of each notch having a flat top surface surrounded by sloping sides. it can. While a four-sided pyramidal notch can be utilized, referring now to FIG. 15C, other pyramid shapes, such as less than four or more than four, such as three, are contemplated. In various embodiments, one or more ridges 415 can comprise a plurality of conical notches, each conical notch tapering upwards to form a sharp protrusion. Or at least a substantially circular base. In certain embodiments, referring now to FIG. 15B, the conical indents can be truncated, and the top of each indent can have a flat top surface surrounded by an annular side. In various embodiments, referring again to FIG. 14, the notch in the ridge 415 extends along the lateral sides of the staple cavity opening 410 and / or between adjacent staple cavity openings 410. can do. In at least one embodiment, the notch may extend around the proximal end 411 and / or the distal end 412 of the staple cavity opening 410. In certain embodiments, the notch of the ridge 415 may surround only some of the staple cavities 484, and in certain other embodiments, with reference to FIG. May, for example, cover all, or at least substantially all, of the cartridge deck 490.

  In various embodiments, referring now to FIG. 10, for example, a staple cartridge, such as staple cartridge 242, includes a cartridge body 285, a plurality of staple cavities 284 defined within cartridge body 285, and each of staple cavities 284. And a staple positioned within. In certain embodiments, the cartridge body 285 includes a first side 245 comprising a first group of staple cavities 284, a second side 247 comprising a second group of staple cavities 284, and a cartridge deck 290. May be further provided. In various embodiments, the cartridge body 285 can further include a plurality of ridges or bumps 215 extending from the cartridge deck 290. In at least one such embodiment, each ridge 215 extends transversely between a central or intermediate portion of cartridge body 245 located adjacent knife slot 262 and an outer portion of cartridge body 245. can do. More specifically, with particular reference to the first side 245 of the cartridge body 285, each ridge 215 includes a first end 213 positioned adjacent the knife slot 262 and a first end 213 of the cartridge body 285. A second end 214 positioned adjacent to the side 261 of the second side. Similarly, referring now to the second side 247 of the cartridge body 285, each ridge 215 includes a first end 213 positioned adjacent the knife slot 262 and a second side 247 of the cartridge body 285. A second end 214 positioned adjacent to H.263. In at least one embodiment, each ridge 215 can have a height measured from deck 290, and in at least one such embodiment, the height of each ridge 215 is along its length. Can be different. In certain embodiments, the second end 214 may be higher than the first end 213, and the height of each ridge 215 may be higher than the second end 214 and the first end 213. And may gradually decrease between. In certain embodiments, not shown, first end 213 of ridge 215 may be higher than second end 214. In at least one embodiment, the height of each ridge 215 may gradually decrease linearly, or at least substantially linearly, between ends 213 and 214. In at least one such embodiment, the height of each ridge 215 may gradually decrease from a maximum height at the second end 214 to a zero height at the first end 213. In certain embodiments, the height of each ridge 215 may be geometrically different between ends 213 and 214. In certain alternative embodiments, referring now to FIG. 11, each ridge 215 'can have a uniform height over its length.

  As described above, the inner end 213 of the ridge 215 may be lower than the outer end 214 of the ridge 215. In various situations, the inner end 213 can then exert less pressure on the tissue secured between the anvil and the staple cartridge 242 as compared to the outer end 214. In various embodiments, each ridge 215 can extend transversely across the cartridge deck 290, as described above. In certain embodiments, each ridge 215 can extend along a ridge axis transverse to the longitudinal axis 299 of the cartridge body 285. In at least one such embodiment, the raised axis may be perpendicular or at least substantially perpendicular to the longitudinal axis 299. In various embodiments, the staple cavities 284 can be arranged in multiple rows, with each row of staple cavities 284 along a longitudinal axis that can be parallel or at least substantially parallel to the longitudinal axis 299. Can be defined. In at least one embodiment, the raised axis of the raised portion 215 can extend in a direction transverse to the longitudinal axis of the staple cavity 284. In at least one such embodiment, the ridge axis of ridge 215 may extend in a direction that is perpendicular or at least substantially perpendicular to the longitudinal axis of staple cavity 284. In various embodiments, referring again to FIG. 10, each ridge 215 can include, in addition to the ridge 209, a sloped surface 208 extending between the ridge 209 and the cartridge deck 290. In certain embodiments, each sloped surface 208 can include, for example, one or more flat surfaces, curved surfaces, concave surfaces, and / or convex surfaces. In various embodiments, each ridge 215 can extend along a path extending across one or more openings 210 of staple cavity 284. In at least one such embodiment, such opening 210 may extend upward through ridge 215. As the ridge 215 extends transversely across the cartridge deck 290, the ridge 215, like the ridge 115, can increase the strength and / or rigidity of the cartridge body 285.

  17 and 18, in various embodiments, a staple cartridge, such as, for example, staple cartridge 642 includes a cartridge body 685, a plurality of staple cavities 684 defined within cartridge body 685, and a staple cavity 684. And a staple positioned within each of the staples. In certain embodiments, the cartridge body 685 includes a first side 645 comprising a first group of staple cavities 684, a second side 647 comprising a second group of staple cavities 684, and a cartridge deck 690. May be further provided. In various embodiments, the cartridge body 685 can further include a plurality of ridges or bumps 615 extending from the cartridge deck 690. In at least one such embodiment, each ridge 615 can extend longitudinally, and each ridge 615 can include a distal end 613 and a proximal end 614, and Distal end 613 can be positioned closer to distal end 643 of cartridge body 685 and proximal end 614 of ridge 615 can be positioned closer to proximal end 641. In at least one embodiment, each ridge 615 can have a height measured from deck 690, and in at least one such embodiment, the height of each ridge 615 is along its length. Can be different. In certain embodiments, the proximal end 614 may be higher than the distal end 613, and the height of each ridge 615 gradually decreases between the proximal end 614 and the distal end 613. obtain. In certain embodiments, not shown, the distal end 613 of the ridge 615 may be higher than the proximal end 614. In at least one embodiment, the height of each ridge 615 may gradually decrease linearly, or at least substantially linearly, between ends 613 and 614. In at least one such embodiment, the height of each ridge 615 may gradually decrease from a maximum height at the proximal end 614 to a zero height at the distal end 613. In certain embodiments, the height of each ridge 615 may be geometrically different between ends 613 and 614. In certain alternative embodiments, each ridge 615 can have a uniform height over its length.

  As described above, the distal end 613 of the ridge 615 may be lower than the proximal end 614 of the ridge 615. In various situations, the distal end 613 can then exert less pressure on the tissue secured between the anvil and the staple cartridge 642 as compared to the proximal end 614. In various embodiments, each ridge 615 can extend longitudinally across the cartridge deck 690, as described above. In certain embodiments, each ridge 615 can extend along a ridge axis that is parallel or at least substantially parallel to the longitudinal axis 699 of the cartridge body 685. In various embodiments, the staple cavities 684 can be arranged in a plurality of rows, with each row of staple cavities 684 having a longitudinal axis that can be parallel or at least substantially parallel to the ridge axis of the ridge 615. Can be defined along. In at least one embodiment, referring again to FIG. 18, each ridge 615 has an inclined surface, which may include, for example, one or more flat surfaces, curved surfaces, concave surfaces, and / or convex surfaces. Can be prepared. In at least one such embodiment, the bottom of the ramp can be distally opposed and can facilitate sliding of the tissue across the staple cartridge 642 when the tissue is positioned within the end effector. In various embodiments, each ridge 615 can extend along a path extending across one or more openings 610 of the staple cavity 684. In at least one such embodiment, such opening 610 can extend upward through ridge 615. As ridges 615 extend transversely across cartridge deck 690, ridges 615 may increase the strength and / or stiffness of cartridge body 685.

  In various embodiments, in addition to the above, the surgical staple may be comprised of titanium (eg, titanium wire, etc.). In certain embodiments, the surgical staple may be comprised of an alloy including, for example, titanium, aluminum, and / or vanadium. In at least one embodiment, the surgical staple may be comprised of surgical stainless steel and / or an alloy composed, for example, of cobalt and chromium. In any case, the surgical staple may be comprised of a metal (eg, titanium) and an outer surface of a metal oxide (eg, titanium oxide). In various embodiments, the metal oxide outer surface may be coated with a material. In certain embodiments, the coating material is polytetrafluoroethylene (PTFE), such as Teflon®, and / or tetrafluoroethylene (TFE), such as ethylene-tetrafluoroethylene (ETFE), perfluoroalkoxyethylene- It may be composed of tetrafluoroethylene (PFA) and / or for example fluorinated ethylene propylene (FEP). Certain coatings may include silicon. In various embodiments, such coating materials can prevent, or at least prevent, further oxidation of the metal. In certain embodiments, the coating material can provide one or more lubricating surfaces against which an anvil, or staple pocket, may be stapled to reduce friction between them. Can contact. In various situations, the lower the frictional force between the staples, the more the staple pockets can reduce the force required to deform the staples.

  U.S. Patent Application Publication No. 2012/0074198, filed September 29, 2010, entitled "STAPLE CARTRIDGE" (now U.S. Patent No. 8,733,613), and filed on February 21, 2013 U.S. Patent Application Publication No. 2013/0161375, entitled "STAPLE CARTRIDGE", is hereby incorporated by reference in its entirety.

  The end effector of the surgical stapling instrument is shown in FIGS. The end effector may include, for example, an anvil, such as anvil 20, and a chin or staple cartridge channel 22 configured to removably support a staple cartridge therein. For example, staple cartridge 2000 is located within cartridge channel 22. The staple cartridge 2000 can include a cartridge body 2010 that includes a plurality of staple cavities 2050 defined therein. Each staple cavity 2050 may be configured to removably store staples therein. The cartridge body 2010 may include a deck surface 2011 and a longitudinal slot 2015 defined in the deck surface 2011 configured to removably receive a firing member and / or a cutting edge therein. The cartridge body 2010 can further include a distal end 2013, a proximal end 2016, and opposing longitudinal sides 2012 extending between the distal end 2013 and the proximal end 2016. In various examples, each longitudinal side 2012 may include adjacent or continuous edges with no breaks defined therein. 7 and FIG. 23, for example, the reader may note that the longitudinal side of the staple cartridge 142 shown in FIG. 7 includes at least one notch defined therein, while the longitudinal side 2012 It will be appreciated that such a notch is not provided.

  Referring primarily to FIG. 55, the cartridge body 2010 may further include a plurality of protrusions 2051 extending from the deck surface 2011. Protrusions 2051 may be configured to engage tissue positioned intermediate anvil 20 and cartridge 2000 and to control movement of tissue relative to cartridge 2000. The tissue may move relative to the cartridge 2000 in various examples. In at least one example, tissue is applied to cartridge 2000 when anvil 20 moves between an open position (FIG. 23) and a closed position where tissue is pushed between anvil 20 and cartridge 2000. Can flow against. In such an example, the tissue may flow laterally toward the longitudinal side 2012, distally toward the distal end 2013, and / or proximally toward the proximal end 2016. In at least one other example, tissue may flow relative to cartridge 2000 as the cutting edge advances distally through tissue captured between anvil 20 and cartridge 2000. In such an instance, the tissue may flow laterally, distally, and / or proximally, but will flow primarily distally due to distal movement of the cutting edge. In various examples, the protrusion 2051 can be configured to restrict or prevent tissue flow to the staple cartridge. Protrusions 2051 may be located at the proximal and / or distal ends of staple cavity 2050. In various examples, each protrusion 2051 can include a cuff extending around the end of staple cavity 2050. In certain examples, each protrusion 2051 may include an arcuate ridge extending around the end of staple cavity 2050.

  Referring primarily to FIG. 55, the cartridge body 2010 may include a gradient transition 2014 extending between the distal tip of the cartridge body 2010 and the deck surface 2011. The gradient transition 2014 may facilitate movement of the cartridge 2000 relative to tissue when positioning the cartridge 2000 and the anvil 20 within a surgical site. In such an example, the tissue may slide on the graded surface 2014. In various examples, gradient surface 2014 may comprise an arc surface. In various examples, the graded surface 2014 may comprise an angled surface. In certain examples, sloped surface 2014 may include a concave surface and / or a convex surface. In at least one example, as shown in FIG. 55, the graded surface 2014 may comprise, for example, a distal concave surface that transitions to a flat, angled surface, which transitions to a proximal convex surface.

  The staple cavities 2050 defined in the cartridge body 2010 may be arranged in a longitudinal row. For example, three longitudinal rows of staple cavities 2050 can be located on a first side of longitudinal slot 2015, and three longitudinal rows of staple cavities 2050 are located on a second side of longitudinal slot 2105. Can be deployed. Each longitudinal row may include a most distal staple cavity 2050 adjacent the distal end 2013 and a most proximal staple cavity 2050 adjacent the proximal end 2016. In various examples, the cartridge body 2010 can further include a protrusion 2053 extending from the deck surface 2011. The protrusion 2053 may be located at the distal end of the most distal staple cavity 2050. Each protrusion 2053 may include, for example, a distal sloped surface configured to facilitate insertion of tissue between staple cartridge 2000 and anvil 20. In various examples, the distal-most cavities 2050 can each include a protrusion 2053 located at its distal end and a protrusion 2051 located at its proximal end.

  Each protrusion 2051 and / or protrusion 2053 may be configured to support at least a portion of a staple that is removably stored within staple cavity 2050. In various examples, each protrusion 2051 may cause end wall 2052 of staple cavity 2050 to extend above deck 2011. In certain examples, referring generally to FIGS. 24 and 26-29, staples positioned within staple cavity 2050 include a base, a first leg extending at a first angle from the base, and a second leg from the base. At a second angle. The first leg may contact the first end wall 2052 (FIG. 55) of the staple cavity 2050, and the second leg may contact the end wall 2052 of the staple cavity. In certain examples, the distance or spread between the first and second legs of the staple is greater than the distance between the end walls 2052, such that when the staple is positioned within the staple cavity 2050. , The legs are biased inward by the end wall 2052. When the staple is stored in the staple cavity 2050 in its unfired or raised position, the tip of the staple leg may be positioned within the protrusion 2051. In such an example, the protrusions 2051 may support and protect the tips of the staple legs on the deck 2011. In some examples, the tip of the staple leg may be positioned below the protrusion 2051 when the staple is in its unfired position, and thus the protrusion 2051 may cause the staple to have its unfired position. When in position, the staple legs may not be supported. When such staples are fired or lifted from staple cavity 2050, the staple legs may contact and be supported by protrusion 2051. In either case, the protrusion 2051 may cause the staple to be sufficiently fired and / or lifted from the staple cavity 2050 when the staple is deployed, such that the staple legs no longer contact the protrusion 2051. Until the staple legs can be supported. Protrusion 2053 can be performed in the same manner as described for protrusion 2051.

  In various examples, in addition to the above, protrusion 2051 can cause staple cavity 2050 to extend above deck 2011 of cartridge body 2010. In certain examples, the protrusion 2051 may be configured such that the end wall 2052 of the staple cavity 2050 extends seamlessly into the protrusion 2051. In other words, a continuous surface may be defined between the end wall 2052 and the protrusion 2051. Such an uninterrupted surface may be such that the staple legs biased against the end walls 2052 and protrusions 2051 contact the edges or steps defined within the staple cavity 2050 and / or the side walls of the staple cavity 2050. The likelihood of biting can be reduced. FIG. 55A illustrates a staircase 2056 defined between a protrusion 2051 and an end wall 2052. Although stairs 2056 comprise outward stairs rather than inward stairs, stairs 2056 may be eliminated to provide an uninterrupted surface as discussed above. In embodiments where the cartridge body 2010 is formed during an injection molding process, the cartridge 2010 may be formed in a mold cavity defined between two halves of an injection mold. The two halves of the injection mold may contact each other to seal the mold cavity, or at least substantially seal. The interface between the two mold halves is often referred to as a seal or parting line, and a small ledge or lip is often formed in the cartridge body along the seal. This is especially true if the sealing line is used to remove air from the mold cavity during the injection molding process. This ledge or lip is often referred to as a "flash". Injection molding can be carefully designed so that the sealing line does not create a ledge or lip at the inward facing surface of the end wall 2052 and / or the protrusion 2051. In at least one example, the protrusion 2051 can include a distal cuff portion 2057 and a transition portion 2058 extending from the opposite end of the cuff portion to the deck 2011. The sealing line between the two mold halves can be chosen such that it extends along the upper surface of the protrusion 2051. An exemplary seal line 2059 is shown in FIG. 55A, but other suitable seal lines may be selected.

  Staple cartridge 2800 is illustrated in FIGS. The staple cartridge 2800 may include a cartridge body 2810. The cartridge body 2810 can include a distal end 2813, a proximal end 2816, and opposing lateral sides 2812. As before, each lateral side 2812 may have a continuous edge with no notch defined therein. The cartridge body 2810 may further include, for example, a deck 2811, a plurality of staple cavities 2850 defined in the deck 2811, and a longitudinal slot 2815 configured to receive a knife edge of the firing member. The cartridge body 2810 may further include a ridge 2851 extending from the deck 2811. In various examples, ridges 2851 can comprise a pattern. In at least one example, each ridge 2851 may extend between a lateral side 2812 and a longitudinal slot 2815. Each raised portion 2851 may have any suitable configuration, such as, for example, a horizontal portion. One or more staple cavities 2850 may extend through the ridge 2851. In some examples, at least a portion of staple cavities 2850 in an inner row of staple cavities 2850, at least a portion of staple cavities 2850 in an intermediate row of staple cavities 2850, and / or in an outer row of staple cavities 2850. At least a portion of the staple cavity 2850 may extend through a horizontal portion of the ridge 2851. Each ridge 2851 may have an inner end 2858 located adjacent to the longitudinal slot 2815 and an outer end 2859 located adjacent to the lateral side 2812. In certain examples, the inner end 2858 can be located distally with respect to the outer end 2859. In other examples, not shown, outer end 2859 can be located distally with respect to inner end 2858. The ridges 2851 can be, for example, parallel. In certain examples, ridges 2851 may include, for example, a tread pattern. In at least one example, a ridge 2851 extending from a deck 2811 on a first side of the longitudinal slot 2815 is provided with a ridge 2851 extending from a deck on a second side of the longitudinal slot 2815. A mirror image may be provided. In various examples, an air gap may be defined between ridges 2851. Tissue may flow into the void, for example, as the tissue is compressed against the cartridge deck 2811 by the anvil. The void may be configured to direct tissue flow in a desired direction.

  The staple cartridge 2900 is illustrated in FIG. The staple cartridge 2900 can include a cartridge body 2910. The cartridge body 2910 can have a distal end 2913, a proximal end, and opposing lateral sides 2912. As before, each lateral side 2912 may have a continuous edge with no notch defined therein. The cartridge body 2910 may further include, for example, a deck 2911, a plurality of staple cavities 2950 defined in the deck 2911, and a longitudinal slot 2915 configured to receive a knife edge of the firing member. The cartridge body 2910 can further include a raised portion 2951 extending from the deck 2911. In various examples, the ridges 2951 can comprise a pattern. Each ridge 2951 may extend between the distal end 2913 and the proximal end of the cartridge body 2910. In at least one example, each ridge 2951 may extend toward a lateral side 2912 and toward a longitudinal slot 2915. In various examples, each ridge 2951 includes an inward and proximally extending angled portion 2954, a longitudinally extending straight portion 2955, and an inwardly and distally extending angled portion. 2956. The ridges 2951 may extend around and / or between the staple cavities 2950. In at least one example, angled portions 2954 and angled portions 2956 can extend between staple cavities 2950 in a longitudinal row of staple cavities 2950. The ridges 2951 can be, for example, parallel to each other. In certain examples, ridges 2951 may comprise, for example, a tread pattern. In at least one example, a ridge 2951 extending from a deck 2911 on a first side of the longitudinal slot 2915 is provided with a ridge 2951 extending from a deck on a second side of the longitudinal slot 2915. A mirror image may be provided. In various examples, a void may be defined between the ridges 2951. Tissue may flow into the void, for example, as the tissue is compressed against the cartridge deck 2911 by the anvil. The void may be configured to direct tissue flow in a desired direction.

  The staple cartridge may include a uniform array of protrusions extending therefrom. In another example, the array may not be uniform. In certain instances, the protrusions in the array may not extend the staple cavities. In various examples, the protrusions in the array may not support staples.

  Staple cartridge 3000 is illustrated in FIGS. The staple cartridge 3000 may include a cartridge body 3010. The cartridge body 3010 can have a distal end 3013, a proximal end, and opposing lateral sides 3012. As before, each lateral side 3012 may have a continuous edge with no notch defined therein. The cartridge body 3010 may further include, for example, a deck 3011, a plurality of staple cavities 3050 defined in the deck 3011, and a longitudinal slot 3015 configured to receive a knife edge of the firing member. The cartridge body 3010 may further include a protrusion 3051 extending from the deck 3011. In various examples, the protrusions 3051 can comprise a pattern. In at least one example, each protrusion 3051 may comprise a pyramid configuration. The pyramid configuration may include, for example, four sides ending in one point. Alternatively, the four sides may end, for example, with a flat surface. Alternatively, the pyramid configuration may include, for example, three sides ending in one point. In any case, as shown in FIG. 59, the array of protrusions 3051 may extend across the deck 3011 between the longitudinal slots 3015 and the lateral sides 3012. The protrusion 3051 may be disposed around the staple cavity 3050. The staple cavities 3050 can be disposed in a longitudinal row, and the protrusions 3051 can be positioned midway between the staple cavities 3050 in the longitudinal row of the staple cavities 3050. Protrusions 3051 may be positioned in the middle of staple cavity 3050 adjacent to a longitudinal row of staple cavities 3050. The protrusion 3051 may be positioned intermediate the innermost row of staple cavities 3050 and the longitudinal channel 3015. The protrusion 3051 may be positioned intermediate the outermost row of staple cavities 3050 and the lateral edge 3012. The protrusion 3051 may be positioned distally with respect to the most distal staple cavity 3050. Protrusion 3051 may be positioned proximal to proximal-most staple cavity 3050. The protrusion 3051 may be positioned distal to the distal end of the longitudinal slot 3015. In other examples, the protrusion 3051 may not be located distal to the distal end of the longitudinal slot 3015.

  Staple cartridge 3100 is illustrated in FIGS. The staple cartridge 3100 may include a cartridge body 3110. The cartridge body 3110 can include a distal end 3113, a proximal end, and opposing lateral sides 3112. As before, each lateral side 3112 may have a continuous edge with no notch defined therein. The cartridge body 3110 may further include, for example, a deck 3111, a plurality of staple cavities 3150 defined in the deck 3111, and a longitudinal slot 3115 configured to receive a knife edge of the firing member. The cartridge body 3110 can further include a protrusion 3151 extending from the deck 3111. In various examples, the protrusions 3151 can comprise a pattern. In at least one example, each protrusion 3151 may comprise a dome configuration. The dome configuration may include, for example, a hemispherical protrusion. In some examples, the dome may end with a flat surface. As shown in FIG. 61, an array of protrusions 3151 may extend across deck 3111 between longitudinal slots 3115 and lateral sides 3112. Protrusions 3151 may be located around staple cavity 3150. The staple cavities 3150 can be arranged in a longitudinal row, and the protrusions 3151 can be positioned in the longitudinal row of the staple cavities 3150 in the middle of the staple cavities 3150. Protrusions 3151 may be positioned in the middle of staple cavity 3150 adjacent to a longitudinal row of staple cavities 3150. The protrusion 3151 may be positioned intermediate the innermost row of staple cavities 3150 and the longitudinal channel 3115. The protrusion 3151 may be positioned intermediate the outermost row of staple cavities 3150 and the lateral edge 3112. Protrusion 3151 may be positioned distal to distal-most staple cavity 3150. Protrusion 3151 may be positioned proximal to proximal-most staple cavity 3150. The protrusion 3151 may be positioned distal to the distal end of the longitudinal slot 3115. In other examples, the protrusion 3151 may not be located distal to the distal end of the longitudinal slot 3115.

  The staple cartridge 3200 is shown in FIG. The staple cartridge 3200 can include a cartridge body 3210. The cartridge body 3210 can include a distal end 3213, a proximal end, and opposing lateral sides 3212. As before, each lateral side 3212 may have a continuous edge with no notch defined therein. The cartridge body 3210 may further include, for example, a deck 3211, a plurality of staple cavities 3250 defined in the deck 3211, and a longitudinal slot 3215 configured to receive a knife edge of the firing member. The cartridge body 3210 may further include a protrusion 3251 extending from the deck 3211. Like the protrusion 2051, the protrusion 3251 may be configured to engage tissue positioned intermediate the anvil and the cartridge 3200 and control movement of the tissue relative to the cartridge 3200. In various examples, the protrusions 3251 can be configured to restrict or prevent tissue flow to the staple cartridge. Protrusions 3251 may be located at the proximal and / or distal ends of staple cavity 3250. In various examples, each protrusion 3251 can include a cuff extending around the end of staple cavity 3250. In certain examples, each protrusion 3251 may include an arcuate ridge extending around the end of staple cavity 3250. In various examples, each protrusion 3251 can include one or more protrusions 3254 defined over the protrusion. The protrusions 3254 can provide a textured surface, which can improve the gripping and holding forces that the protrusions 3251 can apply to tissue positioned intermediate the anvil and the staple cartridge 3200. In various examples, such protrusions 3254 may include, for example, blobs. In certain examples, each protrusion 3254 may include a dome. In at least one example, for example, the protrusion 3254 may be comprised of an elastomeric material such as rubber, thermoplastic elastomer, and / or Santoprene, molded on the protrusion 3251, which may be comprised of, for example, a plastic material. In various examples, protrusion 3254 may be comprised of a flexible material and may not damage tissue compressed by protrusion 3254. The cartridge body 3210 may further include a protrusion 3253. Like protrusion 2053, protrusion 3253 may be located at the distal end of distal-most staple cavity 3250. Each protrusion 3253 may include, for example, a distal sloped surface configured to facilitate insertion of tissue between the staple cartridge 3200 and the anvil. In various examples, the distal-most cavities 3250 can each include a protrusion 3253 located at its distal end and a protrusion 3251 located at its proximal end. Also, as before, each protrusion 3251 and / or protrusion 3253 may be configured to support at least a portion of a staple removably stored within staple cavity 3250.

