Tissue thickness compensator for a surgical stapler comprising an adjustable anvil

• US 8,864,009 B2
• Filed: 04/29/2011
• Issued: 10/21/2014
• Est. Priority Date: 09/30/2010
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Shelton, Frederick E. IV, Baxter, Chester O. III
• Primary Examiner(s): Tecco, Andrew M
• Assistant Examiner(s): CHUKWURAH, NATHANIEL C
• Application Number:
  US13/097,891
• Publication Number:
  US 20120080489A1
• Time in Patent Office: 1,271 Days
• Field of Search: 227/175.1, 227/176.1, 227/178.1, 227/179.1, 227/180.1, 227/19
• US Class Current: 227/175.1
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/0686 having a forming anvil staying below the tissue during stapling
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• 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 17/105 Wound clamp magazines for packaging sharps A61B50/3001
• CPC Class Codes: A61B 17/1155 Circular staplers comprising a plurality of staples
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/2909 Handles
• CPC Class Codes: A61B 17/295 combined with cutting implements
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/00327 : with actuating members moving in opposite directions
• CPC Class Codes: A61B 2017/00473 : Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/00477 : Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00526 : Methods of manufacturing
• CPC Class Codes: A61B 2017/0053 : Loading magazines or sutures into applying tools
• CPC Class Codes: A61B 2017/00818 : Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00862 : elastic or resilient for sutures A61B2017/0618
• CPC Class Codes: A61B 2017/00884 : enhancing wound closure
• CPC Class Codes: A61B 2017/00893 : pharmaceutically effective
• CPC Class Codes: A61B 2017/00951 : adhesive
• CPC Class Codes: A61B 2017/0409 : Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0641 : having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/0688 : Packages or dispensers for surgical staplers
• CPC Class Codes: A61B 2017/07214 : Stapler heads
• CPC Class Codes: A61B 2017/07221 : curved
• CPC Class Codes: A61B 2017/07228 : Arrangement of the staples
• CPC Class Codes: A61B 2017/07235 : containing different staples, e.g. staples of different shapes, sizes or materials
• CPC Class Codes: A61B 2017/07242 : achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
• 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 2017/07257 : characterised by its anvil
• CPC Class Codes: A61B 2017/07264 : characterised by its staple forming cavities, e.g. geometry or material
• CPC Class Codes: A61B 2017/07271 : characterised by its cartridge
• CPC Class Codes: A61B 2017/07278 : characterised by its sled or its staple holder
• CPC Class Codes: A61B 2017/2902 : characterized by features of the actuating rod
• CPC Class Codes: A61B 2017/2908 : Multiple segments connected by articulations
• CPC Class Codes: A61B 2017/291 : the position of the handle being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2916 : pins in guiding slots
• CPC Class Codes: A61B 2017/2919 : details of linkages or pivot points
• CPC Class Codes: A61B 2017/292 : connection of actuating rod to handle, e.g. ball end in recess
• CPC Class Codes: A61B 2017/2923 : Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2927 : the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2931 : with releasable head
• CPC Class Codes: A61B 2017/2933 : camming or guiding means
• CPC Class Codes: A61B 2017/2936 : Pins in guiding slots
• CPC Class Codes: A61B 2017/2944 : Translation of jaw members
• CPC Class Codes: A61B 2017/2946 : Locking means
• CPC Class Codes: A61B 2017/320052 : Guides for cutting instruments by marking A61B2090/395
• CPC Class Codes: A61B 2090/034 : abutting on parts of the device itself
• CPC Class Codes: A61B 2090/037 : with a frangible part, e.g. by reduced diameter
• CPC Class Codes: A61B 2090/0811 : for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 90/92 : coded with colour
• CPC Class Codes: B25C 5/1686 : using pre-loaded cassettes

Abstract

A fastener cartridge can comprise a support portion, a tissue thickness compensator positioned relative to the support portion, and a plurality of fasteners positioned within the support portion and/or the tissue thickness compensator which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein a second jaw, or anvil, can be positioned opposite the first jaw. To deploy the fasteners, a staple-deploying member is advanced through the fastener cartridge to move the fasteners toward the anvil. As the fasteners are deployed, the fasteners can capture at least a portion of the tissue thickness compensator therein along with at least a portion of the tissue being fastened.

