JP6657197B2 - Circular fastener cartridge for applying radially expandable fastener lines - Google Patents

Description

  The present invention relates to stapling instruments and, in various embodiments, to surgical stapling instruments 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 the 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 includes a staple cartridge within the staple cartridge. An anvil having staple forming pockets aligned with the rows can be supported. Generally, the stapling instrument further includes a push bar and a knife blade slidable with respect to the jaw members, and staples via a cam surface on the push bar and / or a cam surface on a wedge sled pushed by the push bar. Staples can be continuously discharged from the cartridge. In at least one embodiment, the camming surface activates a plurality of staple drivers associated with the staples of the cartridge to push the staples against the anvil and to cause the staples to move laterally into the tissue grasped between the jaw members. To form a row of deformed staples spaced apart from each other. 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. Examples of such stapling instruments are described in "SURGITAL STAPLES HAVING COMPRESIVE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING, INSTRUMENTS FOR DEPLOYING U.S. Pat. , Incorporated herein by reference.

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

Various features of the embodiments described herein are set forth with particularity in the claims. However, various embodiments, both with regard to mechanism and method of operation, together with their advantages, may be understood by the following description in conjunction with the accompanying drawings, in which:
1 is a perspective view of a surgical fastening instrument according to at least one embodiment. FIG. 2 is an exploded view of the end effector of the surgical fastener of FIG. 1. FIG. 3 is a plan view of a fastener cartridge of the end effector of FIG. 2. FIG. 3 is a bottom view of the anvil of the end effector of FIG. 2. FIG. 9 is a partial bottom view of an anvil according to at least one embodiment. FIG. 9 is a partial bottom view of an anvil according to at least one embodiment. FIG. 4 is an exploded perspective view of an end effector including a staple cartridge including an angularly oriented staple, a first group of multi-staple drivers, and a second group of multi-staple drivers, in accordance with various embodiments of the present disclosure. FIG. 8 is a perspective view of one of the first multi-staple drivers of FIG. 7; FIG. 9 is a plan view of the first multi-staple driver of FIG. FIG. 9 is a perspective view of the first multi-staple driver of FIG. 8, further illustrating the staple of FIG. 7 supported by the multi-staple driver. FIG. 8 is a perspective view of one of the second multi-staple drivers of FIG. 7. FIG. 8C is a plan view of the second multi-staple driver of FIG. 8C. FIG. 8C is a perspective view of the second multi-staple driver of FIG. 8C, further illustrating the staple of FIG. 7 supported by the multi-staple driver. FIG. 3 is a plan view of a staple cartridge according to various embodiments of the present disclosure. FIG. 4 is a plan view of a multi-staple driver and drive wedge arrangement, according to various embodiments of the present disclosure. FIG. 4 is a plan view of a multi-staple driver and drive wedge arrangement, according to various embodiments of the present disclosure. FIG. 4 is a plan view of a multi-staple driver and drive wedge arrangement, according to various embodiments of the present disclosure. FIG. 4 is a plan view of a single staple driver and drive wedge arrangement, according to various embodiments of the present disclosure. FIG. 15 is an elevation view of the drive wedge of FIG. 14. FIG. 3 is a plan view of a staple and drive wedge arrangement according to various embodiments of the present disclosure. FIG. 3 is a perspective view of a staple according to at least one embodiment illustrated in an unformed, ie, unfired configuration. FIG. 18 is an elevation view of the staple of FIG. 17; FIG. 18 is an elevational view of the staple of FIG. 17 in a configuration after molding, ie, after firing. FIG. 4 is an elevational view of a staple including an expandable coating, according to at least one embodiment illustrated in an unformed, ie, unfired configuration. FIG. 21 is a partial bottom view of the staple of FIG. 20 deployed in a patient's tissue. FIG. 21 is a partial bottom view of the staple of FIG. 20 deployed in a patient's tissue, illustrating the coating in an expanded state. 6 illustrates tissue stapled by a staple line, according to at least one embodiment. 6 illustrates tissue stapled by a staple line, according to at least one embodiment. 6 illustrates tissue stapled by a staple line, according to at least one embodiment. FIG. 5 is an elevational view of a drive wedge and staples according to various embodiments of the present disclosure. FIG. 27 is a perspective view of the drive wedge and staple of FIG. 26. FIG. 27 is a plan view of the drive wedge and staple of FIG. 26. It is a perspective view of a circular stapling device. FIG. 4 is a perspective view of a portion of a stapling head and a fastener cartridge assembly of a circular stapling apparatus. FIG. 14 is a perspective view of a portion of a stapling head of a circular stapling apparatus and another fastener cartridge assembly. FIG. 14 is a perspective view of a portion of a stapling head of a circular stapling apparatus and another fastener cartridge assembly. FIG. 9 illustrates tissue stapled by a staple line according to at least one embodiment, wherein at least a portion of the staples within the staple line overlap. FIG. 33 is a partial plan view of the staple cartridge configured to develop the staple line of FIG. 32. FIG. 34 is a partial plan view of an anvil configured to deform staples released from the staple cartridge of FIG. 33. FIG. 9 is a partial plan view of a staple cartridge configured to deploy staple lines according to at least one embodiment. FIG. 36 is a partial plan view of an anvil configured to deform staples released from the staple cartridge of FIG. 35. FIG. 3 is an exploded perspective view of an end effector including a driverless staple cartridge with a thread, according to various embodiments of the present disclosure. FIG. 38 is a perspective view of the thread of FIG. 37. FIG. 38 is a partial plan view of the thread and the staple of FIG. 37, showing the progress of the staple deployment. FIG. 38 is an elevational view of the thread and staple of FIG. 37, showing the progress of staple deployment. FIG. 38 is a perspective view of the driverless staple cartridge sled shown in FIG. 37, according to various embodiments of the present disclosure. FIG. 40 is a partial plan view of a driverless staple cartridge having angled staples and the threads of FIG. 39, in accordance with various embodiments of the present disclosure. FIG. 41 is a partial perspective view of the sled of FIG. 39 and the staple of FIG. 20, according to various embodiments of the present disclosure. FIG. 3 is a partial perspective view of a thread and staples according to various embodiments of the present disclosure. FIG. 4 is a plan view of an array of staples, according to various embodiments of the present disclosure. FIG. 4 is a plan view of an array of staples and drive wedges, according to various embodiments of the present disclosure. FIG. 4 is a partial perspective view of a staple cartridge having an arrangement of angled staple cavities therein, according to various embodiments of the present disclosure. FIG. 44 is a partial plan view of the staple cartridge of FIG. 43. FIG. 44 is a partial perspective cross-sectional view of the staple cartridge of FIG. 43 showing the staple and driver positioned within the staple cartridge. FIG. 4 is a partial perspective view of a staple cartridge having an arrangement of angled staple cavities therein, according to various embodiments of the present disclosure. FIG. 47 is a partial plan view of the staple cartridge of FIG. 46. FIG. 47 is a partial perspective transverse sectional view of the staple cartridge of FIG. 46. FIG. 4 is a partial perspective view of a staple cartridge having an arrangement of angled staple cavities therein, according to various embodiments of the present disclosure. FIG. 50 is a partial plan view of the staple cartridge of FIG. 49. FIG. 50 is a partial perspective cross-sectional view of the staple cartridge of FIG. 49 showing the staple and the multi-staple driver positioned within the staple cartridge. Fig. 9 shows a previous staple pattern embedded in tissue. 4 shows a staple pattern developed by the staple cartridge of FIG. 3. FIG. 52B illustrates the staple pattern of FIG. 52A in an expanded state. FIG. 9 is a partial plan view of a staple cartridge including a cartridge body and an implantable adjuvant material positioned on the cartridge body, according to at least one embodiment. FIG. 4 is a partial plan view of an implantable adjuvant material, according to at least one embodiment. FIG. 9 is a partial plan view of a staple cartridge including a cartridge body and an implantable adjuvant material positioned on the cartridge body, according to at least one embodiment. FIG. 4 is a partial plan view of an implantable adjuvant material, according to at least one embodiment. FIG. 4 is a partial plan view of an implantable adjuvant material, according to at least one embodiment. FIG. 2 is an exploded perspective view of an end effector and a portion of a surgical stapling instrument. FIG. 14 is a perspective view of a surgical staple cartridge supported on a staple cartridge deck in a position where the buttress member can remove the buttress from the cartridge. FIG. 60 is a top view of the surgical staple cartridge and buttress member of FIG. 59. FIG. 61 is a perspective view of a portion of the surgical staple cartridge and buttress member of FIGS. 59 and 60. FIG. 62 is a perspective view of another portion of the surgical staple cartridge and buttress member of FIGS. 59-61. FIG. 63 is a perspective view of the proximal end of the surgical staple cartridge and buttress member of FIGS. 59-62. FIG. 63 is another perspective view of the surgical staple cartridge and the proximal end of the buttress member of FIGS. 59-63 with the retention tab folded over for insertion into a longitudinal slot in the cartridge. FIG. 65 is another perspective view of the surgical staple cartridge and the proximal end of the buttress member of FIGS. 59-64 with the retention tab inserted into the longitudinal slot and retained therein by the staple sled. FIG. 9 is an exploded view of another surgical staple cartridge and another buttress member. FIG. 67 is a bottom view of the buttress member of FIG. 66. FIG. 67 is an enlarged view of a portion of the buttress member of FIG. 67, with the location of the underlying staple cavity in the staple cartridge indicated by dashed lines. FIG. 10 is an enlarged view of a portion of another buttress member, with the location of the underlying staple cavity in the staple cartridge indicated by dashed lines. FIG. 13 is a top view of a portion of another buttress member, with the location of the underlying staple cavity in the staple cartridge indicated by dashed lines. It is a top view of a part of another buttress member. FIG. 72 is a cross-sectional view of the buttress member of FIG. 71, taken along line 72-72 of FIG. 71. FIG. 14 is a perspective view of another surgical staple cartridge. FIG. 74 is a top view of the surgical staple cartridge of FIG. 73. FIG. 75 is an enlarged perspective view of a portion of the surgical staple cartridge of FIGS. 73 and 74. FIG. 9 is a top view of another surgical staple cartridge. FIG. 77 is a side elevational view of a portion of the surgical stapling apparatus with tissue “T” clamped between the surgical stapling cartridge of FIG. 76 and the anvil of the apparatus. FIG. 77 is an enlarged view of a portion of the surgical staple cartridge of FIGS. 76 and 77, partially shown in cross-section; FIG. 2 is a partial cross-sectional elevation view of a staple cartridge and an anvil, according to various embodiments of the present disclosure. FIG. 2 is a partial cross-sectional elevation view of a staple cartridge and an anvil, according to various embodiments of the present disclosure.

  Corresponding reference numerals 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. Absent.

The applicant of the present application possesses the following patent applications filed on the same date as the present application, each of which is incorporated herein by reference in its entirety:
U.S. Patent Application No. ____________, entitled "SURGICAL STAPLE AND DRIVER ARRANGEMENTS FOR STAPLE CARTRIDGES," Attorney Docket No. END7504USNP / 140284,
U.S. Patent Application No. ____________, entitled "SURGICAL STAPLE AND DRIVER ARRANGEMENTS FOR STAPLE CARTRIDGES," Attorney Docket No. END7505USNP / 140285,
U.S. Patent Application No. ____________, entitled "SURGICAL STAPLING BUTTRESSES AND ADJUNCT MATERIALS" (Attorney Docket No. END75006USNP / 140286)
U.S. Patent Application No. ____________, entitled "FASTENER CARTRIDGE FOR CREATING A FLEXIBLE STAPLE LINE", Attorney Docket No. END7507USNP / 140287,
U.S. Patent Application No. ___________, entitled "METHOD FOR CREATING A FLEXIBLE STAPLE LINE", Attorney Docket No. END75008USNP / 140288.

The applicant of the present application owns the following patent applications filed on June 30, 2014, each of which is incorporated herein by reference in its entirety:
U.S. Patent Application No. 14 / 318,996, entitled "FASTENER CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENT CONFIGURATIONS",
U.S. Patent Application No. 14 / 319,006, entitled "FASTENER CARTRIDGE COMPRISING FASTENER CAVITIES INCLUDING FASTENER CONTROL FEATURES",
U.S. Patent Application No. 14 / 319,014 entitled "END EFFECTOR COMPRISING AN ANVIL INCLUDING PROJECTIONS EXTENDING THEREFROM",
U.S. Patent Application No. 14 / 318,991, entitled "SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZING ARRANGEMENTS",
U.S. Patent Application No. 14 / 319,004, entitled "SURGICAL END EFFECTORS WITH FIRING ELEMENT MONITORING ARRANGEMENTS",
U.S. Patent Application No. 14 / 319,008, entitled "FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS",
U.S. Patent Application No. 14 / 318,997, entitled "FASTENER CARTRIDGE COMPRISING DEPLOYABLE TISSUE ENGAGING MEMBERS",
U.S. Patent Application No. 14 / 319,002, entitled "FASTENER CARTRIDGE COMPRISING TISSUE CONTROL FEATURES",
U.S. Patent Application No. 14 / 319,013, entitled "FASTENER CARTRIDGE ASSEMBLYES AND STAPLE RETAINER COVER ARRANGEMENTS",
U.S. Patent Application No. 14 / 319,016 entitled "FASTENER CARTRIDGE INCLUDING A LAYER ATTACHED THERETO".

  Many specific details are set forth in order to provide a thorough understanding of the overall structure, function, manufacture and use of the embodiments described in the specification 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. It will be appreciated. Variations and changes thereto may be made without departing from the scope of the claims.

  The terms "comprise" (and any form of "comprises", such as "comprises" and "comprising"), "have" (and any form of "have", such as "has" and "having"), " "Include" (and any word form of include, such as "includes" and "including"), "contain" (and any word form of container, such as "contains" and "containing") are open-ended. It is a type connecting verb. As a result, a surgical system, device, or apparatus that "comprises," "has," "includes," or "contains" one or more elements is one or more of those elements. , But is not limited to having only one or more of these elements. Similarly, an element of a system, device, or apparatus that "comprises," "has," "includes," or "contains" one or more features is one or more of those elements. However, the present invention is not limited to having only one or two or more of these features.

  The terms "proximal" and "distal" are used herein with reference to a clinician operating the handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the clinician, and the term "distal" refers to the portion located far from the clinician. It will be further understood that for convenience and clarity, spatial terms such as "vertical", "horizontal", "above", and "below" may be used herein with respect to the drawings. Would. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.

  A surgical fastener 100 is shown in FIG. Surgical fastener 100 is configured to deploy an expandable staple line. Although various expandable staple lines are disclosed herein, the surgical fastener 100 can deploy any one of these expandable staple lines. Further, surgical instruments other than the surgical fastening instrument 100 can deploy any one of the expandable staple wires disclosed herein.

  Surgical fastener 100 includes handle 110, shaft 120, and end effector 200. Handle 110 includes a pistol grip 140, a closure trigger 150 configured to activate a closure system, a firing trigger 160 configured to activate a firing system, and an end effector 200 for articulating with respect to shaft 120. Provided with an articulation actuator 170 configured to operate the articulation system of FIG. The disclosure of U.S. Patent No. 7,845,537, issued December 7, 2010, entitled "SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES" is incorporated by reference in its entirety. Other embodiments with a single trigger configured to activate the closure system and the firing system are envisioned. Various embodiments are envisioned in which the end effector of the surgical instrument is not articulatable. The disclosure of U.S. Patent Application Serial No. 13 / 974,166, filed August 23, 2013, entitled "FIRING MEMBER RETRACTION DEVICES FOR POWERED SURGICAL INSTRUMENTS" is incorporated by reference in its entirety.

  Closure trigger 150 is rotatable toward pistol grip 140 to activate the closure system. Referring mainly to FIG. 2, the closure system includes a closure tube 122 that is advanced distally when the closure trigger 150 is moved toward the pistol grip 140. The closure tube 122 is engaged with a first jaw including the anvil 220 of the end effector 200. In at least one instance, the anvil 220 has one or more protrusions extending from the anvil 220 and positioned in one or more elongated slots 212 defined in a second jaw. 228. The protrusion 228 and the elongated slot 212 are constructed and configured to allow the anvil 220 to rotate between the open and closed positions relative to the second jaw rest or fixed cartridge channel 210. Be placed. In various alternative embodiments, the cartridge channel may be stationary or rotatable with respect to the fixed anvil 220. Whether the cartridge channel or end effector anvil is stationary, the end effector may be articulatable or non-articulable with respect to the shaft.

  Referring again to FIG. 2, anvil 220 includes a tab 226 that engages a slot 124 defined in closure tube 122. As the closure tube 122 is moved distally by the closure trigger 150, the sidewalls of the slots 124 can engage the tabs 226 to rotate the anvil 220 toward the cartridge channel 210. As the closure tube 122 is moved proximally, another side wall of the slot 124 can engage the tab 226 to rotate the anvil 220 away from the cartridge channel 210. In some instances, a biasing spring may be positioned intermediate the anvil 220 and the cartridge channel 210 and configured to bias the anvil 220 away from the cartridge channel 210.

  Referring again to FIG. 2, the firing trigger 160 is rotatable toward the pistol grip 140 to activate the firing system. The firing system includes a firing member extending within shaft 120. The firing system further includes a sled 250 operably engaged with the firing member. When firing trigger 160 is rotated toward pistol grip 140, firing trigger 160 drives firing member and sled 250 distally within end effector 200. End effector 200 further includes a staple cartridge 230 positioned within cartridge channel 210. While the staple cartridge 230 is replaceable and thus removable from the cartridge channel 210, other embodiments are envisioned where the staple cartridge 230 is not easily replaceable and / or removable from the cartridge channel 210. .

  The staple cartridge 230 includes a plurality of staple cavities 270. Although each staple cavity 270 is configured to removably store staples therein, some staple cavities 270 may not accommodate staples stored therein. The staple cartridge 230 further includes a plurality of staple drivers 240 movably positioned therein. Each driver 240 is configured to support three staples and / or lift the three staples out of each staple cavity 270 together or simultaneously. Although each driver 240 of the embodiment shown in FIGS. 1-4 deploys three staples simultaneously, other embodiments are contemplated where the driver can deploy less than three staples or more than three staples simultaneously. The sled 250 includes one or more ramps 252 that are configured to slide beneath the driver 240 to lift the driver 240 upwardly toward the deck surface 233 of the staple cartridge 230. Is done. The sled 250 is moveable from the proximal end 231 to the distal end 232 of the staple cartridge 230, and sequentially lifts the driver 240. When the driver 240 is lifted toward the deck by the sled 250, the driver 240 lifts the staples toward the anvil 220. As the sled 250 is advanced distally, the staples are driven against the anvil 220 and ejected from the staple cavity 270 by the driver 240. The staple cartridge 230 can further include a support pan 260 mounted thereon, the support pan 260 extending around the bottom of the staple cartridge 230 and driving the driver 240, staples and / or sled 250 into the cartridge 230. Hold.

  The sled 250 and / or a pusher member for advancing the sled 250 distally engages the first jaw including the anvil 220 and / or the second jaw including the staple cartridge 230 to engage the anvil 220 and the staple cartridge. 230 may be configured to be positioned relative to each other. In at least one instance, sled 250 includes at least one first protrusion 256 extending therefrom, wherein first protrusion 256 is configured to engage anvil 220 and cartridge channel 210. Configured to engage the at least one second protrusion 258. Projections 256 and 258 can position anvil 220 and staple cartridge 230 relative to each other. As the sled 250 is advanced distally, the protrusions 256 and 258 can position the anvil 220 to set a tissue gap between the anvil 220 and the deck 233.

  End effector 200 can further include a cutting member configured to incise tissue captured between staple cartridge 230 and anvil 220. Referring again to FIG. 2, the sled 250 includes a knife 254, but any suitable cutting member may be utilized. As sled 250 is advanced distally to deploy staples from staple cavity 270, knife 254 is moved distally to traverse tissue. In certain alternative embodiments, the firing member that pushes the sled 250 distally can include a cutting member. Cartridge 230 includes a longitudinal slot 234 configured to at least partially receive knife 254. Anvil 220 also includes a longitudinal slot configured to at least partially receive knife 254, but only one of cartridge 230 and anvil 220 includes a slot configured to receive a cutting member. A form is assumed.

  Still referring to the above, referring primarily to FIG. 1, handle 110 of surgical instrument 100 includes an articulation actuator 170 that, when actuated, allows articulation of end effector 200 about articulation joint 180. When the actuator 170 is pushed in a first direction, the end effector 200 can rotate in a first direction, and when the actuator 170 is pushed in a second direction, the end effector 200 moves in a second, , Can rotate in opposite directions. Referring now to FIG. 2, the end effector 200 includes an articulation stop 182 mounted at the proximal end. In the illustrated embodiment, a catch 182 is mounted to the cartridge channel 210 via a pin 184, which extends through an opening 214 defined in the cartridge channel 210 and the catch 182. The shaft 120 is between a first, engaged position where the lock is engaged with the catch 182 and a second or disengaged position where the lock is disengaged from the catch. A lock that can be moved by a lock may be further included. When the lock is in the engaged position, the lock can hold the end effector 200 in place. When the lock is in the disengaged position, the end effector 200 can rotate about the articulation joint 180. The disclosure of U.S. Patent Application No. 14 / 314,788, filed June 25, 2014, entitled "ROBOTICALLY-CONTROLLED SHAFT BASED ROTARY DRIVE SYSTEMS FOR SURGITAL INSTRUMENTS" is incorporated by reference in its entirety. The disclosure of U.S. Patent Application Publication No. 2013/0168435, filed February 26, 2013, entitled "SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATEABLE END EFFECTOR" is incorporated by reference in its entirety.

  Referring now to FIGS. 3 and 4, the staple cavities 270 of the staple cartridge 200 can be positioned and arranged such that staples stored within the staple cavities are deployed as part of an expandable staple line. . The staple cavities 270 are arranged in a staple cavity array. The staple cavity array includes a first row of staple cavities 270a for removably storing a first row of staples. The first row of staple cavities 270a extends along a first longitudinal axis 272a adjacent to the longitudinal slots 234. The staple cavity array includes a second row of staple cavities 270b for removably storing a second row of staples. The second row of staple cavities 270b extends along a second longitudinal axis 272b adjacent to the first row of staple cavities 270a. The staple cavity array includes a third row of staple cavities 270c for removably storing a third row of staples. The third row of staple cavities 270c extends along the second row of staple cavities 270b.

  3 and 4, the first longitudinal axis 272a is parallel or at least substantially parallel to the second longitudinal axis 272b, but the first longitudinal axis 272a is Other arrangements that are not parallel to the direction axis 272b are possible. Other arrangements in which the second longitudinal axis 272b is parallel or at least substantially parallel to the third longitudinal axis 272c, but where the second longitudinal axis 272b is not parallel to the third longitudinal axis 272c. Is possible. Other arrangements in which the first longitudinal axis 272a is parallel or at least substantially parallel to the third longitudinal axis 272c, but where the first longitudinal axis 272a is not parallel to the third longitudinal axis 272c. Is possible.

  Referring again to FIGS. 3 and 4, staple cartridge 230 includes a first staple cavity array including a first row 270a, a second row 270b, and a third row 270c on a first side of longitudinal slot 234. One portion and a second portion of the cavity array including a first column 270a, a second column 270b, and a third column 270c on the second side of the longitudinal slot 234. The first cavity array portion is a mirror image of the second cavity array portion with respect to the longitudinal slot, but other configurations can be utilized.

  The staple cartridge 230 is configured to deploy the staple array shown in FIG. 52A. The staple cartridge 230 includes a first row of staples 280a along a first longitudinal axis 282a, a second row of staples 280b along a second longitudinal axis 282b, and a third longitudinal axis 282c. A third row of staples 280c along is configured to be deployed. In various instances, the staple cartridge 230 includes a first row of staples 280a, a second row of staples 280b, and a third row of staples 280c on a first side of the longitudinal incision 284, as well as a longitudinal row. Is configured to deploy a first row of staples 280a, a second row of staples 280b, and a third row of staples 280c on the second side of the incision 284. The first row of staples 280a may be positioned adjacent to the longitudinal incision 284, and the third row of staples 280c may be positioned furthest from the longitudinal incision 284. Each second row of staples 280b can be positioned midway between the first row of staples 280a and the third row of staples 280c.

  Further with regard to the above, the first staple 280a is removably stored in the first staple cavity 270a, the second staple 280b is removably stored in the second staple cavity 270b, and the third staple 280c is removably stored within third staple cavity 270c. Staple cavities 270a-270c are configured and arranged to deploy staples 280a-280c in the arrangement shown in FIG. 52A. First staple 280a is oriented at a first angle 274a with respect to longitudinal axis 282a. Second staple 280b is oriented at a second angle 274b with respect to longitudinal axis 282b. Third staple 280c is oriented at a third angle 274c with respect to longitudinal axis 282c. The first angle 274a is different from the second angle 274b, but in other embodiments, the first angle 274a and the second angle 274b may be the same. Third angle 274c is different from second angle 274b, but in other embodiments, third angle 274c and second angle 274b may be the same. The first angle 274a may be the same as the third angle 274c, but in other embodiments, the first angle 274a and the third angle 274c may be different.

  Further with respect to the above, a first angle 274a can be measured relative to a first longitudinal axis 282a, a second angle 274b can be measured relative to a second longitudinal axis 282b, Third angle 274c can be measured with respect to third longitudinal axis 282c. When the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c are parallel to each other, the first angle 274a, the second angle 274b, and / or the third angle 274b. Angle 274c can be measured with respect to any one of first longitudinal axis 282a, second longitudinal axis 282b, and third longitudinal axis 282c. When the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c are parallel to the longitudinal slot 234, the first angle 274a, the second angle 274b, And / or third angle 274c may be measured relative to longitudinal slot 234. Correspondingly, when the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c are parallel to the tissue cross section 284, the first angle 274a, Second angle 274b and / or third angle 274c may be measured relative to tissue cross section 284.

  First staple 280a, second staple 280b, and third staple 280c can be positioned and arranged to provide laterally overlapping staple lines. 52A, the longitudinal rows of the second staples 280b are positioned laterally with respect to the longitudinal rows of the first staples 280a, and the second staples 280b are The longitudinal rows of the third staples 280c are also positioned laterally with respect to the longitudinal rows of the second staples 280b. The third staple 280c is aligned with the gap between the second staples 280b. Such an arrangement can limit the flow of blood from the tissue T to the cross section 284.

  In the illustrated embodiment, each first staple 280a is distal to a distal leg 283b of an adjacent second staple 280b, and further to a distal leg 283b. And a proximal leg 285a which is proximal. Similarly, each third staple 280c has a distal leg 283c that is distal to the distal leg 283b of the adjacent second staple 280b and a proximal leg that is proximal to the distal leg 283b. A proximal leg 285c. The first staple 280a and the second staple 280b adjacent to the third staple 280c described above are moved relative to the proximal leg 285a of the first staple 280a and the proximal leg 285c of the third staple 280c. It includes a proximal leg 285b that is proximal. This is only one exemplary embodiment, and any suitable arrangement can be utilized.

  Further with respect to the above, first staple 280a straddles first longitudinal axis 282a. The distal leg 283a of the first staple 280a is positioned on one side of the first longitudinal axis 282a, and the proximal leg 285a is positioned on the opposite side of the first longitudinal axis 282a. In other words, the legs of the first staple 280a are offset with respect to the first longitudinal axis 282a. An alternative embodiment is envisioned in which the first staple 280a is aligned with the first longitudinal axis 282a, ie, collinear.

  The second staple 280b spans a second longitudinal axis 282b. The distal leg 283b of the second staple 280b is positioned on one side of the second longitudinal axis 282b, and the proximal leg 285b is positioned on the opposite side of the second longitudinal axis 282b. In other words, the legs of the second staple 280b are offset with respect to the second longitudinal axis 282b. An alternative embodiment is envisioned in which the second staple 280b is aligned with the second longitudinal axis 282b, ie, collinear.

  Third staple 280c spans third longitudinal axis 282c. The distal leg 283c of the third staple 280c is positioned on one side of the third longitudinal axis 282c, and the proximal leg 285c is positioned on the opposite side of the third longitudinal axis 282c. In other words, the legs of the third staple 280c are offset with respect to the third longitudinal axis 282c. An alternative embodiment is envisioned in which the third staple 280c is aligned with the third longitudinal axis 282c, ie, collinear.

  In certain embodiments, a first staple 280a can include a proximal leg 285a that is aligned with a distal leg 283b of an adjacent second staple 280b. Similarly, a third staple 280c can include a proximal leg 285c that is aligned with a distal leg 283b of an adjacent second staple 280b. In various embodiments, a first staple 280a can include a proximal leg 285a positioned distal to a distal leg 283b of an adjacent second staple 280b. Similarly, a third staple 280c can include a proximal leg 285c positioned distal to a distal leg 283b of an adjacent second staple 280b.

  The second row of staples 280b is surrounded by the first row of staples 280a and the third row of staples 280c. The second staple 280b is surrounded on one side by the first staple 280a and on the other side by the third staple 280c. More specifically, the first staple 280a is positioned laterally inward with respect to the proximal leg 285b of the second staple 280b, and the third staple 280c is similarly positioned on the second staple 280b. Positioned laterally outward with respect to distal leg 283b. As a result, the first staple 280a can provide a border on one side of the second staple 280b and the third staple 280b can provide a border on the other side of the second staple 280b. .

  FIG. 52 illustrates a conventional staple array. The staple array includes a first row of staples 380a positioned along a first longitudinal axis 382a, a second row of staples 380b positioned along a second longitudinal axis 382b, and a tissue T. And a third row of staples 380c positioned along a third longitudinal axis 382c positioned on the first side of the incision 384 therein. Staple 380a is aligned or at least substantially aligned with first longitudinal axis 382a, staple 380b is aligned or at least substantially aligned with second longitudinal axis 382b, and staple 380c is aligned with third longitudinal axis 382c. Aligned or at least substantially aligned with the direction axis 382c. In other words, the first staple 380a is not oriented at an angle with respect to the first longitudinal axis 382a, and the second staple 380b is oriented at an angle with respect to the second longitudinal axis 382b. Rather, the third staple 380c is not oriented at an angle with respect to the third longitudinal axis 382c. The staple array also includes a first row of staples 380a positioned along a first longitudinal axis 382a, a second row of staples 380b positioned along a second longitudinal axis 382b, and an incision. A third row of staples 380c is positioned along a third longitudinal axis 382c positioned on a second, opposite side of portion 384.

  When a longitudinal pull is applied to the tissue T stapled by the staple array illustrated in FIG. 52, the tissue will expand in the longitudinal direction. Further, in various instances, the staples 380a, 380b, and 380c can translate longitudinally as the tissue is stretched longitudinally. While such an arrangement may be suitable in many situations, the staples 380a, 380b, and 380c may limit tissue stretching and / or movement. In some instances, tissue stapled by staples 380a, 380b, and 380c may be much less flexible than adjacent tissue that is not stapled. In other words, a staple array comprising staples 380a, 380b, and 380c can cause a sudden change in tissue material properties. In at least one instance, large strain gradients can occur in tissue as a result of the staple array, which in turn can cause large stress gradients in the tissue.

  When the staples 380a-380c are ejected from the staple cartridge, the staple legs can pierce the tissue T. As a result, the staple legs create holes in the tissue. Various types of tissue are elastic and can stretch around the staple legs as the staple legs pass through the tissue. In various instances, the elasticity of the tissue allows the tissue to stretch and resiliently return toward the staple legs, reducing or eliminating the gap that exists between the tissue and the staple legs. Can be. Such elasticity may also allow the tissue to stretch when tension is applied to the tissue, but such elasticity may be hindered by certain staple patterns. In at least one instance, the staple pattern shown in FIG. 52 may prevent longitudinal stretching of the tissue. When longitudinal stretching is applied to the stapled tissue by the staple pattern of FIG. 52, the tissue may be pulled away from the staple legs and begin to create a gap between them. In some instances, particularly in obesity resection applications, such gaps can result in increased bleeding from gastric tissue. In certain instances, particularly in lung resection applications, air leaks can occur in lung tissue.

  The staple array shown in FIG. 52A is more flexible than the staple array shown in FIG. Referring now to FIG. 52B, when a longitudinal pull is applied to the tissue T, the staples 280a, 280b, and 280c, one, translate longitudinally as the tissue is stretched longitudinally, and And / or two, as the tissue is stretched longitudinally, it can rotate. The flexible staple array shown in FIG. 52 can create significant extensibility along the staple line, for example, in the longitudinal direction defined by the staple line. Such longitudinal extensibility may reduce stress and / or strain gradients in the stapled tissue T and / or the tissue T surrounding the stapled tissue T. Further, the flexible staple array shown in FIG. 52A reduces or eliminates the gap between the staple leg and the tissue T when longitudinal tension is applied to the tissue, and as a result, the staple leg and the tissue Bleeding and / or air leaks between them.

  With respect to the longitudinal translation of the staples 280a, 280b, and 280c, the first staple 280a can move along a first longitudinal axis 282a and the second staple 280b can move along a second longitudinal axis. The third staple 280c can move along a third longitudinal axis 282c. As the first staple 280a moves along the first longitudinal axis 282a, the first staple 280a can extend across the first longitudinal axis 282a. In other words, the distance between the first staples 280a, ie, the gap distance, is such that a longitudinal force is applied to the tissue along the first longitudinal axis 282a and / or parallel to the first longitudinal axis 282a. Can increase when Similarly, the second staple 280b can extend across the second longitudinal axis 282b as the second staple 280b moves along the second longitudinal axis 282b. The distance between the second staples 280b, the gap distance, is determined when a longitudinal force is applied to the tissue along and / or parallel to the second longitudinal axis 282b. Can increase. Also, similarly, the third staple 280c may extend across the third longitudinal axis 282c as the third staple 280c moves along the third longitudinal axis 282c. The distance between the third staples 280c, or gap distance, is determined when a longitudinal force is applied to tissue along and / or parallel to the third longitudinal axis 282c. Can increase.