  A staple 2130 is illustrated in FIG. 24, which includes a base 2131, a first staple leg 2132a extending from a first end of the base 2131, and a second staple extending from a second end of the base 2131. A staple leg 2132b is provided. The distance between the first end of the base 2131 and the second end of the base 2131 is called the crown distance and is indicated by the dimension E. First staple leg 2132a includes a first portion 2133a extending from base 2131 and a second portion 2134a extending from first portion 2133a. First portion 2133a may extend from base 2131 at a first angle. This first angle is indicated by the angle F, which is measured from the vertical. Second portion 2134a may extend at a second angle from first portion 2133a. This second angle is indicated by the angle K, which is also measured from the vertical. The reader is aware that the first portion 2133a and the second portion 2134a are not collinear, but rather the first portion 2133a extends along a first axis 2137a and the second portion 2134a is It will be appreciated that it extends along a second axis 2138a different from 2137a. Joint 2135a interconnects first portion 2133a and second portion 2134a and is located a distance D measured from support surface 2139 defined at the bottom of base 2131. The second portion 2134a includes a leg tip 2136a located at a distance C measured from the base support surface 2139. First portion 2133a may include a first cantilever extending from base 2131, and second portion 2134a may include a second cantilever extending from first portion 2133a. Distance D may define a first cantilever distance, and the difference between distance C and distance D may define a second cantilever distance.

  The second staple leg 2132b includes a first portion 2133b extending from the base 2131 and a second portion 2134b extending from the first portion 2133b. First portion 2133b may extend from base 2131 at a first angle. This first angle is indicated by angle G, which is measured from the vertical. Angle G may or may not be the same as angle F, as described above. When the second staple leg 2132b is positioned distally with respect to the first staple leg 2132a, for example, in at least one example, the angle G may be less than the angle F. Alternatively, when the first staple leg 2132a is positioned distal to the second staple leg 2132b, for example, the angle F may be less than the angle G in at least one example. Second portion 2134b may extend at a second angle from first portion 2133b. This second angle is indicated by the angle H, which is also measured from the vertical. Angle H may or may not be the same as angle K, as described above. When the second staple leg 2132b is positioned distal to the first staple leg 2132a, for example, the angle H may be less than the angle K in at least one example. Alternatively, when the first staple leg 2132a is positioned distal to the second staple leg 2132b, for example, the angle K may be less than the angle H in at least one example. The reader will notice that the first portion 2133b and the second portion 2134b are not collinear, but rather the first portion 2133b extends along the first axis 2137b and the second portion 2134b is It will be appreciated that it extends along a second axis 2138b different from 2137b. Joint 2135b interconnects first portion 2133b and second portion 2134b and is located a distance B measured from support surface 2139 defined at the bottom of base 2131. Distance B may or may not be the same as distance D, as described above. The second portion 2134b includes a leg tip 2136b located at a distance A measured from the base support surface 2139. As described above, the distance A may or may not be the same as the distance C. First portion 2133b may include a first cantilever extending from base 2131, and second portion 2134b may include a second cantilever extending from first portion 2133b. Distance B may define a first cantilever distance, and the difference between distance A and distance B may define a second cantilever distance. The distance between the first tip 2136a of the first staple leg 2132a and the second tip 2136b of the second staple leg 2312 defines the distance of spread between the staple legs 2132a, 2132b, and by the distance J Is shown. The distance J may or may not be greater than the crown distance E, as described above.

  FIG. 25 shows staples 2130 defined in a cartridge 2110 and positioned within a staple cavity 2150 supported by a staple driver 2040. The reader will understand that the legs 2132a and 2132b of the staple 2130 are biased inward or bent by the end wall of the staple cavity 2150. As a result, the distances A, B, C, D, E, and J change and are represented by A ', B', C ', D', E ', and J', respectively. The staples 2130 can be comprised of an elastic material such as, for example, stainless steel and / or titanium, and changes to these distances are reversed or at least partially reversed when the staples 2130 are ejected from the staple cavities 2150. obtain. Similarly, the angles F, G, H, and K may have changed as a result of positioning the staples 2130 in the staple cavities 2150, which may be changed to angles F ', G', H ', and K', respectively. Represented by As described above, the staples 2130 can be constructed from a resilient material, and changes to these angles can be reversed, or at least partially reversed, as the staples 2130 are ejected from the staple cavities 2150. FIG. 25 illustrates the staple 2130 and driver 2040 in the unfired position. In this unfired position, the tip 2136a of the first staple leg 2132a may extend above the deck surface 2111 of the cartridge 2110 and is positioned within a protrusion 2150a extending from the deck surface 2111, thereby. The tip 2136b of the second staple leg 2132b, which may be protected and also may extend above the deck surface 2111 and is located within a protrusion 2150b extending from the deck surface 2111, May be protected by

  Staple 2230 is illustrated in FIG. The staple 2230 may include a base 2231, a first leg 2232a extending from the base 2231, and a second leg 2232b extending from the base 2231. First leg 2232a may include a first portion 2233a that connects to base 2231 and a second portion 2234a that extends from first portion 2233a. Second leg 2232b may include a first portion 2233b that connects to base 2231 and a second portion 2234b that extends from first portion 2233b. Base 2231, first portion 2233a, and first portion 2233b can have a generally V-shaped configuration. In various examples, the second portion 2234a can extend inward from the first portion 2233a at the joint 2235a, and likewise, the second portion 2234b can extend the first portion 2233b at the joint 2235b. May extend inwardly from. The base 2231, the first leg 2232a, and the second leg 2232b may be configured and arranged such that the staple 2230 is symmetric in its unformed or unfired configuration illustrated in FIG. In various examples, first leg 2232a can be positioned distal to second leg 2232b. Alternatively, first leg 2232a may be positioned proximal to second leg 2232b.

  Staple 2330 is illustrated in FIG. The staple 2330 can include a base 2331, a first leg 2332a extending from the base 2331, and a second leg 2332b extending from the base 2331. First leg 2332a may include a straight portion 2333a that connects to a base 2331 that extends along an axis. Second leg 2332b may include a first portion 2333b that connects to base 2331, and a second portion 2334b that extends from first portion 2333b. The base 2331, the straight portion 2333a, and the first portion 2333b may have a generally V-shaped configuration. In various examples, the second portion 2334b can extend inward from the first portion 2333b at the joint 2335b. Base 2331, first leg 2332a, and second leg 2332b may be configured and arranged such that staple 2330 is asymmetric in its unformed or unfired configuration illustrated in FIG. In various examples, first leg 2332a can be positioned distal to second leg 2332b. Alternatively, first leg 2332a may be positioned proximal to first leg 2332b.

  Staple 2430 is illustrated in FIG. The staple 2430 may include a base 2431, a first leg 2432a extending from the base 2431, and a second leg 2432b extending from the base 2431. First leg 2432a may include a first portion 2433a connecting to base 2431 and a second portion 2434a extending from first portion 2433a. The second leg 2432b may include a first portion 2433b that connects to the base 2431 and a second portion 2434b that extends from the first portion 2433b. Base 2431, first portion 2433a, and first portion 2433b can include a generally V-shaped configuration. In various examples, the second portion 2434a can extend inward from the first portion 2433a at a first angle at the joint 2435a, and similarly, the second portion 2434b can be extended at the joint 2435b. A second angle may extend inward from the first portion 2433b. The first angle and the second angle can be different. Base 2431, first leg 2432a, and second leg 2432b may be configured and arranged such that staple 2430 is asymmetric in its unformed or unfired configuration illustrated in FIG. In various examples, first leg 2432a can be positioned distal to second leg 2432b. Alternatively, first leg 2432a may be positioned proximal to second leg 2432b.

  Staple 2530 is illustrated in FIG. The staple 2530 can include a base 2531, a first leg 2532a extending from the base 2531, and a second leg 2532b extending from the base 2531. First leg 2532a can include a first portion 2533a that connects to base 2531 and a second portion 2534a that extends from first portion 2533a. The second leg 2532b may include a first portion 2533b connecting to the base 2531 and a second portion 2534b extending from the first portion 2533b. Base 2531, first portion 2533a, and first portion 2533b can have a generally V-shaped configuration. In various examples, the second portion 2534a can extend inward from the first portion 2533a at a first angle at the joint 2535a, and likewise, the second portion 2534b can be extended at the joint 2535b. A second angle may extend inward from the first portion 2533b. The first angle and the second angle can be different. Base 2531, first leg 2532a, and second leg 2532b may be configured and arranged such that staple 2530 is asymmetric in its unformed or unfired configuration illustrated in FIG. The staple 2530 can be similar in many respects to the staple 2430 and can include a base 2531 that is wider than, for example, the base 2431 in at least one example. In certain examples, a wider staple base may be contained within a given staple cavity as staple legs 2532a and / or staple legs 2532b extend in a direction that is closer to the vertical. In various examples, first leg 2532a may be positioned distally with respect to second leg 2532b. Alternatively, first leg 2532a may be positioned proximal to second leg 2532b.

  As discussed above, tissue captured between the anvil of the surgical end effector and the staple cartridge may move or flow relative to the end effector during use. Also as discussed above, this movement or flow is generally distant when the firing member of the end effector moves distally to fire staples removably stored within the staple cartridge and cut tissue. Position. If the firing member moves proximally, the movement or flow of tissue may be generally proximal. Nevertheless, distal flow of tissue may cause the staples to transition distally during the firing process. This phenomenon is shown in FIG. FIG. 30 illustrates staples 2630 ejected from staple cavities 2650 defined within cartridge body 2610. The staple 2630 is shown in an at least partially fired position, where the base 2631 of the staple 2630 has been moved upward toward the anvil 20 by a staple driver 2640 and the legs 2632a, 2632b of the staple 2630 are , Emerge from staple cavity 2650 and are in contact with anvil 20. As the reader will appreciate, staple cavity 2650 is a first protrusion configured to support first staple leg 2632a as staple 2630 is ejected from staple cavity 2650 by driver 2640. 2651a and a first end wall 2652a, as well as a second protrusion 2651b and a second side wall 2652b configured to support a second staple leg 2632b. However, as shown in FIG. 30, the staples 2630 can transition distally during the firing process, causing the staple legs 2632a to transition away from the first end wall 2652a and the staple legs 2632b to move to the second protrusions. The transition is made on the portion 2651b. The staple 2630 has transitioned distally, but the first leg 2632a is still received in the first forming cup 22a of the staple pocket formed in the anvil 20, and the second leg 2632b is still The pocket is received in the second forming cup 22b. The staple legs 2632a, 2632b may contact their corresponding forming cups 22a, 22b, but the distal transition of the staples 2630 can, for example, symmetrically form staples, as shown in FIG. May not bring. FIG. 31 illustrates the staple 2630 lifted by the staple driver 2640 above the cartridge deck surface 2611 of the cartridge body 2610 and transformed to its fully fired configuration.

  As discussed above, symmetrical staples may deform asymmetrically as a result of transition by tissue trapped within the end effector. In various examples, the staple cartridge may utilize asymmetric staples, such as the asymmetric staples illustrated in FIGS. 24 and 27-29, which may correct for this transition. The staple legs of these asymmetric staples can be configured in such a way that as the asymmetric staples transition distally, they can transition to an orientation that can deform them into a symmetric, or at least a more symmetric, firing configuration. FIG. 84 illustrates a staple cartridge 4800 that includes a plurality of staple cavities 4850 defined therein, an asymmetric staple positioned within staple cavity 4850, and a plurality of staples configured to eject staples from staple cavity 4850. A cartridge main body 4810 including a driver 4840 is provided. The cartridge body 4810 can include a distal end 4813 and a proximal end 4816, where the staple cavities 4850 can be disposed in a longitudinal row defined in the cartridge body 4810. Cartridge body 4810 is sectioned in a manner such as to show one such longitudinal row of staple cavities 4850 in FIG. In some examples, staples removably stored within a longitudinal row of staple cavities 4850 may have the same asymmetric configuration, but in other examples, as illustrated in FIG. The staples may have different asymmetric configurations. For example, staples 4830 'are stored in the proximal end of the longitudinal row, while staples 4830 "are stored in the distal end of the longitudinal row. As before, each staple 4830 'may include a first staple leg 4832a' and a second staple leg 4832b ', wherein one or both of the staple legs is, for example, a second staple leg 4832b'. Segment 4833b 'and 4834b'. Also, as above, each staple 4830 '' may include a first staple leg 4832a '' and a second staple leg 4832b '', wherein one or both of the staple legs is, for example, a first staple leg 4832b ''. It may include several segments, such as segments 4833a "and 4834a" of staple legs 4832a ", and segments 4833b" and 4834b "of second staple legs 4832b '. Comparing staple 4830 'and staple 4830 ", the reader may find that the angle between segments 4833b" and 4834b "of staple 4830" is greater than the angle between segments 4833b' and 4834b 'of staple 4830'. Will also be noticeable or large. In other words, the distal staples 4830 "can be more asymmetric than the proximal staples 4830 '. In some examples, the movement of the tissue at the distal end 4813 of the staple cartridge 4800 may be greater than the movement of the tissue at the proximal end 4816, and correspondingly, the transition of the staple orientation may change the staple cartridge 4800. It may be larger at the distal end 4813 than at the proximal end 4816. The greater asymmetry of the distal staple 4830 "may compensate for the greater staple transition when compared to the less asymmetry of the proximal staple 4830 'that undergoes a smaller staple transition. This is by way of example only, and various combinations of any suitable staples may be utilized in a staple row to compensate for different staple transitions. For example, it is contemplated that staples located at the proximal end of the longitudinal row may have greater asymmetry than staples located at the distal end of the longitudinal row. It is also contemplated that the longitudinal rows may utilize more than two groups of asymmetric staples.

  As described above, the movement or flow of tissue at the distal end of the end effector may be greater than the movement or flow of tissue at the proximal end of the end effector in various examples. Such an example may occur as a result of distal movement of the firing member within the end effector. Although the firing member is configured to staple and dissect tissue gradually as it moves distally, the firing member can also advance or push tissue distally. This pushing or advancing effect may begin at the proximal end of the end effector and the firing member is moved distally such that a maximum pushing or advancing effect is achieved at the distal end of the end effector. You may increase the degree as you do. Thus, in addition to the above, the staple asymmetry gradient may be utilized within the longitudinal staple rows to compensate for tissue movement and staple transition gradients.

  Additionally or alternatively, the staple cartridge may utilize protrusions having different heights to control the movement of tissue within the end effector. In various examples, the protrusions disclosed herein extending from the staple cartridge deck may reduce the gap between the staple cartridge and the anvil of the end effector. As a result, the protrusion may exert greater local pressure on the tissue located between the anvil and the staple cartridge when compared to an embodiment without the protrusion. In various examples, protrusions having a higher height may apply greater compressive force or pressure to the tissue, while protrusions having a lower height may exert a relatively smaller compressive force or pressure on the tissue. Can be added to Along this line, higher protrusions may provide better control over tissue movement than lower protrusions. As the reader will recall, the movement of the tissue at the proximal end of the end effector is less than the movement of the tissue at the distal end of the end effector, so that again with reference to FIG. A lower protrusion 4851 'at the proximal end 4816 of the cartridge body 4810 and a higher protrusion 4851' 'at the distal end 4813 may be utilized. In at least one example, the lower protrusion 4851 'may extend at a distance 4855' from the deck surface 4811 of the cartridge body 4810, and the higher protrusion 4851 "may be at a distance 4855 'from the lower protrusion 4851'. 'Can extend. In certain examples, the protrusion extending from the cartridge body may include a height ramp extending between the proximal and distal ends of the cartridge body. In at least one example, as discussed above, the sloped protrusion may be highest at the distal end of the cartridge body, while the sloped protrusion is lowest at the proximal end of the cartridge body. possible. In other situations, the sloped protrusion may be highest at the proximal end of the cartridge body, while the sloped protrusion may be lowest at the distal end of the cartridge body.

  As discussed above, movement of the tissue may cause the staples to transition as they are deployed from the staple cartridge. In various examples, higher protrusions may provide better control over such transitions than lower protrusions. More specifically, referring again to FIG. 84, the higher distal projections 4851 ″ extend the staple pocket 4850 than the lower proximal projections 4851 ′ so that the staples 4830 ′ can be proximally extended. The staple 4830 "may be controlled by the distal protrusion 4851" for a longer distance than is controlled by the protrusion 4851 '. The higher protrusion 4851 '' also causes the staple 4830 '' to emerge from the cavity 4850 as compared to the distance the staple 4830 'leg lifts up before emerging from the cavity 4850. The distance that can be lifted up before may be increased. Such an arrangement may, for example, reduce the distance and / or time that the staples 4830 "are exposed to greater tissue movement at the distal end of the staple cartridge 4800.

  As discussed above, a staple cartridge may utilize a configuration of more than one of the staples in a longitudinal staple row. In various examples, a staple cartridge may utilize staples having different configurations within different longitudinal staple rows. In at least one example, a staple cartridge may include staples having a first configuration in a first longitudinal staple row and a second configuration in a second longitudinal staple row. Referring now to FIGS. 49 and 49A, a staple cartridge 2700 can include, for example, a plurality of longitudinal rows of staple cavities 2750 defined in rows, wherein the staple cavities 2750 defined in the first row are , Each having a first staple 2730 ′ (FIG. 50) removably stored within the staple cavity 2750, wherein the staple cavities 2750 defined in the second row are removable within the staple cavity 2750. Staple cavities 2730 ″ (FIG. 51) stored in the staple cavities 2750, respectively, wherein the staple cavities 2750 defined in the third row are removably stored in the staple cavities 2750 2730 ″ ′ (FIG. 52). A first staple 2730 ′ may be located within the innermost longitudinal row of staple cavities 2750, a second staple 2730 ″ may be located within an intermediate row of staple cavities 2750, and a third staple 2730 ′ may be located within the middle row of staple cavities 2750. 2730 ″ ′ may be located within the outermost longitudinal row of staple cavities 2750. A first staple 2730 ′ having a first height A ′ (FIG. 50) and a second staple 2730 ″ having a second height A ″ (FIG. 51) are in their unfired configuration. At some point, the second staple 2730 ″ may be higher than the first staple 2730 ′. Similarly, when the second staple 2730 ″ and the third staple 2730 ′ ″ having the third height A ′ ″ (FIG. 52) are in their unfired configuration, the third staple 2730 ″ '' 'May be higher than the second staple 2730' '.

  In various examples, each of the longitudinal rows of staples may be supported by a longitudinal row of staple drivers. For example, a first longitudinal row of staple drivers may support a first row of first staples 2730 ′, and a second longitudinal row of staple drivers may support a second row of second staples 2730 ″. A second row may be supported, and a third longitudinal row of staple drivers may support a third row of third staples 2730 '' '. In one specific example, referring to FIGS. 49 and 49A, for example, a row of staple drivers 2742 supports a first row of first staples 2730 ′ and a second row of staples 2730 ″, Each staple driver 2742 may support and fire at least one first staple 2730 ′ and at least one second staple 2730 ″. The row of staple drivers 2740 supports a third row of third staples 2730 ′ ″ such that each staple driver 2740 supports and fires at least one third staple 2730 ″ ″. It may be possible to do so. The staple driver 2742 each includes a first cradle 2741 'configured to support a first staple 2730' and a second cradle 2741 'configured to support a second staple 2730' '. And, similarly, staple drivers 2740 may each include a third cradle 2741 '' 'configured to support a third staple 2730' ''. When the staple drivers 2740 and 2742 are in their unfired position, as shown in FIG. 49A, the first cradle 2741 ′ moves from the first row of forming pockets 23 defined in the anvil 20 to the first row. Second cradle 2741 ″ may be supported at a second distance 2732 ″ from a second row of forming pockets 23 defined in anvil 20. Cradle 2741 ′ ″ may be supported at a third distance 2732 ″ ″ from a third row of forming pockets 23 defined in anvil 20. The first distance may be different from the second distance, and / or the second distance may be different from the third distance. As shown in FIG. 49, the first distance is shorter than the second distance, and the second distance is shorter than the third distance. First staple 2730 ′, second staple 2730 ″, and / or third staple 2730 ′ ″ may be raised by driver 2740 and 2742 by firing member 2760 toward anvil 20, for example, staple 2730 ′, As 2730 ″ and 2730 ″ ′ are ejected from staple cavity 2750, they may deform to different formed heights. For example, the innermost row of staples or staples 2730 ′ can be formed at a first formed height, the intermediate row of staples or staples 2730 ″ can be formed at a second formed height, Staples, ie, an outer row of staples 2730 ′ ″, may be formed at a third formed height. The first height may be lower than the second height, and the second height may be lower than the third height. U.S. Patent No. 8,317,070, issued November 27, 2012, entitled "SURGICAL STAPLING DEVICES THAT PRODUCED FORMED STAPLES HAVING DIFFERENT LENGTHS," is hereby incorporated by reference in its entirety.

  In various examples, the cartridge deck of the staple cartridge can be flat. In such an example, the protrusions described herein may extend from a flat deck surface. In other examples, the cartridge deck of the staple cartridge may include a stepped surface that includes, for example, at least two stepped surfaces. Referring again to FIGS. 49 and 49A, the cartridge body 2710 of the staple cartridge 2700 includes a first deck side positioned on a first side of the longitudinal knife channel 2715 and a second side of the longitudinal knife channel 2715. A second deck side positioned may be included. Each deck side includes, for example, a first stair 2711 ′, a second stair 2711 ″, and a third stair 2711 ″ ″. A first longitudinal row of staple cavities 2750 may be defined in a first stair 2711 ′, and a second longitudinal row of staple cavities 2750 may be defined in a second stair 2711 ″. A third longitudinal row of cavities 2750 may be defined in a third step 2711 ′ ″. When the anvil 20 is in its closed position, tissue in contact with the surface 21 of the anvil 20 may be positioned adjacent the deck surface of the cartridge body 2710. In such a situation, the tissue contacting surface 21 is spaced a first distance 2712 'from the first step 2711', a second distance 2712 "from the second step 2711", and a third step 2711 '. A third distance 2712 '' 'from' '' may be located. In various examples, the first distance, the second distance, and / or the third distance can be different. As shown in FIGS. 49 and 49A, the first distance 2712 'is shorter than the second distance 2712 ", and the second distance 2712" is shorter than the third distance 2712 "". In various examples, the first distance 2712 ′ may define a first tissue gap between the first step 2711 ′ and the anvil 20, and the second distance 2712 ″ may be the second step 2712 ″. A second tissue gap between 2711 ″ and the anvil 20 may be defined, the third distance 2712 ′ ″ being the third tissue between the third step 2711 ′ ″ and the anvil 20. May be defined. The gap of the first tissue located on the innermost row of staple cavities 2750 may be smaller than the gap of the third tissue located on the outermost row of staple cavities 2750. The gap in the second tissue located on the middle row of staple cavities 2750 may be larger than the gap in the first tissue and smaller than the gap in the third tissue.

  In addition to the above and referring again to FIGS. 49 and 49A, a first longitudinal row 2751 'of protrusions may extend from a first step 2711' and a second longitudinal row of protrusions. 2751 "may extend from second step 2711", and third longitudinal row 2751 "" of protrusions may extend from third step 2711 "". The first protrusion 2751 'may be defined by a first height 2755', the second protrusion 2751 "may be defined by a second height 2755", and the third protrusion 2751 ". 'May be defined by a third height 2755' ''. The first height, the second height, and / or the third height can be different. As illustrated in FIGS. 49 and 49A, the first height 2755 'may be lower than the second height 2755 ", and the second height 2755" may be lower than the third height 2755' ". It may be lower. In various examples, the lowest longitudinal row of protrusions, or protrusions 2751 ', can extend along the innermost row of staple cavities 2750, and the highest of protrusions, or protrusions 2751' '' The longitudinal rows may extend along the outermost row of staple cavities 2750, and the protrusions having an intermediate height, i.e., protrusions 2751 '', extend along the middle row of staple cavities 2750. obtain. FIG. 76 illustrates an alternative embodiment in which the highest longitudinal row of protrusions, or protrusions 2751 ′ ″, extends along the innermost row of staple cavities 2750, That is, the lowest longitudinal row of protrusions 2751 'extends along the outermost row of staple cavities 2750, and the protrusions having intermediate heights, or protrusions 2751' ', It may extend along the middle row.

  Referring again to FIG. 76, staple cartridge 4000 may be similar in many respects to staple cartridge 2700 discussed above. Similar to staple cartridge 2700, staple cartridge 4000 includes a first row of staple cavities 2750 including a first staple 2730 'removably stored therein, and a second staple removably stored therein. The length of staple cavity 2750 comprising a second row of staple cavities 2750 including 2730 ″ and a third row of staple cavities 2750 including third staples 2730 ′ ″ removably stored therein. It may include a row of directions. In contrast to staple cartridge 2700, the first row of staples 2730 'comprises the outermost row of staples and the third row of staples 2730' '' comprises the innermost row of staples. The staple cartridge 4000 can include drivers 4040 and 4042 that move the third staple 2730 ′ ″ to the third forming distance 2732 from the anvil 20 when the drivers 4040 and 4042 are in the unfired or raised position. To support the second staple 2730 '' at a second formation distance 2732 '' from the anvil 20 and to support the first staple 2730 'at a first formation distance 2732' from the anvil. Is configured. Drivers 4040 and 4042 provide the staples or staples 2730 ′ ″ at the third formed height, the staples or intermediate rows of staples 2730 ″ at the second formed height, staples, That is, the outermost row of staples 2730 'can be deformed to the first formed height. For example, the third formed height may be higher than the second formed height, and the second formed height may be higher than the first formed height. As with staple cartridge 2700, staple cartridge 4000 may include a stepped deck surface. However, the third step 2711 ″ may extend along the innermost row of staple cavities 2750, and the first step 2711 ′ may extend along the outermost row of staple cavities 2750. The first tissue void defined by the first void distance 2712 ′ may be positioned laterally outwardly with respect to the second tissue void defined by the second void distance 2712 ″, This second tissue void may be positioned laterally outwardly with respect to the third tissue void defined by the third void distance 2712 '' '.

