JP6874181B2 - Surgical staples - Google Patents

Description

The present invention presents with surgical instruments and surgical cutting and fastening instruments designed for cutting and fastening tissue in various arrangements, fastener cartridges for that purpose, and surgical fastenings designed for use therein. Regarding ingredients.

Surgical staplers are often used to deploy staples into soft tissue to reduce or eliminate bleeding from soft tissue, for example, especially when tissue is traversed. Surgical staplers, such as end cutters, can include end effectors that can be moved, or jointly flexed, relative to an elongated shaft assembly. The end effector is often configured to secure the soft tissue between the first jaw member and the second jaw member, and the first jaw member is a staple cartridge configured to retract the staples in a removable manner. In many cases, the second jaw member often includes an anvil. Such surgical staples can include a closure system for pivoting the anvil with respect to the staple cartridge.

As outlined above, surgical staplers can be configured to pivot the end effector anvil with respect to the staple cartridge to capture soft tissue between them. In various cases, the anvil may be configured to apply a clamping force to the soft tissue in order to hold the soft tissue firmly between the anvil and the staple cartridge. However, if the surgeon is not satisfied with the position of the end effector, the surgeon generally activates the release mechanism of the surgical stapler to pivot the anvil to the open position and then reposition the end effector. There must be. The staples are then normally unwound from the staple cartridge by threads, which traverse the channels within the staple cartridge, deforming the staples relative to the anvil and anchoring multiple layers of soft tissue together. The thread may engage with a screwdriver located between the staple and the staple to deploy the staple from the staple cartridge. As is often known in the art, staples are developed in the form of multiple staple lines, or rows, in order to more accurately secure multiple layers of tissue together. Staples are usually transformed into a "B" by the end effector anvil. The end effector may also include cutting members such as knives that advance between multiple rows of staples to staple multiple layers of soft tissue together and then ablate the soft tissue.

Such surgical staplers and end effectors may be sized and configured for insertion into body cavities through trocars or other access openings. The end effector is typically connected to an elongated shaft sized to penetrate the trocar or opening. The elongated shaft assembly is often operably connected to a handle that supports a control system and / or trigger that controls the operation of the end effector. To facilitate proper positioning and orientation of the end effector within the body, many surgical instruments are configured to facilitate joint flexion of the end effector with respect to a portion of the elongated shaft.

The above discussion is intended only to explain various aspects of the art in the field of the invention at the time and should not be regarded as denying the claims.

The features and advantages of the present invention and the methods for realizing them will be clarified by referring to the following description of the embodiments of the present invention together with the accompanying drawings, and a deeper understanding of the invention itself can be obtained. Will.
FIG. 3 is a perspective view of a surgical instrument according to various embodiments of the present disclosure. FIG. 3 is an exploded perspective view of the handle assembly of the surgical instrument of FIG. 1 according to various embodiments of the present disclosure. It is an exploded perspective view of the end effector of the surgical instrument of FIG. 1 according to various embodiments of the present disclosure. FIG. 3 is a perspective view of a staple cartridge of the end effector of FIG. 3 according to various embodiments of the present disclosure. FIG. 5 is a cross-sectional perspective view of the staple cartridge of FIG. 4 along the plane shown in FIG. 4 according to various embodiments of the present disclosure. FIG. 3 is a perspective view of the staples shown in the staple cartridge of FIG. 4 according to various embodiments of the present disclosure. It is a front view of the staple of FIG. It is a rear view of the staple of FIG. It is a top view of the staple of FIG. It is a bottom view of the staple of FIG. It is a right side view of the staple of FIG. It is a left side view of the staple of FIG. It is a perspective view of the staple of FIG. It is an elevational view of the thread of the staple of FIG. 6 and the end effector of FIG. 3 showing the tip surface of the thread in contact with the initial drive surface of the staple according to various embodiments of the present disclosure. FIG. 4 is a perspective view of the staple and the thread of FIG. 14, showing the tip surface of the thread in contact with the initial drive surface of the staple. FIG. 14 is an elevational view of the staples and threads of FIG. 14 showing the rear end faces of the threads in contact with the secondary drive surfaces of the staples according to various embodiments of the present disclosure. FIG. 4 is a perspective view of the staple and the thread of FIG. 14, showing the rear end surface of the thread in contact with the secondary drive surface of the staple. FIG. 3 is a cross-sectional elevation view of the end effector of FIG. 3 showing the progress of firing staples from a staple cartridge according to various embodiments of the present disclosure. FIG. 3 is a cross-sectional elevation view of the end effector of FIG. 3 showing the progress of firing staples from a staple cartridge according to various embodiments of the present disclosure. FIG. 3 is a cross-sectional elevation view of the end effector of FIG. 3 showing the progress of firing staples from a staple cartridge according to various embodiments of the present disclosure. FIG. 3 is a cross-sectional elevation view of the end effector of FIG. 3 showing the progress of firing staples from a staple cartridge according to various embodiments of the present disclosure. FIG. 3 is a cross-sectional elevation view of the staple cartridge and thread of FIG. 3 showing staples in unlaunched positions according to various embodiments of the present disclosure. FIG. 22 is a cross-sectional perspective view of the cartridge and thread of FIG. 22, showing staples in the unlaunched position shown in FIG. FIG. 22 is a cross-sectional elevation view of the cartridge and thread of FIG. 22 showing a pair of proximal staples in a partially fired position and the remaining staples in a non-launched position according to various embodiments of the present disclosure. FIG. 24 is a cross-sectional perspective view of the cartridge and thread of FIG. 22 showing a pair of proximal staples in the partially fired position shown in FIG. 24 and the remaining staples in the unfired position shown in FIG. 24. FIG. 22 is a cross-sectional elevation view of the cartridge and thread of FIG. 22 showing a plurality of staple pairs in partial firing positions and proximal staple pairs in a partially deformed configuration according to various embodiments of the present disclosure. FIG. 22 is a cross-sectional perspective view of the cartridge and thread of FIG. 22 showing a plurality of staple pairs at the partial firing position of FIG. 26 and a pair of staples proximal to the partially deformed configuration shown in FIG. FIG. 22 is a cross-sectional elevation view of the cartridge and thread of FIG. 22 showing a plurality of staple pairs in additional firing positions and proximal staple pairs in a further modified configuration according to various embodiments of the present disclosure. FIG. 22 is a cross-sectional perspective view of the cartridge and thread of FIG. 22 showing a plurality of staple pairs at the partial firing position shown in FIG. 28 and a pair of staples proximal to the partially deformed configuration shown in FIG. 28. Cross section of the cartridge and thread of FIG. 22 showing a plurality of staple pairs in a partially deformed configuration and a plurality of staple pairs in a partially deformed configuration and proximal staple pairs in a fully deformed configuration according to various embodiments of the present disclosure. It is an elevation view. Of the cartridges and threads of FIG. 22, which are in the partial firing position shown in FIG. 30 and show a plurality of staple pairs in a partially deformed configuration and in the ejection position shown in FIG. 30 and show a proximal staple pair in a fully deformed configuration. It is a cross-sectional perspective view. Methods for forming staples from material sheets according to various embodiments of the present disclosure are shown. Methods for forming staples from material sheets according to various embodiments of the present disclosure are shown. Methods for forming staples from material sheets according to various embodiments of the present disclosure are shown. FIG. 3 is a perspective view of staples formed from the methods shown in FIGS. 32A-32C according to various embodiments of the present disclosure. It is a top view of the staple of FIG. 33. It is a front view of the staple of FIG. 33. It is a side view of the staple of FIG. 33. FIG. 3 is a perspective view of staples according to various embodiments of the present disclosure. It is a top view of the staple of FIG. 37. It is a front view of the staple of FIG. 37. It is a side view of the staple of FIG. 37. FIG. 3 is a perspective view of staples according to various embodiments of the present disclosure. It is a top view of the staple of FIG. 41. It is a front view of the staple of FIG. 41. It is a side view of the staple of FIG. 41. It is a perspective view of the staple cartridge by various embodiments of this disclosure. FIG. 5 is a cross-sectional perspective view of the staple cartridge of FIG. 45 along the plane shown in FIG. 45. It is a top view of the staple cartridge of FIG. 45. FIG. 3 is a perspective view of staples according to various embodiments of the present disclosure. It is a top view of the staple of FIG. 48. It is a front view of the staple of FIG. 48. It is a side view of the staple of FIG. 48. FIG. 3 is a perspective view of staples according to various embodiments of the present disclosure. It is a top view of the staple of FIG. It is a front view of the staple of FIG. It is a side view of the staple of FIG. FIG. 4 is a partial cross-sectional elevation view of the staple cartridge of FIG. 4 showing staples at partial firing positions within the staple cavity according to various embodiments of the present disclosure. It is a partial plan view of the staple cartridge of FIG. 56 which shows the staple at the partial firing position shown in FIG. 56. FIG. 5 is a partial cross-sectional elevation view of the staple cartridge of FIG. 56 showing the staples at the partial firing position shown in FIG. 56. FIG. 56 is a partial cross-sectional elevation view of the staple cartridge of FIG. 56 showing staples at different partial firing positions according to various embodiments of the present disclosure. FIG. 5 is a partial plan view of the staple cartridge of FIG. 56 showing the staples at the partial firing position shown in FIG. 59. FIG. 5 is a partial cross-sectional elevation view of the staple cartridge of FIG. 56 showing the staples at the partial firing position shown in FIG. 59. FIG. 56 is a partial cross-sectional elevation view of the staple cartridge of FIG. 56, showing staples in injection positions and deformed configurations according to various embodiments of the present disclosure. FIG. 5 is a partial plan view of the staple cartridge of FIG. 56, which is at the injection position shown in FIG. 62 and shows the staples having a deformed configuration. FIG. 62 is a partial cross-sectional elevation view of the staple cartridge of FIG. 56 showing the staples at the injection position and in the deformed configuration shown in FIG. 62. FIG. 3 is an exploded perspective view of an end effector comprising a plurality of fasteners and a firing actuator configured to eject the fastener from the end effector according to various embodiments of the present disclosure. It is a top view of the 1st part of the fastener firing actuator of FIG. 65. FIG. 6 is an elevational view of the first portion of FIG. 66. It is a top view of the 2nd part of the fastener firing actuator of FIG. 65. It is an elevation view of the 2nd part of FIG. 68. FIG. 6 is a cross-sectional view of the end effector of FIG. 65 showing an unlaunched, non-extended launch actuator. It is sectional drawing of the end effector of FIG. 65 which shows the firing actuator in the extended state. FIG. 6 is a cross-sectional view of the end effector of FIG. 65 showing an extended, forward-moving launch actuator. FIG. 6 is a cross-sectional view of the end effector of FIG. 65 showing an anvil of the end effector in the open position and a firing actuator in the unlaunched non-extended state. FIG. 6 is a cross-sectional view of the end effector of FIG. 65 showing an anvil in a closed position and a firing actuator in an unlaunched non-extended state. FIG. 6 is a cross-sectional perspective view of the end effector of FIG. 65 illustrated in the configuration shown in FIG. 73. It is sectional drawing of the end effector of FIG. 65 exemplified by the configuration shown in FIG. 74. FIG. 6 is a cross-sectional view of the end effector of FIG. 65 showing a firing actuator in an extended state and, in addition, a knife member in a non-advanced position. FIG. 6 is a cross-sectional view of the end effector of FIG. 65 showing a forward, extended launch actuator and a knife member in a forward position. FIG. 6 is a cross-sectional perspective view of the end effector of FIG. 65, exemplified in the configuration shown in FIG. 78. FIG. 6 is a partial cross-sectional view of the end effector of FIG. 65, exemplified in a fully fired state. FIG. 6 is a cross-sectional elevation view of the end effector of FIG. 65, exemplified in the configuration shown in FIG. 80. FIG. 5 is a cross-sectional perspective view of the end effector of FIG. 65 illustrated in the configuration shown in FIG. 80. FIG. 6 is a cross-sectional elevation view of the end effector of FIG. 65 showing a knife member in a retracted position. FIG. 5 is a cross-sectional perspective view of the end effector of FIG. 65, exemplified in the configuration shown in FIG. 83. It is a perspective view of the launching member of the end effector of FIG. 65 exemplified by the non-extended configuration shown in FIG. 74. It is a perspective view of the launching member of the end effector of FIG. 65 exemplified by the extension configuration shown in FIG. 77. It is a perspective view of the launching member of the end effector of FIG. 65, which is exemplified in the configuration immediately before the complete launching configuration shown in FIG. 80. It is a perspective view of the firing member of the end effector of FIG. 65 exemplified by the complete firing configuration shown in FIG. 80. FIG. 5 is a cross-sectional view of an end effector including a firing actuator configured to eject a fastener from a fastener cartridge, which is exemplified by a firing actuator in an unlaunched position. It is sectional drawing of the end effector of FIG. 89 exemplified by the launching member at a partial launching position. It is a top view of the staple cartridge main body of the end effector of FIG. 89. It is a perspective view of the firing actuator for use with the cartridge body of FIG. It is a perspective view of the cartridge body of FIG. 91. It is sectional drawing of the cartridge body of FIG. 91 along the straight line 94-94 of FIG. 93.