  As discussed above, the staples 280a, 280b, and / or 280c can move with the tissue T when the tissue T is stretched. When the tissue T is pulled longitudinally, and further with respect to the above, the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c remain parallel to each other. Can be. In some instances, the orientation of the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c may be, for example, a lateral force, ie, a longitudinal force. Can be non-parallel, such as when a lateral force is applied to the tissue T. In certain instances, the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c may be closer together when the tissue T is pulled longitudinally. . Such movement may be the result of a lateral contraction that occurs in the tissue T when a longitudinal stretching force is applied to the tissue T. In some instances, the first longitudinal axis 282a, the second longitudinal axis 282b, and / or the third longitudinal axis 282c may be, for example, when a lateral force is applied to the tissue T. You can stay away from each other.

  With respect to the rotational movement of staples 280a, 280b, and 280c, first staple 280a can rotate with respect to first longitudinal axis 282a when a longitudinal pull is applied to tissue T. Each first staple 280a can rotate between an initial first angle 274a and another first angle 274a when a longitudinal pull is applied to the tissue T. In at least one instance, each first staple 280a has an initial orientation in which the first staple 280a extends transversely to the first longitudinal axis 282a, and a first longitudinal axis 282a. Can be rotated to and from another orientation that is closer to the alignment. In some instances, a longitudinal tensile force is applied to the tissue T to cause the first staple 280a to rotate to an orientation that is collinear with the first longitudinal axis 282a. In various instances, each first staple 280a can rotate about an axis that extends through a first longitudinal axis 282a.

  As discussed above, the first staple 280a may rotate between an initial first angle 274a and another first angle 274a when a longitudinal pull is applied to the tissue T. Can be. In various embodiments, the initial, ie, unstretched, first angle 274a can be, for example, from about 5 ° to about 85 °. In certain embodiments, the initial, ie, unstretched, first angle 274a may be, for example, between about 30 ° and about 60 °. In at least one embodiment, the initial, ie, unstretched, first angle 274a may be, for example, about 45 °. In at least one embodiment, the initial, or unstretched, first angle 274a is, for example, about 10 °, about 20 °, about 30 °, about 40 °, about 50 °, about 60 °, about 70 °. ° and / or about 80 °.

  In various instances, the first angle 274a after stretching can be, for example, from about 5 degrees to about 85 degrees. In certain instances, the first angle 274a after stretching can be, for example, between about 30 degrees and about 60 degrees. In at least one instance, the first angle 274a after stretching can be, for example, about 45 degrees. In at least one instance, the first angle 274a after stretching can be, for example, about 10 °, about 20 °, about 30 °, about 40 °, about 50 °, about 60 °, about 70 °, and / or It can be about 80 °.

  In various examples, the difference between the unstretched first angle 274a and the expanded first angle 274a may be, for example, from about 1 ° to about 45 °. In certain instances, the difference between the unstretched first angle 274a and the expanded first angle 274a may be, for example, about 1 °, about 2 °, about 3 °, about 4 °, and / or about 1 °. 5 °. In certain instances, the difference between the unstretched first angle 274a and the stretched first angle 274a may be, for example, about 5 °, about 10 °, about 15 °, about 20 °, and / or about 25 °.

  Further with regard to the above, the second staple 280b can rotate with respect to the second longitudinal axis 282b when a longitudinal pull is applied to the tissue T. Each second staple 280b can rotate between an initial second angle 274b and another second angle 274b when a longitudinal pull is applied to the tissue T. In at least one instance, each second staple 280b has an initial orientation in which the second staple 280b extends in a direction transverse to the second longitudinal axis 282b, and a second longitudinal axis. It can rotate between another orientation closer to alignment with 282b. In some instances, a longitudinal pull is applied to the tissue T to cause the second staple 280b to rotate to an orientation that is collinear with the second longitudinal axis 282b. In various instances, each second staple 280b may be aligned with and / or rotate about an axis extending through the second longitudinal axis 282b.

  As discussed above, the second staple 280b may rotate between an initial second angle 274b and another second angle 274b when a longitudinal pull is applied to the tissue T. Can be. In various embodiments, the initial, ie, unstretched, second angle 274b may be, for example, from about 5 ° to about 85 °. In certain embodiments, the initial, ie, unstretched, second angle 274b may be, for example, between about 30 ° and about 60 °. In at least one embodiment, the initial, ie, unstretched, second angle 274b can be, for example, about 45 °. In at least one embodiment, the initial, ie, unstretched, second angle 274b is, for example, about 10 °, about 20 °, about 30 °, about 40 °, about 50 °, about 60 °, about 70 °, ° and / or 80 °.

  In various instances, the second angle 274b after stretching can be, for example, from about 5 degrees to about 85 degrees. In certain instances, the second angle 274b after stretching can be, for example, between about 30 degrees and about 60 degrees. In at least one instance, the second angle 274b after stretching can be, for example, about 45 degrees. In at least one instance, the second angle 274b after stretching is, for example, about 10 °, about 20 °, about 30 °, about 40 °, about 50 °, about 60 °, about 70 °, and / or It can be about 80 °.

  In various instances, the difference between the unstretched second angle 274b and the expanded second angle 274b may be, for example, between about 1 ° and about 45 °. In certain instances, the difference between the unstretched second angle 274b and the expanded second angle 274b may be, for example, about 1 °, about 2 °, about 3 °, about 4 °, and / or about It can be 5 °. In certain instances, the difference between the unstretched second angle 274b and the expanded second angle 274b may be, for example, about 5 °, about 10 °, about 15 °, about 20 °, and / or about 25 °.

  Further with respect to the above, the third staple 280c can rotate with respect to the third longitudinal axis 282c when a longitudinal pull is applied to the tissue T. Each third staple 280c is capable of rotating between an initial third angle 274c and another third angle 274c when a longitudinal pull is applied to the tissue T. In at least one instance, each third staple 280c has an initial orientation in which the third staple 280c extends in a direction transverse to the third longitudinal axis 282c, and a third longitudinal axis 282c. Can be rotated to and from another orientation closer to the alignment. In some instances, a longitudinal pull is applied to the tissue T to cause the third staple 280c to rotate to an orientation that is collinear with the third longitudinal axis 282c. In various instances, each third staple 280c may be aligned with and / or rotate about an axis extending through the third longitudinal axis 282c.

  As discussed above, the third staple 280c rotates between an initial third angle 274c and another third angle 274c when a longitudinal pull is applied to the tissue T. Can be. In various embodiments, the initial, ie, unstretched, third angle 274c can be, for example, from about 5 ° to about 85 °. In certain embodiments, the initial, ie, unstretched, third angle 274c can be, for example, between about 30 ° and about 60 °. In at least one embodiment, the initial, ie, unstretched, third angle 274c may be, for example, about 45 °. In at least one embodiment, the initial, ie, unstretched, third angle 274c is, for example, about 10 °, about 20 °, about 30 °, about, 40 °, about 50 °, about 60 °, about 60 °, 70 ° and / or about 80 °.

  In various instances, the third angle 274c after stretching can be, for example, from about 5 degrees to about 85 degrees. In certain instances, the third angle 274c after stretching can be, for example, between about 30 degrees and about 60 degrees. In at least one instance, the third angle 274c after stretching can be, for example, about 45 degrees. In at least one instance, the third angle 274c after stretching can be, for example, about 10 °, about 20 °, about 30 °, about 40 °, about 50 °, about 60 °, about 70 °, and / or It can be about 80 °.

  In various examples, the difference between the unstretched third angle 274c and the expanded third angle 274c can be, for example, from about 1 ° to about 45 °. In certain instances, the difference between the unstretched third angle 274c and the post-stretched third angle 274c is, for example, about 1 °, about 2 °, about 3 °, about 4 °, and / or about 5 °. In certain instances, the difference between the unstretched third angle 274c and the third angle 274c after stretching is, for example, about 5 °, about 10 °, about 15 °, about 20 °, and / or about 25 °.

  In various examples, a first staple 280a in a first row of staples can rotate a first amount and a second staple 280b in a second row of staples can rotate a first amount. And a second amount different from the second amount. The first amount may be less than or greater than the second amount. In various examples, the first staple 280a in the first row of staples can rotate by a first amount and the third staple 280c in the third row of staples can rotate by a first amount. Can be rotated by a third amount different from. The first amount may be less than or greater than the third amount. In various examples, the third staple 280c in the third row of staples can rotate by a third amount and the second staple 280b in the second row of staples can rotate by a third amount. And a second amount different from the second amount. The third amount may be less than or greater than the second amount.

  In at least one application, it may be desirable for the innermost row of staples, ie, the row of staples closest to the incision, to be less flexible or less extensible than the other rows of staples. It would also be desirable for the outermost row of staples, ie, the row of staples furthest from the incision, to be more flexible or extensible than the other rows of staples. When the angle between the first staple axis and the first longitudinal axis is less than the angle between the second staple axis and the second longitudinal axis, the first staple is turned into a second staple. May not have as much room to rotate toward the first longitudinal axis as has to rotate toward the second longitudinal axis, and thus may harden the tissue more than the second staple. Similarly, when the angle between the second staple axis and the second longitudinal axis is less than the angle between the third staple axis and the third longitudinal axis, the second staple is The third staple may not have as much room to rotate toward the second longitudinal axis as it has to rotate toward the third longitudinal axis, and thus may harden the tissue more than the third staple. obtain.

  Further with regard to the above, the staple pattern disclosed in FIG. 52A includes six longitudinal rows of staples. For example, other embodiments with less than six rows of staples, such as four rows of staples, or more than six rows, such as eight rows of staples, are envisioned.

  First staple 280a, second staple 280b, and third staple 280c may have any suitable configuration, such as, for example, a V-shaped configuration, or a U-shaped configuration. A staple comprising a V-shaped configuration may include a base, a first leg extending from a first end of the base, and a second leg extending from a second end of the base. , The first leg and the second leg extend in a direction that is non-parallel to each other. A staple comprising a U-shaped configuration may include a base, a first leg extending from a first end of the base, and a second leg extending from a second end of the base. , The first leg and the second leg extend in directions that are parallel to each other.

  With respect to the staple pattern disclosed in FIG. 52A, for example, each first staple 280a includes a proximal staple leg 285a and a distal staple leg 283a. A staple cartridge configured to deploy the staple pattern disclosed in FIG. 52A can include a proximal end and a distal end. Proximal staple leg 285a may be closer to the proximal end of the staple cartridge than distal staple leg 283a, and similarly, distal staple leg 283a may be closer to the staple cartridge than proximal staple leg 285a. It may be near the distal end. The base of each first staple 280a can define a first base axis. Proximal staple legs 285a and distal staple legs 283a can extend from the first base axis. The first staple 280a can be positioned and positioned such that the first base axis extends toward the longitudinal score line 284 and toward the distal end of the staple cartridge.

  With respect to the staple pattern disclosed in FIG. 52A, for example, each second staple 280b includes a proximal staple leg 285b and a distal staple leg 283b. As discussed above, a staple cartridge configured to deploy the staple pattern disclosed in FIG. 52A can include a proximal end and a distal end. Proximal staple leg 285b may be closer to the proximal end of the staple cartridge than distal staple leg 283b, and similarly, distal staple leg 283b may be closer to the staple cartridge than proximal staple leg 285b. It may be near the distal end. The base of each second staple 280b can define a second base axis. Proximal staple legs 285b and distal staple legs 283b can extend from the second base axis. The second staple 280b can be positioned and positioned such that the second base axis extends toward the longitudinal score line 284 and toward the proximal end of the staple cartridge.

  With respect to the staple pattern disclosed in FIG. 52A, for example, each third staple 280c includes a proximal staple leg 285c and a distal staple leg 283c. As discussed above, a staple cartridge configured to deploy the staple pattern disclosed in FIG. 52A can include a proximal end and a distal end. Proximal staple leg 285c may be closer to the proximal end of the staple cartridge than distal staple leg 283c, and similarly, distal staple leg 283c may be closer to the staple cartridge than proximal staple leg 285c. It may be near the distal end. The base of each third staple 280c can define a third base axis. Proximal staple legs 285c and distal staple legs 283c can extend from a third base axis. The third staple 280c can be positioned and positioned such that the third base axis extends toward the longitudinal score line 284 and toward the distal end of the staple cartridge.

  With respect to the staple pattern disclosed in FIG. 52A, for example, a first staple 280a can be aligned with a third staple 280c. The proximal staple leg 285a of the first staple 280a can be aligned with the proximal staple leg 285c of the third staple 280c. When the proximal staple legs 285a are aligned with the proximal staple legs 285c, the proximal staple legs 285a and 285c can be positioned along an axis that is perpendicular to the score line 284. The distal staple legs 283a of the first staple 280a can be aligned with the distal staple legs 283c of the third staple 280c. When distal staple leg 283a is aligned with distal staple leg 283c, distal staple leg 283a and distal staple leg 283c can be positioned along an axis that is perpendicular to score line 284. . In such a situation, the third staple 280c can seal the tissue if the first staple 280a is deformed. Similarly, the first staple 280a can hold tissue together if the third staple 280c is deformed. In other embodiments, the first staple 280a may not be aligned with the third staple 280c.

  Further with respect to the above, the first staple 280a can align with the third staple 280c when the staple pattern is in an unstretched state. When the staple pattern is stretched in the longitudinal direction, the first staple 280a and / or the third staple 280c can translate and / or rotate. In various situations, the first staple 280a can remain aligned with the third staple 280c as the tissue is stretched longitudinally. In other situations, first staple 280a may not remain aligned with third staple 280c.

  Referring again to the staple pattern disclosed in FIG. 52A, the distal staple leg 283b of the second staple 280b may be connected to the proximal staple leg 285a of the first staple 280a and / or the proximal leg of the third staple 280c. 285c. The distal staple leg 283b of the second staple 280b, the proximal staple leg 285a of the first staple 280a, and / or the proximal staple leg 285c of the third staple 280c are perpendicular to the score line 284. It can be positioned along an axis. The proximal staple leg 285b of the second staple 280b can be aligned with the distal staple leg 283a of the first staple 280a and / or the distal staple leg 283c of the third staple 280c. The proximal staple leg 285b of the second staple 280b, the distal staple leg 283a of the first staple 280a, and / or the distal staple leg 283c of the third staple 280c are perpendicular to the score line 284. It can be positioned along an axis.

  Further with respect to the above, the staple legs of the second staple 280b can be aligned with the staple legs of the first staple 280a and / or the third staple 280c when the staple pattern is in an unstretched state. When the staple pattern is elongated in the longitudinal direction, the first staple 280a, the second staple 280b, and / or the third staple 280c can translate and / or rotate. In various situations, the legs of the second staple 280b may not remain aligned with the legs of the first staple 280a and / or the third staple 280c when the tissue is longitudinally stretched. is there. In other situations, the legs of the second staple 280b may remain aligned with the legs of the first staple 280a and / or the third staple 280c when the tissue is longitudinally stretched. it can.

  In various embodiments, the staple patterns can be arranged such that staples in one longitudinal staple row overlap staples in another longitudinal staple row. For example, the distal staple leg 283b of the second staple 280b positions distally with respect to the proximal staple leg 285a of the first staple 280a and / or the proximal leg 285c of the third staple 280c. be able to. For example, the proximal staple leg 285b of the second staple 280b may be positioned proximally with the distal staple leg 283a of the first staple 280a and / or the distal staple leg 283c of the third staple 280c. Can be. The proximal staple leg 285b of the second staple 280b, the distal staple leg 283a of the first staple 280a, and / or the distal staple leg 283c of the third staple 280c are perpendicular to the score line 284. It can be positioned along an axis.

  As discussed above, the second staple 280b can overlap the first staple 280a and / or the third staple 280c when the staple pattern is in an unstretched state. When the staple pattern is elongated in the longitudinal direction, the first staple 280a, the second staple 280b, and / or the third staple 280c can translate and / or rotate. In various situations, the second staple 280b may remain overlapping the first staple 280a and / or the third staple 280c as the tissue is stretched longitudinally. In some situations, the second staple 280b may no longer overlap the first staple 280a and / or the third staple 280c when the tissue is stretched longitudinally.

  The staple pattern shown in FIG. 52A is shown in an unstretched state. When the tissue stapled by the staple pattern shown in FIG. 52A is stretched longitudinally, the staples may move longitudinally with the tissue and / or rotate within the tissue, as illustrated in FIG. 52B. it can. Such movement is illustrated in FIG.

  Surgical instrument 100 is configured for use during a laparoscopic surgical procedure. End effector 200 and shaft 120 are sized and dimensioned for insertion into a patient via a trocar or cannula. The trocar can include an internal passage having an inner diameter. In some instances, the inner diameter can be, for example, about 5 mm or about 12 mm. The end effector 200 is a linear end effector that applies staples along a straight line. For example, staples are at least partially curved, such as those disclosed in U.S. Patent No. 8,827,133, issued September 9, 2014, entitled "SURGICAL STAPLING DEVICE HAVING SUPPORTS FOR A FLEXIBLE DRIVE MECHANISM". Other surgical instruments applied along the established line are envisioned. The entire disclosure of U.S. Patent No. 8,827,133, issued September 9, 2014, entitled "SURGICAL STAPLING DEVICE HAVING SUPPORTS FOR A FLEXIBLE DRIVE MECHANISM", is hereby incorporated by reference in its entirety. Such a surgical instrument could be adapted to apply a curved, expandable staple line utilizing the principles disclosed herein. Surgical instrument 100 is adapted for use during a laparoscopic surgical procedure, while surgical instrument 100 is adapted for use during an open surgical procedure in which surgical instrument 100 is inserted into a patient through a large incision. Can be used for Further, the expandable staple wires disclosed herein, such as, for example, those disclosed in U.S. Patent Application Publication No. 2014/0042205, filed October 21, 2013, entitled "SURGICAL STAPLING INSTRUMENT," , Can be applied by an open surgical stapler. The disclosure of U.S. Patent Application Publication No. 2014/0042205, filed October 21, 2013, entitled "SURGICAL STAPLING INSTRUMENT" is incorporated herein by reference in its entirety.

  Referring now to FIG. 4, anvil 220 includes an array of molded pockets 290a, 290b, and 290c defined therein configured to deform staples 280a, 280b, and 280c, respectively. A first forming pocket 290a is positioned along a first longitudinal axis 292a, a second longitudinal pocket 290b is positioned along a second longitudinal axis 292b, and a third forming pocket 290c. Are positioned along a third longitudinal axis 292c. The longitudinal axes 292a, 292b, and 292c are parallel and extend between the proximal end 221 and the distal end 222 of the anvil 220. The anvil 220 further includes a longitudinal slot 224 defined therein configured to receive at least a portion of the firing member. In at least one instance, the firing member includes a cutting portion extending between the anvil 220 and the staple cartridge 230. The anvil 220 has a row of first forming pockets 290 a, a row of second forming pockets 290 b, and a row of third forming pockets 290 c on one side of the longitudinal slot 224, and on the opposite side of the longitudinal slot 224. It includes another row of first forming pockets 290a, a row of second forming pockets 290b, and a row of third forming pockets 290c. As the reader will recognize, molded pockets 290a, 290b, and 290c are aligned with and correspond to staple cavities 270a, 270b, and 270c, respectively, defined within staple cartridge 230.

  Forming pockets 290a, 290b, and 290c are configured, for example, to deform staples 280a, 280b, and 280c into a B-shaped configuration. In various instances, the forming pockets 290a, 290b, and 290c are configured, for example, to transform U-shaped staples and / or V-shaped staples into such a B-shaped configuration. Each molded pocket 290a, 290b, and 290c includes a proximal end configured to receive a proximal leg of the staple, and a distal end configured to receive a distal leg of the staple. . Accordingly, any suitable anvil can be utilized to form staples released from the staple cartridge into any suitable shape. Each molded pocket 290a, 290b, and 290c can include a groove extending between a proximal end and a distal end. The groove can include a sidewall configured to deform the staple in a plane and to prevent or at least limit movement of the staple leg out of the plane when the staple leg is deformed.

  Referring now to FIG. 5, anvil 320 includes an array of molded pockets 390a, 390b, and 390c defined therein. As before, a plurality of first forming pockets 390a are disposed along a first longitudinal axis and a plurality of second forming pockets 390b are disposed along a second longitudinal axis. The third shaped pocket 390c is disposed along a third longitudinal axis. Each forming pocket 390a, 390b, and 390c includes a forming pocket proximal end and a forming pocket distal end. For example, each first molded pocket 390a is configured to receive a proximal end 393a configured to receive a proximal leg of the first staple, and a distal end 393a of the first staple. Each of the second shaped pockets 390b includes a proximal end 393b configured to receive a proximal leg of the second staple, and a distal leg of the second staple. A distal end 395b configured to receive a third staple; a respective proximal end 393c configured to receive a proximal leg of the third staple; and a third staple. Including a distal end 395c configured to receive the distal leg of the distal end.

  Proximal ends 393a, 393b, and 393c, and distal ends 395a, 395b, and 395c can comprise any suitable configuration. Referring again to FIG. 5, the proximal ends 393a, 393b, and 393c and the distal ends 395a, 395b, and 395c each include an enlarged cup. The enlarged cups are wider than the groove 397 defined therebetween. In certain instances, the enlarged cups and the grooves extending therebetween may, for example, comprise an hourglass shape. When the staple legs enter such a molded pocket, the legs can enter the enlarged cup, and when the staple legs are deformed, the enlarged cup guides the staple legs into the groove 397. Can be. Each magnifying cup can include curved and / or angled sidewalls that can be configured to guide staple legs toward groove 397. The magnifying cup can adjust the orientation of the misaligned staple legs in certain instances.

  The staple forming pockets 390a, 390b, and 390c are nested. For example, the distal expanding cup 395b of the second forming pocket 390b is positioned intermediate the expanding cups 393c, 395c of the adjacent third stapler forming pocket 390c, and further, the proximal expanding cup of the second forming pocket 390b. 393b is positioned midway between the enlarged cups 393a, 395a of the adjacent first forming pocket 390a. Also, for example, the proximal enlarged cup 393a of the first molded pocket 390a is positioned midway between the enlarged cups 393b, 395b of the adjacent second molded pocket 390b. Further, for example, the distal enlarged cup 395c of the third molded pocket 390c is positioned intermediate the enlarged cups 393b, 395b of the adjacent second molded pocket 390b. The enlarged molding cup of each staple cavity can define a rectangular outer periphery where the entire molding pocket can be positioned. As a result of the nested arrangement described above, the rectangular perimeter of one stapler forming cavity can overlap the rectangular perimeter of another forming cavity. For example, the rectangular periphery of the second molding cavity 390b can overlap the rectangular periphery of the first molding cavity 390a and / or the rectangular periphery of the third molding cavity 390c.

  Referring now to FIG. 6, anvil 420 includes an array of molded pockets 490a, 490b, and 490c defined therein. As before, a plurality of first forming pockets 490a are disposed along a first longitudinal axis, and a plurality of second forming pockets 490b are disposed along a second longitudinal axis. The third molded pocket 490c is disposed along a third longitudinal axis. Each forming pocket 490a, 490b, and 490c includes a forming pocket proximal end and a forming pocket distal end. For example, each first shaped pocket 490a is configured to receive a proximal end 493a configured to receive a proximal leg of the first staple, and configured to receive a distal leg of the first staple. Each of the second shaped pockets 490b includes a proximal end 493b configured to receive a proximal leg of the second staple, and a distal leg of the second staple. A distal end 495b configured to receive the third staple, a proximal end 493c configured to receive a proximal leg of the third staple, and a third staple. A distal end 495c configured to receive the distal leg of the lip.

  The proximal ends 493a, 493b, and 493c, and the distal ends 495a, 495b, and 495c can comprise any suitable configuration. Referring again to FIG. 6, the proximal ends 493a, 493b, and 493c and the distal ends 495a, 495b, and 495c each include an enlarged cup. The enlarged cups are wider than the grooves 497 defined between them. In certain instances, the enlarged cups and the grooves extending therebetween may, for example, comprise an hourglass shape. When the staple legs enter such a forming pocket, the legs can enter the enlarged cup, and when the staple legs are deformed, the enlarged cup guides the staple legs into the grooves 497. Can be. Each enlarged cup can include curved and / or angled sidewalls that can be configured to guide staple legs toward groove 497. The magnifying cup can adjust the orientation of the misaligned staple legs in certain instances.

  The stapler forming pockets 490a, 490b, and 490c are nested. For example, the distal enlarged cup 495b of the second molded pocket 490b is positioned intermediate the enlarged cups 493c, 495c of the adjacent third stapler molded pocket 490c, and further includes a proximal enlarged cup of the second molded pocket 490b. 493b is positioned midway between the enlarged cups 493a, 495a of the adjacent first forming pocket 490a. Also, for example, the proximal enlarged cup 493a of the first molded pocket 490a is positioned midway between the enlarged cups 493b, 495b of the adjacent second molded pocket 490b. For example, the distal enlarged cup 495c of a further third molded pocket 490c is positioned intermediate the enlarged cups 493b, 495b of an adjacent second molded pocket 490b. The enlarged molding cup of each staple cavity can define a rectangular outer periphery where the entire molding pocket can be positioned. As a result of the nested arrangement described above, the rectangular perimeter of one stapler forming cavity can overlap the rectangular perimeter of another forming cavity. For example, the rectangular perimeter of the second molding cavity 490b can overlap the rectangular perimeter of the first molding cavity 490a and / or the rectangular perimeter of the third molding cavity 490c.

  Referring again to FIG. 52A, staples 280a, 280b, and 280c do not overlap. Other embodiments are envisioned where at least some of the staples in the staple pattern overlap. Referring now to FIG. 32, the staple pattern disclosed therein comprises a first row of longitudinal staples 580a and a second row of longitudinal staples 580b. As the reader will recognize, a portion of the staples 580a in the first row and staples 580b in the second row are overlapped. In at least one instance, the base of the second staple 580b extends below the base of the first staple 580a. In such an example, the distal leg 585b of the second staple 580b is positioned on one side of the base of the first staple 580a, and the proximal leg 583b of the second staple 580b is connected to the first staple 580a. Is positioned on the opposite side of the base. Similarly, in at least one instance, the base of the first staple 580a extends below the base of the second staple 580b. In such an example, the distal leg 585a of the first staple 580a is positioned on one side of the base of the second staple 580b, and the proximal leg 583a of the first staple 580a is positioned on the second staple 580b. Is positioned on the opposite side of the base. As a result of the above, the first staple 580a is intermingled with the second staple 580b.

  32, the staple pattern includes a first row of staples 580a, a second row of staples 580b positioned on one side of the longitudinal tissue incision, and a first row of staples 580a. A second row of staples 580b is positioned opposite the longitudinal tissue incision. The first staple 580a is oriented distally and towards the longitudinal tissue incision, and the second staple 580b is oriented proximally and towards the longitudinal tissue incision.

  Referring again to FIG. 32, the first row of staples 580a is positioned along a first longitudinal axis and the second row of staples 580b is positioned along a second longitudinal axis. As a result of the overlap of the first staple 580a and the second staple 580b, in certain instances, the first longitudinal axis may be adjacent to the second longitudinal axis. In some instances, the overlap between the first row of staples and the second row of staples is such that the angled staples in these rows of staples may be of a conventional staple pattern, such as the staple pattern illustrated in FIG. Can have the same centerline spacing that can be achieved with a longitudinally disposed staple pattern. In some instances, the overlap of the first row of staples with the second row of staples is achieved with angled staples in these rows of staples in a conventional longitudinally disposed staple pattern. It can be possible to have closer centerline spacing than can be done. In at least one embodiment, the first longitudinal axis may be collinear with the second longitudinal axis.

  The staple pattern shown in FIG. 32 has a repeating pattern. The repeating pattern comprises two first staples 580a, then two second staples 580b, then two first staples 580a, then two second staples 580b, and so on. This repeating pattern extends longitudinally in the proximal-distal direction. The first row of staples 580a has a cut therein and the cut is filled with staples 580b, and likewise the second row of staples 580b has a cut therein and the cut is a staple. 580a. The repeating pattern is on one side of the longitudinal incision, and the repeating pattern is on the opposite side of the longitudinal incision. These repeating patterns are mirror images of each other. Other repeating patterns are contemplated.

  FIG. 33 illustrates a staple cartridge 530 configured to removably store and expand the staple pattern disclosed in FIG. 32. Staple cartridge 530 includes a first row of staple cavities 570a for removably storing first staples 580a and a second row of staple cavities 570b for removably storing second staples 580b. Including. At least a portion of the first staple cavity 570a and the second staple cavity 570b are interconnected to removably store the overlapping first staple 580a and second staple 580b. The first row of staple cavities 570a may be located along a first longitudinal axis, and the second row of staple cavities 570b may be located along a second longitudinal axis. The first longitudinal axis and the second longitudinal axis may be adjacent or collinear, as appropriate, to deploy the staple patterns disclosed herein. The first row of staple cavities 570a and the second row of staple cavities 570b are positioned on a first side of the longitudinal slot 534, and the first row of staple cavities 570a and the second row of staple cavities 570b. Are positioned on a second side of the longitudinal slot 534. The longitudinal slot 534 is configured to receive a firing member. The firing member can include a cutting element, such as, for example, a knife.

  FIG. 34 illustrates an anvil 520 configured to deform the staples of the staple pattern disclosed in FIG. Anvil 520 includes a first molding cavity 590a configured to deform a leg of first staple 580a, and a second molding cavity 590b configured to deform a leg of second staple 580b. And a repeating pattern of shaped cavities including: The first molding cavities 590a and the second molding cavities 590b are arranged in an alternating pattern. The alternating pattern includes an array of first and second molding cavities 590a and 590b positioned along a first longitudinal axis, positioned on one side of the longitudinal slot 524, and a second longitudinal direction. An array of a first molding cavity 590a and a second molding cavity 590b positioned along an axis. The alternating pattern includes an array of first and second molding cavities 590a and 590b positioned along a first longitudinal axis, positioned opposite the longitudinal slot 524, and a second longitudinal axis. It further comprises an array of first and second molding cavities 590a and 590b positioned along the directional axis. An array of molding cavities 590a, 590b can define a mirror image to longitudinal slots 524. The longitudinal slot 524 is configured to receive a firing member. The firing member can include a cutting element, such as, for example, a knife.

  Although the staple pattern shown in FIG. 32 includes two rows of staples on each side of the longitudinal tissue incision, such a staple pattern may include three or more rows of staples, for example, three rows of staples. Can be included. Such a third row of staples may be intermingled with the first row of staples 580a and / or the second row of staples 580b. Alternatively, such a third row of staples may not be intermingled with a first row of staples 580a or a second row of staples 580b. In such an embodiment, the first row of staples 580a and the second row of staples 580b can be intermingled, and the third row of staples can be, for example, the first row of staples 580a and / or the first row of staples 580a. It can be adjacent to two rows of staples 580b.

  The staple pattern shown in FIG. 35 includes a longitudinal row of first staples 680a, a longitudinal row of second staples 680b, and a longitudinal row of third staples 6870c. The first staple 680a has a first bottom width. The second staple 680b has a second bottom width. The third staple 680c has a third bottom width. The width of the staple base is measured along the base extending between the first staple leg and the second staple leg, the first staple leg extending from the base and extending from the base. The distance between the second staple leg and the second staple leg can be defined. In at least one instance, the base width is measured between the center of the cross section of the first staple leg and the center of the cross section of the second staple leg. In any case, other embodiments are envisioned in which the first bottom width is shorter than the second bottom width, but the second bottom width is shorter than the first bottom width. Other embodiments wherein the third bottom width is shorter than the first bottom width and the second bottom width, but the third bottom width is longer than the first bottom width and / or the second bottom width. is assumed.

  In the embodiment shown in FIG. 35, the second staple 680b has the longest bottom width. As a result, if the staples in the staple pattern rotate within the tissue as the tissue is stretched in the longitudinal direction, the second staple 680b will pass an arc length greater than the first staple 680a. . Similarly, the first staple 680a will pass through a greater arc length than the third staple 680c. In various instances, as a result, the first staple 680a will pass through a first arc length, the second staple 680b will pass through a second arc length, The third staple 680c will pass through the third arc length, and the first arc length, the second arc length, and the third arc length will be different. Such arc lengths may be different for the same degree of staples 680a, 680b, and / or 680c. In certain instances, the first arc length, the second arc length, and / or the third arc length may be the same.

  In the embodiment shown in FIG. 35, the first staples 680a are positioned and arranged alternately within the staple cartridge 630. The distal-most first staple 680 a is oriented toward the distal end of the staple cartridge 630 and toward a longitudinal slot 634 defined in the staple cartridge 630. The next first staple 680 a in the second longitudinal row is oriented toward the proximal end of the staple cartridge 630 and toward the longitudinal slot 634. This pattern then repeats within the longitudinal rows of the first staple 680a.

  The second staples 680b are positioned and arranged alternately within the staple cartridge 630. The distal-most second staple 680 b is oriented toward the distal end of the staple cartridge 630 and toward a longitudinal slot 634 defined in the staple cartridge 630. The next second staple 680 b in the second longitudinal row is oriented toward the proximal end of the staple cartridge 630 and toward the longitudinal slot 634. This pattern then repeats within the longitudinal rows of the second staple 680b.

  The third staples 680c are positioned and arranged alternately within the staple cartridge 630. The distal-most third staple 680c is oriented toward the distal end of the staple cartridge 630 and toward a longitudinal slot 634 defined in the staple cartridge 630. The next third staple 680 c in the third longitudinal row is oriented toward the proximal end of the staple cartridge 630 and toward the longitudinal slot 634. This pattern then repeats within the longitudinal rows of the third staple 680c.

