Surgical Fastening Device With Initiator Impregnation of a Matrix or Buttress to Improve Adhesive Application

• US 20090120994A1
• Filed: 11/09/2006
• Published: 05/14/2009
• Est. Priority Date: 11/09/2006
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Ortiz, Mark S., Shelton, Frederick E. IV, Voegele, James W., Hunt, John V., Plescia, David N., Murray, Michael A., Faller, Craig N., Kolata, Ronald J., Turner, Douglas J., McKenna, Robert H.
• Granted Patent: US 7,708,180 B2
• Time in Patent Office: Days
• US Class Current: 227/180.100
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/07292 Reinforcements for staple line, e.g. pledgets
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 2017/0725 with settable gap between anvil and cartridge, e.g. for different staple heights at different shots
• CPC Class Codes: A61B 2017/320052 Guides for cutting instruments by marking A61B2090/395

Abstract

A material comprising a matrix or a buttress is impregnated with an adhesive initiator and is used with a surgical stapling device and an adhesive. The tissue and material are stapled together, and a knife in the surgical stapling device cuts the tissue and the material. The adhesive is applied across the cut and sets up or polymerizes to seals the cut when the adhesive contacts the adhesive initiator. The surgical stapling device can place the staples in a linear, arcuate, or circular array, and can anastomose luminal tissue. The methods of use can include stapling luminal tissue end to end, stapling two portions of material onto ether side of tissue, and stapling two portions of tissue onto a portion of material. Additionally, a portion of adhesive filed material can be stapled onto one side of portion of tissue and the adhesive initiator impregnated material can be stapled onto the other. Cutting the material and tissue provides a path for the adhesive across the cut, and catalyzes the adhesive from contact with the adhesive initiator.

Claims

1. A surgical stapling instrument for clamping and stapling tissue comprising:

a) a handle, first and a second opposed tissue clamping members connected to the handle, at least one of the first and a second opposed tissue clamping members movable between an open position for receiving tissue and a closed position for stapling tissue therebetween, the first clamping member including a plurality of staples disposed therein in an array, the second clamping member comprising an anvil for forming the staples;

b) a first portion of biocompatible material containing an adhesive initiator and releasably attached to one of the first and second opposed tissue clamping members;

c) a second portion of biocompatible material containing a fluid adhesive and releasably attached to the other of the first and second opposed tissue clamping members; and

d) a knife operably movable between the first and a second opposed tissue clamping members, wherein when the tissue is clamped and stapled, the knife cuts through the tissue and the first and second portions of material to release the adhesive and the cut provides a passage for migration of the adhesive from the second portion of material to the adhesive initiator in the first portion of material to initiate hardening of the adhesive across the cut.

2. The surgical device of claim 1 wherein the first portion of biocompatible material and the second portion of biocompatible material is one or more selected from the group consisting of:

a) a buttress;

b) a matrix having a plurality of openings therein;

c) an open cell foam;

d) a closed cell foam; and

d) a fabric pad.

3. The surgical device of claim 2 wherein one or more of the first portion of biocompatible material and the second portion of biocompatible material is absorbable.

4. The surgical device of claim 2 wherein one or more of the first portion of biocompatible material and the second portion of biocompatible material includes at least one wicking feature.

5. The surgical device of claim 1 wherein the second portion of biocompatible material has a seal to hold the adhesive within, wherein the seal is one selected from the group consisting of:

a) a surface skin on the material;

b) a pouch;

c) a coating;

d) a gelatin; and

e) an absorbable biocompatible material.

6. The surgical device of claim 1 wherein the array of the plurality of staples is a one or more selected from the group consisting of:

a) a circular array;

b) an array of one or more rows; and

c) an arcuate array.

7. The surgical device of claim 1 wherein the adhesive is one or more selected from the group consisting of a polymerizable monomer, a polymerizable 1,1, 1,1-disubstituted ethylene monomer, and a cyanoacrylate formulation.

8. The surgical device of claim 1 wherein the adhesive initiator is one or more selected from the group consisting of:

a) a coating

b) combined with the material

c) contained within the material

9. The surgical device of claim 1 wherein the first portion of biocompatible material and the second portion of biocompatible material is one or more selected from the group consisting of epsilon.-caprolactone glycolide, bovine pericardium, polylactic acid, polyglycolic acid, polyglactin, polydioxanone, polyglyconate, whey protein, cellulose gum, starch, gelatin, silk, nylon, polypropylene, braided polyester, polybutester, polyethylene, and polyetheretherketones.

10. A method for securing a first and a second portion of tissue together with a plurality of staples and an adhesive comprising:

a) placing a portion of material containing an adhesive initiator between a first portion and a second portion of tissue;

b) clamping the material and the first and second portion of tissue between a first and a second clamping member of a surgical device with at least an edge of the material exposed;

c) stapling the two portions of tissue together with the portion of material therebetween with the plurality of staples in an array; and

d) applying an adhesive about the exposed material and the two portions of tissue to initiate the adhesive and secure the two portions of tissue together.

11. The method of claim 10 wherein the step of stapling the two portions of tissue together includes cutting the tissue and the material with the surgical device.

12. The method of claim 11 further comprising removing the tissue from the surgical device before applying the adhesive across the cut.

13. The method of claim 10 wherein the step of applying an adhesive about the exposed material and the two portions of tissue includes placing the adhesive across the cut.

14. The method of claim 10 wherein the portion of material includes at least one wicking feature and the step of applying the adhesive includes drawing the adhesive about the portion of material by wicking action.

15. The method of claim 10 wherein the step of applying an adhesive includes creating a seal.

16. The method of claim 10 wherein the step of stapling the clamped material includes forming the staples in a linear array.

17. The method of claim 10 wherein the step of stapling the clamped material includes forming the staples in a circular array.

18. A method for sealing a first portion and a second portion of tissue together with a plurality of staples and an adhesive comprising:

a) clamping the first portion and the second portion of tissue between a first portion of buttress and between a second portion of buttress with a surgical stapling device, the first portion of buttress containing an adhesive initiator;

b) stapling the first portion and the second portion of tissue between the first portion of buttress and the second portion of buttress by applying a plurality of staples in an array;

c) cutting the tissue and the buttress about the array of staples with a knife of the surgical device;

d) sealing the cut tissue and buttress together by applying an adhesive across the cut and initiating the adhesive by contacting the adhesive with the adhesive initiator in the first portion of buttress.

19. The method of claim 18 wherein the step of sealing the cut tissue and buttress together includes the step of applying the adhesive to the cut with an adhesive applicator.

20. The method of claim 18 wherein the second portion of buttress contains an adhesive sealed therein wherein the step of cutting the tissue and the buttress includes releasing the adhesive from the second portion of buttress.