The applicant of the present application also owns the following patent applications, which are filed on the same day as the present application and the entire contents of which are incorporated herein by reference.
US patent application, name "SURGICAL INSTRUMENTS WITH ARTICULATABLE SHAFT ARRANGEMENTS", agent reference number END7343USNP / 130300.
US patent application, name "ARTICULATABLE SURGICAL INSTRUMENTS WITH SEPARATE AND DISTINCT CLOSING AND FIRING SYSTEMS", agent reference number END7333USNP / 130322.
US patent application, name "SURGICAL CUTTING AND STAPLING INSTRUMENTS WITH INDEPENDENT JAW CONTROLL FEATURES", agent reference number END73336USNP / 130303.
US patent application, name "SURGICAL STAPLES AND STAPLE CARTRIDGES", agent reference number END7331USNP / 130304.
US patent application, name "SURGICAL STAPLES AND METHODS FOR MAKING THE SAME", agent reference number END7335USNP / 130305.
US patent application, name "SURGICAL STAPLES, STAPLE CARTRIDGES AND SURGICAL END EFFECTORS", agent reference number END7332USNP / 130306.
US patent application, name "SURGICAL FASTENEER", agent reference number END7338 USDP / 130307.
U.S. patent application, name "FASTENEER CARTRIDSING AN EXTENDABLE FIRING MEMBER", agent reference number END73444USNP / 130308.
U.S. patent application, name "FASTENER CARTRIGGE COMPRISING A FIRING MEMBER CONFIGURED TO DIRECTLY ENGAGE AND EJECT FASTENEERS FROM THE FASTENEER CARTRIDGE", agent reference number END73.
U.S. patent application, name "FASTENER CARTRIDGE COMPRISING A FIRING MEMBER INCLUDING FASTENEER TRANSFER SURFACES", agent reference number END7340USNP / 130310.
US patent application, name "MODULAR SURGICAL INSTRUMENTS", agent reference number END7342USNP / 130311.
US patent application, name "SURGICAL CUTTING AND STAPLING INSTRUMENTS WITH ARTICULATABLE END EFFECTORS", agent reference number END7334USNP / 130312.
US patent application, name "SURGICAL CUTTING AND STAPLING METHODS", agent reference number END7330USNP / 130313.

Here, certain representative embodiments are described so that the principles of structure, function, manufacture, and use of the devices and methods disclosed herein are comprehensively understood. One or more embodiments of these embodiments are shown in the accompanying drawings. Those skilled in the art will appreciate that the devices and methods specifically described herein and shown in the accompanying drawings are non-limiting exemplary embodiments, as well as the scope of the various embodiments of the invention. You will understand that it is defined only by the claims. The features illustrated or described in the context of one exemplary embodiment may be combined with the features of another embodiment. Such modifications and modifications shall be included within the scope of the present invention.

Throughout this specification, when referring to "various embodiments," "several embodiments," "one embodiment," or "embodiments," the specific embodiments described in the context of those embodiments. It means that a feature, structure, or property is included in at least one embodiment. Accordingly, throughout the specification, terms such as "in various embodiments," "in some embodiments," "in one embodiment," or "in certain embodiments" appear. However, they do not necessarily all refer to the same embodiment. In addition, specific features, structures, or properties may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or properties exemplified or described with respect to one embodiment are, in whole or in part, without limitation with the features, structures, or properties of one or more other embodiments. May be combined with. Such modifications and modifications shall be included within the scope of the present invention.

The terms "proximal" and "distal" are used herein with reference to the clinician operating the handle portion of the surgical instrument. The term "proximal" refers to the part closest to the clinician, and the term "distal" refers to the part located away from the clinician. For convenience and clarity, it is further understood that spatial terms such as "vertical", "horizontal", "top", "bottom" may be used with respect to the drawings herein. There will be. However, surgical instruments are used in many directions and positions, and these terms are not intended to be limited and / or absolute.

Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, one of ordinary skill in the art will readily appreciate that the various methods and devices disclosed herein can be used in a number of surgical procedures and applications, including, for example, open surgery. As you read "Modes for Carrying Out the Invention" herein, various instruments disclosed herein can be used, for example, through natural orifices or through incisions or puncture holes formed in tissues. It will be further recognized by those skilled in the art that it can be inserted into the body by any method such as. The working portion or end effector portion of these instruments may be inserted directly into the patient's body, or an access device having a work passage capable of advancing the end effector and elongated shaft of the surgical instrument. It may be inserted via.