  With further reference to the staple pattern shown in FIG. 35, the longitudinal rows of the first staples 380a are nested within the longitudinal rows of the second staples 380b. Similarly, the longitudinal rows of third staples 380c are nested within the longitudinal rows of second staples 380b.

  The staple cartridge 630 further includes a plurality of first staple cavities 670a configured to removably store the first staple 680a therein, as described above. Staple cartridge 630 includes a plurality of second staple cavities 670b configured to removably store second staples 680b and a plurality of second staples 670c configured to removably store third staples 680c. 3 further comprises a staple cavity 670c. Referring to FIG. 36, anvil 620 may be configured to deform staples 680a, 680b, and 680c as they are ejected from staple cartridge 630. Anvil 620 includes a stapler-formed pocket pattern that is aligned with staple cavities 670a, 670b, and 670c. For example, anvil 620 includes a plurality of first forming pockets 690a aligned with first staple cavities 670a, a plurality of second forming pockets 690b aligned with second staple cavities 670b, and a third staple cavity. A plurality of third forming pockets 690c aligned with 670c.

  As discussed above, the staple pattern can include several rows. The staples in each row can have the same orientation or different orientations. FIG. 23 illustrates an embodiment comprising a row of staples having a first group of staples 780a oriented in a first direction and a second group of staples 780b oriented in a second direction. First staple 780a and second staple 780b are positioned along a longitudinal axis. The first staple 780a is angled with respect to the longitudinal axis and the second staple 780b is aligned with the longitudinal axis. Other arrangements are possible. Staples 780a are arranged in an alternating pattern with staples 780b.

  With continued reference to FIG. 23 and again with reference to FIG. 24, the staples in the staple row can translate and rotate the tissue as the tissue is stretched longitudinally. In some instances, translation and / or rotation of the staples in the tissue can create holes or gaps between the staple and the tissue. Such holes or gaps can cause leakage. Even though the various staple patterns disclosed herein can minimize such leakage, certain modifications of the staple itself can be made to reduce and / or eliminate these leakages. .

  Referring now to FIGS. 17 and 18, the staples are in an unfired configuration, for example, staples 280a, 280b, 280c, 380a, 380b, 380c, 580a, 580b, 680a, 680b, 680c, 780a, and / or 780b. It is shown. Although the unfired configuration of the staple is V-shaped, the principles discussed herein can be applied to staples of any suitable shape. FIG. 19 illustrates the staples of FIGS. 17 and 18 in a fired configuration. Although the post-firing configuration of the staple is B-shaped, the principles discussed herein can be applied to staples of any suitable shape. FIG. 20 shows the staple of FIGS. 17-19 including a coating 881, which is referred to hereinafter as staple 880. FIG. 21 illustrates a staple 880 deployed in tissue and a hole or gap 882 present between the staple 880 and the tissue. FIG. 22 illustrates the coating 881 on the staple 880 in the expanded state. The expanded coating 881 can fill the entire gap 882. In some situations, the expanded coating 881 can stretch the tissue. In various other situations, the coating 881 may not completely fill the gap 882.

  Staple 880 can be comprised of any suitable material, such as, for example, metal. In certain instances, for example, staples 880 can be comprised of titanium and / or stainless steel.

  The expandable staple coating 881 can be comprised of any suitable material. For example, staple coating 881 can be comprised of poly-L-lactic acid and / or poly-95L / 5D lactic acid. Other copolymer compositions of PLA can also be utilized. In various instances, the staple coating 881 can begin forming a gel as soon as the staple 880 is implanted in the tissue, and the gel can expand to fill or at least partially fill the gap 882. it can. In various instances, the coating 881 can be applied to the staples 880 by dipping the staple wire in one or more solutions for coating the wire. In at least one instance, the staple wires can be immersed in a first solution for applying the base coating, and then in a second solution for applying, for example, PLA. In some instances, the coating 881 can be applied to the staples 880 when the staples 880 are positioned in the staple cartridge. The entire disclosure of ELASTOMERIC BIOMATERIALS FOR TISSUE ENGINEERING, Progress In Polymer Science 38 (2013) 584-671 (Q. Chen et al.) Is incorporated herein by reference.

  The staple coating 881 can be made of, for example, a hydrophilic material. For example, the hydrophilic material can include a hydrogel derivitized with a peptide containing RGD peptide sequence microspheres. The metal wires of the staple 880 can be coated with a natural biopolymer, such as, for example, hyaluronan or hyaluronic acid. Other hydrogels can also be utilized. In various instances, the staple coating 881 can begin to expand as soon as the staple 880 is implanted in the tissue, and the coating 881 can expand to fill or at least partially fill the gap 882. . In various examples, the coating 881 can be applied to the staples 880 by dipping the staple wire in one or more solutions for coating the wire. In at least one instance, the staple wire can be dipped, for example, in a first solution to apply the base coating, followed by a second solution to apply the peptide-loaded hyaluronan. In some instances, the coating 881 can be applied to the staple 880 when the staple 880 is positioned in the staple cartridge. ATTACHMENT OF HYALURONAN TO METALLIC SURFACES, J. Biomed. Mater. Res. 68A: 95-106 (2004) (William G. Pitt et al.), The entire disclosure of which is incorporated herein by reference.

  The staple coating 881 can be composed of, for example, xerogel. The staple coating 881 can be comprised of, for example, gelatin microspheres and / or nanospheres. Gelatin comprises collagen in an at least partially denatured or fully denatured form to which cells can bind and be degraded via enzymatic action. In various instances, the gelatin can be loaded, for example, with fibroblast and / or platelet derived growth factor. As the coating 881 degrades, the coating 881 can at least partially fill and at least partially seal the gap 882. In various instances, the coating 881 can be applied to the staples 880 by dipping the staple wires in a water-in-oil emulsion and then freeze-drying the gelatin microspheres and / or nanospheres onto the staple wires. GELATIN MICROSPHERS CROSS-LINKED WITH GENIPIN FOR LOCAL DELIVERY OF GROWTH FACTORS, J.A. Tissue Eng. Regen. Med. 4: 514-523 (2010) (Luis Soloio et al.), The entire disclosure of which is incorporated herein by reference.

  Staple 880 is comprised of a wire having a circular cross section, but staple 880 can be comprised of a wire having any suitable cross section, for example, a polygonal cross section. A non-circular cross-section may have a larger perimeter than a circular cross-section for a particular overall width. Such a non-circular cross section can support a greater amount of coating material than a circular cross section, which causes the coating to expand and fill larger holes than staples having a circular cross section. Can be made possible. In certain instances, a non-circular cross-section can be formed to create one or more grooves in a circular cross-section. In at least one such instance, such a groove can extend longitudinally along the staple leg. In some instances, the longitudinal grooves can extend along an axis. In certain instances, the longitudinal grooves can wrap around the staple legs. In at least one instance, such longitudinal grooves can extend helically around the legs.

  The staples of the staple cartridge can be deployed with or without the use of auxiliary materials, such as buttress materials. In many cases, the adjuvant material can rest on the top surface of the staple cartridge, i.e., the deck, so that when the staples are ejected from the staple cartridge, the staples will force the adjuvant material into contact with the tissue. Can be captured. FIG. 55 illustrates two pieces of adjuvant material 239 positioned on deck surface 238 of staple cartridge 230. A first piece of adjuvant material 239 is positioned on a first side of longitudinal slot 234 and a second piece of adjuvant material 239 is positioned on a second side of longitudinal slot 234. Is done. Alternative embodiments are envisioned in which a single piece of adjuvant material is supported by deck surface 238, the single piece extending across longitudinal slot 234 and both sides of staple cartridge 230. Referring again to FIG. 55, each piece of adjuvant material 239 is substantially rectangular, with rows of first staple cavities 270a, rows of second staple cavities 270b, and third staple cavities 270c. Extend over the staple pattern including the rows of. Staples 280a, 280b, and 280c stored within staple cavities 270a, 270b, and 270c, respectively, assist when staples 280a, 280b, and 280c are formed by anvil 220 and when ejected from staple cartridge 230. It penetrates the agent material 239 and captures a part of the auxiliary material 239 therein.

  In addition to or instead of the adjuvant material positioned on the staple cartridge, the adjuvant material may be positioned on the anvil. The staples that penetrate the tissue can penetrate the anvil supplement before contacting the anvil, and then re-penetrate the anvil supplement before re-entering the tissue.

  After the staples 280a, 280b, and 280c have been deformed by the anvil 220, and further in relation to the above, the adjuvant material 239 is captured against the tissue by the staples 280a, 280b, and 280c. In other words, adjuvant material 239 is implanted into tissue by staples 280a, 280b, and 280c. When the tissue is stretched longitudinally, the adjuvant material 239 can stretch with the tissue, as discussed above.

  Adjuvant materials can provide a number of advantages. The adjuvant material can assist in sealing the puncture created by the staple legs. In various instances, the staple legs can push the adjunct material into the puncture as the staple legs penetrate tissue. The adjuvant material can also help seal the gap created between the staple legs and the tissue as the tissue is stretched longitudinally. Adjuvant materials can reinforce the tissue. In various instances, the adjuvant material can strengthen the tissue and prevent staples from tearing the tissue.

  Referring again to FIG. 55, the reader will recognize portions of the adjuvant material 239 that are not captured by the staples 280a, 280b, and 280c. For example, a portion of the adjuvant material extending around the outer periphery may not be captured by the staple. Similarly, portions of the adjunct material positioned in the middle of the staple may not be captured by the staple. Such non-captured portions of the adjuvant material 239 do not provide the sealing benefits described above, while at the same time, may hinder the extensibility provided by the staple patterns discussed herein. Such non-captured portions may also impede staple rotation within the tissue, as discussed above. Improvements to the embodiment of FIG. 55 are shown in FIGS. 53, 54, 56, and 57. Such embodiments include depressions, notches, cuts, slits, openings, and / or any other suitable interruptions configured to increase the extensibility of the adjuvant material. Further, such interruptions may facilitate rotation of the staples in the tissue.

  With reference to FIG. 53, the adjuvant material 939 includes a scalloped edge or side 938. Scalloped side surface 938 includes a recess or notch 937 defined therein. Notch 937 has a curved configuration, but any suitable configuration can be utilized. Notch 937 reduces the outer perimeter of the uncaught material extending around the perimeter of adjuvant material 939, increasing the flexibility and extensibility of adjuvant material 939.

  Referring again to FIG. 53, the adjuvant material 939 further comprises an opening 936 defined therein. The opening 936 is rectangular and has a through hole, but other embodiments are envisioned. Opening 936 is located halfway between adjacent second staple cavities 270b and halfway between first staple cavity 270a and third staple cavity 270c, but alternative locations are envisioned. Openings 936 reduce the amount of entrapped material in the staple line and increase the flexibility and extensibility of adjuvant material 939.

  Referring again to FIG. 53, the body of adjuvant material 939 extends across staple cavities 270a, 270b, and 270c. Alternative embodiments are contemplated where the adjuvant material 939 does not extend across the staple cavities 270a, 270b, and / or 270c. Referring now to FIG. 54, the adjuvant material 939 'includes slots or openings 935a, 935b, and 935c, wherein the slots or openings 935a, 935b, and 935c are respectively staple cavities 270a, 270b, and 270c. Extending partially across. The openings 935a, 935b, and 935c are larger than the openings 936, but the openings 935a, 935b, and / or 935c can be the same size as the openings 936 and / or larger than the openings 936. .

  Referring to FIG. 56, the adjuvant material 1039 includes a notched edge or side 1038. Notched side 1038 includes a recess or notch 1037 defined therein. Notch 1037 has a square configuration, but any suitable configuration may be utilized. Notch 1037 reduces the perimeter of the uncaught material extending around adjuvant material 1039, increasing the flexibility and extensibility of adjuvant material 1039.

  Referring again to FIG. 56, the adjuvant material 1039 further comprises a slit 1036 defined therein. The slit 1036 is rectangular and has a through hole, but other embodiments are envisioned. The adjuvant material 1039 includes a first row of slits 1036a and a second row of slits 1036b. Slit 1036a is located midway between adjacent second staples 1080b and halfway between first staple 1080a and third staple 1080c, but alternative locations are envisioned. The slit 1036b is located halfway between the adjacent third staples 1080c and halfway between the second staple 1080b and the fourth staple 1080d, but alternative locations are envisioned. Slit 1036a is parallel to first staple 1080a and third staple 1080c, and similarly, slit 1036b is parallel to second staple 1080b and fourth staple 1080d, but the slit may be any suitable May have different directions. Slits 1036a and 1036b reduce entrapped material within the staple line and increase the flexibility and extensibility of adjuvant material 1039. Slits 1036a and 1036b are shorter than the base of staples 1080a, 1080b, 1080c, and 1080d, but slits 1036a and / or 1036b are the same length as the base of staples 1080a, 1080b, 1080c, and 1080d, and / or staples. Embodiments longer than the 1080a, 1080b, 1080c, and 1080d bases are envisioned.

  Referring to FIG. 57, adjuvant material 1139 includes a notched edge or side 1138. Notched side 1138 includes a recess or notch 1137 defined therein. Notch 1137 has a curved configuration, but any suitable configuration can be utilized. Notch 1137 increases the flexibility and extensibility of adjuvant material 1139 by reducing the perimeter of uncaught material extending around adjuvant material 1139.

  Referring again to FIG. 57, the adjuvant material 1139 further comprises a slit 1136 defined therein. The slit 1136 is rectangular and has a through hole, but other embodiments are envisioned. The adjuvant material 1139 includes a first row of slits 1136a and a second row of slits 1136b. Slit 1136a is located midway between adjacent second staples 1180b and halfway between first staple 1180a and third staple 1180c, but alternative locations are envisioned. Slit 1136b is located midway between adjacent third staples 1180c and halfway between second staple 1180b and fourth staple 1180d, but alternative locations are envisioned. Slit 1136a is parallel to first staple 1180a and third staple 1180c, and similarly, slit 1136b is parallel to second staple 1180b and fourth staple 1180d, but the slit can be any suitable May have different directions. The slits 1136a and 1136b reduce entrapped material within the staple line and increase the flexibility and extensibility of the adjuvant material 1139. Slits 1136a and 1136b are shorter than the base of staples 1180a, 1180b, 1180c, and 1180d, but slits 1136a and / or 1136b are the same length as the base of staples 1180a, 1180b, 1180c, and 1180d, and / or staples. Embodiments longer than the bases 1180a, 1180b, 1180c, and 1180d are envisioned.

  As described herein, a firing member and / or wedge sled can fire and / or fire staples across the staple cartridge from staple cavities defined within the staple cartridge. For example, the firing member and / or wedge sled can translate along a firing path within the staple cartridge, and the firing member and / or wedge sled engage the staple driver and / or the staple itself along the firing path. The staples can be driven from the staple cavities. Also, as described herein, a staple arrangement that includes angularly oriented staples can provide various advantages and benefits. For example, an array of angularly oriented staples can provide increased flexibility and / or longitudinal stretch within the stapled tissue.

  When the staples are angularly oriented with respect to the firing path, the staple driver and / or at least a portion of the staples may not overlap and / or be over the firing path. For example, the base of the angularly oriented staples can traverse the firing path such that the staple legs are positioned on both sides of the firing path. Further, the angularly oriented staple driver can traverse the firing path and the ends of the staple driver can be positioned on either side of the firing path. In other instances, only the ends of the staples and / or staple drivers may be above the firing path, and in still other instances, the staples and / or staple drivers may, for example, be completely offset from the firing path. .

  In instances where at least a portion of the staple and / or staple driver is offset from the firing path, the moment arm between the firing path and staples and / or staple driver portions positioned on opposite sides of the firing path may include a staple. The torque may be generated within and / or within the staple driver. The torque can affect the tilt and / or tilt movement of the staple during deployment. As a result, the staple legs of the torqued staple may not be able to engage the tissue with equal force and / or speed, and / or the staple legs may simultaneously penetrate and / or capture the tissue. I can't get it. In various instances, preventing the generation of torque during deployment of the angularly oriented array of staples, as torqueing and / or rotation of the staples during deployment may adversely affect tissue penetration and / or staple formation. It may be desirable to minimize it.

  When the staple driver is angled with respect to the wedge sled firing path, only a portion of the angled driver may receive driving or lifting power from the wedge sled. For example, driving force can be applied to a driver angled along an oblique path. To stabilize the angled driver and prevent torqueing and / or rotation of the driver and thus the staples supported thereon, the wedge sled may include a plurality of drive wedges, One drive wedge can contact the driver and apply driving force at multiple locations on the driver. For example, a pair of laterally spaced drive wedges can engage and lift an angled driver, and the driving force is applied at laterally spaced intervals along the length of the driver. Are distributed. Further, in at least one instance, the laterally spaced drive wedges may be equidistant from the center of mass of the angled driver such that the driver is mass balanced with respect to the plurality of drive wedges. It has become.

  Additionally or alternatively, to stabilize the angled driver and prevent torqueing and / or rotation of the driver and, thus, torqueing and / or rotation of the angled staples supported thereon, Drivers can be connected and / or linked together. In some instances, the angled multi-staple driver can be integrally formed. The connected driver and / or multi-staple driver can support multiple staples, thereby reducing the number of moving parts in the staple cartridge, and connecting each of the interconnected and / or integrated staples. The relative movement between the staple supporting surfaces of the staple receiving pedestal formed on the staple receiving base can be prevented. Further, an angled multi-staple driver may be larger, ie, wider and / or longer, than a single staple driver. As a result, the multi-staple driver can have an increased aspect ratio. For example, a multi-staple driver can have a 1: 1 aspect ratio. In certain instances, the aspect ratio may be 3: 2 or 2: 1. In still other instances, the aspect ratio may be, for example, less than 1: 1 or greater than 2: 1. The greater the aspect ratio of the multi-staple driver, the more stability can be provided to the staples supported thereon.

  In various instances, a single drive wedge can engage an angled multi-staple driver, and in certain instances, the drive force exerted on the driver by the drive wedge is relative to the driver's center of mass. Balance can be adjusted. In another example, the plurality of drive wedges can engage an angled multi-staple driver, which can distribute the driving force laterally across the driver. In various instances, the cumulative drive force exerted on the angled multi-staple driver by laterally spaced drive wedges can be balanced with respect to the driver's center of mass.

  In other situations, the staples can be fired without a driver to stabilize the angled staples in the staple cartridge and prevent torqueing and / or rotation during deployment. For example, a wedge sled may include a staple engaging surface that directly engages a staple engaging surface of a staple in a driverless staple cartridge. The wedge sled can contact each staple at a plurality of laterally spaced locations along the base of the staple. For example, the wedge sled can include a plurality of drive wedges, and at least two drive wedges can contact the angled staples to apply a drive force at multiple locations. In various instances, a pair of laterally spaced drive wedges can engage the angled staples and lift the staples, and the driving force is applied along the length of the base of the stay-pull. They are equally distributed at laterally spaced intervals. Further, in at least one instance, the laterally spaced drive wedges can be equidistant from the center of mass of the angled staples, such that the staples are mass balanced with respect to the drive wedges. It has become.

  An end effector assembly 2000 is disclosed in FIG. As shown, the end effector assembly 2000 includes a first jaw 2002, a second jaw 2004, a closure tube or frame 2006, and an end effector articulation joint 2009. End effector assembly 2000 is movable between a first or open position and a second or closed position. As shown, the first jaw 2002 includes a pivot pin 2008 that is movably positioned within the closure slot 2010 of the second jaw 2004. For example, the pivot pin 2008 causes the first jaw 2002 to pivot relative to the second jaw 2004 and to the frame 2006 of the illustrated end effector assembly 2000 when the second jaw 2004 is pivoted. It is configured to pivot and translate within the closure slot 2010.

  In another example, the first jaw 2002 can be fixed relative to the frame 2006 and the second jaw 2004 pivots relative to the first jaw 2002 to move the end effector assembly 2000 Jaws 2002 and 2004 can be opened and closed. In still other instances, both jaws 2002, 2004 can be pivoted and / or otherwise moved to open and / or close jaws 2002, 2004 of end effector assembly 2000. For example, at least one of the jaws 2002, 2004 may rotate, spin, slide, and / or translate with respect to the other jaws 2002, 2004 and / or the frame 2006 to form the end effector assembly 2000. The jaws 2002, 2004 are opened and / or closed.

  Still referring to FIG. 7, the end effector assembly 2000 is sized and constructed to receive a staple cartridge 2020, which is configured for removable positioning within the end effector assembly 2000. For example, the staple cartridge 2020 shown can be a single-use and / or disposable cartridge, which can be replaced with another staple cartridge after firing the staple 2012 therefrom. The staple cartridge 2020 disclosed in FIG. 7 includes a deck 2026, a cartridge body 2024, and a casing 2022 partially surrounding or enclosing the cartridge body 2024. The staple cartridge 2020 shown also includes a staple 2012 that can be releasably positioned within the cartridge body 2024. The staple 2012 disclosed in FIG. 7 is a generally “V-shaped” staple having non-parallel extending legs.

  In various examples, a staple cartridge, such as staple cartridge 2020, can be integrally formed with, for example, end effector assembly 2000 and / or can be permanently fixed, for example, in one of jaws 2002, 2004. it can. In such instances, end effector assembly 2000 may be a single use and / or disposable end effector. In other instances, a staple cartridge secured to end effector assembly 2000 can reload additional staples, for example, for subsequent firing.

  Referring again to the staple cartridge 2020 disclosed in FIG. 7, a longitudinal slot 2032 is defined at least partially through the cartridge body 2024. The illustrated longitudinal slot 2032 extends along a longitudinal axis L, which extends between a proximal end 2023 and a distal end 2025 of the cartridge body 2024. The longitudinal slot 2032 shown in FIG. 7 extends from the proximal end 2023 toward the distal end 2025 and traverses a portion of the length of the cartridge body 2024.

  In some instances, the longitudinal slots 2032 traverse the entire length of the cartridge body 2024. In other instances, the longitudinal slot 2032 can extend, for example, from the distal end 2023 toward the proximal end 2025. In still other instances, the cartridge body 2024 may not include pre-defined and / or pre-formed longitudinal slots. For example, a firing member and / or cutting element can traverse and / or cut the cartridge body 2024 during a firing stroke to form a slot therein.

  The staple cartridge 2020 disclosed in FIG. 7 is configured to fire an array 2011 of staples 2012 into tissue. The staple array 2011 shown in FIG. 7 includes angled staples 2012, which are angled relative to the longitudinal axis L and to the firing path of the drive wedges 2064a, 2064b. And will be further described herein. The staple cartridge 2020 disclosed in FIG. 7 also includes a multi-staple driver 2040a, 2040b, as described herein, that drives and supports angled staples 2012 in the array 2011.

  Angled staples 2012 are removably positioned within angled staple cavities 2028 defined within cartridge body 2024 disclosed in FIG. For example, the staple cavities 2028 shown are angularly oriented with respect to the longitudinal axis L. The illustrated arrangement of the staple cavities 2028 corresponds to the illustrated staple array 2011 positioned within the staple cartridge 2020. Each staple cavity 2028 shown in FIG. 7 includes an opening 2030 in the deck 2026, each opening 2030 extending at a proximal end, a distal end, and between the proximal and distal ends. Staple axis. The staple axis of the opening 2030 is inclined and / or angled with respect to the longitudinal axis L of the cartridge body 2024. For example, in the staple cartridge 2020 of FIG. 7, all staple cavities 2028 defined in the cartridge body 2024 are angularly oriented with respect to the longitudinal axis L, and the various staple cavities 2028 are positioned relative to other staple cavities 2028. Angle oriented.

  The staple cavities 2028 disclosed in FIG. 7 are arranged in a plurality of rows on each side of the longitudinal slot 2032. For example, a portion of the staple cavity 2028 is disposed on a first side 2027 of the longitudinal slot 2032 in a first inner row 2033, a first outer row 2035, and a first middle row 2037, Another portion of cavity 2028 is disposed in second inner row 2034, second outer row 2038, and second intermediate row 2036 on second side 2029 of longitudinal slot 2032. In the staple cartridge 2020 shown in FIG. 7, the staple cavities 2028 and their rows 2033, 2034, 2035, 2036, 2037, 2038 are symmetric with respect to the longitudinal slots 2032.

  Although the illustrated staple cavities 2028 do not cross or otherwise contact each other, the longitudinal rows 2033, 2034, 2035, 2036, 2037, 2038 of the staple cavities 2028 overlap. For example, the various staple cavities 2028 shown in FIG. 7 extend laterally outward and / or laterally inboard of the staple cavities 2028 in adjacent rows of staple cavities 2028. Further, various illustrated staple cavities 2028 extend proximally and / or distally beyond staple cavities 2028 in adjacent rows of staple cavities 2028. Because the staples 2012 are arranged in an overlapping array 2011, bleeding and / or fluid flow within the stapled tissue can be controlled. Overlapping arrays of staples, like staple array 2011, can be incorporated into, for example, other staple cartridges and / or end effector assemblies disclosed herein.

  In other instances, more or less than three rows of staple cavities 2028 may be positioned on either side 2027, 2029 of the longitudinal slot 2032. In some instances, one of the sides 2027, 2029 of the staple cartridge 2020 may include a different number of rows of staple cavities 2028 than the opposite side 2027, 2029. In some instances, staple cavities 2028 may not overlap longitudinally and / or laterally with staple cavities 2028 in adjacent rows. Additionally or alternatively, in certain instances, the staple cavities 2028 and / or rows thereof may be asymmetric with respect to the longitudinal slots 2032 and / or the longitudinal axis L.

  Still referring to FIG. 7, the illustrated staple cavities 2028 in each longitudinal row are parallel or substantially parallel. For example, as disclosed in FIG. 7, the staple cavities 2028 in the first inner row 2033 are parallel to each other, and the staple cavities 2028 in the first outer row 2035 are parallel to each other, and The staple cavities 2028 in the middle row 2037 are parallel to each other, the staple cavities 2028 in the second inner row 2034 are parallel to each other, and the staple cavities 2028 in the second outer row 2036 are parallel to each other. The staple cavities 2028 in the second intermediate row 2038 are parallel to each other.

  Also, as disclosed in FIG. 7, staple cavities 2028 in each longitudinal row are angularly oriented with respect to staple cavities 2028 in adjacent longitudinal rows. For example, the staple cavities 2028 in the first intermediate row 2037 may be located on the first side 2027 of the illustrated cartridge body 2024, relative to the staple cavities 2028 in the first inner row 2033 and the first outer row 2035. Angle oriented. Further, the staple cavities 2028 in the second intermediate row 2038 are angled with the staple cavities 2028 in the second inner row 2034 and the second outer row 2036 on the second side 2029 of the illustrated cartridge body 2024. Oriented.

  In other instances, only a portion of the staple cavities 2028 in each longitudinal row 2033, 2034, 2035, 2036, 2037, 2038 may be parallel to each other and / or the longitudinal rows 2033, 2034. , 2035, 2036, 2037, 2038 can include staple cavities 2028 that are parallel to one another. Additionally or alternatively, in certain instances, at least a portion of staple cavity 2028 may be randomly oriented. In some instances, at least one of the staple cavities 2028 in the longitudinal rows 2033, 2034, 2035, 2036, 2037, 2038 has at least one adjacent longitudinal row 2033, 2034, 2035, 2036, 2037, It may be parallel to at least one of the staple cavities 2028 in 2038. In certain instances, staple cartridge 2020 can include at least one staple cavity 2028 and / or at least one row of staple cavities that are parallel to longitudinal axis L of cartridge body 2024. For example, see FIG.

  The staple cartridge 2020 disclosed in FIG. 7 includes drivers 2040a, 2040b, which are configured and dimensioned to fit movably within the cartridge body 2024 (FIG. 7). Referring to FIGS. 7 to 9, the drivers 2040a and 2040b include a first driver 2040a (FIGS. 8 to 8B) and a second driver 2040b (FIGS. 8C to 9). The first and second drivers 2040a, 2040b are each configured to support a plurality of staples 2012. As shown in FIGS. 7 to 9, the multi-staple first driver 2040a has a first outer shape, and the multi-staple second driver 2040b has a second outer shape. The outer shape of the multi-staple driver 2040a, 2040b corresponds to the array 2011 of staples 2012 and the arrangement of the staple cavities 2028 shown in FIG.

  As described herein, the placement of the staples 2012 and staple cavities 2028 on the first side 2027 of the longitudinal slot 2032 is different from the staples 2012 and staple cavities 2028 on the second side 2029 of the longitudinal slot 2032. It is a mirror image of an arrangement. Further, the outer shape of the first driver 2040a is a mirror image of the outer shape of the second driver 2040b. As shown in FIG. 7, a first driver 2040a is positioned on a first side 2027 of the longitudinal slot 2032, and a second driver 2040b is positioned on a second side 2029 of the longitudinal slot 2032. You.

  In some instances, the driver on one side of the cartridge body may not be a mirror image of the driver on the opposite side of the cartridge body. Further, first multi-staple driver 2040a and / or second multi-staple driver 2040b can be positioned on different and / or both sides 2027, 2029 of longitudinal slot 2032. For example, multi-staple drivers having different external shapes can be positioned on the same side of the longitudinal slot 2032. In still other instances, staple cartridge 2020 can include three, four or more differently shaped multi-staple drivers. For example, specialized and / or different staple drivers may correspond to particular staples and / or groups of staples. Alternatively, in some instances, all multi-staple drivers in staple cartridge 2020 may have the same external shape.

  The first and second multi-staple drivers 2040a, 2040b disclosed in FIGS. 7-9 include a plurality of troughs, ie, a pedestal 2042 that supports staples. Further, each illustrated driver 2040a, 2040b is configured to drive a plurality of staples 2012. For example, the first driver 2040a (FIGS. 8 to 8B) includes a first cradle 2042a, a second cradle 2042b, and a third cradle 2042c, and the first cradle 2042a and the second cradle 2042c. The platform 2042b and the third cradle 2042c are sized and configured to support one staple 2012, respectively. For example, the base 2014 (FIG. 8B) of the staple 2012 is positioned in a respective cradle 2042a, 2042b, 2042c of the first driver 2040a. 8C-9, the second driver 2040b also includes a first cradle 2042a, a second cradle 2042b, and a third cradle 2042c, the first cradle 2042a, Second cradle 2042b and third cradle 2042c are each sized and configured to support one staple 2012. For example, the base 2014 (FIG. 9) of the staple 2012 is positioned within a respective cradle 2042a, 2042b, 2042c of the second driver 2040a.

  As disclosed in FIG. 7, the first driver 2040a is a right driver, and the right driver is positioned in the right side of the staple cartridge 2020, ie, in the first side 2027. The first cradle 2042a (FIGS. 8-8B) of each first driver 2040a is configured to align with a staple 2012 in the first outer row 2035 of the staple cavity 2028, and The second cradle 2042b of the drivers 2040a (FIGS. 8-8B) is configured to be aligned with the staples 2012 in the first intermediate row 2037 of the staple cavities 2028, and the third of the respective first drivers 2040a. The pedestal 2042c (FIGS. 8-8B) is configured to be aligned with the staples 2012 in the first inner row 2033 of the staple cavities 2028.

  As further disclosed in FIG. 7, the second driver 2040b is a left driver, which is positioned in the left side of the staple cartridge 2020, ie, in the second side 2029. For example, the first cradle 2042a (FIGS. 8C-9) of each second driver 2040b is configured to be aligned with staples 2012 in the second outer row 2036 of the staple cavities 2028, and The second cradle 2042b of the second driver 2040b (FIGS. 8C-9) is configured to be aligned with the staples 2012 in the second intermediate row 2038 of the staple cavity 2028, and the second driver 2040b of each second driver 2040b. Third cradle 2042c (FIGS. 8C-9) is configured to be aligned with staples 2012 in second inner row 2034 of staple cavities 2028.

  Each of the pedestals 2042a, 2042b, 2042c disclosed in FIGS. 8-9 is defined within a stage or platform 2045 of the first driver 2040a or the second driver 2040b. For example, the illustrated first driver 2040a and the illustrated second driver 2040b include a platform 2045, and the pedestals 2042a, 2042b, 2042c are defined within each of the platforms 2045. The platforms 2045 disclosed in FIGS. 8-9 of the drivers 2040a, 2040b are of the same height, or elevation, such that each staple 2012 in the array 2011 is at the same height, i.e., the other staples 2012 in the array 2011. It is configured to hold at altitude. Still referring to FIGS. 8-9, a connection flange 2048 is also disclosed, which connection flange 2048 extends between the steps 2045 of the respective drivers 2040a, 2040b. The connection flange 2048 can limit and / or suppress relative movement between the steps 2045.

  In other examples, the steps or platforms 2045 can have different heights and / or elevations. For example, the height of each step 2045 can be varied to control the post-height of the staples 2012 and, thus, the compression of tissue captured within the shaped staples 2012. Additionally or alternatively, the depth of each pedestal 2042a, 2042b, 2042c can be varied to control the height of the shaped staple 2012 and, therefore, the compression of tissue captured within the shaped staple 2012. it can.

The first and second drivers 2040a, 2040b and their pedestals 2042a, 2042b, 2042c are oriented in an arrangement that complements the arrangement of the staple cavity 2028 and the staple array 2011 in the staple cartridge 2020. As disclosed in FIGS. 8A and 8D, each pedestal 2042a, 2042b, 2042c includes a first end 2044 and a second end 2046, and the first of each pedestal 2042a, 2042b, 2042c. The end 2044 is distal to a second end 2046 of the same cradle 2042a, 2042b, 2042c. Further, an axis is defined between the first end 2044 and the second end 2046 of each cradle 2042a, 2042b, 2042c. For example, the first axis Aa is defined by a first cradle 2042a, a second axis _{A b} is defined by the second cradle 2042B, the third axis _{A c} of the third cradle 2042c.