  Staple cartridge 3600 is illustrated in FIGS. The staple cartridge 3600 can include a cartridge body 3610. The cartridge body 3610 can include a distal end 3613, a proximal end 3616, and opposing lateral sides 3612. The cartridge body 3610 may further include, for example, a deck 3611, a plurality of staple cavities 3650 defined in the deck 3611, and a longitudinal slot 3615 configured to receive a knife edge of the firing member. The cartridge body 3610 may further include protrusions 2051 and 2053 extending from the deck 3611. The cartridge body 3610 may further include a protrusion 3651 extending from the deck 3611. Like the protrusion 2051, the protrusion 3651 can be configured to engage tissue positioned intermediate the anvil and the cartridge 3600 and control movement of the tissue relative to the cartridge 3600. In various examples, the protrusion 3651 can be configured to limit or prevent tissue flow to the staple cartridge. The protrusion 3651 may be located at the proximal and / or distal end of the staple cavity 3650. In various examples, each protrusion 3651 can include a cuff extending around the end of staple cavity 3650. In certain examples, each protrusion 3651 may include an arcuate ridge extending around the end of staple cavity 3650. In various examples, protrusion 3651 may not be as tall as protrusion 2051 and / or protrusion 2053. The higher protrusion 2051 may apply greater local pressure to the tissue than the lower protrusion 3651. In various examples, the protrusions 2051 can provide sufficient control over the tissue to hold the tissue in place during the firing process. In such an example, the protrusion 3651 may provide some additional control over the tissue in addition to protecting and guiding the staples located within the staple cavity 3650.

  In addition to the above, the deck 3611 may include steps 2711 ′, 2711 ″, and 2711 ″ ″ configured to compress tissue positioned intermediate the cartridge body 3610 and the anvil. In various examples, the third step 2711 ″ ″ can include a lowermost deck surface that extends around the distal end 3613 of the cartridge body 2610 along the outermost row of staple cavities 3650. The second stair 2711 "may extend upward from the lowermost deck surface 2711" "and the first stair 2711" may extend upward from the second stair 2711 ". As the cartridge body 3610 slides against tissue, tissue may flow over the distal end 3613 of the cartridge body 3610 onto steps 2711 ', 2711 ", and 2711" ". The cartridge body 3610 may further include ramps 3614 ′ and 3614 ″, which are configured to assist tissue to slide over steps 2711 ′ and 2711 ″, respectively. As discussed in, stairs 2711 ′, 2711 ″, and 2711 ′ ″ may be utilized to control tissue flow to staple cartridge 3600. Referring primarily to FIG. 71, the stairs 2711 'may, in various examples, include a tissue defined between the stairs 2711' 'and the anvil, between the cartridge 3600 and the anvil opposite the cartridge 3600. A void and / or a smaller tissue void may be defined as compared to the tissue void defined between the step 2711 '' 'and the anvil. In the example where step 2711 'and the smallest tissue gap are adjacent longitudinal slot 3615, the tissue adjacent longitudinal slot 3615 is more compressed and stronger than tissue positioned transverse to step 2711'. Get control. Such an embodiment may be advantageous for various reasons. For example, a cutting member passing through the longitudinal slot 3615 attempts to displace the captured tissue between the staple cartridge 3600 and the anvil, and as a result of the compression applied by the innermost stair 2711 ′, the dislocation of the tissue becomes It can be prevented, mitigated, or reduced.

  As discussed above in connection with the embodiment shown in FIG. 76, the staple cartridge includes a stepped deck surface where the smallest tissue void is coextensive with the outermost longitudinal row of staple cavities. obtain. In such an example, the smallest tissue gap may be adjacent to the lateral sides of the cartridge, and the compression applied by the outermost steps will prevent tissue displacement, especially lateral displacement of the tissue. It can be mitigated or reduced. In certain examples, referring again to FIGS. 70-72, lateral displacement of the captured tissue between the staple cartridge 3600 and the anvil may be prevented, mitigated, or reduced by the lateral sidewalls 3617. . Each of the lateral sidewalls 3617 may extend from a lateral side 3612 of the cartridge body 3610 and may prevent lateral movement of tissue. Sidewall 3617 can have any suitable configuration. In at least one example, each sidewall 3617 can include, for example, a corrugated top surface. Referring now to FIG. 73, a staple cartridge 3700 may include a cartridge body 3710 that includes a lateral sidewall 3717 extending from a lateral side 3712 of the cartridge body 3710. In at least one example, each of the lateral sidewalls 3717 can include, for example, a straight upper surface.

  Referring now to FIG. 74, a staple cartridge 3800 may include a cartridge body 3810 with a distal end 3813 and a staple cavity 3850. As before, the cartridge body 3810 can include a protrusion 2053 at the distal end of the distal-most staple cavity 3850. Similarly, as above, the cartridge body 3810 may include a protrusion 2051 that may surround at least a portion of the staple cavity 3850 at a proximal end and / or a distal end. In addition to or in place of the protrusions 2051 and 2053, the staple cartridge body 3810 may further include a protrusion 3851 extending from the staple cartridge body 3810. Each protrusion 3851 may extend around the end of more than one staple cavity 3850. In at least one example, each protrusion 3851 may include an end of staple cavity 3850 in the innermost row of staple cavities 3850, an end of staple cavity 3850 in the outermost row of staple cavities 3850, and / or a staple cavity. It may extend around the end of the staple cavity 3850 in the middle row. In at least one such example, a first portion of the protrusion 3851 may cause the first staple cavity 3850 to extend above the cartridge deck surface, and a second portion of the protrusion 3851 may include the second staple cavity. The 3850 can extend above the cartridge deck surface and the third portion of the protrusion 3851 can cause the third staple cavity 3850 to extend above the cartridge deck surface. A first portion of the protrusion 3851 may protect, guide, and / or hold the first staple, a second portion may protect, guide, and / or hold the second staple, The third portion may protect, guide, and / or retain the third staple. In various examples, the protrusion 3851 can extend between a longitudinal slot 3615 defined in the cartridge body 3810 and a lateral sidewall 3717 extending from the cartridge body 3810. In at least one such example, the protrusion 3851 may extend across the first stair 2711 ', the second stair 2711 ", and / or the third stair 2711". In other words, the protrusion 3851 can extend over a change in altitude in the deck of the cartridge body 3810. In some examples, the top or tissue engaging surface of the protrusion 3851 may be flat regardless of changes in the height of the cartridge deck surface. In other examples, the elevation of the top or tissue engaging surface of the protrusion 3851 may also vary. In at least one such example, for example, the elevation of the top surface of the protrusion 3851 may increase when the elevation of the deck surface increases and may decrease when the elevation of the deck surface decreases. In other examples, for example, the elevation of the upper surface of the protrusion 3851 may decrease when the elevation of the deck surface increases, and may increase when the elevation of the deck surface decreases.

  In various examples, referring again to FIG. 74, the cartridge body 3810 can include a transverse protrusion or rib 3817 extending from the cartridge body 3810. Transverse protrusions 3817 may extend laterally into longitudinal slots 3615 and / or transverse sidewalls 3717. In at least one example, the transverse protrusion 3817 may extend in a direction perpendicular to the longitudinal slots 3615 and / or the lateral sidewalls 3717. In at least one example, the transverse protrusion 3817 may extend between the protrusion 3851 and the sidewall 3717. The transverse protrusion 3817 may also extend between the protrusion 2051 and the side wall 3717, and similarly between the protrusion 2053 and the side wall 3717. In some examples, the protrusion 3817 and the side wall 3717 can be the same height. In other examples, protrusions 3817 and sidewalls 3717 can be at different heights. Referring to FIG. 74, the side wall 3717 is, for example, higher than the protrusion 3817. In any case, the transverse projection 3817 may be configured to limit or prevent tissue flow, for example, particularly to the staple cartridge 3800, in a distal or longitudinal direction.

  Referring now to FIG. 81, a staple cartridge 4500 includes a cartridge body comprising a deck 4511, a proximal end, a distal end 4513, and a longitudinal knife slot 3615 extending between the proximal and distal ends 4513. 4510. The cartridge body 4510 can include, among other features, a gradient transition 2014, protrusions 2051, 2053, and 3651 that at least partially surround the staple cavity 3650, and lateral sidewalls 3617. Indeed, various embodiments are envisioned, in which the tissue control features of the various embodiments disclosed herein are replaced by the tissue control features of the other embodiments disclosed herein. Can be combined with Further, various embodiments are disclosed herein, in which all of the staple cavities defined in the staple cartridge may include protrusions that at least partially surround the staple cavities. Other embodiments are envisioned, wherein less than all of the staple cavities include a protrusion that at least partially surrounds the staple cavities. Referring now to FIG. 82, a staple cartridge 4600 includes a deck 4611, a proximal end 4616, a distal end 4613, and a longitudinal knife slot 4615 extending between the proximal end 4616 and the distal end 4613. A cartridge body 4610 may be included. The cartridge body 4610 may include protrusions 2051 and 2053 extending from the deck 4611 and at least partially surrounding a portion of the staple cavity 4650. For example, the proximal and / or distal ends of the staple cavity 4650 defined in the distal end 4613 of the staple cartridge 4600 can be at least partially surrounded by the protrusion 2051 and likewise the staple cartridge 4600 The proximal and / or distal ends of the staple cavity 4650 defined in the proximal end 4616 may be at least partially surrounded by the protrusion 2051. In such an embodiment, for example, the staple cavity 4650 defined in the middle of the cartridge body 4610, i.e., between the proximal end 4616 and the distal end 4613 of the staple cartridge, may include the protrusion 2051 and / or any other protrusion. It may not be surrounded by any part. Referring now to FIG. 83, a staple cartridge 4700 can include a cartridge body 4710 with a deck 4711, a proximal end, and a distal end 4713. Cartridge body 4710 may include a plurality of staple cavities 4750 defined therein. The distal-most staple cavity 4750 may have a distal end surrounded by a protrusion 2053 and a proximal end surrounded by a protrusion 2051. Other staple cavities 4750 may have a distal end surrounded by a protrusion and a proximal end not surrounded by a protrusion. Certain staple cavities 4750 may have a proximal end surrounded by the protrusion 2051 and a distal end not surrounded by the protrusion.

  As discussed above, the protrusions extending from the deck surface may be configured to protect, support, and / or guide staples located within the staple pocket. FIG. 77 shows a staple cartridge 4100 including a cartridge body 4110 including a deck 4111, a staple cavity 4150 defined in the deck 4111, and a protrusion 4151 extending from the deck 4111. The staple cartridge 4100 may further include a staple 4130 removably positioned within the staple cavity 4150. Protrusion 4151 may include a slot 4154 defined therein, when staple 4130 is stored within staple cavity 4150 and / or staple 4130 has been ejected from staple cavity 4150. Sometimes, it can be configured to support the legs 4132 of the staples 4130. Slot 4154 may comprise an extension of staple cavity end wall 4152. The staple cavity end walls 4152 and / or the slots 4154 may cooperate to support the staple legs 4132 when the staple 4130 is in the unfired position. As shown in FIG. 77, legs 4132 may emerge from protrusions 4151 as staples 4130 are ejected from cavity 4150. In such a situation, end walls 4152 and / or slots 4154 may support portions of staple 4130 that have not yet emerged from staple cavity 4150. In certain examples, protrusions 4151 may not provide lateral support to staple legs 4132. More specifically, with reference to FIG. 77, the slot 4154 can include opposing lateral sides 4155 that can be spaced from, rather than contact, the sides of the staple legs 4132. In various examples, staple 4130 may be deformed to its fully deformed configuration while staple 4130 is still at least partially positioned within staple cavity 4150. In at least one such example, end wall 4152 and / or slot 4154 may support staple 4130 throughout the entire staple 4130 forming process. In another example, staple 4130 may reach its fully deformed configuration after being lifted from slot 4154 onto projection 4151. In such a situation, end wall 4152 and slot 4154 may not support staple 4130 during its entire forming process.

  FIG. 78 shows a staple cartridge 4200 including a cartridge body 4210 including a deck 4211, a staple cavity 4250 defined in the deck 4211, and a protrusion 4251 extending from the deck 4211. The staple cartridge 4200 may further include a staple 4130 removably positioned within the staple cavity 4250. Projection 4251 may include a slot 4254 defined in projection 4251, when staple 4130 is stored within staple cavity 4250 and / or staple 4130 has been ejected from staple cavity 4250. Sometimes, it can be configured to support the legs 4132 of the staples 4130. Slot 4254 may comprise an extension of staple cavity end wall 4252. The staple cavity end walls 4252 and / or slots 4254 may cooperate to support the staple legs 4132 when the staple 4130 is in the unfired position. As shown in FIG. 78, legs 4132 may emerge from protrusions 4251 as staples 4130 are ejected from cavity 4250. In such a situation, end wall 4252 and / or slot 4254 may support a portion of staple 4130 that has not yet emerged from staple cavity 4250. In certain examples, protrusion 4251 may provide lateral support for staple legs 4132. More specifically, referring to FIG. 78, the slot 4254 may have opposing lateral sides 4255 that may contact the sides of the staple legs 4132. In various examples, staple 4130 may be deformed to its fully deformed configuration while staple 4130 is still at least partially positioned within staple cavity 4250. In at least one such example, end wall 4252 and / or slot 4254 may support staple 4130 throughout the entire staple 4130 forming process. In another example, staple 4130 may reach its fully deformed configuration after being lifted from slot 4254 onto protrusion 4251. In such a situation, end wall 4252 and slot 4254 may not support staple 4130 during its entire forming process.

  FIG. 79 shows a staple cartridge 4300 including a cartridge body 4310 including a deck 4311, a staple cavity 4350 defined in the deck 4311, and a protrusion 4351 extending from the deck 4311. The staple cartridge 4300 may further include a staple 4130 removably positioned within the staple cavity 4350. Each protrusion 4351 may include a tapered slot 4354 defined within each protrusion 4351, when staples 4130 are stored within staple cavity 4350 and / or when staples 4130 are removed from staple cavity 4350. When fired, it can be configured to support the legs 4132 of the staples 4130. Each slot 4354 may include an extension of staple cavity end wall 4352 and may include sidewall 4355. The sidewalls 4355 of each slot 4354 may cooperate to support the staple legs 4132 when the staple 4130 is in the unfired position. As the reader will understand from FIG. 79, the staple legs 4132 may not be supported by the end wall 4352. As staples 4130 are ejected from cavity 4350, legs 4132 may emerge from protrusions 4351. In such a situation, sidewalls 4355 of slot 4354 may support portions of staple 4130 that have not yet emerged from staple cavity 4350. In certain examples, sidewalls 4155 of protrusion 4351 may provide lateral support for staple legs 4132. In various examples, staple 4130 may be deformed to its fully deformed configuration while staple 4130 is still at least partially positioned within staple cavity 4350. In at least one such example, slot 4354 may support staple 4130 throughout the entire staple 4130 forming process. In other examples, staple 4130 may reach its fully deformed configuration after being lifted from slot 4354 onto protrusion 4351. In such a situation, slot 4354 may not support staple 4130 during its entire forming process.

  FIG. 80 shows a staple cartridge 4400 including a cartridge body 4410 including a deck 4411, a staple cavity 4450 defined in the deck 4411, and protrusions 4451a and 4451b extending from the deck 4411. The staple cartridge 4400 may further include, for example, a staple 4130 removably positioned within the staple cavity 4450. The staple cavity 4450 includes a first end wall 4452a configured to support and guide a first leg of the staple 4130, and a second end wall 4452a configured to support and guide a second leg of the staple 4130. An end wall 4452b may be provided. The protrusion 4451a may extend a first distance 4455a from the deck 4411, and the protrusion 4451b may extend over the protrusion 4451a at a second distance 4455b from the deck 4411. In various examples, the protrusion 4451a can then support and guide the first staple leg at a first distance, and the protrusion 4451b can support the second staple leg at a second distance. A guidance may be provided, where the second distance may be longer than the first distance. In certain examples, protrusion 4451b may be located at the distal end of staple cavity 4450, and protrusion 4451a may be located at the proximal end of staple cavity 4450. Such an embodiment may be advantageous when the staple 4130 is pushed distally by distal movement of the firing member and tissue knife, as discussed above. Alternatively, protrusion 4451b may be located at the proximal end of staple cavity 4450 and protrusion 4451a may be located at the distal end of staple cavity 4450. In any case, the protrusion 4451b may have, for example, a stepped configuration. In at least one example, protrusion 4451b can include, for example, a first portion defined by height 4455a and a second portion defined by height 4455b.

  85A-85C illustrate a staple cartridge 4900 comprising a cartridge body 4910 including a deck 4911. In various embodiments, the cartridge body 4910 can be constructed from a flexible material. In certain embodiments, the cartridge body 4910 can be comprised of a rigid and flexible material, and at least the deck 4911 can be comprised of a flexible material. The flexible material may include certain plastic materials, such as, for example, polypropylene, and / or elastomeric materials, such as, for example, rubber, thermoplastic elastomers, and / or Santoprene. In various examples, deck 4911 can be constructed from a flexible material. In any case, deck 4911 may include a protrusion 4951 extending from deck 4911. As before, as above, protrusions 4951 may protect, support, and / or guide staple 4130. Also, similar to the above, the protrusion 4951 can prevent or at least limit tissue movement relative to the staple cartridge 4900. When the anvil moves to the closed position opposite the staple cartridge 4900, or when the staple cartridge 4900 moves to the closed position with respect to the anvil, the protrusion 4951 causes the tissue positioned intermediate the anvil and the staple cartridge 4900 to move. Can be compressed. 85A-85C show a series of events in which the protrusion 4951 experiences an increasing compressive force. FIG. 85A shows the protrusion 4951 in an uncompressed configuration. In this configuration, a compression or interference fit may exist between the protrusion 4951 and the staple legs of the staple 4130. FIG. 85B shows the protrusion 4951 in a compressed configuration in response to the application of a compression force. 85A and 85B, it can be seen that the upper surface 4956 of the protrusion 4951 is pressed downward at a distance 4955 toward the deck 4911 and that the shape of the protrusion 4951 is distorted. In this configuration, the protrusions 4951 can grip the staple legs of the staple 4130 and / or hold the staple legs in place. FIG. 85C shows a greater compressive force being applied to the protrusion 4951. 85B and 85C, it can be seen that the upper surface 4956 of the protrusion 4951 is pushed further downward toward the deck 4911, and that the shape of the protrusion 4951 is further distorted. Further, in this configuration, the projections 4951 can increase the gripping force applied to the staple legs.

  85A and 85B illustrate a staple cartridge 5000 including a cartridge body 5010 including a deck 5011. FIG. The cartridge body 5010 is configured to protect, support, and / or guide a plurality of staple cavities 5050 defined within the cartridge body 5010 and a staple 5030 removably positioned within the staple cavity 5050. And a plurality of protrusions 5051 extending from the deck 5011. As before, staple cartridge 5000 may further include staple drivers 5040 and 5042, which are configured to support and lift staple 5030 between an unfired position and a fired position. 86A and 86B illustrate staple 5030 in a partially fired position, where the tip of staple 5030 partially emerges from protrusion 5051. FIG. As before, the cartridge body 5010 can be constructed from a flexible material. The flexible material may include certain plastic materials, such as, for example, polypropylene, and / or elastomeric materials, such as, for example, rubber, thermoplastic elastomers, and / or Santoprene. In various examples, the cartridge body 5010 can be constructed from a flexible material. When a compressive force is applied to the cartridge body 5010, the cartridge body 5010 may flex as illustrated in FIG. 86B. As shown in FIG. 86B, when the deck 5011 of the cartridge body 5010 bends downward, the protrusion 5051 can deflect downward at a distance 5055. In this way, the protrusion 5051 can be mobile.

  Various embodiments are envisioned, in which the protrusions extending from the staple cartridge deck can move relative to the deck. In at least one example, the protrusion may be a first position where the protrusion extends the staple cavity over the deck, and a protrusion may or may not extend the staple cavity over the deck. It may move between the second position or the lowered position. In various examples, one or more protrusions extending from the deck may be foldable. The collapsible protrusion has a first position where the protrusion extends the staple cavity above the deck and a second position where the protrusion may or may not extend the staple cavity above the deck. It can move between the folded position. In at least one example, the foldable protrusions may resiliently return to their unfolded configuration, but in certain instances, the protrusions may not completely fit into their unfolded configuration. It may not return. In various examples, one or more protrusions extending from the deck may be crushable. The collapsible protrusions have a first position where the protrusions extend the staple cavity over the deck and a second position where the protrusions may or may not extend the staple cavity over the deck. It can move between the collapsed position. Crushable projections may not return to their uncrushed configuration.

  As discussed above, the staples of the staple cartridge may be supported by a staple driver when the staple is removably stored within the staple cartridge. Also, as discussed above, the staple driver may be lifted upward by a firing member, such as, for example, firing member 2760. In various examples, referring now to FIGS. 53 and 54, the firing member is configured to advance a staple thread, such as, for example, staple thread 2870, distally to lift the staple driver and staples toward the anvil. obtain. The staple sled 2870 may include a body 2871 and a shoulder 2876 that may be configured to be engaged and support the firing member 2760. The sled 2870 may further include, for example, ramps or ramps 2872, 2873, 2874, and / or 2875, which slide under the staple driver and the sled 2870 slides under the staple driver. At times, lift the staple driver upward. In various examples, in addition to the above, for example, first ramp 2872 can be configured to contact and lift staple drivers within a first row of staple drivers, and second ramp 2873 , May be configured to contact and lift staple drivers in a second row of staple drivers, and a third ramp 2874 to contact and lift staple drivers in a third row of staple drivers. May be configured to contact and lift staple drivers within a fourth row of staple drivers.

  In various examples, in addition to the above, sled 2870 can be configured to lift a staple driver within four rows of staple drivers simultaneously. In some examples, the sled 2870 can synchronously lift the staple driver within four rows of staple drivers. In such an example, the distal ends of the four ramps 2872, 2873, 2874, and 2875 are contacted simultaneously with the four staple drivers so that the staple drivers reach the same height at the same time, causing them to travel in four parallel lifts. It can be configured to lift along a surface. Also, in such an example, the ramps 2872, 2873, 2874, and 2875 may all have the same length. In another example, the sled 2870 can lift the staple drivers alternately, but simultaneously, in each of the four rows of staple drivers. Referring primarily to FIG. 54, the distal end 2872a of the first ramp 2872 may be aligned with the distal end 2875a of the fourth ramp 2875. In various examples, the first ramp 2872 can be parallel to the fourth ramp 2875. Further, first ramp 2872 may define a length of the first ramp, which is the same as the length of the fourth ramp defined by fourth ramp 2875. The distal end 2873a of the second ramp 2873 is distal to the distal end 2872a of the first ramp 2872 and the distal end 2875a of the fourth ramp 2875 at a distance indicated by the distance 2879a. Can be positioned. The second ramp 2873 may not be parallel to the first ramp 2872 and / or the fourth ramp 2875. Further, the second ramp 2873 can define a length of the second ramp, which is longer than a length of the first ramp and / or a length of the fourth ramp. The distal end 2874a of the third ramp 2874 may be positioned distal to the distal end 2873a of the second ramp 2873 at a distance indicated by distance 2878a. Third ramp 2874 may not be parallel to first ramp 2872, second ramp 2873, and / or fourth ramp 2875. Further, third ramp 2874 can define a length of the third ramp, which may be the length of the first ramp, the length of the second ramp, and / or the fourth ramp. It is longer than the length of the slope.

  When the sled contacts the staple driver, in addition to the above, a reaction and / or rotational force may be created between the sled and the staple driver, which may cause the sled and / or the staple driver to generate a reaction and / or rotational force. May be rotated in response to the 53 and 54 may prevent or at least limit rotation of sled 2870 as sled 2870 contacts and lifts the staple driver. Further, sled 2870 can include a stabilizing member 2877 that extends distally to stabilize sled 2870 and prevent and / or prevent rocking or rotation of sled 2870. Stabilizing member 2877 may extend distally to distal ends 2872a, 2873a, 2874a, and 2875a of ramps 2872, 2873, 2874, and 2875, respectively.

  Referring now to FIGS. 54A-54D, the sled 2870 can remove staples from the staple cartridge 2000, for example, as the sled 2870 moves from the proximal end 2016 of the staple cartridge 2000 toward the distal end 2013 of the staple cartridge 2000. It can be configured to deploy. Staple cartridge 2000 and / or sled 2870 can include features that can releasably hold sled 2870 in proximal end 2016 of staple cartridge 2000. In various examples, the cartridge body 2010 of the staple cartridge 2000 is configured to engage the sled 2870 and releasably hold the sled 2870 in its proximal unfired position, as shown in FIG. 54A. A detent 2019 may be included. In at least one example, referring primarily to FIGS. 54B and 54C, each detent 2019 may include a rib or ridge extending inwardly into longitudinal slot 2015. The ridge may, for example, extend vertically into the longitudinal slot 2015. In addition to the above, the body 2871 of the sled 2870 can be positioned within the longitudinal slot 2015 and engage the detent 2019 when the sled 2870 is in its proximal unfired position, as shown in FIG. 54A. Can match. In various examples, detents 2019 can define a gap therebetween that is less than the width of body 2871. In such an example, an interference fit may be between the detent 2019 and the body 2871 of the sled 2870 such that the detent 2019 can grip and hold the sled 2870 in place. When the firing member pushes the sled 2870 distally, the body 2871 may be pushed out of engagement with the detent 2019 and the sled 2870 is advanced distally to fire staples stored in the staple cartridge 2000. I can do it. In various examples, referring now to FIG. 54D, the body 2871 of the sled 2870 can include a groove 2018 defined in the body 2871 that can be configured to releasably receive the detent 2019. Groove 2018 and detent 2019 may define a proximal unfired position of sled 2870 when aligned. Although there are two sets of grooves 2018 and detents 2019 in the illustrated embodiment, a single set may be utilized to releasably hold the sled 2870 in place. In other examples, more than one set of grooves 2018 and detents 2019 may be utilized. In some examples, detent 2019 may extend from body 2871 of sled 2870 and groove 2018 may be defined in cartridge body 2010.