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

Primarily with reference to FIG. 3, the staple 160 may be positionable within the staple cartridge 140 so that it can be ejected. For example, at least one thread 190 may move through the staple cartridge 140 and eject the staple 160 from the staple cartridge 140. A firing bar 156 with a cutting element, knife 158, can also move, for example, through a staple cartridge 140 to cut tissue captured between end effector jaws 123, 124. As shown in FIG. 3, the firing bar 156 and the cutting element 158 can move from the proximal position of the first jaw 123 to the distal position of the first jaw 123. In various embodiments, the tissue located between the staple cartridge 140 and the anvil 124 can be stapled, for example, by the staple 160 and then cut by the cutting element 158. Primarily with reference to FIGS. 4 and 5, the staple cartridge 140 may include a cartridge body 142 and a staple cavity 144 defined within the cartridge body 142. For example, staples such as staple 160 may be removably located within the staple cavity 144. In certain embodiments, each staple cavity 144 may detachably store one staple 160. Each staple cavity 144 may have, for example, a proximal end 146 and a distal end 148, and a longitudinal side wall 150 extends between the proximal end 146 and the distal end 148 of each staple cavity 144. Can exist. As further detailed herein, the proximal end 146, the distal end 148, and / or the longitudinal side wall 150 of the staple cavity 144 can guide the staple 160 during deployment from the staple cavity 144, and / Or can support.

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

Further referring to FIGS. 6-13, the slopes 184 and 186 may be located between the staple legs 164 and 166 and the base 162. For example, the upper slope 184 can extend between the staple legs 164, 166 and the base 162, and / or the lower slope 186 extends between the staple legs 164, 166 and the base 162. obtain. When the tissue is captured by the staple 160, the tissue can be compressed between the base 162 and the deformed staple legs 164, 166, and the slopes 184 and 186 may be in contact with the compressed tissue. In various embodiments, the slopes 184 and 186 may, for example, compress the captured tissue and prevent, for example, the base 162 from unintentionally penetrating and / or cutting the captured tissue.

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

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

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

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

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

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

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

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

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

Primarily with reference to FIGS. 14-17, the thread 190 may move between the drive surfaces 180, 182 of the staple 160. In other words, the thread 190 may exert a driving force on, for example, the initial drive surface 180 of the staple 160, and then move to the second, i.e., the secondary drive surface 182 of the staple 160 to exert the driving force. In certain embodiments, the thread slope 192 may include a front end surface 194 and a rear end surface 196. The front end surface 194 may be adjacent to, for example, the rear end surface 196 and / or may be connected to the rear end surface 196, and the staple 160 may move smoothly between the front end surface 194 and the rear end surface 196. For example, the front end surface 194 may contact the staple 160 and initiate lifting of the staple 160, and the rear end surface 196 may contact the staple 160 and subsequently lift the staple 160. In certain cases, the rear end surface 196 may, for example, smoothly lift the staples 160 to disengage and / or disengage from engagement with the front end surface 194.

Further referring to FIGS. 14-17, for example, the front end surface 194 may be aligned with the initial drive surface 180 and the rear end surface 196 may be aligned with the secondary drive surface 182. During operation, the tip surface 194 of the slope 192 may first come into contact with the staple 160. For example, referring to FIGS. 14 and 15, the tip surface 194 may come into contact with the initial drive surface 180 of the staple 160 as the thread 190 moves. The inclined tip surface 194 can exert a driving force on the initial driving surface 180. This may initiate lifting of the base 162 of the staple 160. For example, when the staple 160 continues to move the first distance, i.e. the thread 190, which can be lifted by the tip surface 194, here with reference to FIGS. 16 and 17, the rear end surface 196 is, for example, 2 of the staple 160. It may be in contact engagement with the next drive surface 182. The inclined tip surface 196 can exert a driving force on the secondary driving surface 182. This allows the lifting of the base 162 of the staple 160 to continue. For example, the staple 160 can be lifted a second distance, i.e., height by the rear end face 196.

In various cases, the rear end surface 196 may, for example, lift the initial drive surface 180 to separate it from contact with the front end surface 194 of the slope 192 and / or release it. For example, the rear end surface 196 can come into contact with the secondary drive surface 182 and the staple 160 can be immediately lifted so that the primary drive surface 180 is released from the drive contact with the front end surface 194. In another embodiment, the front end surface 194 may drive the initial drive surface 180 and the rear end surface 196 may simultaneously drive the secondary drive surface to deploy at least some of the staples. As the thread 190 continues to move, the rear end face 196 can lift the base 162 out of the staple cavity 144 (FIGS. 4 and 5) and / or eject the staple 160 from the cartridge 140 (FIGS. 4 and 5). obtain. For example, the proximal portion of the rear end face 196 may include a thread overdrive 198. In various embodiments, the thread overdrive 198 can extend out of the staple cavity 144 and lift the staple overdrive 188, i.e., the bottom of the middle portion 172 of the base 162 (see FIG. 7) out of the staple cavity 144. Can be put out to.

The development of a plurality of staples 160 according to the exemplary application of the present disclosure is shown in FIGS. 18-21. In certain embodiments, the multi-row staple cavities 144 may be defined in the cartridge body 142. For example, the multi-row staple cavities 144 may be defined on the first side of the cartridge slot 143 (FIG. 3), and the multi-row staple cavities 144 may be defined on the second side of the cartridge slot 143. 18-21 show two rows of staples 160 located within the two rows of staple cavities 144 of the cartridge body 142. Further referring to FIGS. 18-21, the staples 160a, 160c, and 160e may be located, for example, in the inner row of the staple cavity 144, and the staples 160b, 160d, and 160f may be located, for example, outside the staple cavity 144. Can be located in a row of. In various embodiments, the first inner staple 160a may be located closer to the cartridge slot 143 than the first outer staple 160b. For example, the first inner staple 160a may be adjacent to the cartridge slot 143 and the first outer staple 160b may be, for example, intermediate between the first inner staple 160a and the side portion of the cartridge body 142. In various embodiments, additional rows of staples 160 may be defined within the cartridge body 142. For example, at least one row of staples may be located between the first staple 160a and the cartridge slot 143, and / or at least one row of staples 160 may be located, for example, between the first outer staple 160b and the cartridge body 142. Can be done.

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

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

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

FIGS. 22-31 further show exemplary embodiments of staple deployment. For example, the staples 160a, 160b, 160c, and 160d can be located on either side of the cartridge slot 140 and can be ejectably located within the staple cavity 144 defined in the cartridge body 142. Primarily with reference to FIGS. 22 and 23, the staples 160a, 160b, 160c, and 160d may be unfired and the thread 190 may be located proximal to the cartridge body 142. The threads 190 may be aligned with the rows of staple cavities 144 in the cartridge body 142. For example, the first thread 190 may be aligned with the staples 160a, 160c in the first inner row of the staple cavity 144 and the staples 160b, 160d in the first outer row of the staple cavity 144, and the second thread 190 is the first of the staple cavity 144. 2 It may be aligned with the staples 160a and 160c in the inner row and the staples 160b and 160d in the second outer row of the staple cavity 144. For example, the first outer portion 191 of each thread 190 may be aligned with the outer staples 160b, 160d, and the second outer portion 191b of each thread 190 may be aligned with the inner staples 160a, 160c.

Primarily with reference to FIGS. 24 and 25, the first inner staple 160a can be moved or lifted to a partial firing position with respect to the cartridge body 142. For example, the second outer portion 191b of each thread 190 may move and engage the first inner staple 160a. The tip surface 194 of the second outer portion 191b can lift the first inner staple 160a by a first distance. Subsequently, the rear end surface 196 can move and engage with the first inner staple 160a to further lift the first inner staple 160a. In various embodiments, for example, the distal movement of the thread 190 may be coordinated and the first inner staples 160a on either side of slot 143 may be fired simultaneously. When the first inner staple 160a is lifted, a portion of each staple 160a may slide or move in contact with the longitudinal guide surface 150 of the staple cavity 144, which is referred to herein. As further detailed, the torque generated by the threads 190 can be supported and / or balanced.

Referring here to FIGS. 26 and 27, as the thread 190 continues to move relative to the cartridge 140, the thread 190 may move and engage the first outer staple 160b and the second inner staple 160c. In various cases, the thread 190 may come into contact with the first outer staple 160b and the second inner staple 160c at the same time. For example, the first outer portion 191a of the thread 190 may come into contact with the first outer staple 160b, for example, when the second outer portion 191b of the thread 190 contacts the second inner staple 160c. Primarily with reference to FIG. 27, the tip surface 194 of the first outer portion 191a and the second outer portion 191b of the thread 190 can engage the staples 160b, the initial drive surface 180 of the 160c, and the staples 160b with respect to the cartridge body 142. , 160c can be lifted. In addition, the rear end surface 196 of the second outer portion 191b of the thread 190 may continue to lift, for example, the first inner staple 160a. As the first inner staple 160a continues to move out of the staple cavity 144, the anvil 152 (FIGS. 18-21) may initiate deformation of the first inner staple 160a. For example, the staple forming pocket 154 (FIGS. 18-21) can capture, rotate, and / or bend the legs 164, 166 of the first inner staple 160a. As described herein, the anvil 152 may, for example, transform the staple 160a into a modified "B".