In the arrangement shown, the orientation of the first axis A _a is configured to conform or correspond to the orientation of the staple 2012 marked with a supported angle by the first cradle 2042a, the second axis A _b orientation is configured to conform or correspond to the orientation of the staple 2012 marked with a supported angle by the second cradle 2042B, the orientation of the third axis a _c is supported by the third receiving tray 2042c Configured to accommodate or correspond to the orientation of the angled staples 2012.

As disclosed in FIGS. 8A and 8D, the first axis A _a is parallel or generally parallel to the third axis A _c. Furthermore, the second axis _{A b} shown in FIGS. 8A and 8D are cross both the first axis _{A a} and the third axis _{A c.} For example, as disclosed in FIGS. 8A and 8D, the axis A _b 2 are perpendicular or generally perpendicular to the first axis A _a and the third axis A _c.

In instances where the drivers 2040a, 2040b are used in a staple cartridge having a different arrangement of staples 2012 and staple cavities 2028, the relative orientation of the cradle 2042a, 2042b, 2042c may be different. In some configurations, for example, all of the axes A _a , A _b , Ac may be parallel. Still in another arrangement, for example, all the axes _Aa, A b, _{A c,} may cross. In certain instances, one axis _{A a, A b, A c} is may be perpendicular to at least one other axis _{A a, A b, A c} . Additionally or alternatively, in some instances, one axis _{A a, A b, A c} is can be parallel to at least one other axis _{A a, A b, A c} .

  Referring mainly to FIGS. 8-8C, the first and second drivers 2040a, 2040b are pieces that are integrally formed. For example, each of the drivers 2040a and 2040b is made of an integrally molded part. In other instances, at least one step 2045 and / or connection flange 2048 can be independently formed. In such instances, multiple pieces may be glued, welded, and / or otherwise attached together, for example, to form a single piece.

  The multi-staple drivers 2040a, 2040b disclosed in FIGS. 7-9 are configured to drive staples 2012 from a staple cavity 2028 across a plurality of longitudinal rows 2033, 2034, 2035, 2036, 2037, 2039. In the staple cartridge 2020 shown in FIG. 7, the staples 2012 are arranged in three longitudinal rows on each side of the slot 2032, and the drivers 2040a, 2040b cause the staples 2012 in each of the three longitudinal rows to It is configured to support and drive. For example, each illustrated first driver 2040a includes a staple 2012 positioned in a first inner row 2033, a staple 2012 positioned in a first intermediate row 2037, and a first outer staple cavity 2028. It is configured to drive staples 2012 positioned in row 2035. Further, each illustrated second driver 2040b includes a staple 2012 positioned in a second inner row 2034, a staple 2012 positioned in a second intermediate row 2038, and a second outer staple cavity 2028. The staples 2012 positioned in the row 2036 are configured to be driven.

  In other examples, the staples 2012 can be arranged in more than three longitudinal rows or less than three longitudinal rows on each side of the slot 2032, and the drivers 2040a, 2040b Can be configured to engage staples 2012 in each of the longitudinal rows on each side of the staple. For example, the staple cartridge 2020 can have two rows of staple cavities 2028 on either side of the longitudinal axis L, and the multi-staple driver positioned therein can include two pedestals. Can be configured to support staples in each of the two rows. In some instances, the multi-staple driver may fire multiple staples 2012 from the same row of staple cavities 2028. For example, a multi-staple driver can fire adjacent staples 2012 in the same row, for example, a more proximal staple 2012 and a more distal staple 2012. In certain instances, the multi-staple driver may not engage staples 2012 in all rows on the side of longitudinal slot 2032. For example, a separate and distinct driver may engage staples in one of the rows, for example, the outermost row and / or the innermost row. Additionally or alternatively, in certain instances, the staple cartridge 2020 can include at least one multi-staple driver and at least one single staple driver. For example, see FIG.

  The end effector assembly 2000 disclosed in FIG. 7 further includes a firing member 2060, which is configured to move relative to the cartridge body 2024. During the firing stroke, firing member 2060 is configured to traverse cartridge body 2024 and drive engage sled 2058 to move sled 2058 through cartridge body 2024. For example, a portion of the firing member 2060 shown is sized and positioned to fit within the longitudinal slot 2032. As disclosed in FIG. 7, a portion of the firing member 2060 configured to fit within the longitudinal slot 2032 includes a cutting edge 2061, wherein the cutting edge 2061 is a first jaw of the end effector assembly 2000. It is configured to dissect tissue clamped between 2002 and the second jaw 2004.

The wedge sled 2058 disclosed in FIG. 7 is configured to engage the drivers 2040a, 2040b to lift the drivers 2040a, 2040b, and thus fire staples 2012 supported thereon into tissue. In the illustrated end effector assembly 2000, the intermediate wedge 2062 of the sled 2058 can slide and / or translate within the longitudinal slot 2032, and a laterally positioned drive wedge defined on the sled 2058; That is, the drive rails 2064a, 2064b can engage the staple drivers 2040a, 2040b. For example, the sled 2058 shown in FIG. 7 includes a drive wedge or rail 2064a, 2064b that moves along firing paths F ₁ (FIG. 8A) and F ₂ (FIG. 8D) during a firing stroke. Thus, the multi-staple first and second drivers 2040a and 2040b that are longitudinally aligned with the firing paths F ₁ and F ₂ are configured to be in contact with each other.

As disclosed in FIG. 7, the sled 2058 includes drive wedges 2064a, 2064b on either side of the central portion 2062. The drive wedge 2064a on the first side 2027 of the staple cartridge 2020 is configured to move along a _first firing path F ₁ (FIG. 8A), and the drive wedge 2064b on the second side 2029 of the staple cartridge 2020 is , Along a _second firing path F ₂ (FIG. 8D).

  Each drive wedge 2064a, 2064b disclosed in FIG. 7 engages one of the multi-staple drivers 2040a, 2040b to lift the drivers 2040a, 2040b in the staple cavity 2028 and eject the staple 2012 from the cartridge body 2024. It is configured as follows. In the illustrated arrangement, the three stages 2045 of each first driver 2040a remain fixed with respect to each other, and the three stages 2045 of each second driver 2040b remain fixed with respect to each other. . In other words, the steps 2045 of the single driver 2040a, 2040b do not move and / or rotate with respect to each other. Since the steps 2045 of the single drivers 2040a, 2040b do not move and / or rotate with respect to each other, the relative movement of the staples 2012 supported by the respective drivers 2040a, 2040b is also suppressed. Furthermore, each driver 2040a, 2040b has a larger base, or footprint, within the cartridge body 2042, which can further reduce the rotation and / or torque application of the drivers 2040a, 2040b. As a result, movement and / or tilting of the staples 2012 during deployment may be prevented, minimized, and / or controlled by the multi-staple drivers 2040a, 2040b. The multi-staple driver, like the drivers 2040a, 2040b, can be incorporated into, for example, other staple cartridges and / or end effector assemblies disclosed herein.

  In various instances, the drive wedges 2064a, 2064b of the sled 2058 can be sized, configured, and positioned to engage the drive surfaces of the drivers 2040a, 2040b, respectively. For example, the drivers 2040a, 2040b can include ramps and / or tracks that drive the wedge as the firing member 2060 and sled 2058 move through the staple cartridge 2020, respectively. It is configured to guide and / or receive a portion of 2064a, 2064b.

Driver 2040a, 2040b, and the driver 2040a, for staples 2012 supported by 2040b, respectively, the driving wedge 2064A, 2064B, and the corresponding relative positioning of the firing path _F 1, _{F 2} of the in firing drivers 2040a, 2040b And / or may be selected to prevent, reduce, and / or control staple 2012 torque application. For example, the driver 2040a, the outer shape and / or material 2040b, respectively, chosen to install the respective driver 2040a to alignment with the corresponding firing path _F 1, _{F 2,} the mass of 2040b center (COM) can do. Additionally or alternatively, the driving wedge 2064A, 2064B, thus firing path _F 1, _{F 2,} respectively, to extend through the driver 2040a, 2040b center of each mass (COM), positioning the cartridge 2020 Can be.

  In other instances, as further described herein, the sled 2058 can include more than one drive wedge 2064a, 2064b on each side of the intermediate portion 2062. For example, the plurality of drive wedges 2064a, 2064b can move through both sides 2027, 2029 of the cartridge body 2024. Additionally or alternatively, the drive wedges 2064a, 2064b of the wedge sled 2058 can be configured to directly engage and drive the staple 2012, as described further herein.

Mainly referring to FIGS. 8A and FIG. 8D, the first and second driver 2040a, 2040b, respectively, the driving wedge 2064A, the 2064B, respectively, are on the firing path _F 1, _{F 2.} For example, the first driver 2040a is in a first firing on path _{F 1,} the second driver 2040b is above the second firing path _{F 2.} Moreover, each driver 2040a, various parts of 2040b, each driving wedge 2064A, on both sides of the 2064B, therefore, are positioned on opposite sides of the firing path _F 1, _{F 2.} Still referring to FIGS. 8A and 8D, the illustrated drivers 2040a, 2040b are such that the center of mass (COM) of each driver 2040a, 2040b is, for example, the corresponding firing path F _{1 of the} drive wedge 2064a, 2064b, respectively. It is sized and constructed to overlap in F _2. In other words, each of the illustrated driver 2040a, 2040b is balancing by mass with respect to the corresponding firing path _F 1, _{F 2.}

For example, as disclosed in FIG. 8A, the first portion 2047 of the first driver 2040a is positioned on a first side of the firing path _{F 1,} the second portion 2049 of the first driver 2040a is fired It is positioned on a second side of the path F _1. The first portion 2047 of the first driver 2040a have a first mass _{m 1,} the second portion 2049 of the first driver 2040a has a mass _{m 2, m 2} is the first equal to the mass m _1, or substantially equal. Further, as disclosed in FIG. 8D, a first portion 2047 of the second driver 2040b is positioned on a first side of the firing path _{F 2,} a second portion 2049 of the second driver 2040b is fired It is positioned on a second side of the path F _2. The first portion 2047 of the second driver 2040b has a _first mass m ₁ and the second portion 2049 of the second driver 2040b has a mass m _2, which is equal to or equal to the first mass, or substantially equal, the mass m ₂ is equal to the first mass m _1, or substantially equal. Since drivers 2040a, 2040b is balancing by mass with respect to each of the firing path _F 1, _{F 2,} driver 2040a in firing, torquing of the staple 2012 is supported 2040b and thereon minimizes And / or otherwise. Further, a group of staples 2012 deployed by respective drivers 2040a, 2040b can be lifted synchronously with respect to cartridge body 2024 and driven simultaneously or fired into tissue. Drivers balanced by mass, like drivers 2040a, 2040b, can be incorporated, for example, into other embodiments disclosed herein.

Further, as disclosed in FIGS. 8-9, at least one cutout 2050 is defined in the first and second multi-staple drivers 2040a, 2040b. For example, various cutouts 2050 are defined in the connecting flange 2048 of the drivers 2040a, 2040b. Cutout 2050 driver 2040a, to adjust the mass of 2040b, each driver 2040a, sized and positioned so as to adjust the balance relative to firing path _F 1, _{F 2} corresponding to the center of mass of 2040b (COM) Is done. Further, cutout 2050 is sized and positioned to accommodate the outer shape of staple cavity 2028, and within staple cavity 2028, drivers 2040a, 2040b are movably positioned.

  In certain instances, a plurality of staple cavities may be defined within the staple cartridge, at least one staple cavity may be parallel to a longitudinal axis of the staple cartridge, and at least one staple cavity may be defined in the staple cartridge. It can be angularly oriented with respect to the longitudinal axis. Referring to the staple cartridge 2120 shown in FIG. 10, for example, a plurality of staple cavities 2128 are defined in the staple cartridge 2120, and the plurality of staple cavities 2128 are parallel to the longitudinal axis L of the staple cartridge 2120.

In the staple cartridge 2120 shown, a longitudinal slot 2032 is defined partially through the cartridge body 2124. Also defined within the cartridge body 2124 is a row of staple cavities 2128 on either side of the longitudinal slot 2032, the rows of staple cavities 2128 defining staple cavities 2128 oriented parallel to the longitudinal axis L. Including. In the staple cartridge 2120 shown, the staple cavities 2128 in the first row 2137 and the staple cavities 2128 in the second row 2138 are adjacent to the longitudinal slots 2032 and in the first row 2137 and in the second row 2138. Staple cavities 2128 are oriented parallel to the longitudinal axis L. For example, as disclosed in FIG. 10, the staple cavities 2128 in first row 2137 is aligned with the axis _{A b,} the axis _{A b,} which is parallel to the longitudinal axis L.

The staple cartridge 2120 disclosed in FIG. 10 includes an additional row of staple cavities 2128. For example, the illustrated staple cartridge 2120 includes a third row 2135 of staple cavities 2128 and a fourth row 2136 of staple cavities 2128, wherein the staple cavities 2128 have staples that are angularly oriented with respect to the longitudinal axis L. A cavity 2128 is included. In such an instance, the staple cavities 2128 in the third row 4135 and the fourth row 2136 are also angularly oriented with respect to the staple cavities 2128 in the first row 2137 and the second row 2138, and They are angularly oriented with respect to each other. For example, the staple cavities 2128 in the third column 2135 is aligned with the axis _{A a,} the axis _{A a} traverse the longitudinal axis L, transverse to an axis _{A b} of the staple cavity 2128 of the first row 2137. As further disclosed in FIG. 10, the staple cavities 2128 in the fourth column 2136 extends along an axis transverse to the third axis _{A a} staple cavities 2128 in the column 2135 of. The staple cavities 2128 of the first row 3137 and the third row 2135 are positioned on the first side 2127 of the illustrated cartridge body 2124, and the second row 4136 and the fourth row 2138 are positioned on the illustrated cartridge body 2124. Is positioned on the second side 2129.

  In various instances, the staple cartridge 2120 disclosed in FIG. 10 can be used with the end effector assembly 2000 shown in FIG. For example, the staple cartridge 2120 can be mounted in an elongated channel of the second jaw 2004 of the end effector assembly 2000. The staple cartridge 2120 can fire with a single staple driver, a multi-staple driver, and / or a combination thereof. For example, a multi-staple driver can be configured to fire staples from staple cavities 2128 in the first and third rows 2137, 2135 on the first side 2127 of the cartridge body 2124, and another multi-staple driver Staples can be configured to fire from staple cavities 2128 in the second and fourth rows 2136, 2138 on the second side 2129 of the cartridge body 2124. In various instances, a driver can be positioned within cartridge body 2124 such that the driver's cradle is aligned with staples positioned within staple cavity 2128. In such instances, the driver and / or the staples supported thereon may be mass-balanced with respect to the firing path of the sled, for example, sled 2058 (FIG. 7), wherein the sled 2058 2124 can be configured to traverse and engage an internal driver.

  In other examples, staple cartridge 2120 may not include a driver. For example, a firing member and / or thread, such as, for example, firing member 2060 and / or sled 2058 (FIG. 7), directly contacts, engages, and / or engages staples movably positioned within staple cavity 2128. Alternatively, it can be configured to drive it. In such an instance, the staples may be mass balanced with respect to the firing path of the sled 2058. In still other instances, the staples can be held in place within the cartridge body 2124, for example, can be crushed and / or otherwise deformed within the cartridge body 2124.

  In various instances, a multi-staple driver can simultaneously engage the driver during deployment and balance against a plurality of drive wedges that cooperate to lift the driver. For example, a multi-staple driver 2240 and a pair of drive wedges 2264a, 2264b are shown in FIG. The multi-staple driver 2240 is configured for use with a staple cartridge 2020, for example. Additionally or alternatively, driver 2240 can be used with a variety of other staple cartridges having a staple array that matches array 2011 (FIG. 7) and corresponds to the arrangement of driver 2240 shown in FIG.

  In various instances, the staples fired from staple cartridge 2120 can be formed to a variable molded height. For example, the staples can have a greater height between one of the staple legs and the base than between the other staple legs and the base. In such instances, the staples can exert a greater compressive force on the tissue at the shorter ends of the staples. As described in further detail herein, the staple height may be determined when the staple driver includes a step or height difference (see, eg, FIG. 79) and / or the stapler in the anvil. It can be changed when the forming pocket has a step or height difference (see, for example, FIG. 80).

  As the angled staples are deformed to a variable height, the compressive force exerted on the tissue by the angled staples can fluctuate longitudinally and laterally. In certain instances, for example, it may be desirable to compress tissue that is closer to the cut line, ie, laterally inward, than tissue that is farther from the cut line, ie, laterally outward. In such an instance, the lateral tissue variations imparted by the angled staples deformed to different compressed heights may result in greater compressive forces on the laterally inner portion of the tissue and laterally outer portions of the tissue. It is possible to apply a compressive force reduced to the part.

  Referring again to FIG. 10, in certain instances, the staples emitted from the third row 2135 of staple cavities 2128 and from the fourth row 2136 of staple cavities 2128 can be deformed to a variable height. . For example, the staples can have a reduced height closer to the longitudinal axis L and a greater height farther from the longitudinal axis L. Additionally or alternatively, staples emitted from staple cavities 2128 of first row 2137 and from staple cavities 2138 of second row are emitted from staple cavities 2128 of third row 2135 and fourth row 2136. The staples can be reduced to a uniform height, which can be less, ie, less than a smaller height. In such instances, the compressive force exerted on the tissue may be greatest closer to the cut line, and may decrease progressively further outward on the lateral side of the staple line.

  Each driver 2240 disclosed in FIG. 11 includes a plurality of troughs, ie, pedestals 2242a, 2242b, 2242c that support staples. For example, each driver 2240 includes a first cradle 2242a, a second cradle 2242b, and a third cradle 2242c, each of which is one of staples 2012 (FIG. 7), such as It is sized and constructed to support one staple. For example, the base of the staple can be positioned in a respective cradle 2242a, 2242b, 2242c. Referring again to the staple cartridge 2020 shown in FIG. 7, the first cradle 2242a can be aligned with the staples 2012 in the staple cavities 2028 of the first outer row 2035 and the second cradle 2242b can be The staples 2012 in the staple cavities 2028 of the first middle row 2037 can be aligned with the staples 2012 in the staple cavities 2028 of the first inner row 2033. In such an example, first cradle 2242a corresponds to the outer cradle, second cradle 2242b corresponds to the intermediate cradle, and third cradle 2242c corresponds to the inner cradle. . In various instances, another driver arrangement may be positioned on the opposite side of the staple cartridge, while the other driver arrangement may be a mirror image of the driver arrangement shown in FIG.

  The cradle 2242a, 2242b, 2242c shown in FIG. 11 is defined in the support member 2248. The support member 2248 can support staples across a plurality of rows of staple cavities. Further, support member 2248 supports staples 2012 that are oriented at different angles with respect to the longitudinal axis L of the staple cartridge and / or with respect to, for example, the longitudinal firing path of drive wedges 2264a, 2264b. be able to. Referring to the illustrated support member 2248, the support member 2248 is angularly oriented with respect to the firing path of the drive wedges 2264a, 2264b. Further, support member 2248 is angularly oriented with respect to at least one of the pedestals 2242a, 2242b, 2242c defined therein. For example, the intermediate cradle 2242b disclosed in FIG. 11 is angularly oriented with respect to the support member 2248. Further, as disclosed in FIG. 11, outer cradle 2242c and inner cradle 2242a are aligned with support member 2248.

  In certain instances, the height of the support members 2248 may be uniform or generally uniform, such that the respective staples supported by the support members 2248 are positioned at the same height, ie, elevation. In other examples, the support members 2248 can include steps having different heights and / or elevations. For example, the step height can be varied to control the height of the shaped staple, and thus the compression of the tissue captured within the shaped staple. Additionally or alternatively, the depth of each pedestal 2242a, 2242b, 2242b can be varied to control the height of the formed staples, and thus the compression of the tissue captured within the formed staples.

Each cradle 2242a, 2242b, 2242c disclosed in FIG. 11 includes a first end 2244 and a second end 2246. A first end 2244 of each cradle 2242a, 2242b, 2242c is distal to a second end 2246 of the same cradle 2242a, 2242b, 2242c. Further, an axis is defined between a first end 2244 and a second end 2246 of each cradle 2242a, 2242b, 2242c. For example, the first axis _{A a} is defined by a first cradle 2242a and the third cradle 2242C, a second axis _{A b} is defined by the second cradle 2242b. As shown in FIG. 11, a second axis _{A b} crosses the first axis _{A a.} In certain instances, the second axis A _b may be perpendicular or substantially perpendicular to the first axis A _a.

Still referring to FIG. 11, the multi-staple driver 2240 includes rails 2245a, 2045b, which are connected to the support member 2248. Rails 2245a, 2245b are positioned to engage drive wedges 2264a, 2264b of the wedge sled. For example, rails 2245a illustrated, 2245 b, the drive wedge 2264A, is aligned with the firing path _F 1, _{F 2} of the 2264B. In such an example, the rails 2245a, 2245b are elongated to receive driving force from the drive wedge and to stabilize the multi-staple driver 2240 when the drive wedges 2264a, 2264b drive engage the rails 2245a, 2245b. Surface area can be provided.

  Driver 2240 may include a plurality of independently formed components that can be glued, welded, and / or otherwise attached together. For example, support member 2248 can be joined with rails 2245a, 2245b to form driver 2240. In another example, each driver 2240 may be a one-piece component including a support member 2248 and rails 2245a, 2245b.

Disclosed in Figure 11 the driver 2240 is driven wedge 2264A, on the firing path _F 1, _{F 2} of the 2264B. Further, various portions of each illustrated driver 2240 are positioned on opposite sides of wedges 2264a, 2264b. As shown in FIG. 11, the driver 2240, equidistant from the center of mass of the respective drivers 2240 (COM) is a drive shaft, for example, to drive a wedge 2264A, from the firing path _F 1, _{F 2} of 2264b is equidistant Dimensioned and constructed. For example, the firing paths F ₁ , F ₂ shown in FIG. 11 are separated by a width w, and the center of mass of each driver 2240 is positioned between the firing paths F ₁ and F ₂ . As shown in FIG. 11, the center of mass of the respective drivers 2240 may be offset from the first firing path F ₁ by a width w / 2 in the longitudinal direction, the width w / 2 by a second longitudinally from the launch path F ₂ Biased in the direction. As a result, each illustrated driver 2240 is mass balanced with respect to firing paths F ₁ , F ₂ . As the driver 2240 is mass balanced with respect to the firing paths F ₁ , F ₂ , torque application of the driver 2240 and staples during deployment is prevented, minimized, and / or otherwise controlled. Can be done. A mass-balanced driver could, for example, be incorporated into other staple cartridge and end effector assemblies disclosed herein, similar to driver 2240.

  In another example, the firing member can include a single drive wedge aligned with driver 2240, which can be mass-balanced with respect to the drive wedge. For example, the drive wedge can define a firing path that extends through the center of mass (COM) of each driver 2240. In such instances, the drive wedge may have a greater width to increase the stability of driver 2240. In another example, the firing member can include more than two drive wedges, and the cumulative drive force exerted by the drive wedges can be balanced against the driver 2240 geometry.

Each rail 2245a disclosed in FIG. 11, 2245 b is aligned with one of the firing path _F 1, _{F 2.} Specifically, first rail 2245a is aligned with _first firing path F1, and second rail 2245b is aligned with _second firing path F2. Drive wedges 2264a, 2264b are configured to contact rails 2245a, 2245b to lift driver 2240 and the staples supported thereon. Still referring to FIG. 11, the illustrated drive wedges 2264a, 2264b are staggered longitudinally by a distance x. For example, the first wedge 2264a follows the second wedge 2264b by the distance x shown in FIG. Further, the first rails 2245a are staggered in the longitudinal direction with respect to the second rails 2245b. For example, the second rail 2245b is offset distally from the first rail 2245a by a distance y shown in FIG. In the arrangement disclosed in FIG. 11, the distance x is equal to or substantially equal to the distance y such that the drive wedges 2264a, 2264b respectively drive simultaneously contact the rails 2245a, 2245b during the firing stroke. ing.

  The drive wedges 2264a, 2264b disclosed in FIG. 11 simultaneously engage and drive the rails 2245a, 2245b on opposite sides of and equidistant from the center of mass (COM) of the driver 2240, respectively. While lifting, the cumulative driving force is balanced throughout the deployment of driver 2240. As a result, torqueing and / or rotation of the driver 2240, and thus the staples supported thereon, may be prevented, minimized, and / or controlled. For example, similarly to the drive wedges 2264a, 2264b, longitudinally offset drive wedges can be incorporated into other embodiments disclosed herein.

  Since the arrangement of the multi-staple driver 2340a and the single staple driver 2340b is disclosed in FIG. 12, the arrangement of the drivers 2340a and 2340b corresponds to the array 2011 of the staples 2012 shown in FIG. 2020 (FIG. 7). Additionally or alternatively, drivers 2340a, 2340b can be used with various other staple cartridges having a staple array corresponding to the arrangement of drivers 2340a, 2340b shown in FIG.

  Drivers 2340a, 2340b include pedestals 2342a, 2342b, 2342c that support a plurality of troughs, ie, staples. For example, the multi-staple driver 2340a includes a first cradle 2342a and a second cradle 2342b, and the first cradle 2342a and the second cradle 2342b are respectively two staples 2012 shown in FIG. , Sized and constructed to support staples. Further, the single staple driver 2340b includes a third cradle 2342c, which is sized and constructed to support another staple, such as another of the staples 2012 shown in FIG. Is done. For example, the base of the staple 2012 may be in a respective cradle 2342a, 2342b, 2342c.

  Referring again to the staple cartridge 2020 shown in FIG. 7, the first cradle 2342a can be aligned with the staples 2012 in the staple cavities 2028 of the first outer row 2035, and the second cradle 2342b has an intermediate The third cradle 2342c can be aligned with the staples 2012 in the staple cavities 2028 of the inner row 2033, with the staples 2012 in the staple cavities 2028 of the row 2037 being aligned. In such an example, first cradle 2342a corresponds to the outer cradle, second cradle 2342b corresponds to the intermediate cradle, and third cradle 2342c corresponds to the inner cradle. . Further, another driver arrangement can be positioned on the opposite side of the staple cartridge 2020, and the driver arrangement may be a mirror image of the driver arrangement disclosed in FIG.

  Still referring to FIG. 12, each cradle 2342a, 2342b, 2342c is defined within a step and / or support portion 2345. Further, each of the drivers 2340a, 2340b includes a base 2348, 2349, respectively. The base 2348 of each multi-staple driver 2340a extends between steps 2345 of driver 2340a. Further, the base 2349 of each single staple driver 2340b extends from its step 2345.

As disclosed in FIG. 12, each of the drivers 2340a, 2340b is aligned with the firing path _F 1, _{F 2} in the staple cartridge. Specifically, each first driver 2340a is aligned with a _first firing path F1, and each second rail 2340b is aligned with a _second firing path F2. Shown driving wedge 2364a, 2364b are configured to move along a firing path _F 1, _{F 2} in the firing stroke. Further, drive wedges 2364a, 2364b contact drivers 2340a, 2340b, respectively, to lift drivers 2240a, 2340b and staples supported thereon.

Bases 2348, 2349 may serve as counterweights to adjust and / or control the center of mass of drivers 2340a, 2340b. For example, the outer shape and material of each of the base 2348,2349 moves each driver 2340A, maintain the center of mass of the 2340B, and / or to the alignment with the firing path _F 1, _{F 2} corresponding to the center Can be selected as As shown in FIG. 12, first base 2348 includes at least one cutout 2350. The dimensions of the cutout 2350, placement, and the outer shape is selected for the first firing path F ₁ to the first driver 2340a to balancing by mass. For example, each of the first base portion 2348, can constitute a center of mass of the multi-staple driver 2340a to maintain or the center is shifted to the first alignment of the firing path F _1, respectively second base 2349 may be configured to move the center of mass of a single staple driver 2340b to a second alignment with the firing path F _2.

  In addition, bases 2348, 2349 provide an elongated surface area for stabilizing driver 2340 when drive wedges 2364a, 2364b are in driving engagement with drivers 2340a, 2340b. For example, a larger footprint of drivers 2340a, 2340b may promote stability and prevent torqueing and / or rotation of drivers 2340a, 2340b during deployment. Further, as the bases 2348, 2349 provide a larger surface area, the driving force can be distributed to facilitate a balanced driver and staple deployment. Drivers having an elongated surface area, such as bases 2348, 2349, can be incorporated, for example, into other embodiments disclosed herein.

  Still referring to FIG. 12, the illustrated drive wedges 2364a, 2364b are staggered longitudinally by a distance x. For example, the first wedge 2364a follows the second wedge 2364b by a distance x. As further shown in FIG. 12, the illustrated drivers 2340a, 2340b are staggered in the longitudinal direction by a distance y. In the arrangement shown, distance x differs from distance y such that drive wedges 2364a, 2364b do not simultaneously contact drivers 2340a, 2340. For example, in the arrangement shown, the first wedge 2364a contacts the first driver 2340a before the second wedge 2364b contacts the second driver 2340b. In such an example, deployment of first driver 2340a, and thus movement of first cradle 2342a and second cradle 2342c, may involve deployment of second staple 2340b and thus third cradle 2342c. Started before the move. As a result, staples aligned with the first driver 2340a are fired before staples aligned with the second driver 2340b.

  In certain instances, it may be desirable to fire a staple or group of staples before firing another staple or group of staples. For example, to control bleeding and / or fluid flow within the stapled tissue, the staples may include staples positioned further inward, such as staples adjacent to the longitudinal slots and thus adjacent to the score lines. , Can be fired before the staples that are further outside.

  In another example, staples aligned with second driver 2340b can be fired before staples aligned with first driver 2340a. Alternatively, the first driver 2340a and the second driver 2340b fire simultaneously, such that three staples supported by adjacent multi-staple and single staple drivers 2340a, 2340b simultaneously penetrate and capture tissue. Can be.

  The arrangement of the dual staple driver 2440 is shown in FIG. As arranged in FIG. 13, dual staple driver 2440 is configured to fire staples from a staple cartridge having four adjacent rows of staple cavities. For example, the driver arrangement shown in FIG. 13 can be configured to fire staples from four rows of staple cavities on one side of the longitudinal slot in the cartridge body, and the corresponding mirror image driver arrangement is longitudinal. Staples can be configured to fire from four rows of staple cavities on opposite sides of the slot.

  In another example, a single row of dual staple drivers 2440 can be positioned on a first side of a staple cartridge, and a single row of dual staple drivers 2440 can be positioned on a second, or staple cartridge, staple cartridge. It can be positioned on the opposite side. In such an instance, the dual staple driver 2440 can be arranged to fire staples from two adjacent rows of staple cavities on either side of the score line. In another example, a row of dual staple drivers 2440 can be added to the arrangement shown in FIG. For example, a dual staple driver can be arranged to fire staples from six or more adjacent rows of staple cavities.

  The double staple driver 2440 shown in FIG. 13 includes a pair of troughs, that is, cradles 2442a and 2442b that support staples. For example, each dual staple driver 2440 includes a first pedestal 2442a and a second pedestal 2442b sized and constructed to support staples, such as one of staples 2012 (FIG. 7). For example, the base of the staple can be positioned in a respective cradle 2242a, 2242b.

  One first cradle 2442a of the dual staple driver 2440 can align with staples in one row of staple cavities, and a second cradle 2442b of the same dual staple driver 2440 can The staples in the staple cavity can be aligned. Further, the first cradle 2442a of another dual staple driver 2440 can be aligned with the staples in another row of staple cavities, and the second cradle 2442b of the dual staple driver 2440 further includes It can be aligned with staples in another row of staple cavities.

  Still referring to FIG. 13, each dual staple driver 2440 includes a step and / or support portion 2445, and each cradle 2442a, 2442b is defined within one of the steps 2445. Further, each of the drivers 2440 includes a base or connection flange 2448 extending between the steps 2445 of the dual staple driver 2440. The tiers 2445 are connected by connecting flanges 2448 so that the pedestals 2442a, 2442b are linked so that adjustment and / or synchronous staple deployment can be initiated by the dual staple driver 2440.

  The steps 2445 of the driver 2440 may be the same height. Alternatively, in some instances, driver 2440 may include steps of different heights. In still other instances, different drivers 2440 may have, for example, steps of different heights.

As disclosed in FIG. 13, each double staple driver 2440 is above a pair of firing paths. Specifically, one of the drivers 2440 is above the first and second firing paths F ₁ , F ₂ , and the other of the driver 2440 is having the third and fourth firing paths F ₃ , F _On top of ₄ . A plurality of drive wedges 2464a, 2464b, 2464b, 2464d are also shown in FIG. As shown in FIG. 13, drive wedges 2464a, 2464b, 2464c, 2464d are configured to contact dual staple driver 2440 to lift dual staple driver 2240 and staples positioned thereon.

Still referring to FIG. 13, each step 2445 includes a center of mass (COM). Further, each of the firing paths F ₁ , F ₂ , F ₃ , F ₄ is aligned with the center of mass of step 2045. As a result, each stage 2445 is mass balanced with respect to the corresponding firing path F ₁ , F ₂ , F ₃ , F ₄ .

In various instances, bases 2448 extending between steps 2445 may also include a respective firing path F ₁ , F ₂ , F ₃ , F ₄ such that base 2448 maintains the mass balance of dual staple driver 2440. On the other hand, balance can be adjusted by mass.

  In some instances, base 2448 can contribute negligible and / or negligible movement and / or variation to the mass balance of dual staple driver 2440. In such an example, the mass balance of the driver 2240 can be approximated, for example, by the mass balance of the stage 2445.