  As discussed above, the cartridge body may include a tissue support deck and protrusions extending from the deck, which first control the flow of tissue to the cartridge body, and second, A staple cavity defined within the cartridge body may extend over the deck and / or thirdly, be configured to support, protect, and / or guide the staples within the staple cavity. In various examples, the cartridge body and the protrusion may be comprised of an integral piece of material. In at least one example, the protrusion may be formed integrally with the cartridge body. The cartridge body and the protrusions may be composed of a plastic material, for example, may be an integral part formed during the injection molding process. In one particular example, the protrusion can be assembled to the cartridge body. In at least one example, the protrusion can be, for example, adhered to the cartridge body. The cartridge body and the projection may be made of the same material or different materials. In at least one example, for example, the cartridge body may be comprised of a plastic material and the protrusions may be formed of an elastomeric material, such as rubber, thermoplastic elastomer, and / or Santoprene. In various examples, the protrusion may be comprised of a flexible material and may not damage tissue compressed by the protrusion. For example, the protrusions 3051 (FIG. 60) and / or the protrusions 3151 (FIG. 61) can be comprised of an elastomeric material, such as, for example, rubber, thermoplastic elastomer, and / or Santoprene. In at least one example, the cartridge body may be formed during a plastic injection molding process, and the protrusions may be formed during the second molding process using a material that is more flexible than the material making up the cartridge body. It can be formed on the body. In various examples, the protrusions 3051 and / or 3151 can comprise, for example, a textured deck surface. In certain examples, the protrusions 3051 and / or 3151 may be comprised of a material having a higher coefficient of friction than, for example, the cartridge body. Such embodiments may improve the grip between the cartridge body and the tissue.

  In various examples, the protrusion extending from the cartridge body may be stationary and may not move with respect to the cartridge body. In certain instances, as discussed above, the protrusion is flexible and can deform relative to the cartridge body. In some examples, and as discussed above, the cartridge body may be flexible, allowing the protrusion to move as the cartridge body deflects. The staple cartridge can include a protrusion that can extend relative to the cartridge body. Referring now to FIG. 75, a staple cartridge 3900 may include a cartridge body 3910 having a plurality of cavities 3950 defined therein. In various examples, the cavity 3950 can include a deployable tissue engaging member 3940 positioned within the cavity 3950. Each member 3940 can move from an undeployed position to a deployed position. When member 3940 is in its undeployed position, member 3940 may not extend above deck 3911, and when member 3940 is in its deployed position, member 3940 may extend above deck 3911. . Alternatively, member 3940 may extend above deck 3911 when in its undeployed position. In at least one such embodiment, tissue engaging member 3940 can engage tissue in its undeployed position as well as in its deployed position. In either case, member 3940 can include protrusions 3951 extending from member 3940, which can engage, stabilize, and / or compress tissue positioned intermediate anvil 20 and cartridge 3900. It can be configured to

  Referring again to FIG. 75, member 3940 can be deployed by a thread 3970 that longitudinally traverses cartridge body 3910 from its proximal end to its distal end. The sled 3970 can include a ramp 3972 that is configured to continuously engage the members 3940 and lift the members 3940 between their undeployed and their deployed positions. In at least one example, each member 3940 can include a beveled or angled surface 3942 that can contact a ramp 3972. The ramp 3972 may slide beneath the member 3940 to lift the member 3940 to the surface 3979. Surface 3979 may hold members 3940 in their deployed position, for example, as sled 3970 is advanced distally by a firing member, such as firing member 2760. As shown in FIG. 75, the surface 3979 may be long enough to support some members 3940 thereon. Further, surface 3979 may be sufficiently long to support member 3940 during the staple forming and tissue cutting processes performed by firing member 2760. In at least one example, surface 3979 can guide knife edge 2761 of firing member 2760, or be positioned distal thereto. In such an example, member 3940 can retain tissue positioned distally with respect to knife edge 2761 as knife edge 2761 moves distally through the tissue. In other words, the tissue engaging member 3940 can be deployed to grasp a portion of the tissue before the tissue portion is stapled and / or dissected. Cavity 3950 can be configured to support and guide member 3940 and prevent member 3940 from translating or rotating laterally within cavity 3950. The proximal end of surface 3979 may be configured and arranged such that thread 3970 can release member 3940 as knife edge 2761 passes through member 3940. In at least one such example, surface 3979 may no longer support member 3940 as knife edge 2761 slides with member 3940.

  75, in addition to the above, the cavities 3950 may be arranged in longitudinal rows. For example, the cavities 3950 may be arranged in six longitudinal rows consisting of two innermost rows, two outermost rows, and a row positioned intermediate each innermost and outermost row. Other embodiments are envisioned, in which the cavities 3950 are located in less than six rows or in more than six rows. In any case, some of the cavities 3950 defined in the cartridge body 3910 may be configured to support and guide the member 3940, as discussed above, while some of the cavities 3950 are The pod may house, for example, staples such as staples 2630 removably stored within cavity 3950. Sled 3970 may be configured to deploy member 3940 and additionally fire staples. In at least one such example, the sled 3970 includes at least one ramp 3997 configured to lift the staple driver 2640 toward the anvil 20 that can fire staples 2630 as discussed above, for example. A portion 2873 may be further provided. In various examples, ramp 3972 can lead to ramp 2873. In such an example, ramps 3974 can deploy member 3940 to its deployed position before ramps 2873 lift staples adjacent members 3940 to their fully formed position. Various embodiments are envisioned, wherein the outermost row of cavities 3950 includes a tissue engaging member 3940 stored in the outermost row, and the innermost and middle rows of cavities 3950 are the innermost row. And staples removably stored in the intermediate row. Such an embodiment may include two rows of staples and one row of tissue engaging members 3940 on each side of a longitudinal knife slot defined in the cartridge body. Other embodiments are envisioned, in which any suitable arrangement of members 3940 and staples may be utilized.

  As discussed above, embodiments are envisioned wherein the staple cartridge may include a row of staples and a row of deployable tissue engaging members. In at least one embodiment, the deployable tissue engaging members may not be interspersed within the staple rows. Other embodiments are envisioned where the deployable tissue engaging members are dispersed within the staple rows. Also, as discussed above, embodiments are envisioned that utilize a staple cavity to house a deployable tissue engaging member. Certain embodiments are envisioned in which the tissue engaging member is not stored in the staple cavity, but may be stored in a row of cavities adjacent to the staple cavity.

  90-93 illustrate another embodiment with a deployable tissue engaging protrusion. The staple cartridge 5300 can include, for example, a cartridge body 5310 that includes a deck 5311 and a plurality of staple cavities 5350 defined in the deck 5311. The staple cartridge 5310 can include a staple 5330 removably stored within the staple cavity 5350 and a plurality of drivers 5340 configured to eject the staple 5330 from the staple cavity 5350. The staple cartridge 5310 may further include one or more deployable protrusions 5351 removably stored within the staple cavity 5350, as discussed in further detail below. Each driver 5340 may include a cradle 5341 configured to support staples 5330, as well as a drive surface 5342 configured to be engaged by a sled, such as, for example, sled 5370. As above, the sled 5370 may be configured to lift the driver 5340 between an undeployed position and a deployed position. FIG. 92 shows the driver 5340 and staple 5330 in their undeployed position. Referring primarily to FIG. 93, driver 5340 may be configured to lift deployable protrusion 5351 between an undeployed position and a deployed position. In at least one such example, referring primarily to FIGS. 90 and 91, each driver 5340 includes a first deployable protrusion 5351 positioned about a proximal end of driver 5340 and a distal deployable protrusion 5351 of driver 5340. It can be assembled with a second deployable protrusion 5351 positioned around the end, and the upward movement of the driver 5340 is transmitted to the deployable protrusion 5351 to move the protrusion 5351 to their deployed position. Can be moved to In at least one example, protrusion 5351 may be in frictional engagement with driver 5340. When the driver 5340 is lifted upward, the friction fit between the driver 5340 and the protrusion 5351 may lift the protrusion 5351 upward. Each protrusion 5351 can include a tissue engaging portion 5352, which can be configured to contact tissue and apply a compressive force to the tissue. In various examples, the protrusion 5351 may apply a compressive force to tissue until the compressive force exceeds the stiction between the protrusion 5351 and the driver 5340 to move the protrusion 5351 upward. . In this regard, the driver 5340 can move or slide relative to the protrusion 5351. Stated another way, driver 5340 may decouple from protrusion 5341 associated therewith.

  In various examples, referring again to FIG. 93, the tissue engaging portions 5352 of the deployable protrusions 5351 may not extend over the deck 5311 when the protrusions 5351 are in their undeployed position. is there. In other examples, the tissue engaging portions 5352 of the deployable protrusions 5351 may extend over the deck 5311 when the protrusions 5351 are in their undeployed position. In either case, the tissue engaging portions 5352 of the deployable protrusions 5351 may extend above the deck 5311 when the protrusions 5351 are in their deployed position. In addition to the above, since the frictional engagement between each protrusion 5351 and the driver 5340 can be the same, the force that causes the driver 5340 to slide with respect to the protrusion 5351, that is, the sliding power, This can be the same for each protrusion 5351. Other embodiments are envisioned, in which the friction fit between certain protrusions 5351 and certain drivers 5340 may be different from other protrusions 5351 and other drivers 5340. In such an embodiment, the sliding power between the protrusion 5351 and the driver 5340 may be different. In at least one embodiment, a first protrusion 5351 located at the distal end of driver 5340 can begin sliding with a first sliding force and a second projection located at the proximal end of driver 5340. The protrusion 5351 may start sliding with a second sliding force different from the first sliding force. In various examples, the above results can limit the compressive force that the protrusion 5351 can apply to tissue. Further, as a result, the distance that the protrusion 5351 can extend from the deck 5311 of the cartridge main body 5310 can be limited. In various examples, the protrusions 5351 can include a variety of responses to tissue type and / or tissue thickness to be stapled. For example, the protrusions 5351 may be further deployed from the deck 5311 when the tissue is thinner and / or more flexible than when the tissue is thicker and / or more rigid. In any case, the sliding fit between driver 5340 and protrusion 5351 may prevent tissue from being excessively compressed by protrusion 5351.

  In addition to the above, the protrusion 5351 can float with respect to the cartridge deck 5311. In various examples, the protrusions 5351 can be dynamically responsive to compressive pressure created in the tissue captured between the anvil 20 and the staple cartridge 5300. In at least one example, firing member 2760 can cam or move anvil 20 toward staple cartridge 5300 as firing member 2760 advances distally. As the anvil 20 moves toward the staple cartridge 5300, for example, tissue may be compressed by the anvil 20, and in response, the protrusion 5351 may move downward or into the cartridge body 5310.

  In various examples, a staple cartridge can include a protrusion that rigidly extends from a deck of the cartridge body. In at least one example, the deck and the protrusion may not move relative to each other. In another example, the deck may move relative to the protrusion. In at least one such example, the protrusion may rigidly extend from the cartridge body and the deck may include a movable surface. As the tissue is compressed between the anvil and such a staple cartridge, the deck may move downward relative to the protrusion. The deck may be movable between a first position and a second position. When the deck is in its first position, the protrusions may not extend above the top surface of the deck. In such an example, the protrusion may be recessed below the upper surface of the deck when the deck is in its first position. When the deck is in its second position, the protrusions are exposed and may extend over the top surface of the deck. Alternatively, the protrusion may extend above the deck top when the deck is in its first position and its second position. In both cases, the distance that the deck moves relative to the protrusion may be a function of the pressure applied to the tissue. For example, the deck may travel a longer distance when greater compression pressure is applied to the tissue and a shorter distance when less compression pressure is applied to the tissue. The deck surface may float in response to the compression pressure applied to it. Certain embodiments are envisioned where the deck comprises an integral piece of material. Other embodiments are envisioned where the deck is comprised of multiple parts. In at least one such embodiment, each moiety may react independently of the other moiety. In various examples, the deck is constructed from a resilient material that can deflect in response to a compressive pressure applied to the resilient material. In at least one example, the deck may be comprised of, for example, foam. In certain instances, the deck may be composed of, for example, oxidized regenerated cellulose. The deck may be comprised of an implantable material or an implantable material. The deck may or may not be implanted in the patient. In various examples, the deck may include an aperture defined in the deck, which may allow for relative movement between the deck and the protrusion. In at least one such example, the aperture may include through holes and the protrusions may be located within these through holes. In certain examples, the aperture may include interstitial slots extending around the staple cavity, and protrusion (s) extending around the staple cavity. As staples are ejected from the staple cavities, the staples may pass through openings provided by gap slots. In some examples, at least a portion of the deck may be captured by staples and implant the deck against the tissue to be stapled.

  In various examples, the staple cartridge disclosed herein may include an auxiliary material. The auxiliary material may include, for example, at least one layer of material positioned on the deck of the staple cartridge and implanted in the patient by staples deployed from the staple cartridge. In various examples, at least one layer of the material may include, for example, a buttress material and / or a tissue thickness compensator. At least one layer of the material may be comprised of, for example, a Gore Seam Guard material, a Synovis Peri-Strips material, and / or polyurethane. Numerous references disclosing such layers are already incorporated by reference. The entire disclosure of U.S. Patent Application No. 13 / 763,095, filed February 28, 2013, entitled "LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES" (now U.S. Patent Publication No. 2013/0161374), is hereby incorporated by reference. Incorporated in the specification. U.S. Patent Application No. 13 / 531,619, filed June 25, 2012, entitled "TISSUE STAPLELER HAVING A THICKNESS COMPENSATOR COMPRISING INCORPORATING A HEMOSTATIC AGENT" (now U.S. Patent Publication No. 2012/0320842). U.S. Patent Application No. 13 / 531,623, filed June 25, entitled "TISSUE STAPLELER HAVING A THICKNESS COMPENSATOR INCORPORATING AN OXYGEN GENERATING AGENT" (currently U.S. Patent Publication No. 2012/0318843). U.S. patent application Ser. No. 13 / 531,627, filed on the 25th, Titles "TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORING AN ANTI-MICROBIAL AGENT" (currently U.S. Patent Publication No. 2012/0312860), and U.S. Patent Application No. 13 / 531,630 filed June 25, 2012; The entire disclosure of the title "TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORING AN ANTI-INFLAMMATORY AGENT" (now U.S. Patent Publication No. 2012/0318844) is incorporated herein by reference. The layers can be composed of bioabsorbable and / or non-bioabsorbable materials. In some examples, a layer of material may be mounted on the deck. In at least one example, at least one adhesive may be utilized to removably adhere the layer to the deck. In some examples, the layer of material may be removably attached to the deck utilizing, for example, one or more sutures or straps. In one particular example, the layer may consist of a solid piece of material. In some examples, a layer may include an aperture defined in the layer. In at least one such example, a layer may be utilized, for example, with staple cartridge 2000, for example, protrusions 2051 and / or protrusions extending from deck 2011 of staple cartridge 2010 defined in the layer. It may include apertures, slits, and / or slots that are aligned with 2053. In certain instances, the aperture may include a through hole or window extending completely through the layer. For example, the apertures, slits, and / or slots can be cut into the layer using, for example, a bladed cutting member. In some examples, the apertures, slits, and / or slots may be formed, for example, when the layers are molded. In certain examples, apertures, slits, and / or slots may be formed in the layer using, for example, a laser cutting process. In some examples, the aperture may include a recess defined in the layer that does not extend completely through the layer. In various examples, the protrusions can be closely received within the aperture such that relative movement between the cartridge body 2010 and the layer can be prevented or at least limited. In at least one such example, an interference fit may be between the protrusions of the aperture and the sidewall.

  In addition to the above, the auxiliary layer may be composed of, for example, a woven layer and / or a nonwoven layer. The layers can be composed, for example, of a film. In various examples, the layer may include, for example, a textured surface, protrusions, and / or protrusions extending from the layer, which may prevent or at least limit tissue flow to the staple cartridge. Can be configured. The layer includes a first set of areas that are engaged and / or captured by staples ejected from the staple cartridge and a second set of areas that are not engaged or captured by the staples. May be provided. In various examples, the second set of regions can be modified. In at least one example, the layers may be comprised of, for example, a film, and the second set of regions of the film may be modified to include apertures, slits, and / or slots. In at least one example, the perimeter of such a layer comprises cuts defined in the layer, which may soften the edges of the layer. In one particular example, a pattern of cuts may be made in the layer. In at least one such example, the pattern of cuts may include, for example, cuts extending at a 45 degree angle with respect to each other. In some examples, the depth, width, and / or spacing of the cuts may be random. With the above-described cuts, the layers of the film may be more flexible, stretchable, and / or flexible. The cuts may be made, for example, in a woven or nonwoven material. The incisions described above may be made using any suitable process, such as with a mechanical blade system and / or a laser cutting system. In various examples, the first set of regions of the layer may not be modified, as discussed above.

  As discussed above, layers composed of solid pieces of material can be modified to create layers that are more flexible, stretchable, and / or flexible. The layers can be assembled from several pieces of material bonded together. In at least one example, the apertures, slits, and / or slots may be, for example, between bonded pieces of material. In one particular example, a strip of a highly inelastic absorbent polymer is welded into a thinner and more flexible film to provide stretch in one particular intended direction and to stretch in another direction. Stretching can be limited. Such strips can also be used to reinforce highly stressed portions of the film while leaving other portions of the film soft and flexible. One way to accomplish this is to make several thin strips composed of a harder polymer such as, for example, Vicryl. These strips can be, for example, about 0.015 inches to 0.030 inches (0.038 cm to 0.076 cm) in width, and can extend, for example, along the entire length of the staple line. Six strips may be arranged to correspond to the lateral extent of the staple lines of the six longitudinal staple rows. Thereafter, a thin, eg, about 0.008-0.01 cm (about 0.003-inch-0.005 inch) thick, constructed of a flexible, resilient polymer such as, eg, Monocryl or 36/64 PGA / PCL. A continuous film layer may be welded to six strips. In some cases, a molding operation may be utilized. The result is a highly reinforced staple line with flexible sides and the ability to expand and contract easily in the lateral direction, but not in the longitudinal direction. The strip extending from the film may further provide a traction-like retention feature that minimizes tissue flow over the film in a desired direction. In certain examples, a layer composed of woven and / or nonwoven materials may be modified to solidify certain areas of the layer, such as, for example, a first set of areas. The flat extruded fibers can be woven into strips and then solidified by felting and / or using another heat-based technique, for example, by fusing the first set of regions together. I can do it. In some instances, the entire layer may be fused together.

  As discussed above, the staple cartridge may include a protrusion extending from the cartridge body. In addition to or instead of these protrusions, the anvil may include protrusions extending from the anvil, which, first, control the flow of tissue to the anvil and the cartridge body, and As such, the staple cavity can be configured to extend from the opposite side of the tissue, and / or thirdly, to support and / or guide the staples as any are ejected from the staple cavity.

  Anvil 3320 is illustrated in FIGS. 66 and 67. Anvil 3320 may include a distal end 3323, a proximal end 3326, and a tissue engaging surface 3321. The anvil 3320 may further include a pivot 3327 about which the anvil 3320 may be rotated between an open position and a closed position. The anvil 3320 can further include a longitudinal slot 3325 defined in the anvil 3320, the longitudinal slot 3325 configured to receive a portion of the firing and / or cutting member therein. Anvil 3320 may also include lateral sides, which may include longitudinal protrusions or walls 3323 extending from anvil 3320. In various examples, the longitudinal wall 3323 can include, for example, a corrugated surface. In some examples, the longitudinal wall 3323 may include, for example, a flat surface. As above, the wall 3323 may be configured, for example, to restrict or block tissue flow transverse to the anvil 3320.

  In addition to the above, anvil 3320 may include a plurality of staple forming pockets 3322 defined therein, wherein the staple forming pockets 3322 are longitudinally aligned with staple cavities defined in the staple cartridge. Can be placed in a row. For example, the forming pockets 3322 may be located in an innermost row 3328a, an outermost row 3328c, and a row 3328b intermediate the innermost row 3328a and the outermost row 3328c. In at least one example, each staple forming pocket 3322 may include a first or distal forming cup 3322a and a second or proximal forming cup 3322b. The first forming cup 3322a may be configured to receive and deform the first leg of the staple, and the second forming cup 3322b may be configured to receive and deform the second leg of the staple. obtain. The first forming cup 3322a and the second forming cup 3322b can be separated by a flat portion 3322c. Anvil 3320 may further include a tissue engaging protrusion 3324. The protrusion 3324 may be positioned intermediate between the first forming cup 3322a and the second forming cup 3322b. The first protrusion 3324 may be located on a first lateral side of the flat 3322c, and the second protrusion 3324 may be located on a second lateral side of the flat 3322c. Protrusions 3324 extending from anvil 3320 may cooperate with protrusions extending from the staple cartridge to guide and support staples ejected from the staple cartridge. In at least one example, the anvil protrusion 3324 and the staple cartridge protrusion may be connected. In various examples, for example, the cartridge protrusion may extend from the end of the staple cavity, while the anvil protrusion 3324 may be located midway between the cartridge protrusions over the center of the staple cavity. The anvil protrusion 3324 and the cartridge protrusion may cooperate to extend the staple cavity and support and guide the staple while the staple is being formed with respect to the anvil 3320. A cartridge protrusion extending from the end of the staple cavity may support and guide the staple legs as the staple legs emerge from the staple cavity and contact the anvil 3320. When the staple legs are deforming in the forming cups 3322a, 3322b, the staple legs can be supported and guided by the protrusions 3324 extending from the anvil. In various examples, the staple legs can be supported and guided simultaneously by the cartridge projection and the anvil projection 3324. In some examples, the staple legs may be supported and guided by the cartridge projection and the anvil projection 3324, but not simultaneously.

  In various examples, forming cups 3322a, 3322b can be configured to receive at least a portion of the protrusion extending from the staple cartridge into forming cups 3322a, 3322b. In at least one such example, each forming cup 3322a, 3322b can include a wide outer end and a narrow inner end configured to receive a protrusion extending from the staple cartridge. The outer ends of the forming cups 3322a, 3322b may also be configured to initially receive staple legs. Forming cups 3322a, 3322b may further include a curved surface configured to direct staple legs toward a narrow inner end of forming cups 3322a, 3322b. The staple legs can then exit the forming cups 3322a, 3322b from the narrow inner end where the protrusion 3324 is located to support and guide the staple legs. Each forming cup 3322a, 3322b may include an angled surface intermediate the wide outer end and the narrow inner end. The angled surface may guide the staple legs within the forming cups 3322a, 3322b, limit lateral movement of the staple legs, and improve alignment with the narrow inner ends of the staple legs.

  In addition to the above, the protrusions 3324 may engage and hold the tissue in place while the tissue is stapled and / or cut laterally. In certain examples, each protrusion 3324 may include a horizontal portion extending from a tissue engaging surface 3321 that includes a flat surface. FIG. 89 illustrates an alternative embodiment comprising an anvil 5220, which includes a forming pocket 3322 defined in the anvil and a tissue engaging protrusion 5224 extending from the anvil. Like the protrusions 3224, each protrusion 5224 can include a horizontal portion 5224a and a flat surface 5224b configured to engage tissue. In addition, each protrusion 5224 may include a transition surface 5224c intermediate the horizontal portion 5224a and the flat surface 5224c. In various examples, transition surface 5224c may include, for example, a radius. In certain examples, transition surface 5224c may include, for example, a bevel.

  Anvil 5120 is illustrated in FIGS. 87 and 88. Anvil 5120 may include a distal end 5123, a proximal end 5126, and a tissue engaging surface. The tissue engaging surface may include a step. For example, the tissue engaging surface can include, for example, a first step 5121 'and a second step 5121 ". The second step 5121 '' may be higher than the first step 5121 'and may extend from the first step 5121'. The anvil 5120 may further include a pivot 3327 about which the anvil 3320 may be rotated between an open position and a closed position. The anvil 5120 may further include a longitudinal slot 5125 defined in the anvil 5120, which is configured to receive a portion of the firing and / or cutting member therein. Anvil 5120 may also include lateral sides 5123, which may or may not include longitudinal protrusions or walls extending from anvil 5120. In various examples, a higher second step 5121 "may be adjacent to the longitudinal slot 5125, while a first step 5121" may be adjacent to the lateral side 5123. In various examples, the second step 5121 '' may apply a greater compressive force to the tissue than the first step 5121 '. In various alternative embodiments, a higher second step 5121 "may be adjacent to the lateral side 5123, while a first step 5121" may be adjacent to the longitudinal slot 5125. Although anvil 5120 comprises two steps, anvil 5120 may comprise more than two steps. In any case, the anvil 5120 may include a ramp 5128 '' extending between the first step 5121 'and the second step 5121' ', which may facilitate positioning of the anvil 5120 relative to tissue. .

  In addition to the above, anvil 5120 may include a plurality of staple forming pockets 5122 defined therein, which are disposed in longitudinal rows that are alignable with staple cavities defined in the staple cartridge. obtain. In various examples, the outermost row of forming pockets 5122 may be defined during a first step 5121 '. The innermost row of forming pockets 5122 and the middle row of forming pockets 5122 may be defined, for example, in a second step 5121 ''. Other embodiments are envisioned where an intermediate row of forming pockets 5122 is defined in a first step 5121 '. In any case, anvil 5120 may include a tissue engaging protrusion 5124 extending from anvil 5120. In various examples, each protrusion 5124 may comprise, for example, an H-shaped configuration. Protrusions 5124 may extend, for example, between adjacent forming pockets 5122. Protrusions 5124 may extend, for example, between adjacent forming cups in forming pocket 5122. In various examples, protrusions 5124 may surround the ends of the forming cup to support and guide the staple legs formed by the forming cup. Protrusions 5124 may extend, for example, along the lateral sides of forming pocket 5122. The protrusion 5124 may extend, for example, along the lateral sides of the first forming pocket 5122 and the second forming pocket 5122. The lateral sides of the forming pocket 5122 may be, for example, parallel. In various examples, the protrusions 5124 can guide the staple legs within the forming cup and limit lateral movement of the staple legs. FIG. 88 shows a protrusion 5124 on each side of the forming pocket 5122. FIG. 88 also shows a protrusion 5124 on each side of the forming cup of the forming pocket 5122. In various other embodiments, the protrusions may be positioned adjacent only a portion of the forming pocket 5122 of the anvil 5120 and / or only a portion of the forming cup of the forming pocket 5122.