Claims

1. A surgical stapler, comprising:

a staple cartridge, comprising;

a cartridge body comprising a plurality of staple cavities; and

a plurality of staples positioned within said staple cavities, wherein said plurality of staples are arranged in a longitudinal row;

an anvil assembly, comprising;

an anvil frame; and

an anvil comprising a positioning surface and at least one staple forming surface, wherein said anvil is movably retained to said anvil frame; and

an adjustment member movably positionable intermediate said anvil frame and said anvil, wherein said adjustment member comprises a first step comprising a first height and a second step comprising a second height, wherein said second height is different than said first height, and wherein said adjustment member is movable between a first position and a second position to selectively position one of said first step and said second step intermediate said anvil frame and said positioning surface,

wherein said anvil frame comprises a first guide portion, wherein said anvil comprises a second guide portion operably engaged with said first guide portion, and wherein said first guide portion and said second guide portion are configured to permit relative sliding movement between said anvil and said anvil frame;

wherein the surgical stapler further comprises a tissue thickness compensator, wherein said tissue thickness compensator is configured to be captured within said staples and assume different compressed heights within different said staples; and

wherein said plurality of staples comprises;

a first staple configured to capture a first thickness of tissue and a first portion of said tissue thickness compensator, wherein the first portion of said tissue thickness compensator is configured to assume a first height in response to the first thickness of tissue;

a second staple configured to capture a second thickness of tissue and a second portion of said tissue thickness compensator, wherein the second portion of said tissue thickness compensator is configured to assume a second height in response to the second thickness of tissue, wherein the second thickness of tissue is different than the first thickness of tissue, wherein the second height of said tissue thickness compensator is different than the first height of said tissue thickness compensator, and whereby variations in tissue thickness can be compensated for by said tissue thickness compensator.

2. The surgical stapler of claim 1, wherein said tissue thickness compensator is removably attached to said cartridge body.

3. The surgical stapler of claim 1, wherein said cartridge body comprises a deck, wherein at least a portion of each said staple extends above said deck and into said tissue thickness compensator.

4. The surgical stapler of claim 1, wherein said tissue thickness compensator comprises a first tissue contacting surface, wherein said anvil comprises a second tissue contacting surface, and wherein said second tissue contacting surface is spaced apart from said first tissue contacting surface when either of said first step and said second step is positioned intermediate said anvil frame and said positioning surface.

5. The surgical stapler of claim 1, wherein said tissue thickness compensator comprises a first tissue contacting surface, wherein said anvil comprises a second tissue contacting surface, wherein said second tissue contacting surface is spaced apart from said first tissue contacting surface when said first step is positioned intermediate said anvil frame and said positioning surface, and wherein said second tissue contacting surface is capable of being in contact with said first tissue contacting surface when said second step is positioned intermediate said anvil frame and said positioning surface.

6. The surgical stapler of claim 1, wherein said tissue thickness compensator comprises a first tissue contacting surface, wherein said anvil comprises a second tissue contacting surface, and wherein said second tissue contacting surface is capable of being in contact with said first tissue contacting surface when either of said first step and said second step is positioned intermediate said anvil frame and said positioning surface.

7. A surgical stapler, comprising:

a staple cartridge, comprising;

a cartridge body comprising a plurality of staple cavities; and

a plurality of staples positioned within said staple cavities;

an anvil assembly, comprising;

an anvil frame;

an anvil comprising a positioning surface and at least one staple forming surface; and

an adjustment member movably positionable intermediate said anvil frame and said anvil, wherein said adjustment member comprises;

a first step comprising a first height;

a second step comprising a second height, wherein said second height is different than said first height, and wherein said adjustment member is movable between a first position and a second position to selectively position one of said first step and said second step intermediate said anvil frame and said positioning surface; and

a third step comprising a third height, wherein said third height is different than said first height and said second height, and wherein said adjustment member is movable into a third position to position said third step intermediate said anvil frame and said positioning surface; and

a tissue thickness compensator, wherein said tissue thickness compensator is configured to be captured within said staples and assume different compressed heights within different said staples;

wherein said plurality of staples comprises;

a first staple configured to be deformed against said anvil to a deformed height to capture a first region of tissue and a first portion of said tissue thickness compensator along a longitudinal staple line, wherein the first portion of said tissue thickness compensator is configured to apply a first compressive pressure to the first region of tissue in response to a property of the first region of tissue; and

a second staple configured to be deformed against said anvil to the deformed height to capture a second region of tissue and a second portion of said tissue thickness compensator along the longitudinal staple line, wherein the second portion of said tissue thickness compensator is configured to apply a second compressive pressure to the second region of tissue in response to a property of the second region of tissue, wherein the second compressive pressure is different than the first compressive pressure, and whereby variations in tissue thickness can be compensated for by said tissue thickness compensator.