Referring here to FIGS. 28 and 29, when the thread 190 continues to move relative to the staple cartridge 140, the second outer portion 191b of the thread 190 may continue to lift, for example, the first inner staple 160a, eg, anvil 152. (FIGS. 18-21) can continue to deform the first inner staple 160a. In various cases, the thread 190 may also continue to lift the first outer staple 160b and the second inner staple 160c. For example, the rear end surface 196 of the thread 190 may move and engage the secondary drive surfaces 182 of the first outer staple 160b and the second inner staple 160c, eg, the staple legs 164 and 166 are out of the cartridge body 142. The staple base 162 can be lifted upwards to continue moving towards.

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

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

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

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

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

Referring here to FIGS. 45-47, staple cartridges, such as the staple cartridge 240, may be mounted in the elongated channel 122 (FIG. 3) of the end effector 120. For example, staples such as staple 160 may be positioned so that they can be ejected into the staple cartridge 240. For example, the thread 190 (FIGS. 14-17) may move through the staple cartridge 240, from which the staple 160 may be ejected. In various cases, the staple cartridge 240 may include a cartridge body 242 and a staple cavity 244 defined in the cartridge body 242. The staple 160 may be removably located within, for example, the staple cavity 244. For example, each staple cavity 244 may detachably store one staple 160. Further, each staple cavity 244 may have, for example, a proximal end 246 and a distal end 248, with a longitudinal side wall 250 between the proximal end 246 and the distal end 248 of the staple cavity 244. It can be postponed. Similar to the cavities 144 described herein, the proximal end 246, the distal end 248, and / or the longitudinal side wall 250 can guide and / or support the firing staple 160. For example, the longitudinal side wall 250 may balance the torque exerted on the staples 160 by the movement of the threads 190. In various cases, the cavity 244 may also include a diagonal guide surface 251 between the side walls 250. For example, the proximal diagonal guide surface 251a may extend between the proximal end 246 of the cavity 244 and the side wall 250 of the cavity 244. In addition, or instead, the distal diagonal guide surface 251b may extend between the distal end 248 of the cavity 244 and the side wall 250 of the cavity 244. Diagonal guide surfaces 251a, 251b can guide and / or direct, for example, the undulations 178 (FIGS. 6-13) of the staple 160 when the staple 160 is lifted within the staple cavity 244. For example, a portion of the undulations 178 may pivot along the diagonal guide surfaces 251a, 251b and / or move in contact with them. In such an arrangement, the diagonal guide surfaces 251a, 251b can balance, for example, the torque exerted on the staples 160.

Referring here to FIGS. 32A-32C, staples such as staples 160 can be cut, formed and / or punched from material sheets such as material sheet 130. The material sheet 130 can be, for example, metal and can include, for example, stainless steel and / or titanium. In various cases, the material sheet 130 can be substantially flat and / or smooth. Further, in certain cases, the material sheet 130 may undergo bending, folding, undulating and / or wavy formation in various regions such as the first region 134 and the second region 136. The material sheet 130 can be bent using, for example, punches and / or stamps. The flat or substantially flat portions 135a, 135b, and 135c of the material sheet 130 may be located, for example, in the middle of regions 134, 136. The first region 134 can be, for example, between the flat portions 135a and 135b, and the second region 136 can be, for example, between the flat portions 135b and 135c. In various cases, for example, the flat portions 135a and 135c can be coplanar and / or, for example, the flat portion 135b can be parallel to and / or substantially parallel to the flat portions 135a and / or 135c. Can be. Primarily with reference to FIG. 32A, the plurality of flat sheets 130a, 130b, 130c, 130d, 130e, 130f can be laminated and then simultaneously bent in regions 134, 136. In other embodiments, the sheets 130a, 130b, 130c, 130d, 130e, 130f can be individually bent and then laminated, for example.

In various cases, the staple 160 can be cut, formed, and / or punched from the bent sheet 130. For example, with reference primarily to FIG. 32B, the staple contour 132 may be traced, etched, and / or cut into the bent sheet 130. In the bent sheet 130, the staple contour 132 can be machined and / or laser cut, for example. In various cases, the electric discharge machine (EDM) wire 138 can be used to cut the staple contour 132. Further, in certain cases, the plurality of laminated sheets 130 can be cut at the same time. In certain embodiments, with reference primarily to FIG. 32C, the staple contour 132 may form the boundary, or perimeter, of the staple 160. For example, the staple contour 132 can form staples 160 (FIGS. 6-13 and 33-36) and / or, for example, staples with various characteristics similar to staples 160. In various cases, the plurality of staple contours 132 may be cut into the material sheet 130 and the plurality of staples 160 may be formed from a single material sheet 130. As shown in FIGS. 32B and 32C, the EDM wire 138 can penetrate a plurality of material sheets 130 at a time and cut a plurality of staples 160 at a time. Six sheets 130 are cut simultaneously by the EDM wire 138, but any suitable number of sheets 130 can be cut simultaneously. For example, wire 138 can cut less than 6 sheets 130 at the same time or more than 6 sheets 130 at the same time.

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

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

Primarily with reference to FIGS. 33-36, in various cases, the staple 160 is _{cut such that the height H 1} of the base 162 is independent of and / or different from _{the depth D 1} of the staple legs 164 and 166. Can be done. _{For example, the depth D 1} of the staple legs 164 and 166 may correspond to the depth of the material sheet 130 and the base 162 is independent of, for example, the depth of the material sheet 130 and / or the corresponding leg depth D _1. It can be cut to proper height H ₁ obtained. A suitable height H ₁ may be based on, for example, the purpose, application, and / or design of the staple 160 and / or the end effector 120 (FIG. 3) in which the staple 160 can be used. Moreover, the height H ₁ of the base 162 can also vary along its length. For example, the height H ₁ can vary, for example, on and / or near the drive surface of the staple 160 and / or in the gusset between one of the staple legs 164 and 166 and the base 162. The staple contour 132 may be provided with at least one taper and / or step along the length of the base 162, for example. The staple contour 132 may include, for example, a taper or slope capable of forming a secondary drive surface 182 of the base 162. The degree of inclination of the secondary drive surface 182 can be selected, designed, and implemented via the staple contour 132. In certain embodiments, the height H ₁ of the base 162 may be greater than _{the depth D 1} of the staple legs 164 and 166. In other embodiments, the height H ₁ of the base 162 may be less than or equal to _{the depth D 1} of the staple legs 164 and 166. By comparison, the shape of the staples formed from the bent wire can be constrained and / or limited based on the dimensions of the initial wire. For example, in a staple formed of wire, the height of the staple base usually corresponds to the width of the staple leg and the width of the staple leg usually corresponds to the diameter of the wire. For example, the diameter of the wire can be modified by stretching and / or rolling, but the allowed modifications are limited and / or constrained by the volume of the material.

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

Here, with reference to FIGS. 37-40, the staple contour 232 is traced, cut, etched and / or machined onto the material sheet 130 (FIGS. 32A and 32B), eg, staple 160 (FIGS. 33-36). Staples 260 similar to can be formed from the material sheet 130. For example, the staple 260 may include a base 262 and staple legs 264, 266 extending from the base 262. In various embodiments, the staples 260 may include undulations 278, which correspond to bending and / or undulations 134, 136 (FIGS. 32A and 32B) of the material sheet 130 on which the staples 260 are formed. obtain. In certain embodiments, the staple 260 may include, for example, an intermediate portion 272 between the undulating portions 278. Further, at least one drive surface 280, 282 may be formed along the outer circumference of the staple 260 via the staple contour 232.

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

Here, with reference to FIGS. 41-44, the staple contours 332 are traced, cut, etched and / or machined onto the material sheets 130 (FIGS. 32A and 32B), eg, staples 160 and 260 (FIGS. 33-34). Staples 360 similar to 40) can be formed from the material sheet 130. For example, the staple 360 may include a base 362 and staple legs 364, 366 extending from the base 362. In various embodiments, the staples 360 may include undulations 378, which correspond to bending and / or undulations 134, 136 (FIGS. 32A and 32B) of the material sheet 130 on which the staples 360 are formed. obtain. In certain embodiments, the staples 360 may include, for example, an intermediate portion 372 between the undulating portions 378. Further, at least one drive surface 380 and 382 may be formed along the outer circumference of the staple 360 via the staple contour 332.