  Still referring to FIG. 13, the illustrated drive wedges 2464a, 2464b are staggered longitudinally by a distance x. For example, the first wedge 2464a follows the second wedge 2464b by a distance x. Further, the center of mass (COM) of the step 2445 of each double staple driver 2440 is staggered longitudinally by a distance x. In such an instance, drive wedges 2464a, 2464b can move into engagement with driver 2440 at the same time. Since the wedges 2464a, 2464c simultaneously contact their respective drivers 2444, the deployment of a pair of staples supported by each driver 2440 can be synchronized and the staples can be simultaneously driven or fired into tissue. it can. For example, similarly to the wedges 2464a, 2464b, longitudinally staggered wedges can be incorporated into other embodiments disclosed herein.

  In various instances, the drive wedge profile can be selected to balance the forces applied to the staples and drivers during deployment, in combination with the placement of the staples and drivers in the staple cartridge. Further, in certain instances, the profile of the drive wedge can be selected to adjust the staple deployment.

  For example, the driver may include a staggered and / or longitudinally biased drive wedge, wherein the staggered and / or longitudinally biased drive wedges are angularly oriented staples within a staple cartridge. And / or may be configured to engage an angularly oriented driver simultaneously. For example, a staggered drive wedge can simultaneously move into engagement with a first or proximal end of a driver and a second or distal end of the same driver. The staggered drive wedge lifts the driver simultaneously, as both ends of the angled driver are simultaneously engaged by the staggered wedge. As a result, torqueing and / or rotation of the driver during deployment, and thus the staples supported thereon, may be prevented, minimized, and / or controlled.

  In other driverless embodiments described further herein, the staggered drive wedges are simultaneously the first or proximal end of the angled staple and the same angled staple. It can move into engagement with a second or distal end. The staggered drive wedges simultaneously lift the staples because the ends of the angled staples are simultaneously engaged by the staggered wedges. As a result, torqueing and / or rotation of the staple during deployment may be prevented, limited, and / or controlled.

  Additionally or alternatively, the profile of the driver can define at least one firing path that is aligned with the non-angularly oriented staples and / or the driver in the staple cartridge. For example, the firing path may be collinear with various driver and staple axes oriented parallel to the longitudinal axis of the staple cartridge. Because the firing path is collinear with the axis of the staple and / or driver, the staple and / or driver can be balanced with respect to the drive wedge, and the driver and / or staple can be torqued and / or rotated. May be prevented, restricted, and / or controlled.

The arrangement of the driver 2540, the staples 2512a, 2512b, and the drive wedges 2564a, 2564b, 2564c of the wedge sled 2558 is shown in FIGS. The drive wedges 2564a, 2564b, 2564c disclosed in FIGS. 14 and 15 are configured to move along firing paths F ₁ , F ₂ , and F ₃ (FIG. 14), respectively, and fire paths F ₁ , F _2. , and F ₃ extends through the staple cartridge. In various instances, the arrangement of the driver 2540 can be utilized in a staple cartridge having an arrangement of staples 2512a, 2512b and staple cavities corresponding to the driver arrangement shown.

  As disclosed in FIG. 14, the driver 2540 and staples 2512a, 2512b are arranged in a plurality of rows 2534, 2536. Further, the various drivers 2540 and staples 2512a in each row are oriented parallel to the longitudinal axis L, and the various drivers 2540 and staples 2512b in each row are oriented at an angle to the longitudinal axis L. Oriented. For example, the illustrated arrangement includes a pair of longitudinal rows 2534, 2536, in which the driver 2540 and staples 2512a, 2512b in each row 2534, 2536 are oriented and angled parallel to the longitudinal axis L. The orientation is alternately repeated. For example, the driver 2540 shown in the first row 2534 includes a first driver 2540a oriented angularly with respect to the longitudinal axis L, a second driver 2540b oriented parallel to the longitudinal axis L, and a longitudinal axis L And a fourth driver 2540d oriented parallel to the longitudinal axis L.

As disclosed in FIG. 14, the second driver 2540b and the fourth driver 2540d of the first column 2534 are aligned with the _first firing path F1. More specifically, both the proximal end 2546 and the distal end 2544 of the second and fourth drivers 2540b, 2540d are aligned with the _first firing path F1. In such instances, the first firing path _{F 1} extends through the center of mass of the second driver 2540b and the fourth driver 2540d and (COM). First firing path _{F 1} and the second and fourth driver 2540B, since it is aligned with the 2540D, second and fourth drivers 2540b, 2540d, the balance adjustment by mass relative to first firing path _{F 1} 14 and the torque and / or rotation of the second and fourth drivers 2540b, 2540d, and thus the staples supported thereon, may be prevented, limited, and / or controlled.

As disclosed in FIG. 14, the first driver 2540a is aligned with axis A, which traverses longitudinal axis L and firing paths F ₁ , F ₂ , and F ₃ . Further, the third driver 2540c is oriented parallel to axis A. As shown in FIG. 14, the first and third drivers 2540a, 2540c are oriented at an angle with respect to the longitudinal axis L and are over a plurality of firing paths. For example, the first and third driver 2540a illustrated, 2540C are on the first and second firing path _F 1, _{F 2.} As shown in FIG. 14, first firing path _{F 1,} the first and third drivers 2540A, extends through the proximal end 2546 of 2540C, a second firing path _{F 2,} the first and Extending through the distal end 2544 of the third driver 2540a, 2540c.

First and second driver 2540A, the center of mass of 2540c (COM) is first firing path _{F 1} and intermediate the second firing path _{F 2.} For example, first and second driver 2540A, the center of mass of 2540C is located from the first firing path _{F 1} and a second firing path _{F 2} equidistant, therefore, the driver 2540a, 2540c, the first and The second launch paths F ₁ , F ₂ are balanced by mass. As a result, torqueing and / or rotation of the second and fourth drivers 2540b, 2540d shown in FIG. 14, and thus the staples supported thereon, may be prevented, limited, and / or controlled.

  Further, the drive wedges 2564a, 2564c, 2564c shown in FIGS. 14 and 15 are staggered in the longitudinal direction. For example, a first drive wedge 2564a follows a second drive wedge 2564b distally by a distance x, and a second drive wedge 2564b follows a third drive wedge 2564c distally by a distance x. As shown in FIG. 14, the proximal end 2546 and the distal end 2544 of the third angularly oriented driver 2540c are offset by a longitudinal distance y. In the arrangement shown in FIGS. 14 and 15, the longitudinal distance y between the proximal end 2546 and the distal end 2544 of the third driver 2540c is aligned with the proximal end 2546 of the third driver 2540c. Equal to the longitudinal distance x between one drive wedge 2564a and a second drive wedge 2564b aligned with the distal end 2544 of the third driver 2540c.

  In the arrangement disclosed in FIGS. 14 and 15, the first drive wedge 2564a and the second drive wedge 2564b move simultaneously into engagement with the third driver 2540c. For example, first drive wedge 2564a contacts proximal end 2546 of third staple driver 2540c when second drive wedge 2564b contacts distal end 2544 of third staple driver 2540c. The drive wedges 2564a, 2564b, 2564c shown in FIG. 14 are configured to engage the ends of the angled driver so that the lifting force is less than the staples supported on the third angled driver 2540c. Added just below the legs of the As a result, the staple legs can be further stabilized and tilting and / or tilting of the staple legs during deployment can be prevented, minimized, and / or controlled.

  The first and second drive wedges 2564a, 2564b shown in FIGS. 14 and 15 are similarly configured to engage a further driver 2540 in the first row 2534 and have staples 2512a supported thereon, 2512b can be developed sequentially. For example, first drive wedge 2564a contacts proximal end 2546 of first driver 2540a when second drive wedge 2564b contacts distal end 2544 of first driver 2440a. Further, first drive wedge 2564a is configured to sequentially engage and fire parallel drivers 2540b, 2540d and staple 2512a in first row 2534.

  In various instances, the proximal end 2546 and the distal end 2544 of the third driver 2540c may be equidistant from the center of mass of the third driver 2540c. The drive wedges 2464a and 2464b disclosed in FIGS. 14 and 15 simultaneously contact opposite ends of an angularly oriented third staple driver 2540c and apply drive and / or lifting forces to the staple driver 2540c equidistant from the center of mass. As configured to hang on both ends, staple driver 2540c is balanced through deployment. As a result, rotation and / or torque application of the third staple driver 2540c may be prevented, limited, and / or controlled.

  In other instances, the drive wedges 2564a, 2564b may not be able to contact the ends 2546, 2544 of the angled staple driver 2540. However, in such instances, drive wedges 2564a, 2564b may be configured to engage angled staple driver 2540 at a location that is equidistant from the center of mass of driver 2540. Further, drive wedges 2564a, 2564b can simultaneously contact driver 2540c and be biased sufficiently to lift the spaced apart location of driver 2540c.

  In addition, the second and third drive wedges 2564b, 2564c shown in FIGS. 14 and 15 are similarly engaged with the drivers 2540 in the second row 2536 to sequentially rotate the staples 2512a, 2512b supported thereon. It is configured to expand to. Still referring to the arrangement shown in FIG. 14, for example, the drivers 2540 in the second row 2536 may be configured such that the distance between the proximal end 2546 and the distal end 2544 of each driver is also the longitudinal distance y And the longitudinal distance y is equal to the longitudinal distance x between the second drive wedge 2564b and the third drive wedge 2564c.

  In another example, the longitudinal distance between the second drive wedge 2564b and the third drive wedge 2564c is greater than the longitudinal distance between the first drive wedge 2564a and the second drive wedge 2564b. May also be large and / or small. Additionally or alternatively, the angled staples 2512b in the second row 2536 can be oriented at a different angle than the angled staples 2512b in the first row 2534. Further, in various instances, additional rows of drivers 2540 and staples 2512a, 2512b can be added to the arrangement shown in FIG. 14, with additional drive wedges engaging additional drivers 2540 and further staples 2512a. , 2512b. In still other instances, the arrangement can further include, for example, a single row of drivers 2540 and staples 2512a, 2512b.

  The arrangement of staples 2512a, 2512b shown in FIG. 14 can also be fired from a driverless staple cartridge. For example, referring to FIG. 16, the staples 2512a, 2512b can be placed in a driverless cartridge, such as, for example, a staple cartridge 2620 (FIG. 37) described further herein. Staples 2512a, 2512b in the driverless staple cartridge can be directly engaged and / or driven by the sled and / or firing member. For example, the staples 2512a, 2512b can include a thread engaging surface, wherein the thread engaging surface is one or more staple engaging surfaces of the drive wedges 2564a, 2564b, and / or 2564c of the wedge sled 2558. Are configured to be directly engaged by

As described herein, each staple 2512A, 2512b may be balancing by mass relative to the staple 2512A, firing path _F 1 which is aligned with the _{2512b, F 2,} F _3. For example, referring to FIG. 16, the staple 2512a which is arranged parallel to the longitudinal axis L is aligned with one of the firing path _{F 1, F 2, F 3} . In the arrangement shown, one of the drive wedges 2564a, 2564b, 2564c is drivingly engaged with staples 2512a parallel along the length of the base of the staple 2512a. Furthermore, the center of mass of the respective parallel staples 2512a are aligned with one of the firing path _{F 1, F 2, F 3} . In other words, one of the firing paths F ₁ , F ₂ , F ₃ extends through the center of mass of each parallel staple 2512a, so that the staples 2512a are each deployed during deployment. The balance is adjusted by mass with respect to F ₁ , F ₂ , and F ₃ . In such an arrangement, torqueing and / or rotation of the staple 2512a during firing may be prevented, minimized, and / or controlled.

  Further, when the staple arrangement shown in FIG. 14 is utilized in a driverless cartridge, a pair of biased drive wedges 2564a, 2564b, 2564c are simultaneously moved into engagement with respective angularly oriented staples 2512b. Is composed of For example, the first and second drive wedges 2564a, 2564b are configured to simultaneously contact the angled staples 2512b in the first row 2534, and the second and third drive wedges 2564b, 2564c are The angled staples 2512b in the second row 2536 are configured to contact simultaneously. Thereafter, wedge sled 2558 is configured to continue to translate with respect to staples 2512a, 2512b, and sequentially contact staples 2512a, 2512b to drive directly from the driverless staple cartridge.

  As described herein, a driverless staple cartridge can be used to hold and fire a staple array that includes angularly oriented staples. An end effector assembly 2600 including a first jaw 2002, a second jaw 2004, a frame 2006, an articulation joint 2009, and a staple cartridge 2620 without a driver is disclosed in FIG. Staple cartridge 2620 may be a single use and / or disposable cartridge that can be replaced with another staple cartridge after firing. FIG. 37 discloses a staple cartridge 2620 that includes a deck 2626, a cartridge body 2624, and a casing 2622 that partially surrounds or encloses the cartridge body 2624. Further, an array of staples, such as, for example, staples 2612 (FIGS. 39A and 39B), can be removably positioned within the cartridge body 2624.

  In certain instances, the staple cartridge 2620 can be formed integrally with the end effector assembly 2600, for example, and / or can be permanently secured within one of the jaws 2002, 2004. In such instances, end effector assembly 2600 may be a single use and / or disposable end effector. In other instances, the staple cartridge 2620 can be secured to the end effector assembly 2600, for example, and can be reloaded with additional staples for subsequent firing.

  Referring to the staple cartridge 2620 shown in FIG. 37, a longitudinal slot 2632 is defined at least partially through the cartridge body 2624. The longitudinal slot 2632 extends along a longitudinal axis L, which extends between a proximal end 2623 and a distal end 2625 of the cartridge body 2624. The longitudinal slot 2632 shown in FIG. 37 extends from the proximal end 2623 to the distal end 2625 and traverses a portion of the length of the cartridge body 2624.

  In some instances, the longitudinal slot 2632 can traverse the entire length of the cartridge body 2624. In other instances, the longitudinal slot 2632 can extend, for example, from the distal end 2623 to the proximal end 2625. In still other instances, the cartridge body 2624 may not include pre-defined and / or pre-formed longitudinal slots. For example, the firing member and / or cutting element can, for example, traverse and / or cut the cartridge body 2624 during a firing stroke.

  The staple cartridge 2620 disclosed in FIG. 37 is configured to fire an array of angled staples 2612 (FIGS. 38A and 38B), for example, the array is oriented like the staple array 2011 shown in FIG. be able to. The angled staples 2612 can be removably positioned within the angled staple cavities 2628 shown in FIG. 37, and the angled staple cavities 2628 are defined within the cartridge body 2624. For example, the staple cavities 2628 shown are angularly oriented with respect to the longitudinal axis L. Further, the illustrated arrangement of staple cavities 2628 corresponds to the arrangement of staples 2612 positioned within cartridge 2620. Each staple cavity 2628 shown in FIG. 37 includes an opening 2630 in the deck 2626, and each opening 2630 includes a proximal end and a distal end. The staple axis can extend between the proximal end and the distal end, and the staple axis of the opening 2630 shown in FIG. With an angle. In the staple cartridge 2620 of FIG. 37, all staple cavities 2628 are angularly oriented with respect to the longitudinal axis L, and the various staple cavities 2628 are angularly oriented with respect to other staple cavities 2628.

  The staple cavities 2628 shown in FIG. 37 are arranged in a plurality of rows on each side of the longitudinal slot 2632. For example, the staple cavities 2628 are disposed in a first inner row 2633, a first outer row 2635, and a first intermediate row 2637 on a first side 2627 of the longitudinal slot 2632, wherein the staple cavities 2628 are A second inner row 2634, a second outer row 2638, and a second intermediate row 2636 on a second side 2629 of the longitudinal slot 2632. The staple cavities 2628 do not cross or otherwise contact each other, but the longitudinal rows 2633, 2634, 2635, 2636, 2637, 2638 of the staple cavities 2628 overlap. For example, staple cavities 2628 extend laterally outward and / or inward beyond staple cavities 2628 in adjacent rows of staple cavities 2628, and staple cavities 2628 are staples in adjacent rows of staple cavities 2628. Extending proximally and / or distally beyond cavity 2628. The staple cavities 2628 and staples positioned therein are arranged in an overlapping array so that bleeding and / or fluid flow within the stapled tissue can be controlled. In the staple cartridge 2620 shown in FIG. 37, the staple cavities 2628 and rows thereof are symmetric with respect to the longitudinal slots 2632.

  In other examples, more or less than three rows of staple cavities 2628 can be positioned on each side of the longitudinal slot 2632, and in some examples, one side 2627, 2629 of the staple cartridge 2620. Can include a different number of rows of staple cavities 2628 than the other side 2627, 2629 of the staple cartridge 2620. In some instances, the staple cavities 2628 may not overlap longitudinally and / or laterally with the staple cavities 2628 in adjacent rows. Additionally or alternatively, in certain instances, staple cavities 2628 and / or rows thereof may be asymmetric with respect to longitudinal slots 2632 and / or longitudinal axis L.

  Still referring to FIG. 37, the illustrated staple cavities 2628 in each longitudinal row are parallel or substantially parallel. In other words, the staple cavities 2628 in the first inner row 2633 are parallel to each other, the staple cavities 2628 in the first outer row 2635 are parallel to each other, and the staple cavities 2628 in the first middle row 2637. Are parallel to each other, the staple cavities 2628 in the second inner row 2634 are parallel to each other, the staple cavities 2628 in the second outer row 2636 are parallel to each other, and Staple cavities 2628 are parallel to one another.

  Also, as shown in FIG. 37, staple cavities 2628 in each longitudinal row are angularly oriented with respect to staple cavities 2628 in the longitudinal row adjacent to the same side of longitudinal slot 2632. For example, the staple cavities 2628 in the first intermediate row 2637 are angularly oriented on the first side 2627 of the cartridge body 2624 with respect to the staple cavities 2628 in the first inner row 2633 and the first outer row 2635. Is done. Further, the staple cavities 2628 in the second intermediate row 2638 are angularly oriented on the second side 2629 of the cartridge body 2624 with respect to the staple cavities 2628 in the second inner row 2634 and the second outer row 2636. You.

  In other examples, only a portion of the staple cavities 2628 in each longitudinal row 2633, 2634, 2635, 2636, 2637, 2638 may be parallel to each other and / or the longitudinal rows 2633, 2634. , 2635, 2636, 2637, 2638 may include staple cavities 2628 that are parallel to one another. Additionally or alternatively, in certain instances, at least a portion of the staple cavities 2628 may be randomly oriented. In some instances, at least one of the staple cavities 2628 in the longitudinal rows 2633, 2634, 2635, 2636, 2637, 2638 is located in an adjacent longitudinal row 2633, 2634, 2635, 2636, 2637, 2638. May be parallel to at least one of the staple cavities 2628. In certain instances, staple cartridge 2620 can include at least one staple cavity 2628 that is parallel to longitudinal axis L of cartridge body 2624. For example, see FIG.

  Still referring to FIG. 37, the illustrated end effector assembly 2600 includes a firing bar 2660 movably positioned relative to the cartridge body 2624. Fire bar 2660 is configured to traverse cartridge body 2624 to fire staples 2612 (FIGS. 38A and 38B) from staple cavity 2628. The illustrated firing bar 2660 further includes a cutting edge 2661 that is adapted to cut tissue when the firing bar 2660 translates between the first jaw 2002 and the second jaw 2004. Be composed.

  The illustrated firing member 2660 fits within the longitudinal slot 2632 and is movably positioned in a sled 2658 (FIGS. 37-38B), a sled 2758 (FIGS. 39-39B), or a cartridge 2620 without a driver. Sled, such as sled 2858 (FIG. 40), is sized and positioned for driving engagement. As the firing bar 2660 translates through the longitudinal slot 2632, the firing bar 2660 is moved through the cartridge body 2624 into a sled 2658 (FIGS. 37-38B), 2758 (FIGS. 39-39B), or 2858 (FIG. 40). To move.

  The thread 2658 is disclosed in FIGS. The sled 2658 is sized and positioned to directly engage staples 2612 positioned in a driverless cartridge 2620 (FIG. 37). The illustrated sled 2658 includes a central portion 2659 and a drive wedge or drive rail 2664. The drive wedge 2664 includes a beveled staple engaging or staple contact surface 2666 and / or a beveled surface extending from the distal end of the sled 2658 to the proximal end. As shown in FIGS. 37-38B, the sloped surfaces 2666 of the wedges 2664 have equal or substantially equal slopes, or angles.

  Each staple contact surface 2666 shown in FIGS. 37-38B is positioned to directly contact a staple 2612 (FIGS. 38A and 38B) positioned within a staple cartridge 2620. More specifically, the staple contact surface 2666 of the drive wedge 2664 contacts the base 2614 (FIG. 38B) of each staple 2612 and raises the base 2614 of the staple 2612 to eject the staple 2612 from the staple cavity 2628. Configured to lift. For example, the distal end 2667 of each ramp 2666 engages the base 2614 of the staple 2612 to lift the staple 2612 from a lowered and / or unfired position to a raised and / or post-fired position. The ramp 2666 moves distally across the base 2614 of the staple 2612.

  In the illustrated arrangement, the firing bar 2660 and its cutting edge 2661 are configured to slide and / or translate within the longitudinal slot 2632. In addition, the drive wedge 2664 shown in FIGS. 37-38B is shown laterally outside the firing bar 2660 and the cutting edge 2661 and is positioned in a staple cavity 2628 (FIG. 37) with staples 2612 (FIGS. 38A and 38B). It is configured to contact. A plurality of drive wedges 2664 are positioned on either side of the central portion 2659 of the wedge sled 2658. For example, in the illustrated sled 2658, four drive wedges 2664a, 2664b, 2664c, 2664d are positioned on each side of the central portion 2659.

  In addition, in the arrangement disclosed in FIGS. 37-38B, a plurality of drive wedges 2664a, 2664b, 2664c, 2664d are configured to engage a single angled staple 2612. For example, first and second wedges 2664a, 2664b are configured to engage staples 6212 positioned in first outer row 2633 of staple cavities 2628, and second and third wedges 2664b, 2664c. Are configured to engage staples 2612 positioned in first intermediate row 2637, and third and fourth wedges 2664 c, 2664 d are coupled to staples 2612 positioned in first outer row 2635. It is configured to engage.

  In various situations, it may be desirable to support the staples 2612 in the staple cartridge 2620 disclosed in FIG. 37 and drive from multiple locations along the base 2614 (FIG. 38B) of the staples 2612. For example, a staple 2612 that is longitudinally aligned with the firing path of the drive wedge 2664 is supported along the entire length of the base 2614 of the staple 2612. For example, when the staples 2612 are angled with respect to the firing path of the sled 2658, as shown in FIGS. 37-38B, the staples 2612 can be positioned at multiple locations along the base by utilizing multiple drive wedges 2664. Can be supported. As the angled staples 2612 are driven and supported at multiple locations along the base 2614, the staples 2612 are prevented, limited, and / or prevented from rotating and / or torqued during deployment. It can be balanced and / or stabilized so that it can be controlled. For example, similar to staple 2612, direct drive staples that are mass balanced against a plurality of thread engaging surfaces can be incorporated into other embodiments disclosed herein.

  The inclined surfaces 2666 disclosed in FIGS. 37 to 38B are staggered. For example, the illustrated ramps 2666 are staggered longitudinally such that at least one ramp 2666 guides at least one other ramp 2666 in the longitudinal direction. The slopes 2666 of the second and fourth drive wedges 2664b, 2664d guide the slopes 2666 of the first and third drive wedges 2664a, 2664c in the longitudinal direction. The slopes 2666 of the second and fourth drive wedges 2664b, 2664d are higher than the slopes 2666 of the first and third drive edges 2664a, 2664c at the aligned distal end 2667. For example, as shown in FIGS. 38 and 38B, the first and third drive wedges 2664a, 2664c have a distal height y and the second and fourth drive wedges 2664b, 2664d have a height y. It has a lower distal height x.

  The longitudinally staggered inclined surfaces 2666 are configured to move simultaneously into engagement with the angled staples 2612. For example, the staple engaging surfaces 2666 of the first and second wedges 2664a, 2664b are configured to simultaneously engage angled staples 2612 in the first outer row 2633 of staple cavities 2628 (FIG. 37). Is done. In addition, the staple engaging surfaces 2666 of the second and third wedges 2664b, 2664c are configured to simultaneously engage angled staples 2612 in the first intermediate row 2637 (FIG. 37). Further, the staple engaging surfaces 2666 of the third and fourth wedges 2664c, 2664d are configured to simultaneously engage staples 2612 positioned within the first outer row 2635 (FIG. 37).

  The deployment or firing of the staple 2612 is shown in FIGS. 38A and 38B, where the third and fourth wedges 2664c, 2664d of the driver 2658 are in driving engagement with the staple 2612. The third wedge 2664c may first contact the staple 2612 at point A, and the fourth wedge 2664d may first contact the staple 2612 at point B. The third and fourth wedges 2664c, 2664d are configured to simultaneously engage the staples 2612 such that the staples 2612 contact points A and B simultaneously or nearly simultaneously. Due to the height difference between the staple engaging surfaces 2666 of the third and fourth wedges 2664c, 2664d, points A and B are longitudinally moved such that points A and B are at the same or essentially the same height. Can be biased.

  Still referring to FIGS. 38A and 38B, as driver 2658 continues to move distally within staple cartridge 2620, staple 2612 causes staple engaging surfaces 2666 of third and fourth wedges 2664c, 2664d, respectively, to It can be slid up to points A ′ and B ′ on the third and fourth wedges 2664c, 2664d. As shown in FIG. 38B, staples 2612 maintain a vertically upright orientation during deployment. The staple 2612 then slides the staple engaging surfaces 2666 of the third and fourth wedges 2664c, 2664d up to points A ″ and B ″ on the third and fourth wedges 2664c, 2664d, respectively. You can keep moving. As shown in FIG. 38B, staples 2612 continue to maintain a vertically upright orientation. In other words, the pair of staple engaging surfaces 2666 stabilize and / or staple the staple 2612 during deployment so that rotation or torque of the staple 2612 can be prevented, minimized, and / or controlled. Or adjust the balance.

  In other instances, the drive wedges or rails of the wedge sled can all be tilted down to zero or essentially zero height. For example, referring now to FIGS. 39-39B, a wedge thread 2758 is illustrated. Wedge sled 2758 can be used within staple cartridge 2620 and end effector 2600 (FIG. 37) to fire staples 2612 from staple cartridge 2620 (FIG. 39A).

  Similar to sled 2658, wedge sled 2758 disclosed in FIGS. 39-39B includes four drive wedges 2764 on either side of central portion 2759. Each drive wedge 2764 includes a sloped staple engaging surface 2766 that is configured to directly engage staple 2612 and drive the staple 2612 from staple cavity 2628. . Similarly to the sled 2658, the staple engaging surface 2766 of the drive wedge 2764 shown in FIGS. Are staggered in the longitudinal direction so as to follow the direction.

  The longitudinally staggered inclined surfaces 2766 of the drive wedges 2764a, 2764b, 2764c, 2764d disclosed in FIGS. 39-39B are configured to move simultaneously into engagement with the angled staples 2612. For example, the staple engaging surfaces 2766 of the first and second wedges 2764a, 2764b are configured to simultaneously engage angled staples 2612 positioned in the first outer row 2635 (FIG. 37). You. In addition, the staple engaging surfaces 2766 of the second and third wedges 2764b, 2764c are configured to simultaneously engage angled staples 2612 positioned in the first intermediate row 2637 (FIG. 37). You. In addition, the staple engaging surfaces 2766 of the third and fourth wedges 2764c, 2764d are configured to simultaneously engage angled staples 2612 positioned in the first inner row 2633 (FIG. 37). You.

  In addition, the staggered slopes 2666 in the longitudinal direction of the drive wedges 2764a, 2764b, 2764c, 2764d disclosed in FIGS. 39-39B are configured to simultaneously drive the angled staples 2612. For example, the staple engaging surfaces 2766 of the first and second wedges 2764a, 2764b are configured to simultaneously drive angled staples 2612 in a first outer row 2635 of staple cavities 2628 (FIG. 37). You. Further, the staple engaging surfaces 2766 of the second and third wedges 2764b, 2764c are configured to simultaneously drive the angled staples 2612 positioned in the first intermediate row 2637 (FIG. 37). . In addition, the staple engaging surfaces 2766 of the third and fourth wedges 2764c, 2764d are configured to simultaneously engage angled staples 2612 positioned in the first inner row 2633 (FIG. 37). You.

  Referring primarily to FIG. 39A, the second wedge 2764b and the third wedge 2764c on the first side 2627 of the cartridge body 2624 are configured to move into engagement with the second staple 2612b and the second Staple 2612b is the closest staple and is aligned with the firing path of second wedge 2764b and third wedge 2764c. Further, the second wedge 2764b and the third wedge 2764c may be equidistant from the center of mass (COM) of the second staple 2612b. As the sled 2758 continues to translate distally, the second wedge 2764b and the third wedge 2764c are configured to drive engage the second staple 2612b to lift and fire the staple 2612b.

  In the arrangement disclosed in FIG. 39A, the first wedge 2764a and the second wedge 2764b on the first side 2627 of the cartridge body 2624 when the second wedge 2764b and the third wedge 2764c lift the second staple 2612b. Are configured to move into engagement with the first staple 2612a, and the third wedge 2764c and the fourth wedge 2764d on the first side 2627 move into engagement with the third staple 2612c. It is configured as follows. Further, as shown in FIG. 39A, the first wedge 2764a and the second wedge 2764b are equidistant from the center of mass (COM) of the first staple 2612a, and the third wedge 2764c and the fourth wedge 2764c. 2764d is equidistant from the center of mass (COM) of the third staple 2612c. As sled 2758 continues to translate distally, first wedge 2764a and second wedge 2764b are drivingly engaged with first staple 2612a to lift and fire staple 2612b and third wedge 2764c; Fourth wedge 2764d is drivingly engaged with third staple 2612c to lift and fire staple 2612c.

  The drive wedge arrangement of the pair described above and shown in FIG. 39A is configured to simultaneously engage and lift staples 2612 in staple cartridge 2620 as sled 2758 continues to translate distally. As the sled 2758 supports each staple 2612 at multiple locations along the base, the staples 2612 are stabilized and / or balanced during deployment. Further, because the staple engaging surfaces 2766 of the sleds 2758 are equidistant from the center of mass (COM) of each contacted staple 2612, rotation and / or torque application of the staples 2612 is further prevented or minimized. Can be limited or controlled. Further, since the drive wedges 2764a, 2764b, 2764c, 2764 are staggered in the longitudinal direction, the engagement of the plurality of drive wedges 2764a, 2764b, 2764c, 2764 with the respective staples 2612 causes the respective staples 2612 to expand through deployment. Timed and / or synchronized to balance the applied drive.

  Propulsion sled 2858 is shown in FIG. Wedge sled 2758 can be used within staple cartridge 2620 and end effector 2600 (FIG. 37) to fire staple 2612 from staple cavity 2620 (FIG. 39A). Like sleds 2658 and 2758, drive sled 2858 includes a plurality of drive wedges 2864 on either side of central portion 2859. Each drive wedge 2864 includes a sloped staple engagement surface 2866, which is configured to directly engage staple 2612 and drive the staple 2612 from staple cavity 2628. . Further, the angled staple engaging surfaces 2866 are angled, ie, angled laterally. As the staple engaging surfaces 2866 are laterally and longitudinally angled, each surface 2866 includes a longitudinally biased support portion that is angularly displaced through deployment and firing. It is drivingly engaged with the attached staple 2612.

  For example, the inclined staple engaging surfaces 2866 disclosed in FIG. 40 are configured to drively engage staples 2612 along a portion of the base of each staple 2612. In the arrangement shown in FIG. 40, the driving force applied to the staples 2612 is distributed over a larger surface area. For example, staple engaging surface 2866 can contact at least 50% of the length of the base of staple 2612. In another example, the staple engaging surface can contact at least 75% of the length of the base of the staple 2612. In still other instances, the staple engaging surface may contact less than 50% or more than 75% of the base length of the staple 2612. Further, the drive from the sled 2858 is balanced with respect to the center of mass of each staple 2612 to further stabilize and balance the staples 2612 during deployment. As a result, rotation and / or torque application of the staples 2612 can be prevented, minimized, or controlled.

  As described herein, a staple array that includes staples that are angularly oriented with respect to the longitudinal axis of the staple cartridge and / or the firing path of the firing member provides various advantages. For example, such a staple array can provide increased flexibility and / or stretch within the stapled tissue. As a result, the incidence of tissue tear can be reduced. In certain instances, the staple array can also include staples having different length bases. A variable length base in the staple array can facilitate increased flexibility and / or stretch in the stapled tissue. Further, in certain arrangements, staples having shorter bases can be nested within the staple array. For example, staples having shorter bases can be positioned in a smaller space between staples having longer bases. Such an arrangement can increase the density of the staple lines, thereby improving control of bleeding and / or fluid flow within the stapled tissue.

