Tissue thickness compensators comprising therapeutic agents

• US 9,572,574 B2
• Filed: 06/22/2015
• Issued: 02/21/2017
• Est. Priority Date: 09/30/2010
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery LLC (Johnson & Johnson)
• Inventors: Shelton, Frederick E. IV, Schmid, Katherine J., Scheib, Charles J., Aronhalt, Taylor W., Swayze, Jeffrey S., Contiliano, Joseph H., Yang, Chunlin, Henderson, Cortney E., Aldridge, Jeffrey L.
• Primary Examiner(s): Lopez, Michelle
• Application Number:
  US14/746,373
• Publication Number:
  US 20150282809A1
• Time in Patent Office: 610 Days
• Field of Search: 227/175.1, 227/176.1, 227/180.1, 606/151
• US Class Current: 1/1
• 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 17/072 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 17/30 Surgical pincettes without pivotal connectionsfor holding suture needles or materials A61B17/0483; wound clamps A61B17/08 ; hand-held gripping tools without pivotal connections in general B25B9/02
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• 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 2017/00893 pharmaceutically effective
• CPC Class Codes: A61B 2017/00991 Telescopic means
• 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 2017/07257 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 2017/2916 : pins in guiding slots
• CPC Class Codes: A61B 2017/2923 : Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2937 : with flexible part

Abstract

An end effector is disclosed. The end effector comprises a first jaw, a second jaw, wherein at least one of the first jaw and the second jaw is movable to compress tissue between the first jaw and the second jaw, and a cartridge body configured to receive a cutting member. The end effector further comprises a layer arrangement including a tissue contact surface and a plurality of therapeutic agents releasably contained within the layer arrangement, wherein each therapeutic agent is configured to either initially treat the tissue or sustainably treat the tissue in contact with the tissue contact surface, wherein one of the plurality of therapeutic agents is configured to be released by the cutting member, and wherein another of the plurality of therapeutic agents is configured to be released by an absorption process.

Claims

1. An end effector, comprising:

a first jaw;

a second jaw, wherein at least one of said first jaw and said second jaw is movable to compress tissue between said first jaw and said second jaw;

a cartridge body configured to receive a cutting member;

a compensator including a tissue contact surface;

a first therapeutic agent releasably contained within said compensator, wherein said first therapeutic agent is configured to initially treat the tissue in contact with said tissue contact surface, and wherein said first therapeutic agent is configured to be released by the cutting member; and

a second therapeutic agent releasably contained within said compensator, wherein said second therapeutic agent is configured to sustainably treat the tissue in contact with said tissue contact surface, wherein said second therapeutic agent is configured to be released by an absorption process, and wherein said second therapeutic agent is different than said first therapeutic agent.

2. The end effector of claim 1, further comprising:

a first pocket defined in said tissue contact surface, wherein said first pocket is configured to release said first therapeutic agent; and

a second pocket defined in said tissue contact surface, wherein said second pocket is configured to release said second therapeutic agent.

3. The end effector of claim 2, further comprising the cutting member, wherein said compensator further includes a longitudinal axis defining a cutting path for said cutting member on said tissue contact surface, wherein said first pocket extends across said longitudinal axis, and wherein said second pocket does not extend across said longitudinal axis.

4. The end effector of claim 2, wherein said first pocket is one of a plurality of first pockets defined in said tissue contact surface, and wherein said second pocket is one of a plurality of second pockets defined in said tissue contact surface.

5. The end effector of claim 4, wherein said compensator further comprises a longitudinal axis, and wherein said first pockets and said second pockets extend across said longitudinal axis.

6. The end effector of claim 4, wherein said first pockets and said second pockets are arranged on said tissue contact surface in a pattern.

7. The end effector of claim 4, further comprising:

a means for releasing said first therapeutic agent from a said first pocket; and

,

a means for releasing said second therapeutic agent from a said second pocket.

8. The end effector of claim 7, wherein said means for releasing said second therapeutic agent is different than said means for releasing said first therapeutic agent.

9. The end effector of claim 1, wherein said first therapeutic agent comprises a hemostatic agent.

10. The end effector of claim 1, wherein said first therapeutic agent comprises an anti-inflammatory agent.

11. The end effector of claim 1, wherein said second therapeutic agent comprises an antimicrobial agent.

12. The end effector of claim 1, wherein said second therapeutic agent comprises an anticancer agent.

13. An end effector, comprising:

a first jaw;

a second jaw, wherein at least one of said first jaw and said second jaw is movable to compress tissue between said first jaw and said second jaw;

a layer assembly including a tissue contact surface;

a cartridge body configured to receive a cutting member;

a first medicament releasably held within said layer assembly, wherein said first medicament is configured to initially treat the tissue in contact with said tissue contact surface, and wherein said first medicament is configured to be released by the cutting member; and

a second medicament releasably held within said layer assembly, wherein said second medicament is configured to sustainably treat the tissue in contact with said tissue contact surface, and wherein said second medicament is configured to be released by an absorption process.

14. The end effector of claim 13, wherein said second medicament is different than said first medicament.

15. The end effector of claim 13, wherein said layer assembly comprises a first layer and a second layer, wherein said first layer and said second layer define a first packet and a second packet in said tissue contact surface, wherein said first packet is configured to release said first medicament, and wherein said second packet is configured to release said second medicament.

16. The end effector of claim 15, wherein said first packet is one of a plurality of first packets defined in said tissue contact surface, and wherein said second packet is one of a plurality of second packets defined in said tissue contact surface.

17. The end effector of claim 16, wherein said layer assembly further comprises a longitudinal axis, a proximal end, and a distal end, and wherein said first packets and said second packets extend across said longitudinal axis from said proximal end to said distal end.