Like the staple 160 and 260, the depth _{D 3} of the staple legs 364 may correspond to the depth of the material sheet 130. Further, in various cases, the height H _{3 of the staple base 362 may be independent of the depth D 3} of the staple legs 364 and 366 and / or the depth of the material sheet 130. For example, as shown in FIGS. 41-44, the height H _{3 of the staple base 362 is larger than the height H 1} of the staple base 162 (FIGS. 33-36) and the height of the staple base 262 (FIGS. 37-40). Greater than H _2, the depth D ₃ of the staple legs 364 and 366 is, for example, _{equal to the depth D 1} of the staple legs 164 and 166 and equal to the depth D ₂ of the staple legs 264 and 266. In various cases, the width W ₃ of the staple legs 364 and 366 may also be independent of _{the depth D 3 of the staple legs 364 and 366. The height H 3} of the staple base 362 _{and the width W 3} of the staple legs 364 and 366 may be selected, for example, based on the purpose, application, and / or design of the staple 360 and / or end effector 120 (FIG. 3). ..

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

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

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

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

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

In addition to the above, referring here to FIG. 65, the end effector, for example the end effector 120, can be positioned on the opposite side of the staple cartridge 240, which is located in the elongated channel 122, and in addition to the staple cartridge 240. Anvil 124 and may be included. In various cases, the cartridge 240 is configured to slidably accept a plurality of staple cavities 244 and fasteners located within each staple cavity 244, such as staples 460, and a knife 158 inside. Longitudinal slots 243 and may be included. Although staples 460 have been shown in connection with the embodiment shown in FIG. 65, any suitable staple, i.e. fastener, eg staple 160, can be used in this embodiment. Generally referring to FIGS. 73 and 74, the end effector 120 may extend from a shaft 114 which may include a closed tube 115. When the closing tube 115 advances distally, the closing tube 115 can contact the anvil 124 and rotate the anvil 124 between the open position (FIG. 73) and the closed position (FIG. 74). When the anvil 124 is closed, the knife 158 can advance distally to make a transverse incision in the captured tissue between the anvil 124 and the cartridge 240. In the particular end effector disclosed herein, the cartridge located within the end effector 120 may further include a fastener firing actuator, such as a thread 190, which actuator is pushed distally by a knife 158. At the same time that the knife 158 makes a transverse incision in the tissue, the staple is unwound from the cartridge. For the embodiment shown in FIG. 65, the staple cartridge may include a fastener firing actuator such as, for example, a thread assembly 790, which actuator advances distally with or in parallel with the knife 158 to the cartridge 240. Staples 460 can be ejected from. For example, the stapler shaft 114 may include a firing bar 157 configured to advance the knife 158 and, in addition, a pusher bar 159 configured to advance the thread assembly 790. The launch bar 157 and pusher bar 159 may advance simultaneously, but in various cases these operations are timed so that the initial distal movements cannot overlap each other, as further detailed below. obtain. In addition to the initial relative movement between the launch bar 157 and the pusher bar 159, the thread assembly 790 may include two or more parts that can move relative to each other, also as further detailed below. ..

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

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

With reference to FIG. 65 again, the thread assembly 790 may include a plurality of first thread sections 792 and / or a plurality of second thread sections 793. In various cases, the thread assembly 790 includes a first set of threads with a first thread section 792 and a second thread section 793, and a second set of threads with a first thread section 792 and a second thread section 793. It can be equipped with a thread. In certain cases, the second set of threaded portions may constitute the first set of mirror images. For the sake of brevity of the thread assembly 790 description herein, only one set of thread sections will be referred to. However, the reader should be aware that the description related to the operation of a set of threads can also be applied to the simultaneous operation of any suitable number of threads.

In addition to the above, the outer staple row of the cartridge 240, i.e. the row farthest from the channel 243, may guide the inner staple row, i.e. the row closest to the channel 243. In other words, the deformation of the staples in the outer row may start before, or at least slightly before, the deformation of the laterally adjacent staples in the inner row. In other cases, the outer staple row of the cartridge 240, i.e. the row farthest from the channel 243, may lag behind the inner staple row, i.e. the row closest to the channel 243. In other words, the deformation of the staples in the inner row may start before, or at least slightly before, the deformation of the laterally adjacent staples in the outer row. Further, two staple rows are disclosed on both sides of the channel 243 defined in the cartridge 240, but in other embodiments, more than two staple rows, for example three staple rows, are on both sides of the channel 243. I think that it exists in. In such an embodiment, the thread assembly is to deploy additional rows of staples at the same time as the inner staple rows, at the same time as the outer staple rows, and / or at continuous stepwise points relative to the inner and outer staple rows. Can be configured in.

As described above, the first thread portion 792 is movable with respect to the second thread portion 793 of the thread assembly 790. With reference to FIGS. 70-72, the thread assembly 790 is movable between the initial unfired configuration (FIG. 70) and the second extended configuration (FIGS. 71 and 72). Primarily with reference to FIG. 70, in the initial unlaunched configuration of thread assembly 790, the first thread portion 792 is folded within, i.e., retracted within the second portion 793. In at least one such case, the distal end of the first threaded portion 792 may not extend beyond the distal end of the second threaded portion 793. Although not shown, in other cases, the distal end of the first thread portion 792 may be the distal end of the second thread portion 793 when the first thread portion 792 is folded within the second portion 793. It may extend beyond. Further referring to FIG. 70, the reader will further recognize that the staple 460 is in the unlaunched position when the staple 460 has not yet been lifted towards the anvil 124. Comparing FIGS. 70 and 71, the reader will notice that the first thread section 792 extends relative to the second thread section 793. In such a situation, the distal end of the first thread portion 792 is located distal to the distal end of the second thread portion 793. The initial movement of the first thread portion 792 from the unlaunched position to its extension position is one or more staples 460 on the inner slope portion 791a and / or the outer slope portion 791b of the first thread portion 792. Can be positioned below. In other configurations, the initial movement of the first threaded portion 792 from its unlaunched position to its extended position is that of one or more staples 460 on the inner slope portion 791a and / or the outer slope portion 791b. Can be positioned below. In any case, as shown in FIG. 71, the extension of the first threaded portion 792 may lift at least one staple 460 at least partially towards the anvil 124 and / or / or lift at least one staple 460 to the anvil 124. Can be in contact with and at least partially deformed. In certain cases, the extension of the first thread portion 792 can bring at least one staple 460 into contact with the anvil 124 and lift it completely or deform it completely. In various cases, the second thread portion 793 may not advance distally as the first thread portion 792 moves to its extension position, but in certain situations the first thread portion 792 may move to its extension position. At least some distal movement of the second threaded portion 793 may occur as it moves to.

Comparing FIGS. 71 and 72, it can be noticed that the first threaded portion 792 and the second threaded portion 793 advance distally and lift the staple 460 towards the anvil 124. The first thread section 792 and the second thread section 793 may then advance to the distal end of the end effector 120 to complete the firing stroke of the end effector 120, which is further detailed below. In any case, the initial progress of the thread assembly 790 during the firing stroke of the end effector 120 is shown in FIGS. 70-72. FIG. 70 shows a thread assembly 790 in a retracted, unlaunched position. FIG. 71 shows a thread assembly 790 in an extended, partially fired position. FIG. 72 shows the thread assembly 790 in the extended launch position. As outlined above, the pusher bar 159 may move distally to advance the thread assembly 790 through the progress shown in FIGS. 70-72. With reference to FIG. 70, the pusher bar 159 is shown in the initial, unlaunched position and is in contact with the proximal end of the first threaded portion 792. In various embodiments, the pusher bar 159 may include a contact flange 155 extending from its distal end capable of engaging the first thread portion 792. Further referring to FIG. 70, the pusher bar 159 does not have to come into contact with the second thread portion 793 when the pusher bar 159 is in its initial, unfired position. When the pusher bar 159 advances distally, the pusher bar 159 moves the first thread portion 792 distally until the contact flange 155 contacts the proximal end of the second thread portion 793, as shown in FIG. I can let you. As mentioned above, it is this relative movement between the first thread portion 792 and the second thread portion 793 that extends the thread assembly 790. After this, the pusher bar 159 may move distally to simultaneously advance the first thread portion 792 and the second thread portion 793 distally, as shown in FIG. 72.