  In various examples, the protrusions extending from the anvil may have the same height. In other examples, the protrusions extending from the anvil may have different heights. Referring now to FIG. 69, anvil 3520 may include a tissue engaging surface 3321 and a longitudinal slot 3325 defined in anvil 3520, which may be part of the firing and / or cutting member. Are configured to receive Anvil 3520 may also include lateral sides, which may include longitudinal protrusions or walls 3323 extending from anvil 3520. As before, anvil 3520 may include forming pockets located in innermost row 3328a, outermost row 3328c, and intermediate row 3328b between innermost row 3328a and outermost row 3328c. In various examples, anvil 3520 may include, for example, a longitudinal row of first protrusions 3551a adjacent to innermost row 3328a, a longitudinal row of second protrusions 3551b adjacent to middle row 3328b, and A longitudinal row of third protrusions 3551c adjacent outer row 3228c may be provided. The first protrusion 3551a may extend a first distance from the tissue engaging surface 3221, and the second protrusion 3551b may extend at a second distance different from the first distance from the tissue engaging surface 3221. May extend. Third protrusion 3551c may extend a third distance from tissue engaging surface 3221 that may be different from the first and / or second distance. In various examples, the third protrusion 3551c may be higher than the second protrusion 3551b, and the second protrusion 3551b may be higher than the first protrusion 3551a. In various alternative embodiments, the protrusions 3551a may be positioned, for example, adjacent the middle row 3328b and / or the outermost row 3328c, and the protrusions 3551b may be positioned, for example, on the innermost row 3328a and / or the outermost row. The protrusion 3551c may be positioned adjacent to the inner row 3328a and / or the middle row 3328b, for example.

  Anvil 3420 is illustrated in FIG. Anvil 3420 can include a distal end 3423, a proximal end, and a tissue engaging surface 3321. The anvil 3420 may further include a pivot 3327 about which the anvil 3420 may rotate between an open position and a closed position. The anvil 3420 may further include a longitudinal slot 3325 defined in the anvil 3420, the longitudinal slot 3325 being configured to receive a portion of the firing and / or cutting member therein. Anvil 3420 may also include lateral sides, which may include longitudinal protrusions or walls 3323 extending from anvil 3420. The anvil 3420 may include a plurality of staple forming pockets 3322 defined therein, wherein the staple forming pockets 3322 are disposed in longitudinal rows that are alignable with staple cavities defined in the staple cartridge. obtain. In various examples, in addition to the above, anvil 3420 can include a protrusion extending from anvil 3420. For example, anvil 3420 may include a pyramid-shaped protrusion 3051 and / or a dome-shaped protrusion 3151 extending from anvil 3420. Protrusions 3051 and / or protrusions 3151 can improve the gripping force that can be applied to tissue.

  In various examples, the anvil and the protrusion extending from the anvil may be comprised of an integral piece of material. In at least one example, the protrusion may be formed integrally with the anvil. The anvils and protrusions may be comprised of a metallic material, such as, for example, stainless steel, and may be formed, for example, during a machining and / or stamping process. In one particular example, the protrusion can be assembled to the anvil. In at least one example, the protrusion can be, for example, adhered to the anvil. The anvil and the protrusion may be made of the same material or different materials. In at least one example, for example, the anvil may be composed of a metallic material and the protrusions may be formed of an elastomeric material, such as rubber, thermoplastic elastomer, and / or Santoprene. In various examples, the protrusion may be comprised of a flexible material and may not damage tissue compressed by the protrusion. For example, the protrusions 3051 and / or the protrusions 3151 can be made of an elastomeric material such as, for example, rubber, thermoplastic elastomer, and / or Santoprene. In at least one example, the anvil may be formed during a machining and / or stamping process, and the protrusions may be formed on the anvil during the molding process using a material that is more flexible than the material making up the anvil. Can be formed. In various examples, the protrusions 3051 and / or 3151 can comprise, for example, a textured anvil surface. In certain examples, protrusions 3051 and / or 3151 may be comprised of, for example, a material having a higher coefficient of friction than an anvil. Such embodiments may improve the grip between the anvil and the tissue.

  In addition to the above, the anvil may include a uniform array of protrusions extending therefrom. In another example, the array may not be uniform. Referring again to FIG. 68, the protrusion 3051 may extend from the anvil surface 3321 on a first side of the longitudinal slot 3325 and the protrusion 3151 may extend from the anvil surface 3321 to a second side of the longitudinal slot 3325. May extend up. In various examples, the protrusion may be located distally with respect to the forming pocket 3322, for example. In certain examples, the protrusions may be interspersed between the forming pockets 3322. The protrusions include, for example, a surface 3429a defined between the innermost forming pocket 3322 and the slot 3325, a surface 3429b defined between the innermost forming pocket 3322 and the middle forming pocket 3322, and a middle forming pocket 3322. And / or a surface 3429c defined intermediate the outermost forming pocket 3322 and / or a surface 3429d defined intermediate the outermost forming pocket 3322 and the lateral wall 3323.

  FIG. 98 shows an anvil 5920. Anvil 5920 can include a distal end 5923, a proximal end 5926, and a tissue engaging surface 5921. The anvil 5920 may further include a tissue engaging member extending from the surface 5921 configured to prevent or restrict tissue flow to the anvil 5920. In at least one example, anvil 5920 can include, for example, protrusion 5924 'and protrusion 5924' '. The protrusion 5924 '' may be higher than the protrusion 5924 ''. This height difference is indicated by dimension 5925. As shown in FIG. 98, the protrusion 5924 '' can be positioned distal to the protrusion 5924 '. In various examples, protrusions 5924 '' and protrusions 5924 'can be part of a longitudinal row of protrusions. In some examples, protrusions 5924 '' and protrusions 5924 'can be part of different longitudinal rows of protrusions. In certain examples, not shown, the protrusion 5924 'can be positioned distal to the protrusion 5924 ".

  In various examples, the anvils disclosed herein may include auxiliary materials. The auxiliary material can include, for example, at least one layer of material positioned on the tissue engaging surface of the anvil and implanted in a patient by staples deployed from a staple cartridge. In various examples, at least one layer of the material may include, for example, a buttress material and / or a tissue thickness compensator. At least one layer of the material may be comprised of, for example, a Gore Seam Guard material, a Synovis Peri-Strips material, and / or polyurethane. Numerous references disclosing such layers are already incorporated by reference. The entire disclosure of U.S. Patent Application No. 13 / 763,095, filed February 28, 2013, entitled "LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES" (now U.S. Patent Publication No. 2013/0161374), is hereby incorporated by reference. Incorporated in the specification. U.S. Patent Application No. 13 / 531,619, filed June 25, 2012, entitled "TISSUE STAPLER HAVING A THICKNESS COMPENSATOR COMPRISING INCORPORATING A HEMOSTATIC AGENT" (now U.S. Patent Publication No. 2012/0320842). U.S. Patent Application No. 13 / 531,623, filed June 25, 2013, entitled "TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORING AN OXYGEN GENERATETING AGENT", now U.S. Patent Publication No. 2012/0318843. U.S. patent application Ser. No. 13 / 531,627, filed on the 25th, Titles "TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORING AN ANTI-MICROBIAL AGENT" (currently U.S. Patent Publication No. 2012/0312860), and U.S. Patent Application No. 13 / 531,630 filed June 25, 2012; The entire disclosure of the title "TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORING AN ANTI-INFLAMMATORY AGENT" (now U.S. Patent Publication No. 2012/0318844) is incorporated herein by reference. The layers can be composed of bioabsorbable and / or non-bioabsorbable materials. In some examples, a layer of material may be attached to the anvil. In at least one example, at least one adhesive may be utilized to removably adhere the layer to the anvil. In some examples, the layer of material may be removably attached to the anvil utilizing, for example, one or more sutures or straps. In various examples, a layer may include a protrusion extending from the layer, and the protrusion may extend into a forming pocket defined in the anvil. The protrusions may be arranged in an array, or a pattern that is aligned with the array, or a pattern of forming pockets in the anvil. In at least one example, the protrusion may fit snugly within the forming pocket. The protrusions may be configured to limit lateral and / or longitudinal movement of the layer relative to the anvil.

  In one particular example, the layer may consist of a solid piece of material. In some examples, a layer may include an aperture defined in the layer. In at least one such example, a layer can be utilized, for example, with an anvil 3320, e.g., aligned with a protrusion defined from the tissue engaging surface 3321 of the anvil 3320 defined in the layer. It may include apertures, slits, and / or slots. In certain instances, the aperture may include a through hole or window extending completely through the layer. For example, the apertures, slits, and / or slots can be cut into the layer using, for example, a bladed cutting member. In some examples, the apertures, slits, and / or slots may be formed, for example, when the layers are molded. In certain examples, apertures, slits, and / or slots may be formed in the layer using, for example, a laser cutting process. In some examples, the aperture may include a recess defined in the layer that does not extend completely through the layer. In various examples, the protrusions can be closely received within the aperture such that relative movement between the anvil 3320 and the layer can be prevented or at least limited. In at least one such example, an interference fit may be between the protrusions of the aperture and the sidewall.

  In addition to the above, the auxiliary layer may be composed of, for example, a woven layer and / or a nonwoven layer. The layers can be composed, for example, of a film. In various examples, the layers can include, for example, textured surfaces, protrusions, and / or protrusions extending from the layers, such that they prevent or at least limit tissue flow to the anvil. Can be configured. The layer includes a first set of areas that are engaged and / or captured by staples ejected from the staple cartridge and a second set of areas that are not engaged or captured by the staples. May be provided. In various examples, the second set of regions can be modified. In at least one example, the layers may be comprised of, for example, a film, and the second set of regions of the film may be modified to include apertures, slits, and / or slots. In at least one example, the perimeter of such a layer comprises cuts defined in the layer, which may soften the edges of the layer. In one particular example, a pattern of cuts may be made in the layer. In at least one such example, the pattern of cuts may include, for example, cuts extending at a 45 degree angle with respect to each other. In some examples, the depth, width, and / or spacing of the cuts may be random. With the above-described cuts, the layers of the film may be more flexible, stretchable, and / or flexible. The cuts may be made, for example, in a woven or nonwoven material. The incisions described above may be made using any suitable process, such as with a mechanical blade system and / or a laser cutting system. In various examples, the first set of regions of the layer may not be modified, as discussed above.

  As discussed above, layers composed of solid pieces of material can be modified to create layers that are more flexible, stretchable, and / or flexible. The layers can be assembled from several pieces of material bonded together. In at least one example, the apertures, slits, and / or slots may be, for example, between bonded pieces of material. In one particular example, a strip of a highly inelastic absorbent polymer is welded into a thinner and more flexible film to provide stretch in one particular intended direction and to stretch in another direction. Stretching can be limited. Such strips can also be used to reinforce highly stressed portions of the film while leaving other portions of the film soft and flexible. One way to accomplish this is to make several thin strips composed of a harder polymer such as, for example, Vicryl. These strips may be, for example, about 0.015 inch to 0.030 inch (0.038 cm to 0.076 cm) in width and may extend, for example, over the entire length of the staple forming pocket line. Six strips may be arranged to correspond to the lateral extent of the staple lines of the six longitudinal staple rows. Thereafter, a thin, eg, about 0.008-0.01 cm (about 0.003-inch-0.005 inch) thick, constructed of a flexible, resilient polymer such as, eg, Monocryl or 36/64 PGA / PCL. A continuous film layer may be welded to six strips. In some cases, a molding operation may be utilized. The result is a highly reinforced staple line with flexible sides and the ability to expand and contract easily in the lateral direction, but not in the longitudinal direction. The strip extending from the film may further provide a traction-like retention feature that minimizes tissue flow over the film in a desired direction. In certain examples, a layer composed of woven and / or nonwoven materials may be modified to solidify certain areas of the layer, such as, for example, a first set of areas. The flat extruded fibers can be woven into strips and then solidified by felting and / or using another heat-based technique, for example, by fusing the first set of regions together. I can do it. In some instances, the entire layer may be fused together.

  Various embodiments are disclosed herein, including staples removably stored within a staple cartridge in a terminal connection arrangement in one or more longitudinal rows. Similarly, various embodiments are disclosed herein that include an anvil that includes staple forming pockets arranged in a corresponding terminal connection arrangement. Other staples and staple forming pocket arrangements are envisioned and are compatible with the embodiments disclosed herein. Such an arrangement may or may not include a terminal coupling arrangement. U.S. Patent No. 8,186,560, issued May 29, 2012, entitled "SURGICAL STAPLING SYSTEMS AND STAPLE CARTRIDGES FOR DEPLOYING SURGICIAL STAPLES STAPLES WITH TISSUE COMPRESSION REFERENCE TO A REFERENCE TO THE REFERENCE TO THE REFERENCE TO REFERENCE. U.S. Pat. No. 8,365,976, issued Feb. 5, 2013, entitled "SURGICAL STAPLES HAVING DISSOLVABLE, BIOABSORBABLE OR BIOFRAGMENTABLE TABLE PORTIONS AND AND STAPLING INSTRUMENTS INFORMATION SPECIAL INFORMATION SPECIFICATIONS FOR REFERENCE It is.

  19-22 illustrate a motor-driven surgical cutting and fastening instrument 1010 that may or may not be reused. In the illustrated embodiment, the instrument 1010 includes a housing 1012 comprising a handle 1014, which is configured to be grasped, manipulated, and actuated by a clinician. The housing 1012 is operably mounted to a replaceable shaft assembly 1200 to which a surgical end effector 1300 configured to perform one or more surgical operations or procedures is operatively coupled. Is configured. As the modes for carrying out the invention evolve, various unique and novel arrangements of the various forms of interchangeable shaft assemblies disclosed herein will be associated with robotically controlled surgical systems. It should be understood that it may be used effectively. Thus, the term “housing” also refers to at least one control motion configured to generate and add at least one control motion available to operate the interchangeable shaft assemblies disclosed herein and their equivalents. It may include a housing or similar part of a robotic system that accommodates or otherwise supports one drive system. The term "frame" can refer to a portion of a hand-held surgical instrument. The term “frame” can also refer to a portion of a robotically controlled surgical instrument and / or a portion of a robotic system that can be utilized to operatively control the surgical instrument. For example, the interchangeable shaft assembly disclosed herein is disclosed in U.S. Patent Application No. 13 / 118,241, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTABLE STAPLE DEPLOYMENT ARRANGEMENTS" (currently U.S. Patent Application Publication No. US 2012/0298719). ) May be used with the various robotic systems, instruments, components, and methods disclosed. U.S. Patent Application No. 13 / 118,241, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTABLE STAPLE DEPLOYMENT ARRANGEMENTS" (now U.S. Patent Application Publication No. US 2012/0298719), is hereby incorporated by reference in its entirety.

  The housing 1012 shown in FIGS. 19-21 is associated with a replaceable shaft assembly 1200 that includes an end effector 1300 with a surgical cutting and fastening device configured to operatively support a surgical staple cartridge 1304. Let me show you. The housing 1012 may be configured for use in conjunction with a replaceable shaft assembly that includes an end effector, wherein the end effector is adapted to support different sizes and types of staple cartridges and has different shaft lengths. The size, type, etc. In addition, the housing 1012 can also be used effectively with a variety of other interchangeable shaft assemblies, including, for example, high frequency (RF) energy, ultrasonic energy, and / or motion. Other motion and energy forms include assemblies that are configured to apply to end effector arrangements adapted for use in connection with various surgical applications and procedures. Further, the end effector, shaft assembly, handle, surgical instrument, and / or surgical instrument system can utilize any suitable fastener to secure tissue. For example, a fastener cartridge comprising a plurality of fasteners removably stored therein may be removably inserted and / or mounted on an end effector of a shaft assembly.

  FIG. 19 shows a surgical instrument 1010 operably coupled with a replaceable shaft assembly 1200. 20 and 21 illustrate the attachment of the interchangeable shaft assembly 1200 to the housing 1012 or handle 1014. As seen in FIG. 21, handle 1014 may include a pair of interconnected handle housing segments 1016 and 1018 that may be interconnected by screws, snap features, adhesives, and the like. In the illustrated arrangement, the handle housing segments 1016, 1018 cooperate to form a pistol grip portion 1019 that can be grasped and manipulated by a clinician. As discussed in further detail below, handle 1014 operably supports a plurality of drive systems within handle 1014, the drive systems comprising a replaceable shaft assembly operably mounted on handle 1042. It is configured to generate and add various control movements to the corresponding part.

  Referring now to FIG. 21, handle 1014 may further include a frame 1020 operably supporting a plurality of drive systems. For example, the frame 1020 can operably support a "first" or closed drive system, generally designated 1030, that is interchangeable shaft assembly 1200 operably mounted or coupled thereto. May be used to apply closing and opening movements to the In at least one form, the closure drive system 1030 may include an actuator in the form of a closure trigger 1032 that is pivotally supported by the frame 1020. More specifically, as shown in FIG. 21, the closure trigger 1032 is pivotally coupled to the housing 1014 by a pin 1033. Such an arrangement allows the clinician to operate the closure trigger 1032 so that when the clinician grasps the pistol grip portion 1019 of the handle 1014, the closure trigger 1032 is moved from a starting or "inactive" position. It is easy to pivot to an "actuated" position, more specifically a fully compressed or fully activated position. Closure trigger 1032 may be biased to a non-actuated position by a spring or other biasing device (not shown). In various aspects, the closure drive system 1030 further includes a closure linkage assembly 1034 pivotally coupled to the closure trigger 1032. As seen in FIG. 21, closure linkage assembly 1034 may include a first closure link 1036 and a second closure link 1038 that are pivotally coupled to closure trigger 1032 by pins 1035. The second closure link 1038 may also be referred to as a “mounting member” and may include a transverse mounting pin 1037.

  Still referring to FIG. 21, the first closure link 1036 may also have a locking wall or end 1039 configured to cooperate with a closure release assembly 1060 pivotally coupled to the frame 1020. Good things can be observed. In at least one form, the closure release assembly 1060 may include a release button assembly 1062 having a distally projecting locking pole 1064 formed thereon. Release button assembly 1062 may be pivoted in a counterclockwise direction by a release spring (not shown). When the clinician depresses the closure trigger 1032 from the inactive position toward the pistol grip portion 1019 of the handle 1014, toward the point at which the locking pole 1064 transitions into retaining engagement with the locking wall 1039 on the first closure link 1036. , The first closing link 1064 pivots upward, thereby preventing the closing trigger 1032 from returning to the inactive position. Accordingly, the closure release assembly 1060 serves to lock the closure trigger 1032 in the fully activated position. When the clinician desires to unlock and bias the closure trigger 1032 to the inactive position, the clinician simply moves the locking pole 1064 with the lock wall 1039 on the first closure link 1036. The closure release button assembly 1062 is pivoted to escape engagement. When the locking pole 1064 is moved out of engagement with the first closing link 1032, the closing trigger 1032 can pivot back to the inactive position. Other closure trigger locks and release devices may be used.

  An arm 1061 may extend from the closure release button 1062. For example, a magnetic element 1063 such as a permanent magnet may be attached to the arm 1061. When the closure release button 1062 is rotated from its first position to its second position, the magnetic element 1063 may move toward the circuit board 1100. Circuit board 1100 may include at least one sensor configured to detect movement of magnetic element 1063. In at least one embodiment, for example, a “Hall effect” sensor (not shown) can be mounted on the bottom surface of circuit board 1100. The Hall effect sensor may be configured to detect a change in a magnetic field surrounding the Hall effect sensor caused by movement of the magnetic element 1063. The Hall effect sensor can, for example, be in signal communication with a microcontroller that has the closure release button 1062 in its inactive position of the closure trigger 1032 and its first position associated with the release configuration of the end effector. Or is in its activated position of the closure trigger 1032 and its second position associated with the closed configuration of the end effector, and / or in any position between the first and second positions. Can be determined.

  In at least one form, the handle 1014 and the frame 1020 may operably support another drive system, referred to herein as a launch drive system 1080, which has a replacement drive attached thereto. It is configured to apply a firing motion to a corresponding portion of the shaft assembly. The launch drive system 1080 may be referred to herein as a "second drive system." The launch drive system 1080 may use an electric motor 1082 located on the pistol grip portion 1019 of the handle 1014. In various embodiments, the motor 1082 may be a brushed DC drive motor having a maximum speed of, for example, about 25,000 RPM. In other arrangements, the motor may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor 1082 may be powered by a power supply 1090, which in one form may include a removable power pack 1092. As seen in FIG. 21, for example, the power pack 1092 may include a proximal housing portion 1094 configured to be mounted on the distal housing portion 1096. Proximal housing portion 1094 and distal housing portion 1096 are configured to operably support a plurality of batteries 1098 within proximal housing portion 1094 and distal housing portion 1096. Batteries 1098 may each include, for example, lithium ion ("LI") or other suitable batteries. Distal housing portion 1096 is configured to be removably and operably mounted to circuit board assembly 1100, which is also operatively coupled to motor 1082. Several batteries 1098, which may be connected in series, may be used as a power source for surgical instrument 1010. In addition, power supply 1090 may be replaceable and / or rechargeable.

  As outlined above in connection with various other configurations, the electric motor 1082 can have a rotating shaft (not shown), which can be driven on a longitudinally moving drive member 1120. It is operatively associated with a gear reducer assembly 1084 that is mounted in meshing engagement with a set of teeth 1122 or a rack. In use, the voltage polarity provided by the power supply 1090 may cause the electric motor 1082 to operate clockwise, while the voltage polarity applied to the electric motor by the battery may cause the electric motor 1082 to operate counterclockwise. Can be reversed. When the electric motor 1082 rotates in one direction, the drive member 1120 will be driven axially in the distal direction "DD". When the motor 82 drives in the opposite rotational direction, the drive member 1120 will be driven axially in the proximal direction "PD". Handle 1014 may include a switch that may be configured to reverse the polarity applied to electric motor 1082 by power supply 1090. As with the other configurations described herein, handle 1014 can also include a sensor configured to detect the position of drive member 1120 and / or the direction in which drive member 1120 is being moved. .

  The operation of the motor 1082 can be controlled by a firing trigger 1130 pivotally supported on the handle 1014. The firing trigger 1130 can be pivoted between an inactive position and an active position. The firing trigger 1130 may be biased to a non-actuated position by a spring 1132 or other biasing device, so that when the clinician releases the firing trigger 1130, the firing trigger 1130 is triggered by the spring 1132 or a biasing device. It can be pivoted to an inoperative position or otherwise returned. In at least one form, the firing trigger 1130 may be positioned “outside” of the closure trigger 132, as discussed above. In at least one form, the firing trigger safety button 1134 may be pivotally attached to the closure trigger 1032 by a pin 1035. The safety button 1134 may be positioned between the firing trigger 1130 and the closure trigger 1032 and have a pivot arm 1136 projecting from the safety button 1134. See FIG. When the closure trigger 1032 is in the inactive position, the safety button 1134 is housed within the handle 1014 so that the clinician cannot easily touch the safety button 1134 to prevent actuation of the firing trigger 1130; Neither can the firing trigger 1130 be moved to or from the firing position where it can be fired. When the clinician presses closure trigger 1032, safety button 1134 and firing trigger 1130 pivot down, which can then be operated by the clinician.

  As indicated above, in at least one form, the longitudinally movable drive member 1120 has thereon a rack of teeth 1122 for meshing engagement with a corresponding gear 1086 of the gear reducer assembly 1084. ing. Also included in at least one form is a manually actuated “escape” assembly 1140 configured to allow the clinician to manually retract the longitudinal drive member 1120 in the event of a motor 1082 failure. . Escape assembly 1140 may include a lever or escape handle assembly 1142 that is configured to be manually pivoted to form a ratcheted engagement with teeth 1124 also provided in drive member 1120. In this manner, the clinician can manually retract the drive member 1120 by using the escape handle assembly 1142 to ratchet the drive member 1120 in the proximal direction "PD". U.S. Patent Application Publication No. US 2010/0089970 (now U.S. Patent No. 8,608,045) discloses an escape arrangement, as well as other components, that can also be used with the various devices disclosed herein. , Arrangements and systems are disclosed. U.S. Patent Application No. 12 / 249,117, entitled POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, (now U.S. Patent No. 8,608,045), is hereby incorporated by reference in its entirety. It is.

  Referring now to FIGS. 20 and 22, the interchangeable shaft assembly 1200 includes a surgical end effector 1300 configured to operably support a staple cartridge 1304 therein. The end effector 1300 with the elongated channel 1302 may further include an anvil 1306 pivotally supported with respect to the elongated channel 1302. The replaceable shaft assembly 1200 may further include an articulation joint 1270 and an articulation lock that may be configured to releasably hold the end effector 1300 in a desired position relative to the shaft axis SA-SA. For details regarding the structure and operation of the end effector 1300, articulation joint 1270, and articulation lock, see U.S. patent application Ser. LOCK ". The entire disclosure of U.S. Patent Application No. 13 / 803,086, filed March 14, 2013, entitled "ARTICULABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK," is hereby incorporated by reference. As seen in FIG. 22, the replaceable shaft assembly 1200 may further include a proximal housing or nozzle 1201 composed of nozzle portions 1202 and 1203. The replaceable shaft assembly 1200 may further include a closure tube 1260 that can be used to close and / or open the anvil 1306 of the end effector 1300. The shaft assembly 1200 may include a spine 1210 that slidably supports a firing member therein, firstly, and a second closure tube that extends around the spine 210 secondly. It is configured to slidably support the 1260. Spine 210 may also be configured to slidably support a proximal articulated driver. The articulation driver has a distal end configured to operably engage the articulation lock. The articulation lock is associated with an articulation frame that is adapted to operably engage a drive pin on the end effector frame. As indicated above, further details regarding the operation of the articulation lock and articulation frame can be found in US patent application Ser. No. 13 / 803,086. In various situations, the spine 1210 can include a proximal end 1211 that is rotatably supported in the chassis 1240. In one arrangement, for example, the proximal end 1211 of the spine 1210 has a thread 1214 formed thereon for threaded mounting to a spine bearing 1216 configured to be supported within the chassis 1240. . See FIG. Such an arrangement facilitates rotatable mounting of the spine 1210 to the chassis 1240 and allows the spine 1210 to selectively rotate relative to the chassis 1240 about a shaft axis SA.