8. The surgical stapler of claim 7, wherein said tissue thickness compensator is removably attached to said cartridge body.

9. The surgical stapler of claim 7, wherein said cartridge body comprises a deck, wherein at least a portion of each said staple extends above said deck and into said tissue thickness compensator.

10. The surgical stapler of claim 7, wherein said tissue thickness compensator comprises a first tissue contacting surface, wherein said anvil comprises a second tissue contacting surface, and wherein said second tissue contacting surface is spaced apart from said first tissue contacting surface when any one of said first step, said second step, and said third step is positioned intermediate said anvil frame and said positioning surface.

11. The surgical stapler of claim 7, wherein said tissue thickness compensator comprises a first tissue contacting surface, wherein said anvil comprises a second tissue contacting surface, wherein said second tissue contacting surface is spaced apart from said first tissue contacting surface when said first step is positioned intermediate said anvil frame and said positioning surface, and wherein said second tissue contacting surface is capable of being in contact with said first tissue contacting surface when said second step is positioned intermediate said anvil frame and said positioning surface.

12. The surgical stapler of claim 7, wherein said tissue thickness compensator comprises a first tissue contacting surface, wherein said anvil comprises a second tissue contacting surface, and wherein said second tissue contacting surface is capable of being in contact with said first tissue contacting surface when any one of said first step, said second step, and said third step is positioned intermediate said anvil frame and said positioning surface.

13. A surgical stapler, comprising:

a staple cartridge, comprising;

a cartridge body comprising a plurality of staple cavities; and

a plurality of staples positioned within said staple cavities;

tissue thickness compensation means for compensating for different tissue thicknesses captured within different said staples, wherein said tissue thickness compensation means comprises a first tissue contacting surface; and

an anvil assembly, comprising;

an anvil frame;

an anvil comprising a second tissue contacting surface and at least one staple forming surface; and

adjustment means for selectively positioning said second tissue contacting surface relative to said first tissue contacting surface and for compensating for different tissue thicknesses;

wherein each said staple is configured to be deformed to a deformed height by said anvil, wherein each said staple defines a staple entrapment area when deformed to said deformed height, wherein each said staple is configured to capture a portion of said tissue thickness compensator and a portion of tissue in the staple entrapment area, and wherein the thickness of each said portion of said tissue thickness compensator captured within each said staple is dependent on the thickness of the portion of tissue also captured within said staple.

14. The surgical stapler of claim 13, wherein said tissue thickness compensation means is removably attached to said cartridge body.

15. The surgical stapler of claim 13, wherein said cartridge body comprises a deck, wherein at least a portion of each said staple extends above said deck and into said tissue thickness compensation means.

16. The surgical stapler of claim 13, wherein said anvil is movable into a closed position, and wherein said second tissue contacting surface is not in contact with said first tissue contacting surface when said anvil is in said closed position.

17. The surgical stapler of claim 13, wherein said anvil is movable into a closed position, and wherein said second tissue contacting surface is configured to be in contact with said first tissue contacting surface when said anvil is in said closed position.

18. A surgical stapler, comprising:

a staple cartridge, comprising;

a cartridge body comprising a plurality of staple cavities;

a plurality of staples positioned within said staple cavities, wherein said plurality of staples comprises a first staple and a second staple; and

a plurality of staple drivers supporting said plurality of staples, wherein said staple drivers are movable to a fired height to move said staples between an unfired position and a fired position;

tissue thickness compensation means for compensating for different tissue thicknesses captured within different said staples along a staple line based on the variable thickness of tissue along the staple line, wherein said first staple is configured to capture a first portion of said tissue thickness compensator, wherein said second staple is configured to capture a second portion of said tissue thickness compensator, and wherein the thickness of the first portion of said tissue thickness compensator is different than the thickness of the second portion of said tissue thickness compensator;

an anvil comprising a plurality of forming pockets configured to deform said staples to a fired height when said staples are moved into said fired position; and

an adjuster configured to move said forming pockets relative to said fired height of said staple drivers to adjust said fired height of said staples.

19. The surgical stapler of claim 18, wherein said anvil comprises an anvil frame and an anvil plate, wherein said anvil plate comprises said forming pockets, and wherein said anvil plate is positionable relative to said anvil frame by said adjuster.

20. The surgical stapler of claim 19, wherein said adjuster is configured to slide between said anvil frame and said anvil plate.