As mentioned above, the end effector 120 may be configured to perform stapling and transverse incision of tissue at the same time. With reference to FIG. 65 again, the end effector 120 may include a launching member with a knife blade 158 configured to make a transverse incision in the tissue as the knife bar 156 advances distally, i.e. the knife bar 156. With reference to FIGS. 70 and 71 again, the initial distal movement of the push bar 159 does not have to be transmitted to the knife bar 156. In other words, as the thread assembly 790 moves between its retracted position (FIG. 70) and its extended position (FIG. 71), the knife bar 156 may remain stationary or substantially stationary. In such situations, relative motion between the pusher bar 159 and the knife bar 156 can occur at least during the initial portion of the end effector firing stroke. Comparing FIGS. 74 and 77, it can be said that, firstly, the pusher bar 159 advances distally to extend the thread assembly 790, and secondly, the knife bar 156 does not advance distally. Pay particular attention to the proximal end of the knife bar 156 and the pusher bar 159. More specifically, the pusher bar 159 may include a drive pin 759 extending in between, which extends through a drive slot 757 defined within a drive bar 157 extending proximally from the knife bar 156. Exists. As shown in FIG. 74, the drive pin 759 is located at the proximal end of the drive slot 757 when the pusher bar 159 is in its proximal unlaunched position. As shown in FIG. 77, when the pusher bar 159 advances distally, the drive pin 759 may slide distally within the drive slot 757 until the drive pin 759 reaches the distal end of the drive slot 757. .. At this position, the thread 790 is fully extended and the knife bar 156 has not yet advanced distally with the pusher bar 159. As shown in FIGS. 78 and 79, when the drive pin 759 contacts the distal end of the drive slot 757, both the pusher bar 156 and the knife bar 159 can move distally.

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

The above arrangement in which the pusher bar 159 moves the thread assembly 790 before the pusher bar 159 advances the knife 158 can be advantageous in many situations. For example, it is often desirable for tissue to be stapled prior to incision. Therefore, the formation of staples results in or substantially results in a transverse incision of the tissue with the knife bar 156. Staggered deployment of threads 790 and knife bar 156 can facilitate such relative progression between staple formation and tissue incision. In addition, the thread 790 is compactly housed within the retracted, unfired configuration of the end effector 120 to allow for shorter proximal-distal length, or longitudinal length, of the end effector 120. obtain. In other words, the thread assembly, which can initiate a firing stroke at least in a partially folded state, may require less longitudinal room. Moreover, thanks to the longitudinal extensibility of the thread assembly 790, the staple lifting surface of the thread assembly 790 may be longer and may include, for example, a slope angle that is shallower than a single thread, i.e. not acute. In other words, the longer available longitudinal lengths available on the slopes of the thread assembly 790 can enhance the mechanical advantages of the thread assembly 790.

With reference to FIGS. 80-82, the thread assembly 790 and the knife bar 156 may advance distally towards the distal end of the end effector 120 to complete the firing stroke of the end effector 120. When the thread 790 approaches the distal end of the end effector 120, in various cases the first thread portion 792 contacts the distal end 245 of the staple cartridge and with respect to the second thread portion 793 and / or the second. It can retreat within the threaded portion 793. More specifically, the distal end 245 may prevent the distal movement of the first thread portion 792, while the second thread portion 793 relative to the first thread portion 792 to complete the firing stroke. And move distally. In various cases, the second thread portion 793 may advance distally until it contacts the distal end 245 of the staple cartridge, while in other cases the firing stroke is such that the second thread portion 793 is at the distal end. Can be completed before contacting 245. In any case, in the embodiment in which the distal flange 155 of the pusher bar 159 pushes the first thread portion 792 and the second thread portion 793 toward the distal end of the end effector 120, the first thread portion 792 is When the first thread portion 792 reaches the distal end, it disengages from the pusher bar 159 so that the pusher bar 159 can push the second thread portion 793 against the first thread portion 792. Good. In at least one such case, primarily referring to FIG. 77, the distal end of the staple cartridge attaches the first thread portion 792 to the anvil 124 so that the pusher bar 159 can slide under the first thread portion 792. It may include a boss 241 that may be configured to lift upwards towards. In such a situation, the first thread portion 792 may disengage the second thread portion 793 and the pusher bar 159 so that it can operate. In various cases, as described above, the boss 241 is positioned and positioned such that the first thread portion 792 is lifted upward after the deployment and / or movement of all staples of the staple cartridge to the second thread portion 793. obtain. Further, in addition to the above, the distal end of the staple cartridge is configured to lift a first boss 241 configured to lift a first thread portion 792 and a further first thread portion 792. 2 Boss 241 and may be included. In various cases, the boss 241 may be configured to simultaneously and synchronously lift the first thread portion 792. In some cases, the boss 241 may be configured to continuously lift the first thread portion 792.

With reference to FIGS. 85-88, FIG. 85 shows the thread assembly 790 in an early, unfired configuration. In addition to the above, the pusher bar 159 contacts the proximal end 789 of the first thread portion 792, and as shown in FIG. 86, the proximal end 789 of the first thread portion 792 is proximal to the second thread portion 793. The first thread portion 792 may be pushed distally until it is flush with the end 787. At this point, the first thread portion 792 can fully extend relative to the second thread portion 793. The pusher bar 156 can then push the proximal end 787 and the proximal end 789 simultaneously to advance the thread assembly 790 distally. As also mentioned above, with reference to FIG. 87 here, the first thread portion 792 can be stopped, for example, by the distal end 245 of the staple cartridge and lifted upward by the staple cartridge boss 241. At this point, as shown in FIG. 88, the first thread portion 792 can be raised relative to the second thread portion 793 and the distal flange 155, thus the second thread portion 793 for folding the thread assembly 790. In addition, it may slide under the first thread portion 792, at least in part. Comparing FIGS. 87 and 88, the second thread portion 793 moves closer to the ledge 788 defined on the bottom surface of the first thread portion 792, and the distal end 789 of the first thread portion 792 is the second thread. It can be said that it is no longer aligned with the distal end 787 of part 793.

After the firing stroke is complete, here with reference to FIGS. 83 and 84, the knife bar 156 and pusher bar 159 can retract proximally. In various cases, the knife bar 156 can be pulled proximally by the pusher bar 159. More specifically, the pusher bar 159 may retract proximally to the knife bar 159 until the drive pin 759 contacts the proximal end of the drive slot 759. At this point, the pusher bar 159 may pull the knife bar 156 proximally until the flange 153 of the knife bar 156 is no longer located in slot 121 of the anvil 124. The anvil 124 can then move to the open position when the closing tube 115 is pulled proximally. In certain cases, the staple cartridge may include a replaceable staple cartridge. In such cases, the used staple cartridge can be removed from the cartridge channel 122 and, if desired, an unused staple cartridge can be positioned within the cartridge channel 122 to make the surgical instrument reusable. ..

As shown in FIGS. 83 and 84, when the knife bar 156 and pusher bar 159 retract, the folded thread assembly 790 can be left at the distal end of the end effector 120. When removing the used staple cartridge from the cartridge channel 122, the folded thread assembly 790 can be removed from the end effector 120 along with the cartridge. In certain cases, all staple cartridges need not be used before the pusher bar 159 and knife bar 156 retract. In such cases, the thread assembly 790 may only partially advance within the staple cartridge and may not be folded back into the non-extended configuration. Then, when the staple cartridge is removed from the cartridge channel 123, some staples are still located in the staple cavity.

As described herein, the staple cartridge firing actuator, the thread and / or staple fastener, is configured to lift or deploy the staple between the unfired and fired positions. , Or may include two or more staples. For example, a thread may include a first inclined surface configured to unfold a first staple row, a second inclined surface configured to unfold a second staple row, and the like. Each ramp surface comprises an adjacent surface that engages with each staple in the corresponding staple row and is configured to lift the staple until it contacts the anvil located on the opposite side of the staple cartridge and is completely deformed. obtain. Adjacent surfaces defining each inclined surface may include any suitable number of undulations, such as, for example, one or more straight surfaces and / or one or more curved surfaces. In various cases, the adjacent surface may directly engage each staple in the corresponding staple row and remain engaged with the staples in that row as it moves from its unfired position to the fully fired position. possible. After the staple reaches its full launch position, the slope may disengage from the staple. This arrangement may be possible with threads that have relative movable elements, such as thread assembly 790, and / or threads that are not composed of relative movable elements, such as threads composed of a single piece of material.

In various cases, the launch actuator, or thread, may have one or more tilted surfaces, each tilted surface having two or more collaborative drive surfaces. For example, referring here to FIG. 92, the thread 890 may include a first inclined surface 891a comprising an initial, i.e., first drive surface, 895a, and a second, i.e., final drive surface, 896a. The initial drive surface 895a and the final drive surface 896a of the first inclined surface 891a may be configured to cooperatively lift the staples in the first staple row between the unlaunched position and the launched position. With reference to FIGS. 89-92, as the thread 890 moves distally through the staple cartridge, the initial drive surface 895a contacts, for example, the staple 160 and portion of the staple 160 from its unlaunched position (FIG. 89). Can be lifted to the launch position (FIG. 90). The thread 890 may then advance distally such that the final drive surface 896a can lift the staple 160 between its partial launch position and its full launch position. In various cases, the initial drive surface 895a may come into contact with the initial drive surface 180 of the staple 160 to lift the staple 160 to its partial launch position, and the final drive surface 896a may be on the second drive surface 182 of the staple 160. Upon contact, the staple 160 may be lifted to its final firing position. In such a case, the staple 160 may move from the initial drive surface 895a to the final drive surface 896a to complete its deployment, i.e. firing. With reference to FIG. 92, deployment, or firing, of the staple 160 may be completed once the top 898 of the first inclined surface 891a passes under the second driving surface 182 of the staple 160.