  Referring primarily to FIG. 22, the replaceable shaft assembly 1200 includes a closure shuttle 1250 slidably supported within the chassis 1240 so that it can move axially relative thereto. The closure shuttle 1250 is configured to mount on a mounting pin 1037 (FIGS. 20 and 21) mounted on the second closure link 1038, as discussed in further detail below, and a pair of proximally projecting. Including a hook 1252 that performs The proximal end 1261 of the closure tube 1260 is coupled to the closure shuttle 1250 for rotation with respect to the closure shuttle 1250. For example, a U-shaped connector 1263 is inserted into the annular slot 1262 at the proximal end 1261 of the closure tube 1260 and is retained in the vertical slot 1253 on the closure shuttle 1250. Such an arrangement serves to mount the closure tube 1260 on the closure shuttle 1250 for axial movement therewith, while at the same time allowing the closure tube 1260 to rotate relative to the closure shuttle 1250 about the shaft axis SA. enable. The closure spring 1268 is stored on the closure tube 1260 and serves to bias the closure tube 1260 in a proximal direction “PD”, which closes when the shaft assembly is operatively coupled to the handle 1014. It may serve to pivot the trigger to a non-actuated position.

  In at least one form, the interchangeable shaft assembly 1200 may further include an articulation joint 1270. However, other interchangeable shaft assemblies may not be articulatable. As seen in FIG. 22, for example, articulation joint 1270 includes a dual pivot closure sleeve assembly 1271. According to various aspects, the dual pivot closure sleeve assembly 1271 includes an end effector closure sleeve assembly 1272 having upper and lower distal protruding tongues 1273,1274. End effector closure sleeve assembly 1272 is disclosed in U.S. Patent Application Serial No. 13 / 803,086, filed March 14, 2013, entitled "ARTICULATEABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK," which is incorporated herein by reference. Include a horseshoe-shaped aperture 1275 and a tab 1276 for engaging the opening tab on the anvil 1306 in the various manners described in Sections 1 and 2. As described in further detail in the patent application, the horseshoe aperture 1275 and the tab 1276 engage the tab on the anvil when the anvil 1306 opens. The upper dual pivot link 1277 includes upwardly projecting distal and proximal pivot pins, each of which on the closure tube 1260 is an upper distal pivot in the upper proximal projection tang 1273. The pinhole and the upper proximal pinhole in the upper distal protruding tongue 1264 engage. The lower dual pivot link 1278 includes upwardly projecting distal and proximal pivot pins that are respectively a lower distal pinhole and a lower distal pin in a lower proximal projection tang 1274. Engage the lower proximal pinhole in the protruding tongue 1265. See also FIG.

  In use, the closure tube 1260 translates distally (direction “DD”) to close the anvil 1306, for example, in response to actuation of the closure trigger 1032. The anvil 1306 translates the closure tube 1260, and thus the shaft closure sleeve assembly 1272, distally so as to proximate the anvil 1360 in the manner described in the aforementioned referenced US patent application Ser. No. 13 / 803,086. It is closed by striking the surface. As also detailed in this reference, the anvil 1306 translates the closure tube 1260 and the shaft closure sleeve assembly 1272 proximally to contact and press the tab 1276 and the horseshoe aperture 1275 against the anvil tab. Then, the anvil 1306 is released by lifting. In the anvil open position, shaft closure tube 1260 moves to its proximal position.

  As also shown above, the replaceable shaft assembly 1200 further includes a firing member supported for axial movement within the shaft spine 1210. The firing member includes an intermediate firing shaft portion 1222 configured to be mounted on a distal cutting portion or knife bar. The intermediate firing shaft portion 1222 may include a longitudinal slot at its distal end, which may be configured to receive a tab on the proximal end of the distal knife bar. The longitudinal slot and the proximal end can be sized and configured to allow relative movement between them and can include a slip joint. The slip joint can move the intermediate firing shaft portion 1222 of the firing drive to articulate the end effector 1300 without moving, or at least substantially moving, the knife bar. Once the end effector 1300 is properly oriented, the intermediate firing shaft portion 1222 is advanced until the proximal side wall of the longitudinal slot contacts the tab to advance the knife bar and fire the staple cartridge positioned within the channel 1302. May be advanced distally. A further description of the operation of the firing member can be found in US patent application Ser. No. 13 / 803,086.

  As seen in FIG. 22, the shaft assembly 1200 further includes a switch drum 1500 rotatably received on the closure tube 1260. Switch drum 1500 includes a hollow shaft segment 1502 having a shaft boss formed thereon for receiving an outwardly projecting actuation pin therein. In various situations, the actuation pin extends through a longitudinal slot provided in the locking sleeve to facilitate axial movement of the locking sleeve when engaging an articulation driver. The rotary torsion spring 1420 is configured to engage the boss on the switch drum 1500 and a part of the nozzle housing 1203 to apply a biasing force to the switch drum 1500. The switch drum 11075 can further include an at least partially annular opening 1506 defined therein, the opening 1506 receiving an annular mount extending from the housing halves 1202, 1203, and the switch drum It can be configured to allow relative rotation between 1500 and proximal nozzle 1201, but not translation. The mount also extends through an opening 1266 in the closure tube 1260 and seats in a recess in the shaft spine 121. However, rotation of the nozzle 1201 until the mount reaches the end of each slot 1506 of the mount in the switch drum 1500 will result in rotation of the switch drum 1500 about the shaft axis SA. Rotation of the switch drum 1500 will ultimately result in rotation of the actuation pin and lock sleeve between the engaged and disengaged positions. In this manner, the nozzle 1201 may be used to operatively engage and disengage the articulation drive system with the firing drive system in various manners, each of which is hereby incorporated by reference. For further details, see U.S. Patent Application Serial Nos. 13 / 803,086 and 14 / 226,142, filed March 26, 2014, entitled "SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM," filed March 26, 2014, incorporated herein by reference. Has been described.

  As also shown in FIG. 22, the shaft assembly 1200 can include a slip ring assembly 1600 that directs power to and / or from the end effector 1300, And / or may be configured to communicate signals to and / or from the end effector 1300. Slip ring 600 may include a proximal connector flange 1604 that attaches to a chassis flange 1242 extending from chassis 1240 and a distal connector flange located within a slot defined in the shaft housing. The proximal connector flange 1604 can include a first front surface, and the distal connector flange can include a second front surface adjacent to and movably relative to the first front surface. The distal connector flange can rotate relative to the proximal connector flange 1604 about the shaft axis SA. Proximal connector flange 1604 may include a plurality of concentric or at least substantially concentric conductors defined on a first front surface thereof. The connector may be mounted on the proximal side of the connector flange and may have a plurality of contacts, each contact corresponding to one of the conductors and in electrical contact therewith. Such an arrangement allows for relative rotation between the proximal and distal connector flanges 1604 while maintaining electrical contact therebetween. For example, the turret flange 1604 can include an electrical connector 1606 that can have conductors in signal communication with a shaft circuit board 1610 attached to the shaft chassis 1240. In at least one example, a wire harness comprising a plurality of conductors may extend between electrical connector 1606 and shaft circuit board 1610. Electrical connector 1606 may extend proximally through connector opening 1243 defined in chassis mounting flange 1242. See FIG. US patent application Ser. No. 13 / 800,067, filed Mar. 13, 2013, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM", is hereby incorporated by reference in its entirety. U.S. Patent Application No. 13 / 800,025, filed March 13, 2013, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM", is hereby incorporated by reference in its entirety. Further details regarding slip ring assembly 1600 can be found in US patent application Ser. No. 13 / 803,086.

  As discussed above, the shaft assembly 1200 can include a proximal portion that is fixedly attached to the handle 1014 and a distal portion that is rotatable about a longitudinal axis. The rotatable distal shaft portion may rotate relative to the proximal portion about slip ring assembly 1600, as discussed above. The distal connector flange of the slip ring assembly 1600 may be located within the rotatable distal shaft portion. Further, in addition to the above, a switch drum 1500 may also be located within the rotatable distal shaft portion. As the rotatable distal shaft portion rotates, the distal connector flange and switch drum 1500 may rotate in synchrony with each other. In addition, the switch drum 1500 can rotate between a first position and a second position with respect to the distal connector flange. When the switch drum 1500 is in its first position, the articulation drive system may be operatively disengaged from the firing drive system, so that operation of the firing drive system causes the end effector 1300 of the shaft assembly 1200 to move. The joint may not be bent. When the switch drum 1500 is in its second position, the articulation drive system may be in operable engagement with the firing drive system, such that operation of the firing drive system causes the end effector 1300 of the shaft assembly 1200 to articulate. It may be bent. As the switch drum 1500 moves between its first position and its second position, the switch drum 1500 moves relative to the distal connector flange. In various examples, the shaft assembly 1200 can include at least one sensor configured to detect a position of the switch drum 1500.

  22, the chassis 1240 includes at least one, and preferably two, tapered mounting portions 1244 formed thereon, wherein the mounting portions 1244 are within the distal mounting flange portion 1700 of the frame 1020. Is adapted to be received in a corresponding dovetail slot 1702 formed therein. See FIG. Each dovetail slot 1702 may be tapered or, in other words, somewhat V-shaped to seat and receive the mounting portion 1244 therein. As further seen in FIG. 22, a shaft mounting lug 1226 is formed at the proximal end of the intermediate firing shaft 1222. As will be discussed in further detail below, when the replaceable shaft assembly 1200 is coupled to the handle 1014, the shaft mounting lugs 1226 form a firing shaft mounting cradle 1126 formed at the distal end 1125 of the longitudinal drive member 1120. Has been accepted. See FIG.

  Various shaft assembly embodiments use a latch system 1710 to removably couple the shaft assembly 1200 to the housing 1012, and more specifically to the frame 1020. As seen in FIG. 22, for example, in at least one form, latch system 1710 includes a locking member or yoke 1712 movably coupled to chassis 1240. In the embodiment shown, for example, the lock yoke 1712 is U-shaped and has two spaced apart downwardly extending legs 1714. The legs 1714 each have a pivot lug 1715 formed thereon, which is adapted to be received in a corresponding hole 1245 formed in the chassis 1240. Such an arrangement facilitates pivotal mounting of the lock yoke 1712 to the chassis 1240. The locking yoke 1712 may include two proximally projecting locking lugs 1716 that releasably engage with corresponding locking detents or grooves 1704 at the distal mounting flange 1700 of the 1716 frame 1020. It is configured as follows. See FIG. In various configurations, lock yoke 1712 is biased proximally by a spring or biasing member (not shown). Actuation of the lock yoke 1712 may be accomplished by a latch button 1722 slidably mounted on a latch actuator assembly 1720 mounted on the chassis 1240. Latch button 1722 may be biased proximally relative to lock yoke 1712. As discussed in further detail below, lock yoke 1712 may be moved to the unlocked position by biasing the latch button distally, and this bias causes lock yoke 1712 to pivot. The frame 1020 disengages from the retaining engagement with the distal mounting flange 1700. When the locking yoke 1712 is in a “holding engagement” with the distal mounting flange 1700 of the frame 1020, the locking lugs 1716 seat to retain in the corresponding locking detent or groove 1704 at the distal mounting flange 1700.

  When using a replaceable shaft assembly that includes an end effector of the type described herein and other types of end effectors adapted to cut and fasten tissue, the replaceable shaft assembly during operation of the end effector It may be desirable to prevent the inadvertent separation from the housing. For example, during use, the clinician may actuate the closure trigger 32 to grasp and manipulate the target tissue to a desired location. Once the target tissue is positioned within the end effector 1300 in the desired orientation, the clinician fully activates the closure trigger 1032 to close the anvil 1306 and secure the target tissue in a position for cutting and stapling. I do. In this example, the first drive system 1030 is fully operational. After securing the target tissue in the end effector 1300, it may be desirable to prevent the shaft assembly 1200 from inadvertently separating from the housing 1012. One form of the latch system 1710 is configured to prevent such inadvertent separation.

  As seen in particular in FIG. 22, the locking yoke 1712 includes at least one, and preferably two, locking hooks 1718 that are attached to corresponding locking lug portions 1256 formed on the closure shuttle 1250. Adapted to contact. When the closed shuttle 1250 is in the inactive position (i.e., the first drive system 1030 is inactive and the anvil 1306 is open), the lock yoke 1712 pivots in a distal direction to allow the interchangeable shaft The assembly 1200 may be unlocked from the housing 1012. When in this position, the locking hook 1718 does not contact the locking lug portion 1256 on the closure shuttle 1250. However, when closing shuttle 1250 moves to the operative position (ie, first drive system 1030 is activated and anvil 1306 is in the closed position), lock yoke 1712 is prevented from pivoting to the unlocked position. . In other words, if the clinician attempts to pivot lock yoke 1712 to the unlocked position, or, for example, inadvertently hits or contacts lock yoke 1712 in a manner that could otherwise cause it to pivot distally If so, the lock hook 1718 on the lock yoke 1712 will contact the lock lug 1256 on the closure shuttle 1250, preventing the lock yoke 1712 from moving to the unlocked position.

  The attachment of the interchangeable shaft assembly 1200 to the handle 1014 will now be described. To begin the coupling process, the chassis 1240 of the interchangeable shaft assembly 1200 is positioned on or adjacent to the distal mounting flange 1700 of the frame 1020 to form a tapered mounting portion formed on the chassis 1240. 1244 may be aligned with dovetail slot 1702 in frame 1020. The clinician may then move the shaft assembly 1200 along a mounting axis perpendicular to the shaft axis SA to seat the mounting portion 1244 in “operable engagement” with the corresponding dovetail receiving slot 1702. Good. In doing so, the shaft mounting lug 1226 on the intermediate firing shaft 1222 will also seat in the cradle 1126 in the longitudinally movable drive member 1120 and the portion of the pin 1037 on the second closure link 1038 Will seat in the corresponding hooks 1252 in the closure yoke 1250. As used herein, the term "operable engagement" in the context of two components refers to the fact that the two components are sufficiently engaged with each other so that when an actuation motion is applied to them, Are capable of performing the intended action, function and / or action.

  At least five systems of the interchangeable shaft assembly 1200 may be operably coupled with at least five corresponding systems of the handle 1014. The first system can include a frame system that couples and / or aligns the frame or spine of the shaft assembly 1200 with the frame 1020 of the handle 1014. Another system can include a closure drive system 1030 that can operably couple the closure trigger 1032 of the handle 1014, the closure tube 1260, and the anvil 1306 of the shaft assembly 1200. As outlined above, the closure tube mounting yoke 1250 of the shaft assembly 1200 may be engaged with the pin 1037 on the second closure link 1038. Another system can include a firing drive system 1080 that can operatively couple the firing trigger 1130 of the handle 1014 with the intermediate firing shaft 1222 of the shaft assembly 1200. As outlined above, shaft mounting lug 1226 may be operably coupled to cradle 1126 of longitudinal drive member 1120. Another system can communicate to a controller in handle 1014, such as, for example, a microcontroller, that a shaft assembly, such as, for example, shaft assembly 1200, is operably engaged with handle 1014, and And / or secondly, an electrical system may be provided that can communicate power and / or communication signals between the shaft assembly 1200 and the handle 1014. For example, the shaft assembly 1200 can include an electrical connector 1810 operably attached to the shaft circuit board 1610. The electrical connector 1810 is configured to mate with a corresponding electrical connector 1800 on the handle control board 1100. Further details of reclaiming circuits and control systems can be found in U.S. Patent Application Nos. 13 / 803,086 and 14 / 226,142, the entire disclosures of each of which are incorporated herein by reference. Is incorporated into the book. The fifth system may consist of a latch system for releasably locking shaft assembly 1200 to handle 1014.

  Surgical staplers have been used in the prior art to simultaneously make a longitudinal incision in tissue and apply a line of staples to opposing sides of the incision. Such devices generally include a pair of cooperating jaw members that can pass through a cannula passage when the device is intended for endoscopic or laparoscopic applications. One of the jaw members receives a staple cartridge having at least two rows of laterally spaced staples. The other jaw member defines an anvil having staple forming pockets aligned with the rows of staples in the cartridge. The instrument includes a plurality of reciprocating wedges that, when driven distally, pass through an opening in the staple cartridge and engage a driver that supports the staples to direct them toward the anvil. Achieve staple firing.

  Simultaneous cutting of tissue and formation of rows of staples on each side of the cut reduces bleeding and simplifies surgery. Endoscopic and laparoscopic procedures have become preferred over open procedures due to their post-operative recovery time and other advantages. Endoscopic stapling and cutting instruments use long, narrower jaw members that tend to deflect upward when secured to thick tissue. In thick tissue, this upward deflection of the free (distal) end of the jaw creates a difference in formed staple height because the distal gap between the anvil and the cartridge is larger than the proximal gap. obtain. The anvil frequently bows or bends inwardly toward the staple cartridge to ensure more uniform proximal to distal staple formation. This bow is more suitable for thicker tissue and when used on thinner tissue may result in a tighter staple shape at the distal end. To overcome this tight distal closure, pins or bumps were added to the clamping surface of the cartridge adjacent to the distal end of the cartridge. Closure of the anvil to the pin ensures that the void at the distal end is minimal. However, surgeons were concerned that the pins or bumps would cause tissue trauma.

  Various arrangements have been developed to overcome such difficulties. One arrangement includes, for example, an "E-beam" cutting head or firing bar, which is configured to actively move the anvil away from the elongated channel supporting the staple cartridge. Such an E-beam cutting head and firing bar arrangement are disclosed, for example, in U.S. Pat. No. 6,978,921, entitled "SURGICAL STAPLING INSTRUMENT INCORPORATING AN E-BEAM FIRING MECHANISM", the entire disclosure of which is hereby incorporated by reference. Incorporated in the specification.

  For example, as illustrated in FIGS. 2 and 3 herein, the tissue cutting head includes an E-beam 50 that can translate within the end effector 16. As described above, the E-beam 50 includes a vertical portion 52 that can pass through a narrow longitudinal anvil slot 58 that extends through a tissue contacting surface 60 in the anvil 20 and a narrow vertical slot in the staple cartridge 42. 62 and a narrow longitudinal channel slot 64 in the elongated staple channel 40 when the E-beam 50 is advanced distally. Anvil slot 58 may extend upwardly into anvil 20 and may have a laterally enlarged longitudinal dimension sized and configured to receive a top pin 54 extending laterally from vertical portion 52. A distal end that opens into the directional channel 66 may be provided. Similarly, channel slot 64 may extend downwardly into channel 40 and is dimensioned to receive one or more lower legs 70 extending laterally from vertical portion 52. A configured distal end that opens into a laterally enlarged longitudinal channel 68 may be provided. E-beam 50 may extend laterally from vertical portion 52 and may be configured to slide along the top surface of bottom tray 74 of staple cartridge 42, with one or more intermediate portions. A pin 72 may be further provided. In certain embodiments, intermediate pin 72 can be configured to seat staple cartridge 42 or to ensure that staple cartridge 42 remains seated in channel 40. A longitudinal firing recess 75 formed in the staple cartridge 42 on the bottom tray 74 is sized to translate the intermediate pin 72 through the staple cartridge 42.

  Various elongate channel arrangements include an elongate slot or a longitudinal slot, wherein the slot defines a start position of the E-beam cutting head at a proximal portion of the elongate channel and an end position adjacent the distal end of the elongate channel. Extending between. The vertical portion of the E-beam cutting head extends through its longitudinal slot, and the lower leg portion of the E-beam rides on the bottom surface of the elongate channel. The leg portions may actively assist in spacing the anvil relative to the elongate channel and may serve as a convenient means for a clinician to locate the cutting head in the elongate channel. By observing the position of the cutting head legs as the cutting head is advanced distally through the cartridge, the clinician will know exactly where in the cartridge the cutting head is located. While providing an effective means for spacing the anvil and monitoring the position of the cutting head, such an arrangement uses stiffness and twisting and spreading of the channel by using longitudinal slots in the elongated channel. Channel resistance may be reduced.

  To avoid such spreading of the elongate channels, it may be desirable to eliminate longitudinal slots to increase resistance to twisting and spreading when stapling thick tissue. However, such an arrangement may not allow the surgeon to ascertain the distance the stapling has progressed by observing the position of the knife leg. FIG. 32 illustrates an elongate channel 6022 that may be similar to the various elongate channels disclosed herein, except for the following differences, including, for example, elongate channels 22 and 302. Elongated channel 6022 may be molded and / or machined and / or otherwise formed from a suitable polymeric material and may include a substantially sturdy bottom portion 6024. The elongate channel 6022 is configured to operably support a surgical staple cartridge (not shown) within the elongate channel 6022. The elongate channel 6022 may include an elongate internal slot 6026 defined by two inwardly extending ledge portions 6028. The inwardly extending ledge portion 6028 also defines an elongated internal passageway 6030 between the ledge portion 6028 and the solid bottom portion 6024. The elongated inner slot 6026 extends for most of the length of the elongated channel 6022, but does not extend through the bottom surface 6024 of the elongated channel 6022. The internal passageway 6030 is dimensioned to slidably accommodate the leg (s) formed or otherwise mounted on the cutting head.

  FIG. 42 illustrates an E-beam cutting head 6050 that may be used, for example, in conjunction with an elongated channel 6022. However, as will become apparent below, the elongate channel 6022 can also be used in connection with a variety of different cutting head arrangements using a single leg or multiple legs on the bottom of the cutting head. Referring to FIG. 42, the cutting head 6050 includes a vertical portion 6052 that terminates in two laterally extending lower legs 6070. The vertical portion 6052 is configured to pass through the elongated slot 6026 such that the lower leg 6070 is received below the corresponding ledge portion 6028.

  Referring again to FIG. 32, the elongate channel 6022 may further include a proximal channel opening 6040 provided at the proximal end of the bottom portion 6024 of the elongate channel 6022. The proximal channel opening 6040 allows the clinician to see at least one of the leg 6070 or other portion (s) of the cutting head 6050 when the cutting head 6050 is in the starting or unfired position. Can be. This "start position" may also correspond to the position when the cutting head 6050 is in the lockout position discussed in more detail below. Similarly, a distal channel opening 6042 is provided at the distal end of the bottom portion 6024 so that the clinician can view the legs 6070 of the cutting head 6050 when the cutting head 6050 is in its “full firing” or “end position”. Or at least one of the other part (s) can be seen. Such an arrangement provides an elongate channel that is relatively stiff compared to other channels having longitudinal slots that extend longitudinally through the bottom of the elongate channel, while providing the clinician with the cutting head at its starting position or Provides a way to specify where to end. Proximal channel opening 6040 and distal channel opening 6042 can be used, for example, to easily mount cutting head 6050 in elongated channel 6022 (through proximal channel opening 6040) and to cut (through distal channel opening 6042). The head 6050 may be shaped in the manner illustrated in FIG. 32 to facilitate removal from the elongate channel 6022. To this end, the elongate channels 6022 each have a closed bottom with openings 6040, 6042 corresponding to the start and end of the cutting head firing stroke. Such an arrangement allows visualization of the start and end of firing and also allows the cutting head to move downward to a locked position, discussed in more detail below.

  Elongated channel 6022 may advantageously employ a manually advanced cutting head assembly or a cutting head assembly advanced by a motor driven firing system. For example, the aforementioned surgical instrument 10 includes a cutting head 50 that is manually advanced by activating the trigger 32. In various arrangements, the cutting head 50 can be advanced from its start position to its end position by activating the firing trigger 32 three times. Thus, for example, actuation of trigger 32 once can cause the cutting head to move distally in the elongate channel a third of the distance between the starting and ending positions ("first"). Launch position "). Activating the trigger a second time allows the cutting head 50 to advance two-thirds of the way between the start position and the end position ("second firing position"), and trigger 32 to be activated a third time. When activated, the cutting head 50 can be advanced from the second firing position to the end position. In this way, when the cutting head 6050 is visible through the distal channel opening 6042, the clinician knows that the cutting head 6050 has been fully fired. Such an elongate channel 6022 can also be used in conjunction with a powered surgical instrument 1010 (FIGS. 19-22).

  33-35 illustrate another elongate channel arrangement 6122 that is similar to the elongate channel 6022 except as noted. Portions of the elongated channel configuration 6122 that are identical to portions of the elongated channel configuration 6022 share the same element numbers. Specifically, as seen in FIG. 33, a series of spaced indicator openings 6144 are provided in the bottom portion 6124. The indicator openings 6144 may vary in number, size, and spacing, but in at least one arrangement, the indicator openings 6144 have the same dimensions so that they communicate with the elongated internal passageway 6030; Evenly spaced by a straight line. As can be seen in those figures, the shape of the indicator opening 6144 is circular. As also seen in FIG. 33, light source 6160 is a proximal end of elongate channel 6122 such that light source 6160 projects light into interior passageway 6030 (represented by the dashed “L” in FIGS. 33 and 34). Can be attached to The light source 6160 can receive power through a conductor 6164 coupled to a handle, such as a surgical instrument or robotic system, to which the elongate channel 6122 is operably mounted, for example, one or more light emitting diodes ( “LEDs”) or other light source arrangements. When power is supplied to light source 6160, light is projected into internal passageway 6030. When the cutting head 6050 is in the starting position, the cutting head 6050 may prevent any light "L" from being seen through any of the indicator openings 6144. Thus, when light "L" is not visible through any of the indicator openings 6144, the clinician knows that the cutting head 6050 is in the starting position. As the cutting head 6050 advances distally past the indicator opening 6144, a light "L" impinges on the cutting head 6050, as shown in FIG. Visible through the unlit indicator opening 6144. In this manner, such an arrangement allows a clinician to monitor the progress of the cutting head 6050 moving the elongate channel 6122 distally from its start position to its end position. Such an elongate channel arrangement is also stiffer and more rigid than an elongate channel arrangement having an elongate slot extending completely through most of the bottom surface of the elongate channel. In one arrangement, the clinician can determine the position of the cutting head because there is no bright light through the indicator opening where the cutting head is located. All of the other indicator openings have bright light passing through them. Thus, in one arrangement, the "dark" or unlit indicator opening is where the cutting head is located. In other embodiments, the light source may be omitted. The clinician can still monitor the position of the cutting head 6050 in the elongated channel 6122 by looking at the position of the leg 6070 through the indicator opening 6144.