Staple array 3011 is shown in FIG. Array 3011 includes long staples 3012 and short staples 3013. As shown in FIG. 41, a long staple 3012 has a base length of _{l 1,} short staple 3013 has a base length of _{l 2} of less than _{l 1.} In an array 3011 shown, the first long staple 3012a is aligned with the axis _{A a} first short staple 3013 is aligned with the axis _{A b} is parallel to the axis _{A a.} Staple 3012e, 3013b, 3013c, and 3013d, etc., further long staple and a short staple 3012,3013, for example, is parallel to the axis _{A a} and _{A b.} As further disclosed in the array 3011 shown in FIG. 41, the second long staple 3012 is aligned with the axis _{A c} crossing the axis _{A a} and _{A b.} For example, staples 3012c, 3012d, and the like 3012F, long staple 3012 further is parallel to the axis _{A c.}

In another arrangement, a further short staple 3012 may also be parallel to the axis A _c. In some instances, the various staples can be positioned along an axis that is non-parallel to the axes A _a , _Ab, and _Ac . For example, staple array 3011 can include staples oriented parallel to the longitudinal axis of the staple cartridge and / or the firing path of the drive sled. Furthermore, in various instances, the staple array 3011 can include a staple having a base length which is different from the l ₂ and l _1. In some instances, staple array 3011 can include additional and / or fewer longitudinal rows of staples 3012, 3013. For example, a row of long staples 3012 aligned with a first long staple 3012a can be removed and / or a row of long staples 3012 aligned with a second long staple 3012b can be removed. The row of short staples that can and / or be aligned with the first short staples 3013a can be removed and / or the row of long staples 3012 that are aligned with the third long staples 3012c can be removed. The rows of short staples 3013 that can be removed and / or aligned with the second short staples 3013b can be removed and / or of the long staples 3013 aligned with the fourth long staples 3012d. Columns can be removed.

  Referring again to FIG. 41, a short staple 3013 is embedded in a staple array 3011 intermediate two long staples 3012. For example, the two long staples 3012 in the array 3011 are parallel and laterally aligned, such as the third long staple 3012c and the sixth long staple 3012f shown in FIG. In such an arrangement, a space is defined between the third long staple 3012c and the sixth long staple 3012f, and the space is configured to accommodate the third short staple 3013c. Accordingly, the third short staple 3013c in the illustrated array 3011 is sandwiched between the third long staple 3012c and the sixth long staple 3012f. In such an arrangement, the third short staples 3013c and similarly arranged short staples 3013c in the array 3011 can increase the density of staple lines by filling the space between the long staples 3012. In an example, bleeding and / or fluid flow control is improved because the staple lines are densified in the array 3011.

  For example, similar to staple array 3011, densified staple lines can be incorporated into other embodiments disclosed herein.

  In other instances, the long staples 3012 that define the space between them to accommodate short staples may be non-parallel to one another. For example, the third and sixth long staples 3012c, 3012f can be inclined with each other and / or otherwise non-parallel. Additionally or alternatively, the long staples 3012 that define the space between them to accommodate the short staples 3013 can only partially overlap laterally. For example, in certain instances, the third long staple 3012c may be laterally outward or laterally inward with respect to the sixth long staple 3012f, and one of the third and sixth staples 3012c, 3012f. Only the parts are arranged laterally.

  For example, an array of staples, such as array 3011, can be positioned within a driverless staple cartridge, such as, for example, a driverless staple cartridge 2620 (FIG. 37), and directly engage the staple cartridge by a drive sled. Can be driven from the staple cartridge. In such instances, the staples 3012, 3013 in the array 3011 can be mass balanced with respect to the drive wedge of the sled that drives in contact with the staples 3012, 3013. For example, the drive wedge can apply a firing force at the end of the staple base equidistant from the center of mass of each staple 3012, 3013. In other instances, the firing force can be applied at various spaced locations along the base of the staples 3012, 3013, and the cumulative firing force can be balanced against the staples 3012, 3013. it can. In instances where the staples are not on the firing path and / or are not balanced with respect to the firing path, a staple driver may be used. For example, a multi-staple driver can simultaneously lift multiple staples from a staple cartridge, as described further herein.

Staple array 3111 is shown in FIG. Array 3111 includes long staples 3112 and short staples 3113. As shown in FIG. 42, a long staple 3112 has a base length of _{l 1,} short staple 3113 has a base length of _{l 2} of less than _{l 1.} In an array 3111 shown, first short staple 3113a is aligned with the axis _{A a} first long staple 3112a is aligned with the axis _{A b} transverse to the axis _{A a.} Additional short staple 3113 is oriented parallel to the axis _{A a,} further long staple 3112 is parallel to the axis _{A b.}

In another arrangement, at least one short staple 3113 may be oriented parallel to the axis A _b, and / or at least one long staple 3112 may be oriented parallel to the axis A _a. In some instances, it can be positioned along various staples 3112 and 3113 to the axis is non-parallel to the axis _{A a} and _{A b.} For example, staple array 3111 may include staples oriented parallel to the longitudinal axis of the staple cartridge and / or the firing path of drive wedge 3064, which staples are also shown in FIG. Further, in various instances, staple array 3111 can include staples having a baseline length different from l ₂ and l ₁ and / or staple array 3111 can further and / or more of staples 3112, 3113. It can include fewer longitudinal rows.

  Still referring to FIG. 42, the short staples 3113 can be embedded in a staple array 3111 intermediate the at least two laterally overlapping long staples 3112. In such an arrangement, the nested short staples 3113 in the array 3111 can increase the density of staple lines by filling the space between adjacent long staples 3112. The staple lines can be densified in the array 3111 to improve bleeding and / or fluid flow control. For example, similar to staple array 3111, densified staple lines can be incorporated into other embodiments disclosed herein.

  In other instances, the long staples 3112 that define the space between them to accommodate short staples may be non-parallel to one another. Additionally or alternatively, the long staples 3112 defining the space between them to accommodate the short staples 3113 may only partially overlap.

  For example, an array of staples, such as array 3111, can be positioned in a driverless staple cartridge, such as, for example, a driverless staple cartridge 2620 (FIG. 37), and staples by a drive sled, such as sled 2058 (FIG. 37). The cartridge can be directly engaged with and driven from the staple cartridge. In such an instance, the staples 3112, 3113 in the array 3111 can be mass balanced with respect to the drive wedge 3064 of the sled that contacts and drives the staples 3112, 3113. For example, the drive wedge 3064 can apply a firing force at the end of the staple base equidistant from the center of mass of the staples 3112, 3113.

  In other instances, the firing force can be applied at various spaced locations along the base of the staples 3112, 3113, and the cumulative firing force can be balanced against the staples 3112, 3113. it can. In instances where the staples 3112, 3113 are not above the firing path and / or are not balanced with respect to the firing path, a staple driver may be used. For example, a multi-staple driver can simultaneously lift multiple staples from a staple cartridge, as described further herein.

  In various instances, if the sled is configured to drive staples directly, the staple may include a sled engaging surface and the sled may include a staple engaging surface. The staples may be generally "V-shaped" staples having a base and non-parallel extending legs. For example, referring again to staple 2612 shown in FIGS. 39B and 40, for example, staple 2612 includes a base 2614, a first leg 2616 extending from a first end of base 2614, and a second leg of base 2614. Includes a second leg 2618 extending from the end. The staple 2612 can be formed of a wire, such as a wire having a circular cross-section, and thus the outer periphery of the staple 2612 can be comprised of a rounded surface. As a result, the thread engaging surface of the staple 2612 may include a rounded surface and / or a contoured surface.

  In another example, the staples 2612 can be formed of wires having a polygonal cross-section, so that the outer periphery of the staples 2612 can include edges and a flat surface, ie, a plane. In such embodiments, the thread engaging surface of the staple 2612 can include, for example, at least one flat surface and / or plane. In still other instances, the outer periphery of the staple 2612 can include both contoured and planar surfaces. For example, the staples 2612 can be formed of wire having a circular cross-section, which can be flattened and / or otherwise deformed to form a flat thread-engaging surface. Can be.

  In certain instances, staples can be formed of pieces of material. For example, staples can be stamped, cut, and / or molded from a sheet of material. Various stamped staples are described in U.S. Patent Application No. 14 / 138,481, filed December 23, 2013, entitled "SURGICAL STAPLES AND METHODS FOR MAKING THE SAME", which is incorporated by reference. Which is incorporated herein in its entirety. In various instances, the staples can be, for example, stamped or otherwise formed of a single piece of material, for example, while remaining a single and / or unitary piece of material. can do. In various examples, the thread engaging surface of the staple, the stamped staple, etc., can include a flat or flat surface of a stamped or otherwise formed piece. Further, in certain instances, the thread engaging surface may include a groove and / or cutout, and the groove and / or cutout may be configured to receive a drive wedge of a wedge sled. When the staples are angularly oriented with respect to the firing path of the drive wedge, the grooves can traverse the base of the staples at an angle.

  Stamped staples 2912 are shown in FIGS. The staple 2912 includes a base 2914, a first leg 2916, and a second leg 2918. 26 to 28, the outer peripheral portion of the staple 2912 includes a flat surface and a contour surface. In addition, staple 2912 includes a groove or track 2915 (FIGS. 27 and 28), which is cut into base 2914. Groove 2915 is configured to receive a drive wedge 2964 of drive sled 2958.

  In various instances, the width of the groove 2915 may be slightly larger than the width of the drive wedge 2964 received therein. For example, the width of the groove 2915 can be dimensioned to receive the drive wedge 2964 and prevent lateral movement of the staple 2915 relative to the wedge 2964.

  The staples 2912 shown in FIGS. 26-28 are angularly oriented with respect to the firing path F of the drive wedge 2964 (FIG. 28). For example, staple 2912 extends along axis A (FIG. 27), which traverses firing path F. As a result, the illustrated grooves 2915 are angularly oriented throughout the base 2914 of the staple 2912. For example, the axis A can be oriented at an angle θ with respect to the launch path F. The angle θ shown in FIG. 28 is 45 °.

  The base 2914 has an extended length l. For example, the length 1 of the base 2914 is greater than the length of the staple legs 2916, 2918. As base 2914 is elongated, groove 2915 includes an elongated guide surface, or track, for drive wedge 2964, which promotes the stability of staples 2912 during deployment. For example, as with the staples 2912, elongated guides for receiving drive wedges, or staples with tracks, can be incorporated into other embodiments disclosed herein.

  Referring primarily to FIG. 28, the staples 2912 have a center of mass (COM) that coincides with the firing path F. For example, the firing path F extends through the center of mass (COM) of the staple 2912 such that the staple 2912 is balanced against the drive wedge 2964. As a result, the driving force applied to the staple 2912 can simultaneously lift the staple legs 2916, 2918, and torque or rotation of the staple 2912 is prevented, minimized, and / or controlled. obtain.

  In various examples, a groove or track similar to groove 2915 can be defined in unshaped staples. For example, wire staples can be cut, stamped, and / or ground to create a track that slidably receives a drive wedge. In such instances, the staple base may have the same length as the staple legs, or in other instances, the staple base may be flattened to increase or elongate the length. . Further, in certain instances, a plurality of drive wedges can be drivingly engaged with the staple, as described further herein. In such an instance, the staple may include a plurality of grooves or tracks, each of which may be configured to receive a drive wedge. Further, in certain instances, for example, a staple having a guide track similar to groove 2915 may be oriented parallel to the longitudinal axis of the staple cartridge. For example, parallel staples can be longitudinally aligned with the firing path of the drive wedge. In such an instance, the guide track defined in the base of the staple may extend along a base of the staple parallel thereto.

  As described herein, angularly oriented staples can provide high flexibility and / or stretch to the stapled tissue. For example, the angled staples in the array of fired staples may be aligned with the longitudinal axis of the score and / or staple lines to facilitate stretching and / or longitudinal deformation of the stapled tissue. Can be pivoted and / or rotated toward alignment. The angled staples can pivot and / or rotate within the stapled array of tissue, thereby reducing and / or preventing tissue tearing and / or stretching. Further, stress in the tissue and / or trauma to the stapled tissue can be minimized.

  In addition to the longitudinal flexibility provided by the longitudinally extendable array of fired staples, it may be desirable to provide lateral customization to the tissue to be treated by the array of staples. For example, the compression force on the tissue can be optimized and / or adjusted based on the relative lateral position of the tissue with respect to the staple line. In certain instances, it may be desirable to customize the compressive force on the tissue before and / or during stapling. In other instances, it may be desirable to customize the compression force applied to the stapled tissue. Further, in still other instances, it may be desirable to customize the compressive force on the tissue, for example, before, during and after stapling.

  The combination of lateral tissue compression customization and longitudinal tissue flexibility can provide a synergistic tissue effect. For example, when the compressive force applied to the tissue during and / or after stapling causes less stress to develop in the compressed tissue and / or reduces the affected tissue trauma, the compressed tissue may become elastic. It can accommodate increased deformation. In other words, when the optimally compressed tissue is stretched and / or stretched, the optimally compressed tissue may better accommodate the rotation and / or pivoting of the staples within the tissue. Further, when the stapled tissue readily accommodates staple pivoting and / or movement, stress in the stapled tissue may be reduced and trauma to the stapled tissue may be minimized. Thus, as the staples pivot and / or move to accommodate tissue stretching or longitudinal stretching, stress and / or trauma to optimally compressed tissue can be further minimized.

  Staple cartridge 3420 is shown in FIGS. The illustrated staple cartridge 3420 includes a cartridge body 3424 and a deck 3422. A plurality of staple cavities 3428 are defined in the body 3424 of the staple cartridge 3420 shown, each staple cavity 3428 forming an opening 3430 in the deck 3422. Further, the staple cavities 3428 shown in FIGS. 43-45 are angularly oriented with respect to the longitudinal axis L of the staple cartridge 3420 (FIG. 44). In the staple cartridge 3420 shown, the longitudinal slots 3432 are defined partially through the cartridge body 3424, and three rows of staple cavities 3428 are positioned on either side of the longitudinal slots 3432. The arrangement of staple cavities 3428 shown in FIGS. 43-45 is configured to receive an array of angled staples. A plurality of staples, such as, for example, staple 3412 (FIG. 45) are removably positioned within staple cavity 3428.

  In the staple cartridge 3420 shown, the staple cavities 3428 in the outer row on the first side of the longitudinal slot 3432 are oriented at a first angle with respect to the longitudinal axis L (FIG. 44), and The staple cavities 3428 in the middle row on the first side of the slot 3432 are oriented at a second angle with respect to the longitudinal axis L, and the staple cavities in the inner row on the first side of the longitudinal slot 3432. 3428 is oriented at a third angle with respect to the longitudinal axis L. In the illustrated staple cartridge 3420, the third angle is the same or substantially the same as the first angle, the second angle is 90 ° or about 90 °, and the first angle and the third angle are different from each other. Biased.

  As further shown in FIGS. 43-45, the staple cavities 3428 in the outer row on the second side of the longitudinal slot 3432 are oriented at a fourth angle with respect to the longitudinal axis L (FIG. 44), The staple cavities 3428 in the intermediate row on the second side of the longitudinal slot 3432 are oriented at a fifth angle with respect to the longitudinal axis L, and in the inner row on the second side of the longitudinal slot 3432. Staple cavity 3428 is oriented at a sixth angle with respect to longitudinal axis L. In the illustrated staple cartridge 3420, the sixth angle is the same or substantially the same as the fourth angle, the fifth angle is 90 ° or about 90 °, and the fourth angle is Biased. Further, in the arrangement shown in FIGS. 43 to 45, the second angle is the same or substantially the same as the fourth angle and the sixth angle, and the first angle is different from the third angle and the fifth angle. The same or almost the same.

  In other examples, staple cartridge 3420 can include additional and / or fewer rows of staple cavities. Additionally or alternatively, the angular orientation of the staples 3412 in each row may be adjusted and / or modified to accommodate different arrays. For example, in certain instances, the at least one staple cavity may be parallel to the longitudinal axis L.

  In various instances, the staple cartridge 3420 shown in FIGS. 43-45 can be used with the end effector 2000 shown in FIG. For example, staple cartridge 3420 can be mounted in an elongated channel of second jaw 2004. Further, in certain instances, staple cartridge 3420 may fire with a single staple driver, a multi-staple driver, and / or a combination thereof. For example, a single staple driver 3440 (FIG. 45) can be positioned within a respective staple cavity 3428 and can drive engage staples 3412 supported thereon. The drivers 3440 shown in FIG. 45 can be positioned within the cartridge body 3424 such that the cradle of each driver 3440 is aligned with one of the staples 3412 positioned within one of the staple cavities 3428. .

  In certain instances, staple cartridge 3420 can include a multi-staple driver. For example, a multi-staple driver can be configured to fire staples 3412 (FIG. 45) from a first group of staple cavities 3428, and another multi-staple driver can place staples 3412 into a second group of staple cavities. It can be configured to fire from 3428. In other examples, staple cartridge 3420 may not include a driver. For example, a firing member and / or thread, such as firing member 2660 and sled 2658 (FIG. 37), can be configured to directly contact, engage, and / or drive staple 3412. it can. In various instances, the driver 3440 and / or the staple 3412 can be mass-balanced during deployment, for example, to the firing path of the sled, such as the sled 2058 (FIG. 7) and / or the sled 2658 (FIG. 37). it can.

  The deck 3422 shown in FIGS. 43-45 includes a plurality of longitudinally extending portions. For example, deck 3422 may include a first longitudinal portion 3422a, a second longitudinal portion 3422b, and a third longitudinal portion 3422c on one side of longitudinal slot 3432, as well as a longitudinal slot 3432. The opposite side includes a fourth longitudinal portion 3422d, a fifth longitudinal portion 3422e, and a sixth longitudinal portion 3422f. As shown in FIGS. 43-45, the longitudinal rows of staple cavities 3428 are aligned with respective longitudinally extending portions 3422a, 3422b, 3422c, 3422d, 3422e, 3422f. For example, the outer row of staple cavities 3428 on the first side of the longitudinal slot 3432 is aligned with the first longitudinal portion 3422a and the middle row of staple cavities 3428 on the first side of the longitudinal slot 3432. Are aligned with the second longitudinal portion 3422b, and the inner row of staple cavities 3428 on the first side of the longitudinal slot 3432 are aligned with the third longitudinal portion 3422c. Further, the outer row of staple cavities 3428 on the second side of the longitudinal slot 3432 is aligned with the fourth longitudinal portion 3422d, and the middle row staple cavities 3428 on the second side of the longitudinal slot 3432. Are aligned with the fifth longitudinal portion 3422e, and the inner row of staple cavities 3428 on the second side of the longitudinal slot 3432 are aligned with the sixth longitudinal portion 3422f.

  In other examples, the staple cartridge 3420 can include additional and / or fewer longitudinally extending portions. For example, the longitudinal portions can be adjusted and / or modified to accommodate different placements of the staple cavities and staples. In certain embodiments, more than two longitudinal rows of staple cavities can coincide with at least one longitudinal portion. Additionally or alternatively, the at least one longitudinal portion may not include, for example, staple cavities and / or rows of staples.

  In the illustrated staple cartridge 3420, adjacent longitudinal portions 3422a, 3422b, 3422c, 3422d, 3422e, and 3422f are vertically offset from each other by a ridge 3423. For example, a ridge 3423 extends between a first portion 3422a and a second portion 3422b, and another ridge 3423 extends between a second portion 3422b and a third portion 3422c. I do. Further, in the illustrated arrangement, the raised portion 3423 extends between the fourth portion 3422d and the fifth portion 3422e, and another raised portion 3423 includes the fifth portion 3422e and the sixth portion 3422f. Extending between. As shown in FIGS. 43-45, a longitudinal slot 3432 extends between a third portion 3422c and a fourth portion 3422d.

  The ridges 3423 disclosed in FIGS. 43-45 define a height change within the deck 3422. For example, the ridge 3423 between the ridge 3423 between the first portion 3422a and the second portion 3422b defines a step up, so that the second portion 3422b can Have a higher altitude. In various instances, the ridges 3423 adjust the height of the deck 3422 laterally. For example, the ridges 3423 increase the height of the deck 3422 inward and decrease the height of the deck 3422 so that the maximum height is adjacent to the longitudinal slot 3432 and laterally. The part on the side has the shortest height.

  The gap between the deck 3422 and the staple forming surface of the anvil may cause tissue when the jaws of the end effector are clamped, such as the first jaw 2002 and the second jaw 2004 of the end effector 2000 (FIG. 7). Control the degree of compression. Thus, the height of the deck 3422 can affect the degree of tissue compression between the clamped jaws. For example, in areas where the deck 3422 is higher, the compression of adjacent tissue can be relatively increased between the clamped jaws, and in areas where the deck 3422 is shorter, the compression of adjacent tissue can be increased between the jaws. It can be relatively reduced. Accordingly, the ridges 3423 disclosed in FIGS. 43-45 can affect lateral variations in tissue compression. As described further herein, the degree of tissue compression can be selected and / or optimized to reduce stress and / or trauma to the compressed tissue. Further, the staple cartridge 3420 is configured to fire a flexible array in the longitudinal direction of the staples 3412, thereby further maintaining the integrity of the stapled tissue.

  The ridges 3423 disclosed in FIGS. 43-45 affect steep and / or steep steps between adjacent longitudinal portions 3422a, 3422b, 3422c, 3422d, 3422e, and 3422f. 43-45 further disclose that ridges 3423 surround staple cavities 3428 in adjacent rows of staple cavities 3428. FIG. For example, the ridge 3423 extends generally along a path that corresponds and / or matches the angular orientation of the staple cavity or the adjacent cavity 3428. As a result, the ridge 3423 includes a plurality of contours and / or bends. In addition, the ridge 3423 includes a plurality of straight or generally straight portions intermediate the contour.

  In another example, the ridges 3423 can define a low slope elevation change. For example, at least one ridge 3423 and / or a portion thereof may be gently sloped to different altitudes and / or incremented in steps. Further, in certain instances, the height of the longitudinal portions 3422a, 3422b, 3422c, 3422d, 3422e, 3422f can vary. For example, the height of each longitudinal portion 3422a, 3422b, 3422c, 3422d, 3422e, 3422f can vary laterally and / or longitudinally. In such instances, the deck may, for example, define an intermediate sloping and / or angled surface of the ridge 3423.

  In other staple cartridges, the ridges can extend along different paths between the rows of staples and the staple cavities. For example, staple cartridge 3520 shown in FIGS. 46-48 is similar to staple cartridge 3420 (FIGS. 43-45), and like reference characters refer to like elements. For example, the staple cartridge 3520 includes a cartridge main body 3524 and a deck 3522. A plurality of staple cavities 3528 are defined in the body 3524 of the staple cartridge 3520 shown, each staple cavity 3528 forming an opening 3530 in the deck 3422. Further, the staple cavities 3528 shown in FIGS. 46-48 fit the array of staple cavities 3428 shown in FIGS. For example, in the staple cartridge 3520 shown, the longitudinal slots 3532 are defined partially through the cartridge body 3524, and three rows of staple cavities 3528 are positioned on either side of the longitudinal slots 3532. The arrangement of staple cavities 3528 shown in FIGS. 46-48 is configured to receive an array of angled staples. For example, a plurality of staples, such as staple 3412 (FIG. 45), can be removably positioned within staple cavity 3528.

  The deck 3522 disclosed in FIGS. 46-48 includes a plurality of longitudinally extending portions. For example, the illustrated deck 3522 includes a first longitudinal portion 3522a, a second longitudinal portion 3522b, and a third longitudinal portion 3522c on one side of the longitudinal slot 3532, as well as a longitudinal slot. Opposite to 3432 includes a fourth longitudinal portion 3522d, a fifth longitudinal portion 3522e, and a sixth longitudinal portion 3522f. As shown in FIGS. 46-48, the longitudinal rows of staple cavities 3528 are aligned with respective longitudinally extending portions 3522a, 3522b, 3522c, 3522d, 3522e, 3522f. Further, in the illustrated staple cartridge 3520, adjacent longitudinal portions 3522a, 3522b, 3522c, 3522d, 3522e, and 3522f are vertically offset from each other by a ridge 3523.

  The ridge 3523 disclosed in FIGS. 46-48 extends along a different path than the ridge 3423 of the deck 3422 (FIGS. 43-45). For example, the ridge 3423 includes a plurality of cut-ins, such as, for example, cut-ins 3523a, 3523b, 3523c, and 3523d (FIG. 47), and the ridge 3523 extends along and / or adjacent the staple cavity 3528. Does not exist. The outer shape of the cut-ins 3523a, 3523b, 3523c, and 3523d can be selected to adjust tissue compression. For example, cut-in can enlarge the area of pressure reduction and reduce adjacent areas of pressure increase. In various instances, it may be desirable to provide cut-ins 3523a, 3523b, 3523c, and 3523d towards knife slot 3532, for example, to provide an area of reduced tissue compression.

  As further described herein, the ridges 3523 disclosed in FIGS. 46-48 can affect lateral variations in tissue compression. For example, the degree of tissue compression can be selected and / or optimized to reduce stress and / or trauma to the compressed tissue. Further, the staple cartridge 3520 is configured to fire a flexible array in the longitudinal direction of the staples 3512, thereby further maintaining the integrity of the stapled tissue.

  In other instances, the ridges on the cartridge deck may be straight or generally straight. For example, staple cartridge 3620 shown in FIGS. 49-51 is similar to staple cartridge 3420 (FIGS. 43-45), and like reference characters refer to like elements. For example, the staple cartridge 3620 includes a cartridge main body 3624 and a deck 3622. A plurality of staple cavities 3628 are defined in the body 3624 of the staple cartridge 3620 shown, with each staple cavity 3628 forming an opening 3630 in the deck 3622. Further, the staple cavities 3628 shown in FIGS. 49-51 are compatible with the arrangement of the staple cavities 3528 shown in FIGS. For example, in the illustrated staple cartridge 3620, the longitudinal slots 3632 are defined partially through the cartridge body 3624, and three rows of staple cavities 3628 are positioned on either side of the longitudinal slots 3632. The arrangement of staple cavities 3628 shown in FIGS. 46-48 is configured to receive an array of angled staples. A plurality of staples, such as, for example, staple 3612 (FIG. 51) are removably positioned within staple cavity 3628.

  The deck 3622 disclosed in FIGS. 49-51 includes a plurality of longitudinally extending portions. For example, the illustrated deck 3622 includes a first longitudinal portion 3622a, a second longitudinal portion 3622b, and a third longitudinal portion 3622c on one side of the longitudinal slot 3632, and a longitudinal slot 3622c. Opposite to 3632 includes a fourth longitudinal portion 3622d, a fifth longitudinal portion 3622e, and a sixth longitudinal portion 3622f. As shown in FIGS. 49-51, the longitudinal rows of staple cavities 3628 are aligned with respective longitudinally extending portions 3622a, 3622b, 3622c, 3622d, 3622e, 3622f. Further, in the illustrated staple cartridge 3620, adjacent longitudinal portions 3622a, 3622b, 3622c, 3622d, 3622e, and 3622f are vertically offset from each other by a ridge 3623.

  The ridge 3623 disclosed in FIGS. 49-51 extends along a different path than the ridge 3423 of the deck 3422 (FIGS. 43-45) and the ridge 3523 of the deck 3522 (FIGS. 46-48). For example, the ridge 3623 extends along a straight path that extends parallel to the longitudinal slot 3632. Further, a portion of the longitudinal ridge 3523 extends through a staple cavity 3628 in the staple cartridge 3620. As a result, one end, or one side, of the staple cavity 3628 is positioned within one of the longitudinal deck portions 3622a, 3622b, 3622c, 3622d, 3622e, or 3622f, and the other end of the same staple cavity 3628, the opposite side Is positioned within another one of the longitudinal deck portions 3622a, 3622b, 3622c, 3622d, 3622e, or 3622f.

  As further described herein, the ridges 3623 disclosed in FIGS. 49-51 can affect lateral variations in tissue compression. For example, the degree of tissue compression can be selected and / or optimized to reduce stress and / or trauma to the compressed tissue. Further, the staple cartridge 3620 is configured to fire a flexible array in the longitudinal direction of the staples 3612, thereby further maintaining the integrity of the stapled tissue.

  In certain instances, staple cartridge 3620 includes a multi-staple driver, such as multi-staple driver 3640 disclosed in FIG. Each multi-staple driver 3640 is configured to fire staples 3612 from a group of staple cavities 3628. For example, similar to the multi-staple drivers 2040a, 2040b (FIGS. 7-9), the multi-staple driver 3640 includes three steps 3645, with a trough or cradle 3642 defined within each step 3645. Further, the steps 3645 of the multi-staple driver 3640 are connected by connecting flanges 3648. Each multi-staple driver 3640 shown in FIG. 51 is configured to support staples 3612 across multiple rows of staple cavities 3628 and to fire staples 3612 from staple cavities 3628 in multiple rows. In FIG. 51, the height of each step 3645 and the depth of each pedestal 3642 defined therein are the same, and the staple 3612 formed between the steps 3645 and the staple forming surface on the anvil are the same. It has a height after molding.

  As discussed further herein, it may be desirable to customize and / or optimize the post-form staple height to affect various tissue compressions within the formed staple. Accordingly, at least one of the multi-staple drivers 3640 can be modified to form staples 3612 of different molded heights. For example, the steps 3645 and / or the cradle 3642 of the staple multi-staple driver 3640 may have different dimensions such that at least two of the staples 3612 formed by the modified multi-staple driver 3640 have different post-mold heights. Can be modified to have In another example, the steps 3645 and / or pedestals 3642 of the different staple drivers 3640 are configured such that the first driver 3640 forms a staple 3612 having a first molded height, and the second driver The 3640 can be modified to be configured to form a staple having a second, or different, molded height 3612.

  In still other instances, staple cartridge 3620 can include a single staple driver. Alternatively, staple cartridge 3620 may not include a driver. For example, the firing member and / or sled, such as firing member 2660 and sled 2658 (FIG. 37), can be configured to directly contact, engage, and / or drive staple 3612, for example. it can. In various instances, driver 3640 and / or staple 3612 can be mass-balanced with respect to the firing path of the sled, such as, for example, sled 2058 (FIG. 7) and / or sled 2658 (FIG. 37).

  As described herein, the staples in the staple array can be formed at different post-heights to customize and / or optimize tissue compression in the formed staples. For example, in various instances, it may be desirable to vary tissue compression and, thus, staple dimensions after molding in the lateral direction. In such a situation, for example, tissue closer to the score line may compress more than tissue farther from the score line. Various staple arrays having different unformed heights and / or different post-heights are disclosed in US Pat. U.S. Patent No. 7,726,537, issued on June 1, 2010, entitled "SURGICAL STAPLETER WITH UNIVERSAL ARTICULATION AND TISSUE PRE-CLAMP", U.S. Patent No. 7,641, issued on January 5, 2010 No. 091, entitled "STAPLE DRIVE ASSEMBLY", U.S. Patent No. 7,635,074, issued on December 22, 2009, entitled "STAPLE DRIVE ASSEMBLY", and U.S. Patent issued on August 16, 2011 Seventh, No. 97,469, are described in the title "STAPLE DRIVE ASSEMBLY", these are their respective entireties are hereby incorporated by reference.

  Referring again to FIGS. 49-51, in various instances, the staple cartridge 3620 can be used with an end effector configured to deform the staples 3612 to different molded heights. The angled staple cavities 3628 in the staple cartridge 3620 are arranged in a plurality of rows. For example, the angled staple cavities 3628 may be disposed in a first outer row, a first middle row, and a first inner row on a first side of the staple cartridge 3620 and include the angled staple cavities 3628. Are disposed on a second side of the staple cartridge 3620 in a second outer row, a second intermediate row, and a second inner row. In various instances, the staples 3612 fired from the staple cavities 3628 in the first outer row take a higher molded height than the staples 2612 fired from the staple cavities 3628 in the first middle row. And / or staples 3612 fired from staple cavities 3628 in the first intermediate row have a higher formed height than staples 2612 fired from staple cavities 3628 in the first inner row. Can be taken. Additionally or alternatively, staples 3612 fired from staple cavities 3628 in the second outer row may take a higher molded height than staples 2612 fired from staple cavities 3628 in the second intermediate row. Staples 3612 that can and / or are fired from staple cavities 3628 in the second intermediate row take a higher molded height than staples 2612 that are fired from staple cavities 3628 in the second inner row. be able to.

  In certain instances, staples 3612 fired from staple cartridge 3620 can have different unformed heights. For example, staples 3612 fired from staple cavities 3628 in the first outer row can have a greater unformed height than staples 2612 fired from staple cavities 3628 in the first middle row, and In other words, staples 3612 firing from staple cavities 3628 in the first intermediate row can have a greater unformed height than staples 2612 firing from staple cavities 3628 in the first inner row. Additionally or alternatively, staples 3612 fired from staple cavities 3628 in the second outer row can have a greater unformed height than staples 2612 fired from staple cavities 3628 in the second intermediate row. And / or staples 3612 fired from staple cavities 3628 in the second intermediate row may have a greater unformed height than staples 2612 fired from staple cavities 3628 in the second inner row. it can.

  In various instances, staple arrays having different unformed heights and / or different formed heights can be incorporated into the various staple cartridges described herein. For example, staple cartridge 3420 (FIGS. 43-45) and / or staple cartridge 3520 (46-48) can include staples having different unformed heights and / or bring staples to different post-formed heights. Can be configured to fire. In such instances, the stepped cartridge decks 3422 (FIGS. 43-45), 3522 (FIGS. 46-48), and 3622 (FIGS. 49-51) may, for example, affect variable pre-fire tissue compression. For example, different post-mold staple heights can affect variable post-fire tissue compression.

  As described herein, angled staple arrays provide enhanced flexibility to stapled tissue. A staple that is angled with respect to the score line and / or the longitudinal axis of the staple cartridge can have one staple leg that is closer to the score line than another staple leg. In such an arrangement, the staples can be formed at different post-heights to customize and / or optimize tissue compression laterally. For example, one end of the staple can be formed at a first height and the other end of the staple can be formed at a second, different height. In such instances, the tissue being treated by the same row of staples may be subjected to different compressive forces.