In addition to the above, with reference to FIG. 92 again, the initial drive surface 895a and the final drive surface 896a of the first inclined surface 891 may be configured to cooperatively deploy the staples in the first staple row. Thread 890 may include additional ramps to unfold additional staple rows. For example, the thread 890 may include a second inclined surface 891b with an initial drive surface 895b and a final drive surface 896b, which may be configured to co-deploy the staples in the second staple row. In various cases, the thread 890 unfolds a third sloping surface and a staple in a fourth staple row similar to the first sloping surface 891a, which is configured to unfold, for example, the staples in the third staple row. It may further include any suitable number of inclined surfaces, such as a fourth inclined surface similar to the second inclined surface 891b, which is configured to do so. In any case, the drive surfaces of the tilted drive surfaces, such as the drive surfaces 895a, 895b, 896a, and 896b, may include any suitable configuration, such as, for example, a linear profile and / or a curved profile. Further referring to FIG. 92, the first inclined surface 891a may include a transition drive surface 897a between the initial drive surface 895a and the final drive surface 896a. Similarly, the second inclined surface 891b may include a transition drive surface 897b between the initial drive surface 895b and the final drive surface 896b. In various cases, the transition drive surface may include a transition portion between one drive surface and another drive surface. In some cases, the transition drive surface may include, for example, a surface that simultaneously drives the initial drive surface 180 and the second drive surface 182 of the staple 160. In various cases, the ramp may include any suitable number of drive surfaces.

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

The above considerations relating to the inclined surface 891a, the initial drive surface 895a, the final drive surface 896a, and the transition drive surface 897a also apply to, for example, the inclined surface 891b, the initial drive surface 895b, the final drive surface 896b, and the transition drive surface 897b. The same can be said.

In various cases, in addition to the above, the first inclined surface 891a can be parallel to the second inclined surface 891b. In other cases, the first inclined surface 891a does not have to be parallel to the second inclined surface 891b. In various cases, the first inclined surface 891a can be defined by a first height and the second inclined surface 891b can be defined by a second height. In some cases, the first height can be the same as the second height. In such a case, the first staple row formed by the first inclined surface 891a and the second staple row formed by the second inclined surface 891b can be formed at the same height. In other cases, the first height can be different from the second height. In such a case, the first staple row formed by the first inclined surface 891a and the second staple row formed by the second inclined surface 891b may be formed at different heights. All disclosures of US Pat. No. 8,317,070, entitled "SURGICAL STAPLING DEVICES THAT PRODUCTS FORMED STAPLES HAVING DIFFERENT LENGTHS", issued November 27, 2012, are incorporated herein by reference.

As mentioned above, the threads can directly drive and deploy any other suitable fasteners stored in the staples and / or cartridges. In other words, the thread may come into direct contact with the staple and the drive is not between the thread and the staple. Such an arrangement differs from an arrangement that includes a plurality of drive units that support the staples. In such an arrangement, the thread engages the drive and lifts the staples. In these arrangements, the drive unit is often configured to completely eject the staples from the stored staple cavities. More specifically, the drive unit is configured to lift the staple so that when the staple is in the fully fired position, the staple is fully positioned on top of the staple cartridge, i.e., above the deck. To lift the staples completely above the deck of the staple cartridge, the drive may also be lifted, at least partially, above the deck. Such an arrangement can be characterized as a staple overdrive. Many of the teachings described herein include embodiments that include one or more threads that directly drive the staples, plus one or more threads to drive the staples. It can be applied to an embodiment including a plurality of driving units driven by. For example, the thread 890 has been described in connection with an embodiment that directly drives the staples 160, but the thread 890 is also used in embodiments that include a drive that is configured to deploy the staples from the staple cavity. Can be done. In such an embodiment, each drive unit is engaged by, for example, a first drive surface similar to the first drive surface 180, which is configured to be engaged by an initial drive surface 895a, and, for example, a final drive surface 896a. A second drive surface similar to the second drive surface 182, which is configured to be combined, may be included.

In the embodiments disclosed herein where the staples are driven directly by the threads, i.e. without the use of a drive unit, in addition to the above, the staples can be lifted completely above the deck by the threads themselves, i.e. over. Can be driven. Here, referring to FIGS. 91-94, the thread 890 is configured to partially extend above the deck surface 141 of the cartridge 142. More specifically, when the inclined surfaces 891a and 891b pass through and / or between the cavities 144 and eject the staples 160 from, for example, the staple cavities 144, the tops 898 and the second inclined of the first inclined surfaces 891a. The top 898 of the surface 891b may extend above the deck surface 141. In such a situation, the thread 890 is configured to partially extend above the staple cavity opening defined within the deck surface 141. In various cases, the cartridge 142 may further comprise a plurality of covers 145 located within and / or aligned with the rows of staple cavities 144. For example, the cover 145 may be located in the middle of adjacent staple cavities 144 in a row of staple cavities. In certain cases, the cover 145 may be located proximal and / or distal to the staple cavity 144. In various cases, with reference primarily to FIG. 94, the top 898 of the inclined surface 891 may pass under the cover 145. In such cases, each cover 145 may include a bottom surface such as an arched bottom surface 147 that is configured to allow an inclined surface 891 to pass under it. Further referring to FIG. 94, the cartridge 142 is configured to accommodate, for example, a first longitudinal slot 149 configured to slidably accept a first inclined surface 891a and a second inclined surface 891b therein. It may include a second longitudinal slot 149 that is configured. In various cases, the cartridge 142 may include a plurality of longitudinal slots 149 configured to accommodate the inclined surface of the thread 890. In certain cases, longitudinal slots 149 can be defined by covers 145 and staple cavities 144. In some situations, each longitudinal slot 149 may correspond to a longitudinal row of staple cavities 144, where the longitudinal slot 149 has an inclined surface passing through the longitudinal slot 149 stapled as outlined above. Staple cavities 144 may be placed within a row of staple cavities that communicate with each other so that they can pass through the cavities 144.

In various cases, the deck of the cartridge may be configured to be in direct contact with the tissue to be fastened and / or to support the tissue to be fastened. In certain circumstances, the cartridge assembly is described in US Patent Application No. 12 / 894,369, named "IMPLANTABLE FASTENEER CARTRISING A SUPPORT RETAINER" (current US Patent Application Publication No. 2012/0080344, filed September 30, 2010). ), U.S. Patent Application No. 13 / 097,856, Name "STAPLE CARTRIGGE COMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF" (Current U.S. Patent Application Publication No. 2012/0080336, U.S.A., April 29, 2011) Patent Application No. 13 / 242,066, named "CURVED END EFFECTOR FOR A STAPLING INSTRUMENT" (current US Patent Application Publication No. 2012/0080498, filed September 23, 2011), eg, Organization. It may include layers located on the deck, such as thickness compensators. U.S. Patent Application No. 12 / 894,369, named "IMPLANTABLE FASTENEER CARTRIDGE COMPRISING A SUPPORT RETAINER" (current U.S. Patent Application Publication No. 2012/0080344, filed September 30, 2010), U.S. Patent Application No. 13/097 , 856, named "STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF" (current US Patent Application Publication No. 2012/0080336, April 29, 2011, filed April 29, 2011), and US Patent Application No. 856. The entire disclosure of the name "CURVED END EFFECTOR FOR A STAPLING INSTRUMENT" (current US Patent Application Publication No. 2012/0080498, filed September 23, 2011) is incorporated herein by reference. In various cases, with reference to FIG. 93 again, the deck 141 and cover 145 may be configured to be in direct contact with the tissue. In such a situation, the cover 145 may extend above the deck 141, so that the deck 141 and the cover 145 may have a non-uniform support surface. In various cases, the cover 145 may exert additional pressure on the tissue located directly above and / or adjacent to each longitudinal row of staples. This additional pressure can move the fluid present in the tissue away from the staple line before, during, and / or after the staple formation process. As a result, better staple formation and / or staple retention within the tissue can be promoted. The cover 145 may also be configured to grip the tissue located between the staple cartridge and the anvil, in particular along the staple line where staple formation occurs. The cover may also be configured to support the staples as they are ejected from the staple pockets and locally control the staple forming process. U.S. Patent Application No. 12 / 893,461, named "STAPLE CARTRIDGE" (current U.S. Patent Application Publication No. 2012/0074198, filed September 29, 2010) and U.S. Patent Application No. 27, 2013. The entire disclosure of 13 / 851,676, named "TISSUE THICKNESS COMPENSATOR COMPRISING A CUTTING MEMBER PHAT", is incorporated herein by reference.