  FIG. 36 illustrates another elongate channel arrangement 6222 that is similar to the elongate channel 6122 except for the differences described. Portions of the elongated channel configuration 6222 that are identical to portions of the elongated channel configuration 6122 share the same element numbers. As seen in this figure, a series of spaced indicator openings 6144 are provided through the bottom surface 6224. In the arrangement shown, the indicator openings 6144 have the same size and shape, but are provided through the bottom surface 6224 with different spacing. For example, the proximal indicator opening 6144P may be separated from the proximal opening 6040 by a first separation distance “FSD”, for example, when the cutting head 6050 is in the starting position, through which the legs of the cutting head 6050 may be. Make at least one of the part 6070 or other part visible. Similarly, the distal-most indicator opening 6144D may be spaced from the adjacent indicator opening 6144 by a second spacing “SSD” that is different from the first spacing FSD. As seen in FIG. 36, for example, SSD is larger than FSD. The distal-most indicator opening 6144D may correspond to the position of the cutting head 6050 at its end position. To this end, the elongate channel arrangement 6222 illustrates a variably spaced indicator opening that decreases as the number of openings moves from proximal to distal.

  FIG. 37 illustrates another elongated channel arrangement 6322 that is similar to the elongated channel 6122 except for the differences described. Portions of the elongated channel configuration 6322 that are identical to portions of the elongated channel configuration 6122 share the same element numbers. As seen in that figure, the elongate channel arrangement 6322 includes a series of elongate discrete indicator openings 6144 '. In the arrangement shown, the indicator openings 6144 'have the same size and shape, but are evenly spaced.

  FIG. 38 illustrates another elongate channel arrangement 6422 that is similar to elongate channel 6222 except as noted. Portions of the elongate channel arrangement 6422 that are identical to parts of the elongate channel arrangement 6222 share the same element numbers. As seen in that figure, only two spaced “discrete” indicator openings 6144 ″ are provided through the bottom surface 6424. In the arrangement shown, the indicator openings 6144 '' have the same size and shape, but are provided through the bottom surface 6424 at different spacing intervals. For example, the proximal indicator opening 6144P ″ may be separated from the proximal opening 6040 by a first separation distance “FSD”, and the distal-most indicator opening 6144D ″ may be the proximal-most indicator opening 6144. '', The first and second distances FSD may be different from each other by a second distance “SSD”. In at least one arrangement, for example, where the elongate channel 6422 is used with a cutting head assembly that is manually advanced by actuating a firing trigger, at least one leg or other portion of the cutting head assembly may include: As the cutting head assembly advances through the “first stroke” or first actuation of the firing trigger, it is visible through the proximal indicator opening 6144P ″. Similarly, at least one leg or other portion of the cutting head assembly is visible through the most distal indication opening 6144D '' during the second stroke or second actuation sequence of the firing trigger. . To this end, the elongate channel 6422 includes an elongate slot-shaped indicator opening as well as a circular upper indicator opening that provides more closure / less opening as it moves from proximal to distal.

  FIG. 39 illustrates another elongate channel arrangement 6522 that is similar to the elongate channel 6422 except as noted. Portions of the elongate channel arrangement 6522 that are identical to parts of the elongate channel arrangement 6422 share the same element numbers. As can be seen in this figure, the elongate channel 6522 includes a combination of round, evenly spaced indicator openings 6144, as well as a combination of re-proximal elongated indicator openings 6144P ″, and a first stroke of the firing trigger. Or, during the actuation sequence, allow the clinician to see at least one leg or other portion of the cutting head assembly. Thus, the elongate channel 6522 uses a combination of slotted slots. Any one of the elongate channel arrangements described above may incorporate a light source 6160 specifically described herein in connection with the embodiment shown in FIG. 33, or they may not include a light source. May be used.

  Other cutting head monitoring arrangements emit light below the opening of the channel or below the interior of the slot of the channel, such as one or more light source arrangements or light emitting diode ("LED") arrangements. May be provided. This will greatly increase the user's ability to locate the moving cutting head and determine whether all strokes have been completed. In some arrangements, for example, the LEDs may include multi-colored LEDs that change from green to blue (or other color scheme) as the cutting head advances toward the channel, further increasing the cutting head advance. Discriminate.

  In various end effector configurations, it may be desirable to use a system to prevent advancement or firing of the cutting head unless an unused staple cartridge is operatively attached to the elongated channel. For example, U.S. Patent No. 6,988,649, entitled "SURGICAL STAPLING INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT", and U.S. Patent No. 7,044,352, each of which is incorporated herein by reference in its entirety. "SURGICAL STAPLING INSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING" discloses various lockout systems. In such a lockout arrangement, the cutting head or "firing bar" is typically biased to a locked position by a spring arrangement. The cutting head cannot be advanced by the firing drive system of the surgical instrument until an unused cartridge is installed in the elongated channel.

  Referring to FIGS. 40-42, a cutting head 6050 mounted on a firing bar 6080 is shown. As shown, the firing bar 6080 is a laminated structure. However, firing bar 6080 may be an integral structure. In either case, the firing bar 6080 is operatively associated with the firing drive system of the surgical instrument described herein or otherwise known. Activation of the firing drive system axially advances the firing bar 6080 and the cutting head 6050 mounted thereon through a surgical staple cartridge mounted in the elongated channel 6122. The vertical portion 6052 of the cutting head 6050 includes a tissue cutting surface 6053 located between the upper end portion 6054 and the central hook portion 6056. See FIG. An upper pin or tab 6058 extends laterally from each side of the upper end portion 6054. The upper tab 6058 is configured to be slidably received within an upper passage in an anvil operably mounted in the elongate channel, as discussed further below.

  FIG. 41 illustrates the position of the cutting head 6050 and firing bar 6080 when no surgical staple cartridge is present in the elongated channel 6122. When in that position, firing bar 6080 and cutting head 6050 are biased in a downward direction “D” by a spring arm 6090 supported by a shaft spine (not shown) coupled to elongated channel 6122. As can be seen, the spring arm 6090 is in sliding engagement with a spring tail 6082 formed at the distal end of the firing bar 6080. The bottom portion of the spring tail 6082 is biased against a sloped surface 6123 formed on the elongated channel 6122 when the cutting head 6050 is in its locked position shown in FIG. As further seen in FIG. 41, when the cutting head 6050 is in the locked position and the clinician inadvertently attempts to advance or “fire” the cutting head 6050 distally through the elongated channel 6122, the lower leg The one or more 6070 will contact the bottom of the elongate channel 6122. In other words, when the cutting head 6050 is in the locked position, the legs 6070 are not aligned with the internal passageway 6030 of the elongate channel 6122, so that the cutting head assembly 6050 is axially within the elongate channel 6122. Can not move forward. The clinician recognizes that the cutting head is locked by observing the position of the leg 6070 within the proximal opening 6040.

  FIG. 40 illustrates the position of the cutting head 6050 and firing bar 6080 as an unused surgical staple cartridge is operably supported within the elongated channel 6122. The body of the surgical staple cartridge is not shown in FIG. 40, but a wedge sled assembly 6078 is shown. It is understood that the wedge thread assembly 6078 is in the position shown in FIG. 40 of the unfired or unused staple cartridge. In that position, the wedge sled assembly 6078 causes the cutting head 6050 to face upward as the cutting head 6050 advances distally until the point above which the legs 6070 enter the internal passageway 6030 of the elongated channel 6122. Engage with hook portion 6056 on cutting head 6050 to lift in the direction (arrow “U” in FIG. 40). When using elongated channels with closed or substantially closed bottoms, such as those described herein, in some cases, dimensional stacking situations may occur, and extremely thin using end effectors. When cutting and stapling tissue, interference between the channel bottom and the knife leg (s) may occur. If the tissue is too thin, for example, the compressive resistance of the tissue may not be sufficient to force the anvil away from the elongated channel and load those two components against the cutting head tab. If this situation occurs, the knife leg (s) may extend well below the bottom of the elongated channel such that the cutting head cannot be advanced distally. The cutting head assembly 6050 and elongated channel arrangement 6122 shown in FIGS. 40 and 41 can prevent this from occurring.

  As seen in FIGS. 40 and 41, for example, the distal end of each leg 6070 may have a chamfer 6072 formed thereon. The chamfer 6072 is configured to engage a corresponding portion of the elongate channel 6122 as the cutting head 6050 advances distally, causing the leg 6070 to enter the internal passageway 6030. Thus, the chamfer 6072 forms a small “lead-in” ramp, which assists in guiding the leg 6070 into the passageway 6030. As seen in FIGS. 40 and 41, the portion of the elongate channel 6122 that defines the proximal end 6131 of the internal passageway 6030 may have a chamfer 6133 thereon or otherwise beveled as shown. You may be. In alternative arrangements, a plurality of legs 6070 (or a single leg may be provided with a chamfer 6072, or a proximal end portion 6131 of the internal passageway 6030 may be provided with a chamfer 6133, or both. May be provided as shown in FIGS. 40 and 41.

  FIGS. 43 and 44 illustrate an end effector 7016, which may be similar to the end effector 16 or 300 or other end effectors disclosed herein, for example. In this arrangement, the closure tube or sleeve 7028 has a series of indicator openings 7144 through which the clinician can view the firing bar 6080. Fire bar 6080 may be provided with a status indicator 6084 thereon that may be viewed by a clinician through indicator opening 7144 as fire bar 6080 is advanced distally. Status indicator 6084 may simply include a colored indicator or other feature that would serve as an indicator indicator. In one arrangement, the status indicator 6084 comprises one or more light emitting diodes (LEDs) or other light sources powered by the power source of the surgical instrument or system to which the end effector 7016 is mounted.

  FIG. 45 illustrates another end effector 7016 where the closure sleeve section 7030 includes an indicator window 7032 that allows a clinician to determine whether the cutting head is in its locked position. In this arrangement, if the clinician can see the spring tail 6082 through the indicator window 7032, the cutting head is not in its locked position. If the clinician cannot see the spring tail 6082 through the indicator window 7032, the cutting head is in the locked position. In an alternative arrangement, the indicator window 7032 is such that when the spring tail 6082 is visible through the indicator window 7032, the cutting head is in its locked position, and when the spring tail 6082 is not visible through the indicator opening, the cutting head is not in the locked position. As such, it may be provided at such a location (eg, below the closure sleeve section). To assist a clinician in determining the position of the cutting head, the cutting head may be provided in a particular light or fluorescent color. These color schemes may be, for example, radium based. Further, the color of the cutting head may vary along its length to allow the clinician to easily locate it.

  FIG. 47 illustrates an anvil 7020 that includes a plurality or series of indicator openings 7044 that provide a view into passageway 7022 where upper end portion 6054 on cutting head 6050 passes axially into passageway 7022. In the embodiment shown in FIG. 47, the indicator openings 7044 have a circular shape and are evenly spaced along the length of the anvil 7020. In the embodiment shown in FIG. 48, the indicator openings 7044 are closer together and spaced apart at the proximal end of the anvil 7020. The spacing between the indicator openings 7044 gradually increases distally in the anvil 7020. However, the size, shape, and spacing of the indicator openings 7044 may vary. Referring to FIG. 42, an indicator member 6059 may be provided on the upper end portion 6054 of the cutting head 6050. In one embodiment, indicator member 6059 comprises one or more light emitting diodes or other light sources that can draw power from the surgical instrument through conductor 6081 passing through firing bar 6080. Such an arrangement allows a clinician to see the position of indicator member 6059 through indicator opening 7044 in anvil 7020 as cutting head 6050 is advanced through the end effector. In other arrangements, the cutting head may not be provided with an indicator member (LED, light). However, the upper end portion of the cutting head may be provided with a colored or fluorescent label that will increase its visibility through the indicator opening in the anvil. For example, the color may be radium based. The cutting head may alternatively be provided with a laser scribed number to provide a means for determining the position of the cutting head within the channel or anvil.

  Anvil 7020 shown in FIG. 46 uses an indicator system generally designated as 7200. In this embodiment, indicator system 7200 includes a flexible strip or corrugated spring 7202 stored at least at its proximal end 7204 in a slot 7021 provided in anvil 7020. The wave spring 7202 extends the length of the anvil 7020 and is at least coextensive with the portion of the anvil 7020 having the indicator opening 7044 therethrough. As seen in FIG. 46, a series of indicator members 7206 are mounted on the flexible strip 7202 such that each indicator member 7206 is slidably supported in a corresponding indicator opening 7044. Each indicator member 7206 is initially supported within indicator opening 7044 so as not to protrude from its corresponding indicator opening 7044. In other words, the wave spring 7202 is configured to bias the indicator member 7206 to an initial position where it does not protrude from its respective indicator opening 7044. However, as the cutting head 6050 is advanced distally through the end effector, the upper portion 6054 of the cutting head 6050 is shown in FIG. As described above, the indicator member 7206 slides along the bottom of the wave spring 7202 so as to be protruded from the indicator opening 7044, and functions to urge the wave spring 7202 upward. This allows the clinician to monitor the position of the cutting head 6050 within the end effector by noting which indicator member 7206 protrudes from its indicator opening 7044.

  In this way, some of the elongate channel arrangements disclosed herein offer significant improvements over previous elongate channel arrangements. For example, at least some of the elongated channel arrangements do not use elongated slots that extend through the bottom of the channel. Thus, such elongated channel arrangements tend to be stiffer and resist spreading during operation. These advantages are also achieved while providing the clinician with a means for monitoring the progress of the cutting head. For example, some elongate channel arrangements provide periodic visibility along the length of the channel to inform the clinician where the cutting head is in the firing cycle. At least some of the elongated channel arrangements may allow a clinician to see at least a portion of the cutting head when the cutting head is in a fully deployed position, as well as when the cutting head is in a fully retracted position. To Further, at least some of the channel and / or anvil arrangements provide visibility of at least a portion of the cutting head from the side or top of the end effector or otherwise from the side or top of the end effector. A means is provided for locating the cutting head.

  As described above, the surgical staple cartridge operably supports within the surgical staple cartridge a series of staple drivers, each supporting one or more surgical staples thereon. The staple driver is supported in a correspondingly shaped staple pocket arranged in a linear orientation within the cartridge body. The surgical staple is movable on the driver such that when the driver is driven upwards in the cartridge, the staple is secured between the cartridge and the anvil and is driven through tissue that contacts the underside of the anvil. Supported. When the anvil is open, the staples remain in the stapled tissue. Because the staples are "loosely" supported in their respective pockets on their staple drivers, they may be removed from the staple cartridge if the staple cartridge is inadvertently turned over before use. May come off. To avoid this from happening, a cartridge cover is typically removably attached to the staple cartridge prior to use. When mounted on the cartridge, the cartridge cover covers the staple pocket and holds the staple in the staple pocket regardless of the position of the cartridge. If the clinician desires to install the cartridge in the end effector, the cover is removed before installing.

  As discussed further above, the staple driver is driven continuously upward in the cartridge by a wedge sled that is driven distally with the cutting head assembly. In at least some arrangements, the wedge sled is thus oriented to the nearest "start" position of the unused cartridge prior to firing. Indeed, as also discussed above, at least some arrangements include a wedge thread (when in its starting position) and a cutting head (when in its starting position) to move the cutting head from the locked position in preparation for firing. When in its locked position). In at least some prior art arrangements, however, the cartridge lacked means or structures to ensure that the wedge sled remained in its starting position prior to use. The cartridge cover 7250 shown in FIGS. 64 and 65 can address such issues.

  FIG. 64 illustrates a surgical staple having a cartridge body 7222 operably supporting a plurality of staple drivers (not shown) within the cartridge body 7222 on each lateral side of the longitudinally extending slot 7224. The cartridge 7220 is illustrated. A longitudinally extending slot 7224 is configured to facilitate longitudinal movement of the cutting head through the cartridge. As seen in FIG. 65, cartridge 7220 also supports wedge sled 7230 at a starting position adjacent the proximal end of cartridge body 7222. FIGS. 64 and 65 also illustrate a cartridge cover 7250 that includes a top 7252 that is configured to cover the cartridge deck 7226 when the cartridge cover 7250 is installed on the cartridge 7220. More specifically, the upper portion 7252 is configured to cover all of the fastener cavity openings in the deck 7226 of the cartridge body 7222 when the upper portion 7252 is in the “covering position”. The cartridge cover 7250 is detachably attached to the staple cartridge 7220 by a pair of flexible mounting arms 7254 configured to hold and engage the cartridge body 7222. The clinician can easily remove the cartridge cover 7250 by pulling the flexible mounting arm 7254 out of the retaining engagement with the cartridge body 7222. The cartridge cover 7250 may further include a pair of downwardly extending lateral plates 7255 that function to position the cartridge cover 7250 at a desired location on the cartridge 7220. For example, a lateral side plate 7255 may be positioned to engage a laterally extending lip 7227 formed on each side of the cartridge deck 7226. The cartridge cover 7250 is oriented such that it is received in a longitudinally extending slot 7224 when the cartridge cover 7250 is mounted on the cartridge 7220, as shown in FIG. 65. Fins 7256 may also be included. The locating fins 7256 engage to retain a portion of the wedge thread 7230 and are configured to retain the wedge thread 7230 in its starting position or engagement notch 7258 or other formation (s). )including. In this way, when the cartridge cover 7250 is installed over the staple cartridge 7220, the staples are retained in their respective pockets regardless of the orientation of the cartridge 7220. In addition, wedge sled 7230 is held in its starting position. In various arrangements, the locating fins may be dimensioned thereto to establish a friction fit with the longitudinally extending slots 7224. In such an arrangement, the cover 7250 can be held in position on the cartridge 7220 without the need for a mounting arm 7254 using friction fit. In other arrangements, the friction fit established between the locating fins 7256 and the cartridge body 7222, as well as the mounting arm 7254, can be used to hold the cover 7250 on the cartridge body 7222 in a coated position. In addition, retaining ribs 7257 may be formed on the locating fins 7256 to further establish a friction fit with the cartridge body 7222. Also, as seen in FIG. 65, the distal end 7221 of the surgical staple cartridge 7220 can have a nasal surface 7223 that is angled with respect to the cartridge deck 7226. In various arrangements, the cartridge cover 7250 may also include a nose 7251 configured to retain and engage the distal end 7221 of the surgical staple cartridge 7220. For example, the nose 7251 may be configured to cover the nasal surface 7223 of the cartridge 7220 and includes a distal retention tab 7253 that is positioned to hook and engage the distal end 7221 of the cartridge 7220. In addition, a separation tab or protrusion 7259 may be formed on the nose 7251 to facilitate separation of the retention tab 7253 from the cartridge 7220. Thus, in one particular arrangement, the distal end of the cartridge cover 7250 absorbs all of the nose-down force, and only a small longitudinal movement of the cover 7250 relative to the cartridge body 7222 increases the force. Is directly transmitted to the cartridge 7220. Such an arrangement functions to prevent the cover 7250 from moving the sled 7230 proximally under such conditions. When the clinician desires to use cartridge 7220, cartridge cover 7250 is removed. In at least some arrangements, the cartridge cover 7250 may be provided in a particular color, which corresponds to the size of staples received in the staple cartridge 7220.

  As discussed in detail above, in various embodiments, the surgical staple is supported on a "driver" operably supported in a pocket formed in the body of the staple cartridge. Various forms of drivers may be used. For example, a driver may be configured to support a single surgical staple, while another driver may support multiple surgical staples. The driver is supported in the cartridge body in a longitudinally extending row provided on each lateral side of a centrally located elongate slot that houses the passageway through which the cutting member or cutting head passes. As already discussed herein, the cutting head includes a wedge thread that is in continuous contact with the driver and configured to drive them upward in their respective pockets, or a wedge thread. Work with threads. As the driver moves upward in the staple cartridge, the surgical staple (s) supported thereon are secured between the cartridge and the anvil and are driven upward through tissue that contacts the underside of the anvil.

  As is known, the lower surface of the anvil typically includes a "staple forming" surface with a series of staple forming pockets arranged to contact the ends of the staple legs. The pocket is positioned so that when the staple legs contact, the legs are urged to wrap around in the pocket and ultimately form closed staples that are substantially similar to a "B-shape". , Has been molded. Misalignment of the staple legs during the forming process can deform the staples and, in severe cases, can cause unwanted leakage. The configuration of the staple driver shown in FIGS. 94 and 95 may help maintain staple alignment during the firing process. Further, if the driver is not maintained in proper alignment within its respective pocket during the firing process, a higher firing force must be generated to fire the staples supported thereon.

  FIGS. 94 and 95 show a “dual” staple driver 7300. As seen in those figures, the staple driver 7300 includes a first driver portion 7310 and a second driver portion 7350 separated in a "alternate" orientation by a centrally located separator portion 7340. The staple driver 7300 may be of unitary construction, for example, molded from a suitable polymeric material. The first driver portion 7310 includes a centrally located first cavity 7312 that divides the first driver 7310 into a first proximal upright support portion 7320 and a first distal upright support portion 7330. First proximal upright support portion 7320 has a first proximal body portion 7321 having an upper end 7322 with a first proximal cradle section 7324 formed therein. Similarly, first distal upright support portion 7330 has a first distal body portion 7331 having a first distal end 7332 formed in first distal cradle section 7334. First proximal cradle section 7324 and first distal cradle section 7334 are aligned so as to support the base of the surgical staple in first proximal cradle section 7324 and first distal cradle section 7334. Is configured. As further seen in FIG. 94, the first proximal upright support portion 7320 has a narrow shape that is somewhat tapered when viewed from above. Stated another way, the first proximal upright support portion 7320 has a first proximal end 7326 having a width "PW" that is less than the central width "CW" of the first proximal body portion 7321. Similarly, first distal upright support portion 7330 has a first distal end 7336 having a distal width "DW" that is less than the central width "CW" of first distal body portion 7331. In at least one arrangement, the distal width "DW" is equal to the proximal width "PW".

  With further reference to FIG. 94, the second driver portion 7350 is centrally located dividing the second driver portion 7310 into a second proximal upright support portion 7360 and a second distal upright support portion 7370. A second cavity 7352 is included. The second proximal upright support portion 7360 has a second proximal body portion 7361 having an upper end 7362 with a second proximal cradle section 7364 formed therein. Similarly, the second distal upright support portion 7370 has a second distal body portion 7371 having a second distal end 7372 with a second distal cradle section 7374 formed therein. Second proximal cradle section 7364 and second distal cradle section 7374 are aligned and support another surgical staple base in second proximal cradle section 7364 and second distal cradle section 7374. It is configured to As further seen in FIG. 94, the second proximal upright support portion 7360 has a shape that is somewhat tapered when viewed from above. In other words, the second proximal upright support portion 7360 has a proximal end 7366 having a width "PW" that is less than the central width "CW" of the second proximal body portion 7361. Similarly, second distal upright support portion 7370 has a distal end 7376 having a distal width "DW" that is less than the central width "CW" of second distal body portion 7371. Thus, the first driver portion 7310 and the second driver portion 7350 have similar shapes.

  To provide a more stable staple driver 7300 during the firing process, the first driver portion 7310 and the second driver portion 7350 further include a stabilizing arrangement cooperating with a complementary staple pocket in the staple cartridge body. Can be provided. For example, the first staple driver portion 7310 can have a first proximal set 7327 of laterally projecting struts 7328, 7329 formed on a first proximal end 7326 thereof. As shown, a first distal set 7337 of laterally projecting struts 7338, 7339 may also be provided on first distal end 7336 of first distal upright support portion 7330. Similarly, second staple driver portion 7350 can have a second proximal set 7367 of laterally projecting struts 7368, 7369 formed on its second proximal end 7366. As shown, a second distal set 7377 of laterally projecting struts 7378, 7379 may also be provided on the second distal end 7376 of the second distal upright support portion 7370.

  As indicated above, the staple driver 7300 is movably supported using complementary staple pockets in the staple cartridge. As the wedge sled is driven distally, its counterpart is in driving contact with the centrally located separator portion 7340, driving driver 7300 upward. Each of the laterally projecting struts 7328, 7329, 7338, 7339, 7368, 7369, 7378, and 7379 are received in correspondingly shaped grooves in the staple cartridge body, and during its advancement toward the anvil, the driver 7300 functions to maintain alignment and prevent twisting. In one arrangement, driver 7300 is molded or otherwise formed of a solid material. In other arrangements, however, the first driver portion 7310 and the second driver portion 7350 may be hollow, further maintaining alignment of the driver in its respective pocket, thereby reducing the need for It allows those portions of the driver 7300 to be somewhat flexible and pliable so as to further reduce the applied driving force. In either arrangement, the alignment of the driver within its respective pocket is further enhanced by providing aligned posts on both ends of both driver portions.

  FIG. 96 shows another “dual” staple driver 7400 configured to be received in a complementary staple pocket formed in the body of the surgical staple cartridge. As seen in FIG. 96, the staple driver 7400 includes a first driver portion 7410 and a second driver portion 7450 separated in a “staggered” orientation by a centrally located separator portion 7440. The staple driver 7400 may be of unitary construction, for example, molded from a suitable polymeric material. First driver portion 7410 includes a centrally located first cavity 7412 that divides first driver 7410 into first proximal upright support portion 7420 and first distal upright support portion 7430. First proximal upright support portion 7420 has a first proximal body portion 7421 having an upper end 7422 formed in first proximal cradle section 7424. Similarly, first distal upright support portion 7430 has a first distal body portion 7431 having a first distal end 7432 formed in first distal cradle section 7434. The first proximal cradle section 7424 and the first distal cradle section 7434 are aligned to support the base of the surgical staple in the first proximal cradle section 7424 and the first distal cradle section 7434. Is configured. As further seen in FIG. 96, the first proximal upright support portion 7420 and the first distal upright support portion each have a shape that is somewhat tapered.