  Staple cartridge 3720 and anvil 3703 are shown in FIG. Staple cartridge 3720 is similar to staple cartridge 3620 (FIGS. 49-51), and like reference characters refer to like elements. For example, the staple cartridge 3720 includes a cartridge main body 3724 and a deck 3722. Deck 3722 includes a plurality of longitudinally extending portions 3722a, 3722b, 3722c, with adjacent longitudinal portions 3722a, 3722b, 3722c separated by a ridge 3723. The ridge 3723 extends longitudinally along at least a portion of the length of the cartridge body 3722. An angled staple cavity 3728 is defined in the cartridge body 3724 and the ridge 3723 extends through the staple cavity 3728. As a result, a first end of the illustrated staple cavity 3728 is positioned within the first longitudinal portion 3722a, and a second end of the illustrated staple cartridge 3728 is positioned in the second longitudinal portion 3728a. It is positioned within 3722b. Further, a longitudinal slot 3732 is defined partially through the illustrated cartridge body 3724.

  In various examples, the staple cartridge 3720 can include a plurality of staple cavities 3728, wherein the plurality of staple cavities 3728 are configured to receive an array of angled staples 3712. For example, staple cartridge 3720 can include an arrangement of staple cavities 3728 corresponding to the arrangement of staple cavities 3628 shown in FIGS. In certain instances, for example, three rows of staple cavities 3728 can be positioned on either side of a longitudinal slot 3732.

  An unformed staple 3712 and a deformed staple 3712 'are shown in FIG. The staple 3712 includes a base 3714, a first leg 3716 extending from the base 3714, and a second leg 3718 extending from the base 3714. Driver 3740 is also shown in FIG. Driver 3740 includes a trough or cradle 3742, which is configured to support a base 3714 of staple 3712. Driver 3740 and cradle 3742 defined therein have a variable height between first end 3741 and second end 3743 of driver 3740. For example, a first end 3741 of the driver 3740 defines a first height, a second end 3743 of the driver 3740 defines a second height, and the second height is 1 height.

  When the driver 3740 is fired and lifted within the staple cavity 3728, the staples 3712 ride up on the lifting driver 3740 and are deformed by the stapler forming pockets 3705 of the anvil 3703. The shaped staple 3712 'is also shown in FIG. The formed height of the staple 3712 'is a function of the distance between the driver 3740 after lifting and the stapler forming pocket 3705 of the anvil 3703, ie, the gap. The distance between the staple support surface 3742 of the driver 3740 and the staple forming pocket 3705 after lifting varies in the staple cartridge 3720 disclosed in FIG. 79, so that the formed staple 3712 'has a variable height. For example, the height of the formed staple 3712 'is greater between the first leg 3716' and the base 3714 'than between the second leg 3718' and the base 3714 '. In various instances, the angular orientation of the staples 3712 'allows the first leg 3716' to be located farther from the longitudinal slot 3732 than the second leg 3718 '. In such an instance, first leg 3716 'may be the outer leg of staple 3712' and second leg 3718 'may be the inner leg of staple 3712'. In such an arrangement, the tissue compression may be greater between the inner leg 3718 'and the base 3714' than between the outer leg 3716 'and the base 3714'.

  For example, similar to staple cartridge 3720 and anvil 3705, staple cartridges and anvil arrangements configured to deform angled staples to different molded heights are described in other embodiments disclosed herein. Can be incorporated. For example, similar to driver 2740, a driver having, for example, a cradle to support variable height staples can be incorporated into other staple cartridges and / or end effector assemblies disclosed herein.

  The unformed staple 3712 shown in FIG. 79 also has a variable height. For example, the staple 3712 defines a first height at a first leg 3716 and a second height at a second leg 3718, wherein the second height is less than the first height. It is. Further, the base 3714 of the staple 3712 defines a bend, or step 3715, which raises the second leg 3718 relative to the first leg 3716.

  In another example, unformed staples 3712 can have a uniform height. Additionally or alternatively, the base 3714 of the unformed staple 3712 may be straight or generally straight between the first leg 3716 and the second leg 3718. In such an instance, the staples 3712 may still have a variable post-formed height when the distance between the staple support surface 3742 of the driver 3740 and the staple forming pocket 3705 after lifting is variable. For example, one of the staple legs 3716, 3718 may be more deformed and / or compressed than the other staple leg 3716, 3718 to accommodate additional leg length. In addition, as the distance between the staple support surface 3742 and the staple forming pocket 3705 varies, the base 3714 can be bent and / or otherwise deformed during firing to accommodate height differences. it can.

  Staple cartridge 3820 and anvil 3803 are shown in FIG. Staple cartridge 3820 is similar to staple cartridge 3620 (FIGS. 49-51), and like reference characters refer to like elements. For example, the staple cartridge 3820 includes a cartridge body 3824 and a deck 3822. Unlike deck 3622 (FIGS. 49-51), deck 3822 has a flat or generally flat, stepless surface. An angled staple cavity 3828 is defined in the cartridge body 3824. Further, a longitudinal slot 3832 is defined partially through the illustrated cartridge body 3824.

  In various examples, a staple cartridge 3820 can include a plurality of staple cavities 3828, wherein the plurality of staple cavities 3828 are configured to receive an array of angled staples. For example, staple cartridge 3820 can include an arrangement of staple cavities corresponding to the arrangement of staple cavities 3628 shown in FIGS. In certain instances, three rows of staple cavities 3828 can be positioned, for example, on either side of a longitudinal slot 3832.

  An unformed staple 3812 is shown in FIG. The staple 3812 includes a base 3814, a first leg 3816 extending from the base 3814, and a second leg 3818 extending from the base 3814. Driver 3840 is also shown in FIG. Driver 3840 includes a trough or cradle 3842, which is configured to support a base 3814 of staple 3812.

  Anvil 3803 includes a laterally stepped cartridge facing surface 3801. First staple forming pocket 3805a and second staple forming pocket 3805b are defined in stepped surface 3801. As shown in FIG. 80, the first staple forming pocket 3805a is in the first step 3801a of the stepped surface 3801, and the second staple forming pocket 3805b is in the second step 3801b of the stepped surface 3801. It is in.

  When driver 3840 is fired and lifted within staple cavity 3828, staple 3812 rides up on driver 3840 during lifting and is deformed by staple forming pockets 3805a, 3805b of anvil 3803. A shaped staple 3812 'is also shown in FIG. The formed height of the staple 3812 'is a function of the distance between the driver 3840 after lifting and the staple forming pockets 3805a, 3805b of the anvil 3803, ie, the gap. Since the distance between the staple support surface 3842 of the driver 3840 after lifting and the respective staple forming pockets 3805a, 3805b is different in the staple cartridge 3720 disclosed in FIG. 79, the formed staple 3812 'has a variable height. take. For example, the height of the formed staple 3812 'is greater between the first leg 3816' and the base 3814 'than between the second leg 3818' and the base 3814 '. In various instances, the angular orientation of the staples 3812 'allows the first leg 3816' to be positioned farther from the longitudinal slot 3832 than the second leg 3818 '. In such an instance, first leg 3816 'may be the outer leg of staple 3812' and second leg 3818 'may be the inner leg of staple 3812'. In such an arrangement, the tissue compression may be greater between the inner leg 3818 'and the base 3814' than between the outer leg 3816 'and the base 3814'.

  In another example, staples 3812 'can be deformed to a smaller height at outer legs 3816'. As a result, tissue compression may be greater between the outer leg 3816 'and the base 3814' than between the inner leg 3818 'and the base 3814'.

  For example, similar to staple cartridge 3820 and anvils 3805a, 3805b, staple cartridges and anvil arrangements configured to deform angled staples to different molded heights are described in other implementations disclosed herein. Can be incorporated into the form. For example, as with pockets 3805a, 3805b, for example, variable depth pockets can be incorporated into other embodiments disclosed herein.

  The unformed staple 3812 shown in FIG. 80 also has a variable height. For example, the staple 3812 defines a first height at a first leg 3816 and a second height at a second leg 3818, wherein the second height is less than the first height. It is.

  In other instances, unformed staples 3812 may have a uniform height. In such an instance, the staples 3812 may previously assume a variable post-formed height when the distance between the staple support surface 3842 of the driver 3840 and the staple forming pocket 3805 after lift is variable. For example, one of the staple legs 3816, 3818 may be more deformed and / or compressed than the other staple legs 3816, 3818 to accommodate additional leg lengths.

  In certain types of surgical procedures, the use of surgical staples or surgical fasteners has become a preferred method of joining tissue, and specially configured surgical staplers or circular surgical fasteners have been developed for these applications. Has been developed. For example, intraluminal or circular staplers have been developed for use in surgical procedures used to form "anastomosis." Circular staplers useful for performing an anastomosis are described, for example, in US Pat. No. 5,104,025, entitled “INTRALUMINAL ANASTOMOTIC SURGICAL STAPLER WITH DETACHED ANVIL”, US Pat. No. 5,309,927, entitled “CIRCULAR STAPLETER TESTING TESTING. SPRING METHOD, US Patent No. 7,665,647, entitled "SURGICAL CUTTING AND STAPLING DEVICE WITH WHITE CLOSURE APPARATUS FOR LIMITING MAXIMUM TISSUE COMPRESS, US Patent No. 68, USS FORGUS, FORMULS, US Patent No. 68, US FORGUS, FORMULA, US Patent No. 68, US FORGUS, US FOR PACKAGES, US Pat. TEM AND STAPLE CARTRIDGES FOR DEPLOYING SURGICAL STAPLE WITH TISSUE COMPRESSION FEATURES, each of which is incorporated herein by reference in its entirety.

  One form of "anastomosis" involves a surgical procedure, in which parts of the intestine are joined together after the connection (usually the diseased part) is excised. This procedure involves joining the ends of two tubular sections together to form a continuous tubular path. Previously, this surgical procedure was a labor and time consuming operation. The surgeon had to accurately cut and align the end of the intestine and maintain that alignment while joining the ends with multiple sutures. With the development of circular fastening devices, this anastomosis procedure has been greatly simplified and the time required to perform the anastomosis has been reduced.

  Generally, conventional circular staplers or fasteners consist of an elongated shaft that includes a proximal actuation mechanism and a distal stapling mechanism mounted on the shaft. The distal stapling mechanism typically consists of a fixed stapling cartridge containing a plurality of staples arranged in a concentric array. A round blade is also mounted concentrically in the cartridge such that the blade is inside the staple. The blade is axially movable in a distal direction. Extending axially from the center of the cartridge is a trocar shaft. The trocar shaft is also axially movable within the elongate shaft. The trocar shaft is configured to be removably attached to the anvil member. The anvil member includes a staple forming lower surface positioned to face a staple cartridge that forms an end of the staple when the staple is advanced and contacts the anvil member. The distance between the distal surface of the staple cartridge and the staple forming lower surface of the anvil is controlled by an adjustment mechanism mounted on the proximal end of the stapler shaft. Tissue contained between the staple cartridge and the staple anvil is stapled and cut at the same time as the actuation mechanism is actuated by the surgeon.

  When performing an anastomosis using a circular stapler, the intestine is typically first stapled using a conventional surgical stapler, and a double row of staples is applied to the target site of the intestine (ie, the lesion). Part or specimen). The target site is usually cut at the same time as the site is stapled. Next, after removing the specimen, the surgeon typically inserts the anvil proximal to the staple line into the proximal end of the lumen (ie, intestine). This is done by the surgeon inserting an anvil head into the portal cut into the proximal lumen (intestine). Sometimes, the anvil may be placed transanally by placing the anvil head at the distal end of the stapler and inserting the instrument through the rectum. The proximal end of the intestine is then sutured to the anvil shaft using a suture or other conventional tying device. Next, the surgeon cuts off excess tissue adjacent to the knot, and the surgeon attaches the anvil to the trocar shaft of the stapler. The surgeon then closes the gap between the anvil and the cartridge by pulling the anvil toward the staple cartridge. As the anvil moves toward the cartridge, the proximal and distal ends of the intestine are clamped therebetween. The stapler is then actuated, causing the row of staples to be driven through the ends of the intestine to form contact with the anvil. At the same time, as the staples are driven and formed, the circular blade is driven through the end of the intestinal tract tissue, cutting the end adjacent the inner row of staples. The surgeon then retrieves the stapler from the intestine and the anastomosis is complete.

  Effective healing of a colorectal anastomosis can be challenged by several factors and conditions. For example, healing can be effected by the presence of bacterial contamination of the anastomotic area. In general medicine, the success rate of anastomosis tends to increase with patient return to mobility. It is desirable for the patient to return to transit as soon as possible. One of the ways to prevent content passage is the risk of "stenosis". If the colon content cannot pass through the staple line, or if the colon content dramatically stresses the staple line, tears, tears, or leaks may occur. Staple linear expandable lines have been developed for highly expandable organs such as the lungs. However, such staple configurations are not suitable for use in connection with circular staplers.

  FIG. 29 illustrates one form of a circular stapler or stapling apparatus generally designated 5000. Various circular stapling devices for placing surgical staples or fasteners are well known and used. Accordingly, various details regarding the structure and operation of the circular stapling apparatus are described herein beyond what may be necessary to understand the innovations and arrangements disclosed herein and illustrated in the accompanying drawings. Are not discussed in detail. For further details regarding circular fasteners and stapling devices, see U.S. Patent No. 7,665,647, entitled "SURGICAL CUTTING AND STAPLING DEVICE WITH WHITE CLOSURE APPARATUS FOR LIMITING MAXIMUM TISSUE COMPOSITION," which is incorporated by reference. , As well as other U.S. patents incorporated herein by reference. In general, the circular stapling apparatus 5000 shown in FIG. 29 includes a handle 5010 that supports a head 5002, an anvil 5004, an adjustment knob assembly 5006, and a trigger 5008 thereon. Handle assembly 5010 is coupled to head 5002 by arcuate shaft assembly 5012. In the illustrated arrangement, trigger 5008 is pivotally supported by handle assembly 5010 and is used to operate stapler 5000 when a safety mechanism (not shown) is released. When the trigger 5008 is activated, the firing mechanism is movably advanced within the shaft assembly 5012 and the staples or fasteners are ejected or deployed from the head 5002 to cause contact of the anvil 5004 with the anvil forming lower surface 5005. Is formed. At the same time, a round blade operably supported within head 5002 (not visible in FIG. 29) has been advanced distally toward anvil 5004 and clamped between head 5002 and anvil 5004 in a known manner. Serves to cut the organization. The stapling device 5000 is then removed from the surgical site, leaving the stapled tissue in place.

  29, the anvil 5004 includes a circular body portion 5014 having an anvil shaft 5016 protruding therefrom. Anvil shaft 5016 is configured to be removably attached to trocar shaft 5050 operably supported within shaft assembly 5012. See FIG. 29A. As can be seen, trocar shaft 5050 is movably supported by shaft assembly 5012 and is operatively associated with adjustment knob assembly 5006 rotatably supported on handle assembly 5010. Anvil shaft 5016 may be removably attached to trocar shaft 5050 by retaining clips 5052, or other releasable fastening arrangements may also be used to removably secure anvil shaft 5016 to trocar shaft 5050. obtain. Once the anvil shaft 5016 is attached to the trocar shaft 5050, the clinician can move the anvil 5004 toward and away from the head 5002 by rotating the adjustment knob 5006 in the appropriate direction of rotation.

  FIG. 29A illustrates a head 5002 having a unique and novel fastener cartridge assembly 5020 operably mounted therein. As can be seen, the fastener cartridge assembly 5020 includes a cartridge body 5022 that includes a circular deck 5030. Circular deck 5030 may form a flat surface 5032, which is positioned to face staple forming lower surface 5005 of anvil 5004 when anvil shaft 5016 is attached to trocar shaft 5050. A plurality of fastener cavities 5040 are provided in the circular deck 5030 and configured to receive at least one surgical staple or surgical fastener (not shown) therein, and at least one surgical staple or surgical staple. The fastener is operably supported on a driver assembly 5060 movably supported within the body 5022 of the fastener cartridge assembly 5020. Driver assembly 5060 is operatively coupled to a corresponding movable portion of shaft assembly 5012 operatively associated with trigger 5008. Activation of trigger 5008 may, for example, result in an axial movement of driver assembly 5060 in a distal direction "DD". Movement of driver assembly 5060 in the distal direction “DD” results in movement or extrusion of surgical staples or fasteners supported within respective fastener cavities 5040 and staple forming lower surface 5005 on anvil 5004. Contact will be formed.

  Still referring to FIG. 29A, for example, each fastener cavity 5040 includes two cavity ends 5042, 5044. In the illustrated arrangement, each cavity end 5042, which may also be referred to herein as a "first cavity end", is positioned on a first circular axis "FCA" having a first radius "FR". Is done. The first radius "FR" may be measured from the instrument shaft axis "SA". Also, in the illustrated arrangement, each cavity end 5044, which may also be referred to herein as a "second cavity end", has a second radius "SR" that is different from the first radius "FR". 2 on a circular axis "SCA". In the illustrated embodiment, the second radius “SR”, also measured from the shaft axis “SA”, is greater than the first radius “FR”. Also, in the illustrated embodiment, each fastener cavity 5040 includes a cavity axis “CA”. In the illustrated embodiment, each fastener cavity 5040 is disposed within a circular deck 5030 relative to a first circular axis "FCA" and a second circular axis "SCA", and each has a cavity axis "CA". ] Form an acute angle with the first circular axis "FCA" and the second circular axis "SCA". In other words, the cavity ends 5042 of adjacent fastener cavities 5040 are adjacent to one another, and the ends 5044 of the same fastener cavity 5040 are spaced from one another. Such an arrangement may be referred to herein as a “zigzag” orientation. However, in other arrangements, the cavity axis "CA" may be perpendicular to the first and second circular axes "FCA" and "SCA".

  In the arrangement illustrated in FIG. 29A, each cavity end 5042, 5044 may be V-shaped to generally terminate at a point. For example, each cavity end 5042 may terminate generally at point 5043 and each end 5044 may terminate generally at point 5045. Point 5043 may be positioned on or intersect with first circular axis "FCA", and point 5045 may be positioned on second circular axis "SCA". It may be positioned or intersect a second circular axis "SCA". Such a cavity arrangement results in the application of surgical staples or fasteners in a pattern similar to tissue. In the illustrated arrangement, the fastener cavities 5040 each support one surgical staple or surgical fastener therein. However, in other arrangements, more than one staple or fastener may be supported within each cavity. Fastener cartridge assembly 5020 uses similar sized staples in each fastener cavity 5040. In other arrangements, different sizes of surgical staples or fasteners may be used in the fastener cartridge assembly. Surgical staples that can be used include, for example, two staple legs extending from a central body portion or crown. The legs may be received within the V-shaped ends 5042, 5044 of the fastener cavity 5040, and when the legs are ejected from the cavity 5040, the legs may be in the first or second circular shape. It extends through the axis. These staple orientations may address some of the concerns associated with staple stenosis discussed above. In particular, the staple configuration formed when using the fastener cartridge assembly 5020 may allow the staple lines to expand and bend like the natural colon rather than the general staple lines. For example, a staple or fastener can twist when the staple or fastener is pulled radially, and the staple or fastener minimizes stress on the healing zone and maximizes flexibility and strength. Can be

  Another area of interest associated with a colorectal anastomosis procedure involves radial leakage through the attachment area. The fastener cartridge assembly 5020 described above may also address this area of interest. Another fastener cartridge assembly 5120 is shown in FIG. 30 and may address various issues and concerns discussed above. As can be seen in the figure, the fastener cavities are arranged in an "asymmetrical pattern" and the inner ring of the cavities, i.e., the staples applied through the inner circular array, are the outer rings of the cavities, i.e. the outer It performs a different function than staples or fasteners applied through a circular array.

  Referring more particularly to FIG. 30, the fastener cartridge assembly 5120 includes a cartridge body 5122 that includes a circular deck 5130. Circular deck 5130 may form a flat surface 5132, which is positioned to face staple forming lower surface 5005 of anvil 5004 when anvil shaft 5016 is attached to trocar shaft 5050. A first ring 5036 of the first cavity 5040 is provided in the circular deck 5130, and a second ring 5160 of the second cavity 5170 is provided through the cartridge deck 5130 as shown. Each of the first and second cavities 5040, 5170 is configured to receive at least one surgical staple or surgical fastener (not shown) therein and includes at least one surgical staple or surgical fastener. The fastener is operably supported on a driver assembly 5060 movably supported within the body 5122 of the fastener cartridge assembly 5120.

  Each fastener cavity 5040 includes two cavity ends 5042, 5044. Each cavity end 5042 is positioned on a first circular axis "FCA" having a first radius "FR". The first radius "FR" may be measured from the instrument shaft axis "SA". Each cavity end 5044 is positioned on a second circular axis "SCA" having a second radius "SR" different from the first radius "FR". In the illustrated embodiment, the second radius “SR”, also measured from the shaft axis “SA”, is greater than the first radius “FR”. Each fastener cavity 5040 includes a cavity axis “CA”. In the illustrated embodiment, each fastener cavity 5040 is disposed in a circular deck 5130 relative to a first circular axis "FCA" and a second circular axis "SCA", and each includes a cavity axis "CA". ] Form an acute angle with the first circular axis "FCA" and the second circular axis "SCA". In other words, the cavity ends 5042 of adjacent fastener cavities 5040 are adjacent to one another, and the ends 5044 of the same fastener cavity 5040 are spaced from one another. Such an arrangement may be referred to herein as a “zigzag” orientation. However, in other arrangements, the cavity axis "CA" may be perpendicular to the first and second circular axes "FCA", "SCA".

  Also, in the arrangement illustrated in FIG. 30, each cavity end 5042, 5044 may be V-shaped to generally terminate at a point. For example, each cavity end 5042 may terminate generally at point 5043 and each end 5044 may terminate generally at point 5045. Point 5043 may be positioned on or intersect with first circular axis "FCA", and point 5045 may be positioned on second circular axis "SCA". It may be positioned or intersect a second circular axis "SCA". Such a cavity arrangement results in the application of surgical staples or fasteners in a pattern similar to tissue. Also, in the illustrated arrangement, the second ring 5160 includes a plurality of second fastener cavities 5170 aligned on a third circular axis "TCA", wherein the third circular axis "TCA" is , At a third radius “TR” from the shaft axis “SA”. In the illustrated arrangement, the third radius "TR" is less than the first and second radii. However, in other arrangements, the third radius "TR" is larger than the first radius. However, in a further arrangement, the third radius "TR" is larger than the first and second radii.

  The unique and novel fastener cartridge assembly 5120 serves to orient the staples or fasteners into tissue such that the staples or fasteners are "adjustable" for the amount of expansion applied to the staple line. . Surgical staples that can be used include, for example, two staple legs extending from a central body portion or crown. The leg is such that, when the leg is ejected from the cavity, the leg is in any case a first circular axis "FCA", a second circular axis "SCA", or a third circular axis " It may be received within the V-shaped end of the fastener cavity to extend through the "TCA". These staple orientations can result in amelioration of the problems associated with staple stenosis discussed above. For example, one ring of staples or fasteners (eg, second ring 5160) provides a standard sealing mechanism, and first ring 5036 includes a radial and flexible aspect of the staple line. Can be aligned. Accordingly, such an arrangement may also provide the same or similar advantages discussed above with respect to fastener cartridge assembly 5020.

  FIG. 31 illustrates another unique and novel fastener cartridge assembly 5220 that may also address the various problems and concerns discussed above. As can be seen, the fastener cavities are arranged in an "asymmetrical pattern" and the staples applied through the inner ring of the cavities are staples or fasteners applied through the outer rings of the cavities. It performs a different function than the tool.

  Referring more particularly to FIG. 31, the fastener cartridge assembly 5220 includes a cartridge body 5222 including a circular deck 5230. Circular deck 5230 may form a flat surface 5232, which is positioned to face staple forming lower surface 5005 of anvil 5004 when anvil shaft 5016 is attached to trocar shaft 5050. A first ring 5236 of the first cavity 5240 is provided in the circular deck 5230, and a second ring 5260 of the second cavity 5270 is provided through the cartridge deck 5230 as shown. Each of the first and second cavities 5240, 5270 is configured to receive at least one surgical staple or surgical fastener (not shown) therein and includes at least one surgical staple or surgical fastener. The fastener is operably supported on a driver assembly 5060 movably supported within the body 5222 of the fastener cartridge assembly 5220.

  Each fastener cavity 5240 includes two cavity ends 5242,5244. Each cavity end 5242 is positioned on a first circular axis "FCA" having a first radius "FR". The first radius "FR" may be measured from the instrument shaft axis "SA". Each cavity end 5244 is positioned on a second circular axis "SCA" having a second radius "SR" different from the first radius "FR". In the illustrated embodiment, the second radius “SR”, also measured from the shaft axis “SA”, is greater than the first radius “FR”. Each fastener cavity 5240 includes a cavity axis “CA”. In the illustrated embodiment, each fastener cavity 5240 is disposed within a circular deck 5230 relative to a first circular axis "FCA" and a second circular axis "SCA", and each has a cavity axis "CA". ] Form an acute angle with the first circular axis "FCA" and the second circular axis "SCA".

  Also, in the arrangement illustrated in FIG. 31, each cavity end 5242, 5244 may be V-shaped to generally terminate at a point. For example, each cavity end 5242 may terminate generally at point 5243 and each end 5244 may terminate generally at point 5245. Point 5243 may be positioned on or intersect with first circular axis "FCA", and point 5245 may be located on second circular axis "SCA". It may be positioned or intersect a second circular axis "SCA". Such a cavity arrangement results in the application of surgical staples or fasteners in a pattern similar to tissue. Also, in the illustrated arrangement, the second ring 5260 includes a plurality of second fastener cavities 5270 aligned on a third circular axis "TCA", wherein the third circular axis "TCA" is , At a third radius “TR” from the shaft axis “SA”. In the illustrated arrangement, the third radius "TR" is less than the first and second radii. However, in other arrangements, the third radius "TR" is larger than the first radius. However, in a further arrangement, the third radius "TR" is larger than the first and second radii. These staple orientations can result in amelioration of the problems associated with staple stenosis discussed above. In particular, the staple configuration formed when using the fastener cartridge assembly 5220 may allow the staple lines to expand and bend like the natural colon rather than the general staple lines. For example, a staple or fastener can twist when the staple or fastener is pulled radially, and the staple or fastener minimizes stress on the healing zone and maximizes flexibility and strength. Can be

  The adjuvant film / buttress material has been shown to improve hemostasis and pneumostasis by sealing around the staple tip. In many applications, buttress materials have been used to harden and / or reinforce soft tissue. Various buttress material arrangements have been developed and configured for placement of the surgical staple cartridge or surgical stapling device on the anvil. It can be difficult to attach the buttress member to the cartridge or anvil and then release the buttress material therefrom. FIG. 58 illustrates the surgical end effector 5300 and portions of the surgical cutting and fastening instrument 5400. End effector 5300 uses a unique and novel arrangement that attaches buttress member 5500 to and releases surgical staple cartridge 5320. An example of a surgical cutting and fastening instrument of the type shown in FIG. 58 is disclosed in U.S. patent application Ser. And this entire disclosure is incorporated herein by reference. Further details beyond those needed to understand the construction and use of end effector 5300 may be obtained by reference to that document, as well as numerous other documents incorporated by reference into that document. Can be.

  As seen in FIG. 58, the end effector 5300 shown therein includes an elongated staple channel 5302 configured to operably support a staple cartridge 5320 therein. The elongate staple channel 5302 is coupled to a spine portion 5404 operably supported within the elongate shaft assembly 5402 of the surgical stapling instrument 5400. The staple cartridge 5320 includes a cartridge body 5322 that can be made from a polymeric material. In the illustrated embodiment, a metal bottom tray 5324 is attached to the cartridge body 5322. The cartridge body 5322 includes a deck 5330 having a plurality of staple cavities 5332 defined therein. Each staple cavity 5332 is configured to removably store staples therein. The cartridge body 5322 further includes a longitudinal slot configured to removably receive the firing member 5410 therein. The cartridge body 5320 can further include a distal end 5326, a proximal end 5328, and opposing longitudinal sides 5329 extending between the distal end 5326 and the proximal end 5328. In various instances, each longitudinal side 5329 can include an adjacent or continuous edge with no interruption defined therein.

  Located within each staple cavity 5332 is a staple 5342, which is supported on a corresponding staple driver 5340, and the corresponding staple driver 5340 is movably supported within the cartridge body 5322. The staple driver 5340 is lifted upward when the firing member 5410 is driven distally through the staple cartridge 5320. As discussed in further detail in U.S. Patent Application No. 14 / 318,991, firing member 5410 advances staple thread 5350 distally to move staple driver 5340 and staple 5342 upward and staple cavity 5332. It is configured to lift out of. End effector 5300 further includes an anvil 5360 that is attached to elongated staple channel 5302. In the illustrated embodiment, anvil 5360 includes a pair of trunnions 5362 movably received within trunnion slots 5304 of elongated staple channel 5302. As further seen in FIG. 58, anvil 5360 includes an anvil tab 5364 that interacts with obturator tube segment 5420. Movement of the closure tube segment 5420 in the distal direction “DD” can move the anvil 5360 in the direction of the staple cartridge 5320. Due to movement of the closure tube 5420 in the proximal direction “PD”, the anvil separates from the staple cartridge 5320. Other embodiments may use a cartridge and anvil arrangement, wherein the anvil is stationary (eg, non-movably secured to an elongate shaft of a surgical device) and has an elongate channel and / or staple cartridge. Is movable toward and away from the anvil.

  As seen in FIGS. 58 and 59, buttress member 5500 is configured to be received between surgical staple cartridge 5320 and anvil 5360. More precisely, buttress member 5500 is configured to be received between staple forming lower surface 5366 of anvil 5360 and deck 5330 of staple cartridge 5320. In the illustrated embodiment, the buttress member 5500 is configured to be mounted under tension on the deck 5330 of the staple cartridge 5320. The buttress material, including buttress member 5500, can include, for example, a material from Gore SeamGuard, a material from Synovis peri-Strips, and / or polyurethane. Other suitable buttress or adjuvant materials are disclosed in U.S. patent application Ser. No. 14 / 318,991, filed Jun. 30, 2014, entitled "SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZING ARRANGEMENTS", the entire disclosure of which is hereby incorporated by reference. Is previously incorporated herein by reference. A variety of other suitable buttress or adjunct materials are also disclosed in U.S. Patent Application No. 13 / 763,095, filed February 28, 2013, entitled "LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES," which is incorporated herein by reference. Is incorporated herein by reference in its entirety. U.S. Patent Application No. 13 / 531,619, filed June 25, 2012, entitled "TISSUE STAPLER HAVING A THICKNESS COMPENSATOR COMPRISING INCORPORATENING A HEMOSTATIC AGENT", filed on June 25, 2012, U.S. Patent Application No. 13/531, No. 623, entitled "TISSUE STARPERS INFORMATION AGENT", U.S. Patent Application No. 13 / 531,627, filed on June 25, 2012, entitled "TISSUE AVIT GAN ANTI-MICROBIAL AGENT "and U.S. Patent Application No. 13 / 531,630, filed on June 25, 2012, entitled" TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORING AN ANTAGENTIER, also refer to INFOMATTER INFORMATION. Incorporated herein.

  In the illustrated embodiment, staple cartridge 5320 extends upward from deck 5330 adjacent each staple cavity 5332 in various manners and arrangements as described in detail in U.S. Patent Application No. 14 / 318,991. Includes a protrusion 5336. In other embodiments, the staple cartridge does not have such protrusions. In the illustrated embodiment, buttress member 5500 includes a hole 5502 corresponding to protrusion 5336 therein. See, for example, FIGS. However, as can be seen in those figures, holes 5502 only accommodate protrusions 5336 so that the buttress material straddles the area corresponding to at least each portion of the crown of the staple supported within the cavity. Those portions of buttress material corresponding to the staple crown are generally identified as 5504 in FIGS.

  The buttress member 5500 may be held in tension prior to activation of the surgical instrument, and then released from the cartridge body 5322 when the surgical instrument is actuated, ie, “fired”. And means for releasably securing buttress member 5500 to cartridge body 5322. For example, as seen in FIG. 58, buttress member 5500 includes a distal end 5503 having at least one distal retention feature 5506 therein. In the illustrated arrangement, two distal holes 5506 are provided at the distal end 5503 and are configured to receive corresponding retaining members 5338 projecting from the distal end 5326 of the cartridge body 5322. As shown in FIGS. 59 and 60, a retaining member 5338 may extend distally of distal end portion 5503 of buttress member 5500 to releasably retain the distal end of buttress member 5500 to distal end portion 5326 of cartridge 5320. It is configured to be received in the bore 5506. Other forms of releasable retaining members (shape, number, size, configuration) and arrangements also allow the buttress member 5500 to be attached to the staple cartridge 5320 when tension is applied to the buttress member 5500 in a proximal and / or distal direction. Can be used to hold releasably.

  Referring to FIGS. 63-65, buttress member 5500 includes a proximal end portion 5510 having a proximal retention feature 5511 thereon. In the illustrated embodiment, the proximal retention mechanism 5511 includes at least one retention tab 5512 protruding proximally therefrom. The retention tab 5512 is such that when the hole 5506 is inserted into the cartridge body 5322 above the retention member 5338 and the buttress member 5500 is received in the cartridge deck 5330, the retention tab 5512 is aligned with the elongated slot 5334 in the cartridge body 5322. Located in. See FIG. 64. The retention tab 5512 is folded over the proximal end of the cartridge body by the staple sled 5350 and is retained in the elongated slot 5334 when the staple sled 5350 is in the proximal starting position within the cartridge 5320. The staple thread 5350 may be of the type and construction disclosed in U.S. Patent No. 14 / 318,991, wherein the staple thread 5350 stabilizes the thread 5350, prevents rocking or rotation of the staple thread 5350, and / or Includes a stabilizing member 5352 extending distally for obstruction. As can be seen in FIG. 65, retention tab 5512 is retained within elongated slot 5534 by stabilizing member 5352 and / or other portions of staple thread 5350. Such an arrangement serves to hold buttress member 5500 on staple deck 5330 under tension. In other words, buttress member 5500 can be extended between retaining member 5338 and proximal end 5328 of staple cartridge 5320. When the clinician has actuated the surgical instrument to begin the firing process, firing member 5410 is advanced distally in distal direction "DD". Firing member 5410 interlocks with staple thread 5350 and firing member 5410 causes staple thread 5350 to move distally through staple cartridge 5320, as discussed in U.S. Patent Application No. 14 / 318,991. , Driving the staple driver 5340 upwardly, the staple 5342 supported thereon is driven to form contact with the lower side 5366 of the anvil 5360 and is clamped between the anvil 5360 and the staple cartridge 5320. The tissue is cut by cutting member 5410. Once the staple sled 5350 has moved out of engagement with the retention tab 5512, the retention tab 5512 can be released and release the buttress material 5500 with the stapled tissue from the staple cartridge 5320. Such an arrangement serves to release the tension of the buttress material 5500 at the start of the firing process. Further, with such a buttress arrangement, no additional release parts or configurations are required.