As mentioned above, primarily referring to FIGS. 58, 61, and 64, a staple cavity, such as a staple cavity 144, induces a staple, such as a staple 160, when lifted between the unlaunched and fired positions. It may include a first side wall 150a and a second side wall 150b that can be configured to do so. In various cases, the side walls 150a, 150b may be configured and arranged such that the entire staple 160 is located midway between the side walls 150a, 150b when the staple 160 is in its unlaunched position. In other situations, primarily referring to FIGS. 22-31, the side wall 150 of the staple cavity 144 is located in the middle of the side wall 150 with less than the entire staple 160 when the staple 160 is in its unlaunched position. It may be configured as follows. For example, the base 162 of the staple 160 in the outermost row of staple cavities 144 defined within the cartridge body 142 is not supported by at least one of the side walls 150 when the staple 160 is in its unlaunched position. Good. However, when the staple 160 is lifted upwards, the base 162 of the staple 160 may be supported by both side walls 150. With reference to FIGS. 93 and 94, for example, a portion of the staple cavity 144 of the cartridge 142, such as the cavity 144a, may only support both sides of the base 162 at the end of the lifting operation. In any case, the side wall of the staple cavity 144 defined in the cartridge body 142 does not have to fully support the staple 160 in its unlaunched position, but with reference to FIGS. 3 and 65 again, the jaw 122 Cartridge channel 123 may support staple 160 at least in part. In other words, the cartridge body 142 and the cartridge channel 123 may work together to define the staple cavity 144 to support and / or surround the staple 160 through the lifting action of the staple 160. For example, the cartridge body 142 and the cartridge channel 123 may work together to support and / or surround the staple 160 when it is in its non-lifting position. In some situations, at some point during the lifting operation of the staple 160, the cartridge channel 123 no longer supports and / or surrounds the staple 160. In such a situation, the cartridge body 142 may fully support the staple 160 during the remaining lifting operation. In at least one embodiment, the cartridge channel 123 and the cartridge body 142 may work together to support the staple 160 for half or about half of the lifting motion. In other embodiments, the cartridge channel 123 and the cartridge body 142 may work together to support the staple 160 for less than half or longer than half the lifting motion. In some cases, the cartridge body 142 and the cartridge channel 123 may work together to support and / or surround the staple 160 throughout the lifting operation of the staple 160.

The various embodiments described herein are described in the context of linear end effectors and / or linear fastener cartridges. Such embodiments and their teachings may be applied to non-linear end effectors and / or non-linear fastener cartridges, such as circular and / or undulating end effectors. For example, various end effectors, including non-linear end effectors, are described in US Patent Application No. 13 / 036,647 filed February 28, 2011, entitled "SURGICAL STAPLING INSTRUMENT" (current US Patent Application Publication No. 2011/0226837). ), Which is incorporated herein by reference in its entirety. In addition, US Pat. The whole is incorporated herein. US Patent Application No. 12 / 031,873 filed on February 15, 2008, named "END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT", current US Patent No. 7,980,443 are also incorporated herein by reference in their entirety. The full disclosure of US Pat. No. 7,845,537, entitled "SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES", issued December 7, 2010, is incorporated herein by reference. See all disclosures of U.S. Patent Application Nos. 13 / 118,241, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS" (current U.S. Patent Application Publication No. 2012/0298719, filed May 27, 2011). Is incorporated herein by.

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

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

Any patent gazette or other disclosure, in whole or in part, which is incorporated herein by reference, is the current definition, description, or other disclosure whose content is incorporated herein by reference. It is incorporated herein only to the extent that it is consistent with. Accordingly, to the extent necessary, the disclosures expressly set forth herein shall supersede any contradictory literature incorporated herein by reference. Any document, or portion thereof, that is incorporated herein by reference but is inconsistent with existing definitions, descriptions, or other disclosed documents described herein is in reference and existing. It shall be incorporated only to the extent that there is no contradiction with the disclosed content of.

Although the present invention has been described as having an exemplary design, the present invention may be further modified within the spirit and scope of the present disclosure. Accordingly, this application shall include any modification, use, or adaptation of the invention that uses its general principles. Further, the present application shall include such deviations from the present disclosure as being known or becoming customary in the field in which the invention relates.

[Implementation mode]
(1) Staple cartridge,
Cartridge body and
The staple cavity defined in the cartridge body and
A staple that is removable within the staple cavity, wherein the staple comprises a plurality of drive surfaces, the drive surfaces being configured to move along parallel paths within the staple cartridge. Staple cartridge with staples.
(2) The staple is
A base portion including an intermediate portion, wherein the intermediate portion further includes an inclined drive surface.
The staple cartridge according to the first embodiment, further comprising a pair of legs located on the side surface of the intermediate portion.
(3) The staple cavity is
Proximal end and
At the distal end,
Longitudinal guide surface extending between the proximal end and the distal end, wherein the intermediate portion of the base is configured to move along the longitudinal guide surface. The staple cartridge according to embodiment 2, further comprising a directional guide surface.
(4) The base is configured to move along the first path, and the legs are configured to move along a second path parallel to the first path. The staple cartridge according to aspect 2.
(5) The staple cartridge according to the first embodiment, wherein the drive surface is offset in the longitudinal direction.

(6) The plurality of drive surfaces include a first drive surface and a second drive surface, the first drive surface further includes a protrusion, and the second drive surface further includes an inclined surface. The staple cartridge according to aspect 1.
(7) The staple cartridge according to the first embodiment, wherein the thread is configured to lift the drive surface along the parallel path in the staple cartridge.
(8) Surgical staples
1st staple leg and
2nd staple leg and
Surgical staples with multiple separate, separate staple drive surfaces.
(9) The surgical staple according to embodiment 8, wherein the separate, separate staple drive surfaces are offset in the longitudinal direction.
(10) The surgical staple according to embodiment 8, wherein the separate, separate staple drive surfaces are offset laterally.

(11) The surgical staple according to embodiment 8, further comprising a base, wherein the first and second staple legs extend from the base.
(12) The base comprises the plurality of separate, separate staple drive surfaces, and the separate, separate staple drive surfaces.
Separate, separate first drive surface,
The surgical staple according to embodiment 11, comprising a separate, separate second driving surface.
(13) The surgical staple according to embodiment 12, wherein the first drive surface is aligned with the first staple leg portion, and the second drive surface is offset from the first staple leg portion.
(14) The surgical staple according to embodiment 12, wherein at least one of the staple driving surfaces has a protrusion.
(15) The surgical staple according to embodiment 14, wherein at least one of the staple driving surfaces has an inclined surface.

(16) The surgical staple according to embodiment 8, wherein the plurality of separated, separate staple driving surfaces are integrally formed with the surgical staple.
(17) Staple cartridge
Cartridge body and
A staple cavity defined in the cartridge body, wherein a plurality of parallel lifting planes are defined across the staple cavity.
A staple that is removable and is located in the staple cavity.
A staple leg that is configured to move within the first lifting plane of the plurality of parallel lifting planes.
A staple cartridge comprising a staple, comprising a base, which is configured to move within a second lifting plane of the plurality of parallel lifting planes.
(18) The staple cavity is
Proximal end and
At the distal end,
Longitudinal guide surface extending between the proximal end and the distal end, wherein a portion of the base is configured to move along the longitudinal guide surface. The staple cartridge according to embodiment 17, further comprising a guide surface.
(19) The staple cartridge according to embodiment 17, wherein the staple further comprises a plurality of separate, separate drive surfaces.
(20) The staple cartridge according to embodiment 19, wherein the separated, separate drive surfaces are offset in the lateral and longitudinal directions.

Claims (7)

Surgical staples
1st staple leg and
2nd staple leg and
A base including an intermediate portion, wherein the first and second staple legs extend from the base.
With multiple separate, separate staple drive surfaces,
The first staple leg portion and the second staple leg portion define a first surface extending in the longitudinal direction.
The intermediate portion of the base defines a second surface that is parallel to the first surface and is offset laterally from the first surface.
A surgical staple in which at least one of the plurality of separate, separate staple drive surfaces comprises a protrusion. The surgical staple according to claim 1, wherein the plurality of separate, separate staple drive surfaces are offset in the longitudinal direction. The surgical staple according to claim 1, wherein the plurality of separate, separate staple drive surfaces are offset laterally. The plurality of separate, separate staple drive surfaces
A first drive surface that intersects the first surface and does not intersect the second surface,
The surgical staple according to claim 1, further comprising a second driving surface that intersects the second surface and does not intersect the first surface. The surgical staple according to claim 4, wherein the first drive surface is aligned with the first staple leg portion, and the second drive surface is offset from the first staple leg portion. The surgical staple according to claim 4, wherein at least one of the plurality of separate, separate staple drive surfaces comprises an inclined surface. The surgical staple according to claim 1, wherein the plurality of separated, separate staple driving surfaces are integrally formed with the surgical staple.

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