18. The end effector of claim 17, wherein said first packets and said second packets are arranged on said tissue contact surface in a pattern.

19. An end effector, comprising:

a first jaw;

a second jaw, wherein at least one of said first jaw and said second jaw is movable to compress tissue between said first jaw and said second jaw;

a layer assembly including a tissue contact surface;

a first medicament releasably held within said layer assembly, wherein said first medicament is configured to initially treat the tissue in contact with said tissue contact surface; and

a second medicament releasably held within said layer assembly, wherein said second medicament is configured to sustainably treat the tissue in contact with said tissue contact surface;

wherein said layer assembly comprises a first layer and a second layer, wherein said first layer and said second layer define a first packet and a second packet in said tissue contact surface, wherein said first packet is configured to release said first medicament, wherein said second packet is configured to release said second medicament, wherein said first packet is one of a plurality of first packets defined in said tissue contact surface, wherein said second packet is one of a plurality of second packets defined in said tissue contact surface, and wherein said first packets and said second packets are configured to release said first medicament and said second medicament respectively by rupturing when the tissue is compressed.

20. An end effector, comprising:

a first jaw;

a second jaw, wherein at least one of said first jaw and said second jaw is movable to compress tissue between said first jaw and said second jaw;

a layer assembly including a tissue contact surface;

a first medicament releasably held within said layer assembly, wherein said first medicament is configured to initially treat the tissue in contact with said tissue contact surface; and

a second medicament releasably held within said layer assembly, wherein said second medicament is configured to sustainably treat the tissue in contact with said tissue contact surface;

wherein said layer assembly comprises a first layer and a second layer, wherein said first layer and said second layer define a first packet and a second packet in said tissue contact surface, wherein said first packet is configured to release said first medicament, wherein said second packet is configured to release said second medicament, wherein said first packet is one of a plurality of first packets defined in said tissue contact surface, and wherein said second packet is one of a plurality of second packets defined in said tissue contact surface, the end effector further comprising;

a cutting member, wherein said first packets and said second packets are configured to release said first medicament and said second medicament respectively when incised by said cutting member.

21. An end effector, comprising:

a first jaw;

a second jaw, wherein at least one of said first jaw and said second jaw is movable to compress tissue between said first jaw and said second jaw;

a layer assembly including a tissue contact surface;

a first medicament releasably held within said layer assembly, wherein said first medicament is configured to initially treat the tissue in contact with said tissue contact surface; and

a second medicament releasably held within said layer assembly, wherein said second medicament is configured to sustainably treat the tissue in contact with said tissue contact surface;

wherein said layer assembly comprises a first layer and a second layer, wherein said first layer and said second layer define a first packet and a second packet in said tissue contact surface, wherein said first packet is configured to release said first medicament, wherein said second packet is configured to release said second medicament, wherein said first packet is one of a plurality of first packets defined in said tissue contact surface, and wherein said second packet is one of a plurality of second packets defined in said tissue contact surface, the end effector further comprising;

a staple cartridge including staples, wherein said first packets and said second packets are configured to release said first medicament and said second medicament respectively when punctured by said staples.

22. An end effector, comprising:

a first jaw;

a second jaw, wherein at least one of said first jaw and said second jaw is movable to compress tissue between said first jaw and said second jaw;

a cartridge body configured to receive a cutting member;

a layer arrangement including a tissue contact surface; and

a plurality of therapeutic agents releasably contained within said layer arrangement, wherein each therapeutic agent is configured to either initially treat the tissue or sustainably treat the tissue in contact with said tissue contact surface, wherein one of said plurality of therapeutic agents is configured to be released by the cutting member, and wherein another of said plurality of therapeutic agents is configured to be released by an absorption process.

23. An end effector, comprising:

a first jaw;

a second jaw, wherein at least one of said first jaw and said second jaw is movable to compress tissue between said first jaw and said second jaw;

a layer assembly, comprising;

a tissue contact surface;

a first packet;

a first medicament releasably held within said first packet, wherein said first medicament is configured to initially treat the tissue in contact with said tissue contact surface;

a second packet; and

a second medicament releasably held within said second packet, wherein said second medicament is configured to sustainably treat the tissue in contact with said tissue contact surface; and

a cutting member configured to incise said first packet and said second packet, wherein said first packet is configured to release said first medicament and said second packet is configured to release said second medicament when incised by said cutting member.

24. An end effector, comprising:

a first jaw;

a second jaw, wherein at least one of said first jaw and said second jaw is movable to compress tissue between said first jaw and said second jaw;

a layer assembly, comprising;

a tissue contact surface;

a first packet;

a first medicament releasably held within said first packet, wherein said first medicament is configured to initially treat the tissue in contact with said tissue contact surface;

a second packet; and

a second medicament releasably held within said second packet, wherein said second medicament is configured to sustainably treat the tissue in contact with said tissue contact surface; and

a staple cartridge including staples, wherein said first packet is configured to release said first medicament and said second packet is configured to release said second medicament when punctured by said staples.

25. An end effector, comprising:

a first jaw;

a second jaw, wherein at least one of said first jaw and said second jaw is movable to compress tissue between said first jaw and said second jaw;

a layer assembly, comprising;

a tissue contact surface;

a first packet;

a first medicament releasably held within said first packet, wherein said first medicament is configured to initially treat the tissue in contact with said tissue contact surface;

a second packet; and

a second medicament releasably held within said second packet, wherein said second medicament is configured to sustainably treat the tissue in contact with said tissue contact surface; and

wherein said first packet is ruptured to release said first medicament and said second packet is ruptured to release said second medicament when the tissue is compressed between said first jaw and said second jaw.