Existing stapling techniques are not particularly suitable for use with tissue that undergoes stretching during the healing process. For example, in thoracic parenchyma stapling, staple lines are fired into the lungs in a collapsed configuration. After the procedure is completed, the lungs inflate, which often results in doubling of the lung surface area. Existing stapling techniques generally do not have the ability to stretch as much as lung tissue. This can result in a dramatic strain gradient in the immediate vicinity of the staple line, which can result in high stresses within the staple line, especially in the row of staples farthest from the cut. Accordingly, there is a need for a technique that allows staple lines to be stretched and / or increased in length to remove strain gradients and associated stresses to eliminate or at least reduce potential sources of leaks. Do
The adjuvant film / buttress material has been shown to improve hemostasis and pneumostasis by sealing around the staple tip. In many applications, buttress materials are used to harden and / or reinforce soft tissue. However, existing buttress materials may not be sufficiently elastic so as not to hinder the flexibility of the elastic staple wire. FIGS. 66-68 illustrate one form of buttress material 6100 that can address such issues. As seen in those figures, buttress material 6100 includes a buttress body 6102 sized to be operably received on a deck 6004 of a surgical staple cartridge 6000. In the illustrated embodiment, the surgical staple cartridge 6000 includes a cartridge body 6002 that defines a deck 6004. The cartridge body 6002 includes a centrally located elongated slot 6006 configured to receive a tissue cutting member (not shown) therethrough. A plurality of staple pockets, or staple cavities, are provided in deck 6004 on each side of elongated slot 6006. As shown, a first cavity 6012 of a first row 6010 is provided on each side of an elongated slot 6006. The first cavities 6012 in each first row 6010 are parallel to each other. Each of the first cavities 6012 is disposed at an angle to and adjacent to the elongate slot 6006. The illustrated cartridge body 6002 further includes two rows 6020 of second staple cavities 6022 that are disposed at an angle to the first staple cavities 6012. Two rows 6030 of third staple cavities 6032 are also provided within the cartridge body 6002 as shown. In at least one form, a third staple cavity 6032 is parallel to a corresponding first staple cavity 6012. However, other staple or fastener cavity arrangements can be used. Further, staple cartridge body 6002 can have a lateral ledge 6008 that projects laterally therefrom. As can also be seen in FIG. 66, the proximal end 6003 of the cartridge body 6002 is narrower than the rest of the cartridge body 6002.

  In the illustrated embodiment, buttress body 6102 includes four edges 6110, 6140, 6150, 6160, and a central portion 6152. At least two of the edges 6110, 6140, 6150, 6160 include various edge notch configurations. In the illustrated embodiment, the edges 6110, 6160 include an edge notch therein. More specifically, as can be seen in FIG. 67, a first plurality of first edge notches 6114 are formed in the first portion 6112 of the first edge 6110. In the illustrated embodiment, the first edge notches 6114 extend inward from the first edge portion 6112 at a first acute angle 6115 (“notch angle”) and are parallel to each other. As further seen in FIGS. 66 and 67, a second edge notch 6118 extends inward from the second portion 6116 of the first edge portion 6112. In one arrangement, for example, the second edge notch 6118 extends vertically ("notch angle") inward from the second portion 6116. As further seen in FIGS. 66 and 67, a third edge notch 6122 extends inward from the third portion 6120 of the first edge portion 6110. In one arrangement, for example, the third edge notch 6122 extends vertically ("notch angle") inward from the third portion 6120. As further seen in FIGS. 66 and 67, a fourth edge notch 6126 extends inward from the fourth portion 6124 of the first edge portion 6110. In one arrangement, for example, fourth edge notch 6126 extends inwardly from fourth portion 6124 at an acute angle (“notch angle”). As further seen in FIGS. 66 and 67, a fifth edge notch 6130 extends inward from the fifth portion 6128 of the first edge portion 6110. In one arrangement, for example, fifth edge notch 6130 extends inwardly from fifth portion 6128 at an acute angle (“notch angle”).

  Still referring to FIGS. 66 and 67, a series of primary edge notches 6164 extend inward from the primary portion 6162 of the second edge portion 6160. In the illustrated arrangement, primary edge notch 6164 extends vertically (“notch angle”) inward from primary edge portion 6162. As further seen in FIGS. 66 and 67, a secondary edge notch 6168 extends inward from the secondary portion 6166 of the second edge 6160. In one arrangement, for example, secondary edge notch 6168 extends inwardly from secondary edge portion 6166 at an acute angle ("notch angle"). As further seen in FIGS. 66 and 67, a tertiary edge notch 6172 extends inward from the next portion 6170 of the second edge 6160. In one arrangement, for example, the next edge notch 6172 extends inwardly from the next portion 6170 at an acute angle (“notch angle”). As further seen in FIGS. 66 and 67, a quaternary edge notch 6176 extends inward from the quaternary portion 6174 of the second edge 6160. In one arrangement, for example, a quaternary edge notch 6176 extends vertically (“notch angle”) inward from the quaternary portion 6174. As further seen in FIGS. 66 and 67, a fifth edge notch 6180 extends inward from the fifth portion 6178 of the second edge portion 6160. In one arrangement, for example, a quintic edge notch 6180 extends inward from the quintic portion 6178 vertically (“notch angle”).

  The buttress material 6100 illustrated in FIGS. 66 and 67 also has five different widths, W1, W2, W3, W4, W5, along the entire length of the buttress 6100. W1 corresponds to the edge portions 6112, 6162. W2 corresponds to the edge portions 6116, 6166. W3 corresponds to the edge portions 6120, 6170. W4 corresponds to the edge portions 6124, 6174. W5 corresponds to the edge portions 6128, 6178. Other buttress material embodiments may have a fixed width or a different number of widths to facilitate operative support of the surgical stapling instrument on the staple cartridge and / or anvil. Further, the number, shape, size, and arrangement of the edge notches can vary from embodiment to embodiment.

  In the embodiment shown in FIGS. 66 and 67, buttress material 6100 includes a plurality of cutout openings therein. As can be seen in those figures, the cutouts are arranged in parallel rows. In particular, the cutouts 6204 in rows 6200 include slits that are positioned at an angle to the edge portions such that the cutouts 6204 in each row 6200 are parallel to one another. Cutout 6204 may or may not extend completely through buttress material 6100. Similarly, cutout 6206 in row 6202 comprises a transverse slit perpendicular to the edge portion of buttress material 6100. Cutout 6206 may or may not extend completely through buttress material 6100. In other embodiments, the number, shape, size, orientation, spacing, depth, and location of such cutouts can vary.

  FIG. 68 illustrates one cutout arrangement, with staple cavity locations 6012, 6022, and 6032 indicated by dashed lines. As can be seen, any portion of any of the cutouts 6204, 6206 can be removed from the staple cavities 6012, 6022, 6032 when the buttress material 6100 is aligned and positioned on the deck 6004 of the surgical staple cartridge 6000. It is not positioned above any one. FIG. 69 illustrates a similar buttress material arrangement, with staple cavities 6012, 6022, and 6032 indicated by dashed lines. The portion 6103 of the buttress material 6100 'where the staple / fastener legs will eventually penetrate is also shown in dashed lines. Portion 6103 may also be referred to herein as a "staple penetration zone." As can be seen, no portion of any of the cutouts 6208, 6209 is located above the staple penetration zone 6103. Cutouts 6208 and 6209 are located in a longitudinal row of buttress material 6100 '. The cutouts 6208 in each row are substantially parallel to one another and are positioned at an acute angle to the edge of the buttress material 6100 '. Similarly, the cutouts 6209 in each row are arranged substantially parallel to one another and the cutouts 6209 are perpendicular to the cutouts 6208 in the adjacent row. Cutout 6208 may or may not extend completely through buttress material 6100 '. As can also be seen in FIG. 69, one entire row of cutouts 6208 is positioned between the fastener cavity 6032 and the location of the buttress material 6100 'edge to facilitate further flexibility of the buttress material 6100'. I do. As in other embodiments, the number, shape, size, orientation, spacing, depth, and location of such cutouts can vary.

  FIG. 70 shows another buttress member embodiment 6100 ''. In this embodiment, the buttress material includes a plurality of edge notches 6300 that include undulating wavy curves that form a meandering edge. Such edge notches / serpentine edges allow for staple rotation while reducing material stress during elongation.

  FIGS. 71 and 72 illustrate another buttress member 6400 made from a woven material that may or may not be bioabsorbable. Further, the buttress material may include any of the buttress materials described herein, including the unique and novel attributes described below. For example, buttress member 6400 may be a correspondingly shaped portion (eg, a strut) of a surgical staple cartridge or anvil to support buttress member 6400 in a desired orientation / alignment with respect to the staples / fasteners in the staple cartridge. , Projections, etc.), and holes or openings 6402 therethrough. In the illustrated arrangement, the buttress member 6400 includes a plurality of buttress members 6400 internally positioned for alignment with the corresponding 6012, 6022, 6032 fastener cavities in the surgical staple cartridge when supported on the cartridge deck. Staple zones 6404, 6406, 6408. The staple zone may be formed by compressing and heating the material to cause the material to assume a compressed state permanently. As seen in FIG. 72, the compressed staple area (generally represented as 6410) has a smaller cross-sectional thickness than the adjacent uncompressed portion of the buttress member 6400 (generally represented as 6412). Further, buttress member 6400 can have linear edges 6420, 6422, 6424 and / or serpentine edges 6426. The buttress member may have a shape that matches the shape of the surgical staple cartridge and / or anvil of the surgical instrument.

  All of the buttress member embodiments described above may be used on a surgical staple cartridge deck or in conjunction with a surgical stapling device anvil. All of the buttress members may have a shape that matches the shape of the surgical staple cartridge and / or anvil, and may have straight or linear edges or edge portions, and / or wavy, saw, and / or It may have a serpentine edge, or a combination of such edge configurations. The buttress member may have a constant width or may have multiple widths. The cutout through the buttress material removes excess material to promote or enable buttress deformation, twisting, etc., with less stress through the buttress material during longitudinal extension. In other words, the cutout allows the buttress to "accordion" just as the staples themselves are moving. The serpentine or irregular edges allow for staple rotation while at the same time reducing the stress of the material during stretching. The buttress configuration described above comprises a "softened structure" that allows for increased extensibility, while still sealing the relevant area. Further, the buttress member described above does not only suppress staple twist, but also allows the staples and adjunct (buttress) to move as well when stretched. Such buttress member arrangements include buttress members that inherently have regions of varying mechanical behavior that allow for optimal performance of the staple wire.

  73-78 illustrate another staple cartridge 6500 that is similar in construction to the staple cartridge 6000 described above, except that the staple cartridge 6500 additionally includes a plurality of protrusions. In the illustrated embodiment, the surgical staple cartridge 6500 includes a cartridge body 6502 defining a deck 6504. The cartridge body 6502 includes a centrally located elongated slot 6506 mounted within the bottom tray 6524 and configured to receive a tissue cutting member (not shown) therethrough. A plurality of staple pockets, or staple cavities, are provided in the deck 6504 on each side of the elongated slot 6506. As shown, a first cavity 6512 of a first row 6510 is provided on each side of the elongated slot 6506. The first cavities 6512 in each first row 6510 are parallel to each other. Each of the first cavities 6512 is disposed at an angle to and adjacent to the elongated slot 6506. The illustrated cartridge body 6502 further includes two rows 6520 of second staple cavities 6522 disposed at an angle with respect to the first staple cavities 6512. A third staple cavity 6532 of two rows 6530 is also provided in the cartridge body as shown. In at least one form, a third staple cavity 6532 is parallel to a corresponding first staple cavity 6512. The cartridge body 6502 further has two longitudinal sides 6508.

  The cartridge body 6502 can further include a plurality of protrusions 6550 extending from the deck surface 6504. The protrusion 6550 can be configured to engage tissue positioned intermediate the anvil 5360 and the cartridge 6500 and control movement of the tissue relative to the cartridge 6500. The tissue can move relative to the cartridge 6500 in various instances. In at least one instance, the tissue can flow relative to the cartridge 6500 when the anvil is moved between an open position and a closed position where the tissue is squeezed between the anvil and the cartridge 6500. . In such instances, tissue may flow laterally toward the longitudinal side 6508, distally toward the distal end 6503, and / or proximally toward the proximal end 6505. In at least one other instance, the tissue can flow relative to the cartridge 6500 as the cutting member is advanced distally through the captured tissue between the anvil and the cartridge 6500. In such instances, the tissue may flow laterally, distally, and / or proximally, but mainly distally due to distal movement of the cutting edge. In various examples, the protrusion 6550 can be configured to limit or prevent tissue flow to the staple cartridge. The protrusion 6550 can be positioned at the proximal and / or distal ends of the staple cavities 6512, 6522, 6532. In various examples, each protrusion 6550 can include a cuff extending around an end of a corresponding staple cavity 6512, 6522, and 6532. In certain instances, each protrusion 6550 can include an arcuate ridge extending around the end of a corresponding staple cavity 6512, 6522, and 6532.

  76-78 illustrate a cartridge arrangement including a protrusion 6550. FIGS. The cartridge arrangement shown in FIGS. 73-75 is similar to the cartridge of FIGS. 76-78, but also includes a row of protrusion posts 6560 formed on deck surface 6504. In the arrangement of FIGS. 73-75, for example, a protrusion post 6560 is provided between each staple cavity 6512, 6522, and 6532 in each row of staple cavities. The protrusion posts 6560 serve to further control tissue flow during the clamping and reflex process.

  Referring primarily to FIG. 73, cartridge body 6502 includes a ramp transition 6570 extending between the distal tip of cartridge body 6502 and deck surface 6504. Inclined transition 6570 facilitates movement of cartridge 6500 relative to tissue when positioning cartridge 6500 and anvil within a surgical site. In such instances, the tissue may slide on the inclined surface 6570. In another arrangement, the inclined surface 6570 comprises an R-plane. In the illustrated arrangement, sloped surface 6570 comprises an angled surface. In still other arrangements, the inclined surface 6570 comprises a concave surface and / or a convex surface.

  Staple cavities 6512, 6522, and 6532 defined in the cartridge body 6502 are disposed in longitudinal rows on each side of the longitudinal slots 6506. Each protrusion 6550 can be configured to support at least a portion of a staple 6542 removably stored in staple cavities 6512, 6522, and 6532. In various instances, each protrusion 6550 can extend end walls 6513, 6515 of staple cavities 6512, 6522, and 6532 above deck 6504. In certain instances, referring generally to FIG. 78, a staple 6542 positioned within a staple cavity 6512, 6522, 6532 includes a base 6543, a first leg extending from the base 6543 at a first angle. 6545 and a second leg 6547 extending from the base 6543 at a second angle. The first leg 6545 can contact the first end wall 6513 of the staple cavity 6532 and the second leg 6547 can contact the second end wall 6515 of the staple cavity 6512, 6522, 6532. be able to. In certain instances, the distance, or spread, between the first leg 6545 and the second leg 6547 of the staple 6542 is such that when the stable 6542 is positioned within the staple cavities 6512, 6522, 6532, The distance between the end walls 6513, 6515 may be wider such that the legs 6545, 6547 are biased inward by the end walls 6513, 6515. When the staples 6542 are stored in the staple cavities 6512, 6522, 6532 in the unfired or non-raised position, the tips of the staple legs 6545, 6547 may be positioned within the protrusions 6550. In such an example, the protrusion 6550 can support and protect the tips of the staple legs 6545, 6547 above the deck 6504. In some instances, the tips of the staple legs 6545, 6547 may be positioned below the protrusion 6550 when the staple 6542 is in its unfired position, and thus the protrusion 6550 may be positioned on the stable 6542. In some cases, the distal ends of the staple legs 6545 and 6547 are not supported when in the unfired position. When such a staple 6542 is fired or lifted from the staple cavities 6512, 6522, 6532, the staple legs 6545, 6547 may then contact and be supported by the protrusion 6550. In any case, the protrusion 6550 causes the staple 6542 to fire sufficiently from the staple cavities 6512, 6522, 6532 such that when the staple 6542 is deployed, the staple legs 6545, 6547 no longer contact the protrusion 6550. The staple legs 6545, 6547 may continue to be supported until lifted.

  For example, the layers can be made from any biocompatible material, such as a buttress material. The buttress material may be formed from natural and / or synthetic materials. The buttress material can 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 buttress materials may be made include, for example, poly (lactic acid), poly (glycolic acid), poly (hydroxybutyrate), poly (azine phosphate), polyester, polyethylene glycol , Polyethylene oxide, polyacrylamide, polyhydroxyethyl methyl acrylate, polyvinylpyrrolidone, polyvinyl alcohol, polyacrylic acid, polyacetate, polycaprolactone, polypropylene, aliphatic polyester, glycerol, poly (amino acid), copoly (ether ester), polyalkylene Oxalates, polyamides, poly (imino carbonates), polyalkylene oxalates, polyoxaesters, polyorthoesters, polyphosphazenes and copolymers, block copolymers, homopolymers, Rend and / or combinations include, but are not limited to.

  Natural biopolymers can be used in forming the buttress material. Suitable natural biological polymers include, for example, collagen, gelatin, fibrin, fibrinogen, elastin, keratin, albumin, hydroxyethyl cellulose, cellulose, oxidized cellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethyl cellulose, chitin, chitosan, And / or combinations thereof, but are not limited thereto. Natural biopolymers can be combined with any of the other polymeric materials described herein to produce a buttress material. Collagen of human and / or animal origin, such as porcine type I or bovine collagen, human type I or type III human collagen, can be used to form the buttress material. The buttress material can be made from denatured collagen, that is, collagen that has at least partially lost its helical structure, for example, by heating or any other method, consisting primarily of non-hydrated chains of molecular weight close to 100 kDa. The term "denatured collagen" refers to collagen that has lost its helical structure. The collagen used in the porous layer as described herein may be natural collagen or, in particular, as obtained, for example, through pepsin digestion and / or after moderate heating as defined above. It may be atelocollagen. Collagen may have been 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 yarns suitable for knitting or weaving, or may be staple fibers, such as those often used to make nonwoven materials. The fibers can be made from any biocompatible material. Fibers can be made from natural or synthetic materials. The material from which the fibers are formed can be bioabsorbable or non-bioabsorbable. It should be understood 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 the fibers can be made include, for example, poly (lactic acid), poly (glycolic acid), poly (hydroxybutyrate), poly (azine phosphate), polyester, polyethylene glycol, Polyethylene oxide, polyacrylamide, polyhydroxyethyl methyl acrylate, polyvinyl pyrrolidone, polyvinyl alcohol, polyacrylic acid, polyacetate, polycaprolactone, polypropylene, aliphatic polyester, glycerol, poly (amino acid), copoly (ether ester), polyalkylene oxa , Polyamides, poly (iminocarbonates), polyalkylene oxalates, polyoxaesters, polyorthoesters, polyphosphazenes and copolymers, block copolymers, homopolymers, their branes And / or combinations include, but are not limited to. If the buttress material is fibrous, the buttress material may be formed using any method suitable for forming a fibrous structure, including, but not limited to, knitting, weaving, non-woven techniques, and the like. If the buttress material is a foam, the porous layer is formed using any method suitable for forming a foam or spongy body, including, but not limited to, freeze-drying or freeze-drying the composition. Can be done.

  Buttress materials may have the property of congestion. Illustrative examples of materials that can be used in providing buttress material with the ability to help stop bleeding or major bleeding include, for example, 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, hydroxy Ethyl starch, hydroxyethyl cellulose, cellulose, oxidized cellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethyl cellulose, chitin, chitosan, agarose, maltose Maltodextrin, alginate, coagulation factor, methacrylate, polyurethane, cyanoacrylic acid, platelet agonist, vasoconstrictor, alum, calcium, RGD peptide, protein, protamine sulfate, epsilon aminocaproic acid, ferric sulfate, basic sulfate Ferric chloride, ferric chloride, zinc, zinc chloride, aluminum chloride, aluminum sulfate, aluminum acetate, permanganate, tannin, bone wax, polyethylene glycol, fucan, and / or combinations thereof, including Not limited. The use of natural biopolymers, and especially proteins, can be useful in forming buttress materials with the properties of congestion. For example, suitable natural biopolymers include, but are not limited to, collagen, gelatin, fibrin, fibrinogen, elastin, keratin, albumin, and / or combinations thereof. The natural biopolymer can be combined with any other hemostat to create a buttress 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 Hemosatic Device",
U.S. Patent No. 7,000,818, issued February 21, 2006, entitled "SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTING CLOSING AND FIRING SYSTEMS",
U.S. Patent No. 7,422,139, issued September 9, 2008, entitled "MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK",
U.S. Patent No. 7,464,849, issued December 16, 2008, entitled "Electro-Mechanical Surgical Installation With Close System And Anvil Aliment Components",
U.S. Pat. No. 7,670,334, issued Mar. 2, 2010, entitled "SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR",
U.S. Patent No. 7,753,245, issued July 13, 2010, entitled "SURGICAL STAPLING INSTRUMENTS",
US Patent No. 8,393,514 issued March 12, 2013, entitled "SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE",
U.S. Patent Application No. 11 / 343,803, entitled "SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES", currently U.S. Patent No. 7,845,537;
US patent application Ser. No. 12/031573, filed Feb. 14, 2008, entitled "SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES",
US patent application Ser. No. 12 / 031,873, filed Feb. 15, 2008, now US Pat. No. 7,980,443, entitled “END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT”;
U.S. Patent Application No. 12 / 235,782, currently U.S. Patent No. 8,210,411, entitled "MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT",
US patent application Ser. No. 12 / 249,117, currently US Pat. No. 8,608,045, entitled POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM,
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, now US Pat. No. 8,733,613, entitled "STAPLE CARTRIDGE",
US patent application Ser. No. 13 / 036,647, filed Feb. 28, 2011, now US Pat. No. 8,561,870, entitled “SURGICAL STAPLING INSTRUMENT”;
U.S. Patent Application Serial No. 13 / 118,241, currently U.S. Patent Application Publication No. 2012/0298719, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTABLE STAPLE DEPLOYMENT ARRANGEMENTS",
U.S. Patent Application No. 13 / 524,049, filed June 15, 2012, entitled "ARTICULABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE", now US Patent Application Publication No. 2013/03334278;
U.S. patent application Ser. No. 13 / 800,025, 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 January 31, 2006, entitled "SURGICAL CUTTING AND FASTENING INSTRUMENT WITH WITH CLOSURE TRIGGER LOCKING MECHANISM",
U.S. Patent Application Publication No. 2010/0264194, filed April 22, 2010, now U.S. Patent No. 8,308,040, entitled "SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATEABLE END EFFECTOR".

  Although various embodiments of the apparatus have been described herein in connection with the specific disclosed embodiments, many modifications and variations can be made to those embodiments. Also, while materials are disclosed with respect to particular components, other materials may be used. In addition, various embodiments allow a single component to be replaced by multiple components, and multiple components to 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. In any case, however, the device can be readjusted for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the apparatus, followed by steps of cleaning or replacing 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. Once certain parts have been cleaned and / or replaced, the device can be reassembled for later use, either at a reconditioning facility or by a surgical team immediately prior to the surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present invention.

  Preferably, the invention described herein will be processed before surgery. First, get new or used equipment and wash if necessary. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. Next, the containers and instruments are placed in a radiation field, such as gamma rays, X-rays, and high energy electrons, that can penetrate the containers. 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 a representative 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 from the present disclosure as if they were known or customary in the art to which this invention pertains.

  Any patents, publications, or other disclosures, which are, in whole or in part, incorporated herein by reference, may be incorporated by reference into existing definitions, descriptions, or other disclosures that may be incorporated into this disclosure. Is incorporated herein only to the extent that it does not conflict with the disclosure of As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting description incorporated herein by reference. Any references, or portions thereof, which are incorporated herein by reference, but which conflict with the existing definitions, descriptions, or other disclosures set forth herein, or portions thereof, are incorporated by reference. It shall be incorporated only to the extent that there is no inconsistency with the content.

(Embodiment)
(1) A fastener cartridge assembly for use with a circular surgical fastener, comprising:
A cartridge body including a circular deck,
A plurality of fastener cavities opening through the circular deck, each of the fastener cavities including two cavity ends, wherein the one cavity end of each of the fastener cavities is a first cavity end; And the other cavity end of each of the fastener cavities is positioned on a second circular axis having a second radius different from the first radius. And a plurality of fastener cavities positioned at the fastener cartridge assembly.
2. The fastener of claim 1, wherein the fastener cavities are arranged in a circular array, wherein the circular array includes at least one line of the fastener cavities arranged in a zigzag orientation. Cartridge assembly.
(3) the one cavity end of each of the fastener cavities and the other cavity end of each of the fastener cavities are V-shaped, terminating at a point, and defining one end of the one cavity end; The fastener cartridge of claim 1, wherein the point is positioned on the first circular axis and the point on the other cavity end is positioned on the second circular axis. assembly.
(4) further comprising another plurality of other fastener cavities opening through the circular deck, each of the other fastener cavities including a third radius different from the first and second radii. The fastener cartridge assembly of claim 1, wherein the fastener cartridge assembly is aligned on a third circular axis.
(5) further comprising another plurality of other fastener cavities opening through the circular deck, each of the other fastener cavities including a third radius different from the first and second radii. The fastener cartridge assembly of claim 1, wherein the fastener cartridge assembly is aligned on a third circular axis.

The fastener cartridge assembly according to claim 5, wherein each of the other fastener cavities is aligned on one of the first circular axis and the second circular axis.
(7) The fastener cartridge assembly of embodiment 4, wherein each of the other fastener cavities includes another size that is different from a size of each of the fastener cavities.
The fastener cartridge assembly according to claim 1, wherein each fastener cavity supports at least one surgical fastener therein.
The fastener cartridge assembly of claim 2, wherein each fastener cavity supports at least one surgical fastener therein.
(10) An embodiment wherein each of the fastener cavities internally supports at least one surgical fastener and each of the other fastener cavities internally supports at least one other surgical fastener. A fastener cartridge assembly according to aspect 4.

Aspect 11. The method of embodiment 10, wherein each of the surgical fasteners has a fastener size and each of the other surgical fasteners has another fastener size different from the fastener size. Fastener cartridge assembly.
(12) A fastener cartridge assembly for use with a circular surgical fastener, comprising:
A cartridge body including a circular deck,
A plurality of fastener cavities opening through the circular deck, arranged in a circular array, wherein the circular array includes at least one line of the fastener cavities arranged in a zigzag orientation; A plurality of fastener cavities.
13. The apparatus of claim 12, further comprising another plurality of other fastener cavities opening through the circular deck, each of the other fastener cavities being aligned on a circular axis. Fastener cartridge assembly.
14. The fastener cartridge assembly of claim 12, wherein each of the fastener cavities supports at least one surgical fastener therein.
(15) An embodiment wherein each of the fastener cavities internally supports at least one surgical fastener and each of the other fastener cavities internally supports at least one other surgical fastener. 14. The fastener cartridge assembly according to aspect 13.

(16) each of the surgical fasteners has a surgical fastener size, and each of the other surgical fasteners has another surgical fastener size different from the surgical fastener size; 17. The fastener cartridge assembly according to embodiment 15.
(17) A fastener cartridge assembly for use with a circular surgical fastener, comprising:
A circular cartridge body,
A plurality of surgical fasteners operably supported within the circular cartridge body;
When the firing motion is applied, the plurality of surgical fasteners are driven out of the circular cartridge body in a circular array such that the surgical fasteners are oriented relative to one another in a zigzag orientation. Means for guiding the plurality of surgical fasteners while in the circular cartridge body.
(18) The plurality of surgical fasteners includes a first plurality of surgical fasteners and a second plurality of surgical fasteners, wherein the means for guiding is configured to be activated when a firing motion is applied. The first plurality of surgical fasteners are driven out of the circular cartridge body in a circular array, and the first plurality of surgical fasteners are oriented relative to one another in a zigzag orientation. Guiding the first plurality of surgical fasteners while in the circular cartridge body such that the second plurality of surgical fasteners are oriented in another circular array. 18. The fastener cartridge assembly according to embodiment 17, wherein the fastener cartridge assembly is configured to:
(19) each of the surgical fasteners of the first plurality of surgical fasteners has a first fastener size, and each of the surgical fasteners of the second plurality of surgical fasteners has a first fastener size; 19. The fastener cartridge assembly according to claim 18, wherein each has a second fastener size different from the first fastener size.
(20) A fastener cartridge assembly for use with a circular surgical fastener, comprising:
A circular cartridge body,
A plurality of surgical fasteners operably supported within the circular cartridge body, each of the surgical fasteners including a pair of fastener legs;
When a firing motion is applied, the plurality of surgical fasteners are driven out of the circular cartridge body in a circular array, and one leg of each of the surgical fasteners is moved to a first radius. And the other leg of each of the surgical fasteners extends through a second circular axis having a second radius different from the first radius. Means for guiding the plurality of surgical fasteners while in the circular cartridge body so as to extend the fastener cartridge assembly.

Claims (9)

A fastener cartridge assembly for use with a circular surgical fastener, comprising:
A cartridge body including a circular deck,
A first plurality of fasteners opening cavity through the circular deck, respectively that of the first plurality of fasteners cavity comprises two hollow end portions, said first plurality of fastening hollow end of each hand of the sushi cavity is positioned on a first circular axis having a first radius, the cavity end of each of the other sides of the first plurality of fasteners cavity, A first plurality of fastener cavities positioned on a second circular axis having a second radius different from the first radius;
E Bei and a second plurality of fasteners opening cavity through the circular deck,
The first plurality of fastener cavities are arranged in a circular array, the circular array including at least one line of the first plurality of fastener cavities arranged in a zigzag orientation;
A fastener cartridge assembly , wherein each of the second plurality of fastener cavities is aligned on a third circular axis including a third radius different from the first and second radii . The one cavity end of each of the first plurality of fastener cavities and the other cavity end of each of the first plurality of fastener cavities are V-shaped and terminate at a point; The point of the one cavity end is positioned on the first circular axis and the point of the other cavity end is positioned on the second circular axis. The fastener cartridge assembly of claim 1. Wherein their respective the first plurality of fasteners cavity and supported within at least one surgical fastener, the fastener cartridge assembly according to claim 1. Before SL each of the second plurality of fasteners cavity and supported within at least one outer family fastener, the fastener cartridge assembly according to claim 1. A fastener cartridge assembly for use with a circular surgical fastener, comprising:
A cartridge body including a circular deck,
A first plurality of fasteners opening cavity through the circular deck, arranged in a circular array, said circular array, said first plurality of fasteners cavity arranged in the orientation of the zigzag of at least one line, a first plurality of fasteners cavity,
A second plurality of fastener cavities opening through the circular deck, each of the second plurality of fastener cavities being aligned on a circular axis having a different radius than the circular array. A second plurality of fastener cavities . Wherein their respective the first plurality of fasteners cavity and supported within at least one surgical fastener, the fastener cartridge assembly of claim 5. Before SL each of the second plurality of fasteners cavity and supported within at least one outer family fastener, the fastener cartridge assembly of claim 5. A fastener cartridge assembly for use with a circular surgical fastener, comprising:
A circular cartridge body,
A first plurality of surgical fasteners and a second plurality of surgical fasteners operably supported within the circular cartridge body;
When firing motion is applied, said first plurality of surgical fasteners, the orientation of the circular cartridge body in a circular array are driven out, the first plurality of surgical fastener zigzag And the second plurality of surgical fasteners are driven out of the circular cartridge body so that the second plurality of surgical fasteners are Guiding the first plurality of surgical fasteners and the second plurality of surgical fasteners while in the circular cartridge body such that they are aligned on a circular axis having a different radius from Fastener cartridge assembly. A fastener cartridge assembly for use with a circular surgical fastener, comprising:
A circular cartridge body,
A first plurality of surgical fasteners and the second plurality of surgical fasteners that are operatively supported within said circular cartridge body, respectively that of the first plurality of surgical fasteners A first plurality of surgical fasteners and a second plurality of surgical fasteners, including a pair of fastener legs;
When firing motion is applied, said first plurality of surgical fasteners from said circular cartridge body shaped circular array is driven out, one of each of said first plurality of surgical fasteners legs are through the first circular axis having a first radius extending legs of each of the other side of said first plurality of surgical fasteners, said first radius through the second circular axis with different second radius extend, and said second plurality of surgical fasteners from said circular cartridge body is driven out and the second The first and second surgical fasteners are positioned within the circular cartridge body such that the plurality of surgical fasteners are aligned on a third circular axis that includes a third radius different from the first and second radii . hand for guiding one of the plurality of surgical fasteners and the second plurality of surgical fasteners Comprises, when the fastener cartridge assembly.

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