  With further reference to FIG. 96, the second driver portion 7450 is centrally located, dividing the second driver portion 7450 into a second proximal upright support portion 7460 and a second distal upright support portion 7470. A second cavity 7452 is included. The second proximal upright support portion 7460 has a second proximal body portion 7461 having an upper end 7462 with a second proximal cradle section 7464 formed therein. Similarly, second distal upright support portion 7470 has a second distal body portion 7471 having a second distal end 7472 with a second distal cradle section 7474 formed therein. The second proximal cradle section 7464 and the second distal cradle section 7474 are aligned to support another surgical staple base in the second proximal cradle section 7664 and the second distal cradle section 7474. It is configured to

  To provide a more stable staple driver 7400 during the firing process, the first driver portion 7410 and the second driver portion 7450 further include a stabilizing arrangement cooperating with a complementary staple pocket in the staple cartridge body. Can be provided. For example, first staple driver portion 7410 can have a first proximal set 7427 of laterally projecting struts 7428, 7429 formed on first proximal body portion 7421. As shown, a first distal set 7437 of laterally projecting struts 7438, 7439 may also be provided on the first distal body portion 7431 of the first distal upright support portion 7430. Similarly, the second staple driver portion 7450 can have a second proximal set 7467 of laterally protruding struts 7468, 7469 formed on the second proximal body portion 7461. As shown, a second distal set 7477 of laterally projecting struts 7478, 7479 may also be provided on the second distal body portion 7471 of the second distal upright support portion 7470.

  As indicated above, the staple driver 7400 is movably supported using complementary staple pockets in the staple cartridge. As the wedge sled is driven distally, its counterpart is in driving contact with the centrally located separator portion 7440, driving driver 7400 upward. Each of the laterally projecting struts 7428, 7429, 7438, 7439, 7468, 7469, 7478, and 7479 are received in correspondingly shaped grooves in the staple cartridge body to maintain alignment of the driver 7400 and its Acts to prevent torsion and drives its advance towards the anvil. In one arrangement, the driver 7400 is molded or otherwise formed from a solid material. In other arrangements, however, the first driver portion 7410 and the second driver portion 7450 may be hollow, further maintaining alignment of the driver in its respective pocket, thereby reducing the need for It allows those portions of the driver 7400 to be somewhat flexible and flexible so as to further reduce the driving force applied. In either arrangement, the alignment of the driver within its respective pocket is further enhanced by providing aligned posts on both ends of both driver portions.

  FIG. 97 illustrates a staple or driver pocket 7510 formed in the body portion 7502 of the staple cartridge 7500. The staple or driver pocket 7510 is configured to operably support a complementary “single” staple driver within the staple or driver pocket 7510. As seen in that figure, the staple pocket 7510 is formed of two inwardly extending proximal posts 7512, 7514 and two inwardly extending distal posts 7516, 7518. Posts 7512, 7514, 7516, and 7518 are configured to slidably extend into corresponding gutters provided on the staple driver. Such a driver pocket configuration functions to provide additional stability and alignment of the driver as driven from the pocket. FIG. 97 illustrates a staple or driver pocket configured to operably support a single staple driver therein, but the same concept is constructed to support multiple surgical staples. Can be applied to those driver pockets that are configured to support For example, the struts used in the embodiment of the driver shown in FIGS. 94-96 are grooves configured to slidably receive corresponding posts formed on the sides of staple pockets in the cartridge body. May be replaced by

  As illustrated in FIGS. 94-96, various driver arrangements essentially include a driver body or driver body portion including an outer surface and a tip and a termination. In various arrangements, the outer surface includes any portion of the inner wall of the staple pocket movably supported within the staple pocket, except for the laterally extending features / posts formed thereon. Can be sized and shaped to avoid contact. For example, the dual staple driver 7400 shown in FIG. 96 includes a first driver portion 7410 and a second driver portion 7450. First driver portion 7410 and second driver portion 7450 have only one portion in contact with the inner wall of the staple pocket formed thereon, such as elements 7428, 7429, 7438, 7439, 7468, 7469. The staple pocket may be dimensioned to be a laterally extending feature. The most proximal end of the first driver portion 7410 may have a “tip” and the most distal end of the second driver portion 7450 may have a “terminus”. In yet another arrangement, for example, the leading and trailing ends may have a narrower gap between their ends and their corresponding pocket portions than gaps between other driver portions and other portions of the staple pocket. As such, they may be dimensioned relative to the corresponding portion of the staple pocket in which they are received. The size of the gap may be dimensioned to improve the lateral stability of the driver during operation without establishing a friction fit between the outer surface of the driver and the inner wall of the staple pocket. In another arrangement, the driver is such that the only portion (s) of the driver that contacts the inner wall portion of the staple pocket is comprised of one or more configurations (posts) on the tip and / or end of the driver. May be configured for staple pockets (e.g., sized and shaped). Conversely, one or more grooves may be provided at the leading and / or trailing end configured to receive a corresponding configuration on the inner wall portion of the staple pocket, wherein the configuration may include a driver. During operation, it is the only contact point (s) between the driver and the inner wall of the staple pocket. As indicated above, the driver generally extends longitudinally of a staple pocket provided on each lateral side of a centrally located elongate slot that houses the passage of a cutting member or cutting head therethrough. May be supported in the cartridge body in the existing row. In certain arrangements, the various drivers disclosed herein that use one or more struts / laterally extending features provide for one of the staple pockets on one or both sides of the elongated slot. One or more than two longitudinal rows (or portions of the longitudinal rows) may be used. For example, a row of staple pockets on one side of the elongate slot closest to the edge of the cartridge body may include a driver using a strut / laterally extending configuration, while another row of staple pockets includes a conventional driver. May be used. This arrangement may be used with staple pocket 7510. That is, staple pockets 7510 may be used only in certain longitudinal rows (or portions of longitudinal lines) of staple pockets on one or both sides of the elongated slot.

  Tissue flow can be one of the issues that cause staple deformation. During stapling, tissue flows both distally and laterally, and lateral movement is more harmful than longitudinally. Staples are directed laterally and distally from their respective pockets by tissue flow and high compressive forces. By tightening the fit between the driver and the portion of the cartridge adjacent to it, the driver also has a reduced ability to rock, so the staples have a reduced ability to rock left, right or back and forth during firing. ing. The various drivers and staple pocket arrangements disclosed herein function to minimize such wobble. The struts / laterally extending features disclosed herein may be provided to all of the drivers or simply to a particular area of driver (eg, a driver in an outer row within a cartridge). Such struts / laterally extending features may be, for example, on the sides of the driver, on the ends of the driver, or both. The term "post" when used to describe the driver stabilization arrangement disclosed herein encompasses the various laterally extending vertically elongated configurations shown in this drawing. The term "post" is in any case used in a correspondingly shaped groove provided in the inner wall of the staple pocket (in arrangements where the post / laterally extending feature is on the driver) or (post / A variety of differently shaped laterally extending features that are configured to be movably received in various driver portions (in configurations where the laterally extending features protrude from the inner wall of the staple pocket). Can also be included. The struts may, for example, comprise a single laterally extending feature or may comprise a plurality of aligned laterally extending features. For example, the struts may be composed of pillar sections or alignment portions / configurations. In other arrangements, other protrusion shapes may be used.

  For the various embodiments disclosed herein, the fastener cartridge can include a layer of a material that can be implanted in a patient. Such layers may include, for example, one or more pieces of buttress material and / or one or more tissue thickness compensators. US Patent Application Serial No. 13 / 097,856, filed April 29, 2011, entitled "STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF," is hereby incorporated by reference. Referring now to FIGS. 99-102, a staple cartridge 8000 includes a cartridge body 8010 and an embedable layer 8020. The cartridge body 8010 includes a proximal end 8012, a distal end 8014, and a deck 8016 extending between the proximal end 8012 and the distal end 8014. The deck 8016 is configured to support tissue when the tissue is secured between the staple cartridge 8000 and the anvil. The cartridge body 8010 further includes a fastener cavity defined therein, each configured to store a fastener, such as, for example, staples, within the cartridge body 8010. Each fastener cavity includes a proximal end and a distal end. The proximal end of each fastener cavity is closer to the proximal end 8012 of the cartridge body 8010 than the distal end of each fastener cavity, and correspondingly, the distal end of each fastener cavity is distal of the cartridge body 8010. Closer to the end 8014.

  In addition to the above, the cartridge main body 8010 includes a protrusion extending from the deck 8016. In various examples, the protrusions may be arranged in any suitable arrangement. For example, the distal protrusion 8017 may be positioned adjacent the distal end of the fastener cavity, while the proximal protrusion 8019 may be positioned adjacent the proximal end of the fastener cavity. Good. As before, the distal projection 8017 and / or the proximal projection 8019 can be configured to guide a fastener stored in the fastener cavity when the fastener is ejected from the fastener cavity. In such an example, distal protrusion 8017 and / or proximal protrusion 8019 may extend into a fastener cavity on deck 8016. Some fastener cavities may have adjacent distal protrusions 8017 and proximal protrusions 8019, while other fastener cavities may have only one or the other. Some fastener cavities may not have either a distal projection 8017 or a proximal projection 8019 associated therewith.

  Layer 8020 includes a layer body 8026 that includes a proximal end 8022 and a distal end 8024. The proximal end 8022 of the layer body 8026 is positioned adjacent or associated with the proximal end 8012 of the cartridge body 8010, and the distal end 8024 is positioned adjacent or associated with the distal end 8014. I have. In one particular example, layer 8026 may consist of a solid sheet of material. In various examples, the layer body 8026 can extend over one or more fastener cavities defined in the cartridge body 8010. In at least one such example, layer body 8026 includes a portion 8025 that extends over the fastener cavity. When the fastener is ejected from the fastener cavity, the fastener can trap portion 8025 therein, thereby retaining layer 8020 in tissue. In some examples, layer body 8026 may include openings that are aligned with some of the fastener cavities in cartridge body 8010.

  Layer body 8026 may include an aperture defined therein that is aligned with protrusions extending from deck 8016. For example, the layer body 8026 may include a distal aperture 8027 aligned with at least some of the distal projections 8017 and / or a proximal aperture 8029 aligned with at least some of the distal projections 8019. . In various examples, the distal aperture 8027 and the distal projection 8017 can be sized and configured such that there is a gap between them. Similarly, the proximal aperture 8029 and the proximal protrusion 8019 can be sized and configured such that there is a gap between them. In some examples, distal aperture 8027 and distal projection 8017 can be sized and configured such that there is an interference fit therebetween. Also, similarly, the proximal aperture 8029 and the proximal protrusion 8019 can be sized and configured such that there is an interference fit therebetween. In at least one such example, an interference fit between the protrusion and the aperture can releasably hold the layer 8020 to the cartridge body 8010. In use, the fasteners stored in the cartridge body 8010 can contact portions 8025 of the layer 8020 when the fasteners are ejected from the cartridge body 8010, lifting the layer 8020 away from the deck 8016 and raising the aperture. Disengage from the protrusion.

  Layer body 8026 may include apertures 8028, each configured to receive a distal projection 8017 and a proximal projection 8019 therein. Each aperture 8028 may include an elongated slot having a proximal end configured to receive a distal projection 8017 and a distal end configured to receive a proximal projection 8019. In some examples, a clearance fit may exist between aperture 8028 and protrusions 8017 and 8019. In one particular example, an interference fit exists between the aperture 8028 and the projections 8017 and 8019, which can releasably hold the layer 8020 to the cartridge body 8010. In at least one example, aperture 8028 can be sized and configured to telescope to house distal projection 8017 and proximal projection 8019 therein.

  The layer 8020 may be removably attached to the cartridge body 8010. In certain examples, the distal end 8024 of the layer 8020 may be removably attached to the distal end 8014 of the cartridge body 8010. In some examples, the proximal end 8022 of the layer 8020 can be removably attached to the proximal end 8012 of the cartridge body 8010. In at least one example, the mounting portion 8021 can be utilized to releasably hold the layer 8020 to the cartridge body 8010.

  The layer of buttress material or the like may be made, for example, from any biocompatible material. The buttress material may be formed from natural and / or synthetic materials. The buttress material may be bioabsorbable and / or non-bioabsorbable. It should be understood that any combination of natural, synthetic, bioabsorbable, and non-bioabsorbable materials can be used to form the buttress material. Some non-limiting examples of materials from which the buttress material may be formed include, for example, poly (lactic acid), poly (glycolic acid), poly (hydroxybutyrate), poly (phosphazine), polyester, polyethylene glycol, poly Ethylene oxide, polyacrylamide, polyhydroxyethyl methyl acrylate, polyvinylpyrrolidone, polyvinyl alcohol, polyacrylic acid, polyacetate, polycaprolactone, polypropylene, aliphatic polyester, glycerol, poly (amino acid), copoly (ether-ester), polyalkyleneoxa , Polyamide, poly (iminocarbonate), polyalkylene oxalate, polyoxaester, polyorthoester, polyphosphazene, and their copolymers, block copoly Chromatography, homopolymers, blends, and / or combinations include, but are not limited to.

  Natural biopolymers may be used to form the buttress material. Suitable natural biopolymers include, for example, collagen, gelatin, fibrin, fibrinogen, elastin, keratin, albumin, hydroxyethyl cellulose, cellulose, oxidized cellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethyl cellulose, chitan, chitosan, and / or the like. , But is not limited thereto. The natural biopolymer may be combined with any of the other polymer materials described herein to produce a buttress material. Collagens of human and / or animal origin, such as porcine or bovine collagen type I, human collagen type I, or human collagen type III, can also be used to form the buttress material. The buttress material is made from denatured collagen or collagen composed, for example, of predominantly unhydrated chains, of molecular weight close to 100 kDa, at least partially losing its helical structure by heating or any other method. May be done. The term "denatured collagen" refers to collagen that has lost its helical structure. The collagen used for the porous layer described herein may be native collagen, or atellocollagen, especially, for example, by pepsin digestion as defined above and / or after moderate heating. Can be obtained. Collagen may be previously chemically modified by oxidation, methylation, succinylation, ethylation, and / or any other known process.

  If the buttress material is fibrous, the fibers may be filaments or twists suitable for braiding or weaving, or may be staple fibers such as those often used in the preparation of nonwoven materials. The fibers can be made from any biocompatible material. The fibers may be formed from natural or synthetic materials. The material from which the fibers are formed may be bioabsorbable or non-bioabsorbable. It should be appreciated that any combination of natural, synthetic, bioabsorbable, and non-bioabsorbable materials can be used to form the fibers. Some non-limiting examples of materials from which fibers can be formed include poly (lactic acid), poly (glycolic acid), poly (hydroxybutyrate), poly (phosphazine), polyester, polyethylene glycol, polyethylene oxide, Acrylamide, polyhydroxyethyl methyl acrylate, polyvinyl pyrrolidone, polyvinyl alcohol, polyacrylic acid, polyacetate, polycaprolactone, polypropylene, aliphatic polyester, glycerol, poly (amino acid), copoly (ether-ester), polyalkylene oxalate, polyamide , Poly (iminocarbonate), polyalkylene oxalate, polyoxaester, polyorthoester, polyphosphazene, and their copolymers, block copolymers, homopolymers Blends, and / or combinations include, but are not limited to. When the buttress material is fibrous, the buttress material is formed using any method suitable for forming a fibrous structure, including, but not limited to, braiding, weaving, non-woven techniques, and the like. obtain. If the buttress material is a foam, the porous layer may be formed using any suitable method for forming a foam or sponge, including, but not limited to, freeze-drying or freeze-drying the composition. Can be formed.

  The buttress material may have hemostatic properties. Illustrative examples of materials that can be used to provide a buttress material capable of assisting in bleeding or bleeding, such as poly (lactic acid), poly (glycolic acid), poly (hydroxybutyrate), poly (hydroxybutyrate) Caprolactone), poly (dioxanone), polyalkylene oxide, copoly (ether-ester), collagen, gelatin, thrombin, fibrin, fibrinogen, fibronectin, elastin, albumin, hemoglobin, ovalbumin, polysaccharides, hyaluronic acid, chondroitin sulfate, hydroxyethyl Starch, hydroxyethyl cellulose, cellulose, oxidized cellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethyl cellulose, chitan, chitosan, agarose, maltose, maltodex Trin, alginate, coagulation factor, methacrylate, polyurethane, cyanoacrylate, platelet agonist, vasoconstrictor, alum, calcium, RGD peptide, protein, protamine sulfate, ε-aminocaproic acid, iron sulfate, basic iron sulfate, iron chloride, Examples include, but are not limited to, zinc, zinc chloride, aluminum chloride, aluminum sulfate, aluminum acetate, permanganate, tannin, bone wax, polyethylene glycol, fucan, and / or combinations thereof. The use of natural biopolymers, and specifically proteins, can be useful in forming buttress materials with hemostatic properties. Suitable natural biopolymers include, but are not limited to, for example, collagen, gelatin, fibrin, fibrinogen, elastin, keratin, albumin, and / or combinations thereof. The natural biopolymer may be combined with any other hemostatic agent to create a buttressed porous layer. The entire disclosure of U.S. Patent No. 8,496,683, issued July 30, 2013, entitled "BUTTRESS AND SURGICAL STAPLING APPARATUS" is hereby incorporated by reference.

All of the following disclosures are incorporated herein by reference.
U.S. Pat. No. 5,403,312, issued Apr. 4, 1995, entitled "Electrosurgical Hemostatic Device",
U.S. Patent No. 7,008,018, issued February 21, 2006, entitled "SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTING CLOSING AND FIRING SYSTEMS",
U.S. Pat. No. 7,422,139 issued on Sep. 9, 2008, entitled "MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK",
U.S. Pat. No. 7,746,849, issued Dec. 16, 2008, entitled "Electro-Mechanical Surgical Installation With Closure System And Anvil Alignment Components",
U.S. Pat. No. 7,670,334 issued Mar. 2, 2010, entitled "SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR",
U.S. Pat. No. 7,753,245, issued Jul. 13, 2010, entitled "SURGICAL STAPLING INSTRUMENTS",
U.S. Pat. No. 8,393,514 issued Mar. 12, 2013, titled "SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE",
U.S. patent application Ser. No. 11 / 343,803, entitled "SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES" (now U.S. Pat. No. 7,845,537);
US patent application Ser. No. 12/031573, filed Feb. 14, 2008, entitled "SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES",
U.S. Patent Application Serial No. 12 / 031,873, filed February 15, 2008, entitled "END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT" (now U.S. Patent No. 7,980,443);
U.S. Patent Application No. 12 / 235,782, entitled "MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT" (now U.S. Patent No. 8,210,411);
U.S. Patent Application No. 12 / 249,117 entitled POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM (now U.S. Patent No. 8,608,045);
U.S. patent application Ser. No. 12 / 647,100, filed Dec. 24, 2009, entitled "MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTORY CONTROL CONTROL ASSEMBLEY" (now U.S. Pat. No. 8,220,68).
US patent application Ser. No. 12 / 893,461, filed Sep. 29, 2012, entitled “STAPLE CARTRIDGE” (now US Pat. No. 8,733,613);
U.S. patent application Ser. No. 13 / 036,647, filed Feb. 28, 2011, entitled "SURGICAL STAPLING INSTRUMENT" (now U.S. Pat. No. 8,561,870);
U.S. Patent Application No. 13/118241, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTABLE STAPLE DEPLOYMENT ARRANGEMENTS" (now U.S. Patent Application Publication No. 2012/0298719);
U.S. Patent Application No. 13 / 524,049, filed June 15, 2012, entitled "ARTICULABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE" (now U.S. Patent Application Publication No. 2013/0333428);
US patent application Ser. No. 13/800025, filed Mar. 13, 2013, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM",
U.S. Patent Application No. 13 / 800,067, filed on March 13, 2013, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM",
U.S. Patent Application Publication No. 2007/0175955 filed on Jan. 31, 2006, entitled "SURGICAL CUTTING AND FASTENING INSTRUMENT WITH WHITE CLOSURE TRIGGER LOCKING MECHANISM," and U.S. Patent Application filed on Apr. 22, 2010. No. 2010/0264194, entitled "SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR" (currently US Pat. No. 8,308,040).

  Although various embodiments of the device have been described herein in connection with certain disclosed embodiments, many modifications and variations can be made to those embodiments. Also, where materials are disclosed for a particular component, other materials may be used. Further, according to various embodiments, a single component may be replaced by multiple components and multiple components may be replaced by a single component to perform a given function or functions. You may. The above description and the following claims are intended to cover all such modifications and variations.

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

  Preferably, the invention described herein will be processed before surgery. First, a new or used instrument is obtained and optionally cleaned. The instrument may then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. Next, the containers and utensils are placed in an irradiation facility that can penetrate the containers, such as gamma rays, X-rays, and high energy electron beams. The 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.

  Although the invention has been described as having an exemplary design, the invention may be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures as those which become known or become conventional in the art to which this invention pertains.

  In whole or in part, any patents, publications, or other disclosures that are incorporated herein by reference should not be incorporated into existing definitions, descriptions, or other disclosures that may be incorporated into this disclosure. It shall be incorporated herein only to the extent not inconsistent with the disclosed document. Thus, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting document incorporated herein by reference. Any references, or portions thereof, which are hereby incorporated by reference, but which contradict existing definitions, descriptions, or other disclosures set forth herein, are incorporated by reference into the incorporated references. It shall be incorporated only to the extent that there is no inconsistency with the content.

(Embodiment)
(1) A fastener cartridge,
The cartridge body,
Deck and
A fastener cavity defined in the deck;
A cartridge body, comprising: a protrusion extending from the deck;
A fastener removably stored in the fastener cavity;
A layer of material supported by the deck,
A layer body,
A fastener cartridge comprising: a layer of material comprising: an aperture defined in the layer body; wherein the protrusion is positioned within the aperture.
(2) the protrusion and the aperture are dimensioned and configured such that an interference fit exists between the protrusion and the aperture, the interference fit transferring the layer of material to the cartridge body; The fastener cartridge of claim 1, releasably retaining.
(3) The fastener cartridge according to embodiment 1, wherein the protrusion is located in the middle of the fastener cavity.
The fastener cartridge of claim 1, wherein the protrusion extends from the fastener cavity onto the deck.
The fastener cartridge of claim 1, wherein the protrusion is configured to guide the fastener when the fastener is ejected from the fastener cavity.

(6) The fastener cartridge according to embodiment 1, wherein the aperture includes a through hole.
The fastener cartridge of claim 1, wherein the layer comprises a buttress material.
(8) The fastener cartridge according to embodiment 1, wherein the layer comprises a tissue thickness compensator.
(9) A fastener cartridge,
The cartridge body,
Deck and
A fastener cavity defined in the deck, wherein each of the fastener cavities comprises a proximal end and a distal end;
A proximal projection extending from the deck, wherein each of the proximal projections is located at the proximal end of the fastener cavity;
A distal projection extending from the deck, wherein each of the distal projections is located at the distal end of the fastener cavity. ,
A fastener removably stored in the fastener cavity;
A layer of material supported by the deck,
A layer body,
A proximal aperture defined in the layer body, wherein each of the proximal apertures is configured to receive the proximal protrusion;
A distal aperture defined in the layer body, wherein each of the distal apertures is configured to receive the distal projection. And a fastener cartridge.
(10) the distal projection and the distal aperture are sized and configured such that there is an interference fit between them; and the proximal projection and the proximal aperture are interference between them. 10. The fastener cartridge of claim 9, wherein the interference fit is sized and configured such that a fit is present, and wherein the interference fit releasably retains the layer of material to the cartridge body.

(11) the distal protrusion extends from the fastener cavity over the deck, and the distal protrusion guides the fastener when the fastener is ejected from the fastener cavity. 10. The fastener cartridge of embodiment 9, wherein the fastener cartridge is configured to:
(12) the proximal protrusion extends over the deck from the fastener cavity, and the proximal protrusion guides the fastener when the fastener is ejected from the fastener cavity. 10. The fastener cartridge of embodiment 9, wherein the fastener cartridge is configured to:
(13) The fastener cartridge according to embodiment 9, wherein the proximal aperture and the distal aperture comprise through holes.
The fastener cartridge of claim 9, wherein the layer comprises a buttress material.
(15) The fastener cartridge of embodiment 9, wherein the layer comprises a tissue thickness compensator.

(16) A fastener cartridge,
The cartridge body,
Deck and
A fastener cavity defined in the deck;
A cartridge body comprising an array of fastener cavity dilators extending from the deck;
A fastener removably stored in the fastener cavity;
A layer of material supported by the deck,
A layer body,
A fastener cartridge comprising: an array of apertures defined in the layer body, the array of apertures matching the array of fastener cavity dilators; and a layer of material.

Claims (8)

A fastener cartridge,
The cartridge body,
Deck and
A fastener cavity defined in the deck;
A cartridge body, comprising: a protrusion extending from the deck;
A fastener removably stored in the fastener cavity;
A layer of material supported by the deck,
A layer body,
A layer of material, comprising an aperture defined in the layer body, wherein the protrusion is positioned within the aperture;
The protrusion includes a first protrusion located at a proximal end of the cartridge body, and a second protrusion located at a distal end of the cartridge body;
The first protrusion and the second protrusion extend from the fastener cavity over the deck;
A fastener cartridge, wherein a first distance between an uppermost end of the second protrusion and the surface of the deck is greater than a second distance between an uppermost end of the first protrusion and the surface of the deck.   The protrusion and the aperture are sized and configured such that there is an interference fit between the protrusion and the aperture, the interference fit releasably releasing the layer of material to the cartridge body. The fastener cartridge of claim 1 for retaining.   The fastener cartridge according to claim 1, wherein the protrusion is positioned intermediate the fastener cavity.   The fastener cartridge of claim 1, wherein the protrusion is configured to guide the fastener when the fastener is ejected from the fastener cavity.   The fastener cartridge of claim 1, wherein the aperture comprises a through hole before the fastener is ejected from the fastener cavity.   The fastener cartridge of claim 1, wherein the layer comprises a buttress material.   The fastener cartridge according to claim 1, wherein the layer comprises a tissue thickness compensator. A fastener cartridge,
The cartridge body,
Deck and
A fastener cavity defined in the deck;
A cartridge body comprising an array of fastener cavity dilators extending from the deck;
A fastener removably stored in the fastener cavity;
A layer of material supported by the deck,
A layer body,
An array of apertures defined in the layer body, the array of apertures coinciding with the array of fastener cavity dilators.
The array of fastener cavity dilators includes a first fastener cavity dilator located at a proximal end of the cartridge body and a second fastener cavity dilator located at a distal end of the cartridge body. Including
The first fastener cavity dilator and the second fastener cavity dilator extend from the fastener cavity onto the deck;
A first distance between a top end of the second fastener cavity dilator and a surface of the deck is greater than a second distance between a top end of the first fastener cavity dilator and a surface of the deck. Large, fastener cartridge.

Images