Staple cartridge comprising a variable thickness compressible portion

• US 10,136,890 B2
• Filed: 04/29/2011
• Issued: 11/27/2018
• Est. Priority Date: 09/30/2010
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon, LLC (Johnson & Johnson)
• Inventors: Shelton, IV, Frederick E., Baxter, III, Chester O., Swayze, Jeffrey S., Morgan, Jerome R., Rhee, Sora, Aronhalt, Taylor W.
• Primary Examiner(s): Chukwurah, Nathaniel
• Application Number:
  US13/097,954
• Publication Number:
  US 20120080340A1
• Time in Patent Office: 2,769 Days
• Field of Search: 2271751, 2271761, 2271791, 2271801, 2271811, 606153, 606219
• 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 instrument, comprising:

an anvil, comprising a longitudinal row of first forming pockets and a longitudinal row of second forming pockets;

a firing member comprising a first cam and a second cam, wherein said first cam comprises a resilient pad, and wherein said second cam is configured to engage said anvil;

a staple cartridge, wherein said staple cartridge is movable relative to said anvil between a first position and a second position, and wherein said staple cartridge comprises;

a cartridge body, comprising;

a deck, comprising;

a longitudinal slot;

a first deck surface positioned on a first side of said longitudinal slot; and

a second deck surface positioned on a second side of said longitudinal slot;

a bottom portion positioned opposite said deck;

a proximal end;

a distal end;

a longitudinal row of first staple cavities extending between said proximal end and said distal end, wherein said first forming pockets are positioned relative to said first staple cavities when said staple cartridge is in said second position; and

a longitudinal row of second staple cavities extending between said proximal end and said distal end, wherein said second forming pockets are positioned relative to said second staple cavities when said staple cartridge is in said second position, and wherein each said first staple cavity and said second staple cavity comprises an opening in said deck;

a metal support extending under said bottom portion, wherein said metal support comprises a bottom cam surface configured to be engaged by said first cam of said firing member to position said cartridge body relative to said anvil;

a plurality of first staple drivers movable between an unfired position and a fired position, wherein each said first staple driver comprises a first support cradle, and wherein a first distance is defined between each said first support cradle and a said first forming pocket when said first staple drivers are in said unfired position;

a plurality of second staple drivers movable between an unfired position and a fired position, wherein each said second staple driver comprises a second staple support cradle, wherein a second distance is defined between each said second support cradle and a said second forming pocket when said second staple drivers are in said unfired position, and wherein said first distance is different than said second distance;

a plurality of first staples, wherein each said first staple is positioned in a said first staple cavity and supported by a said first support cradle, and wherein said first staples comprise a first unformed height;

a plurality of second staples, wherein each said second staple is positioned in a said second staple cavity and supported by a said second support cradle, wherein said second staples comprise a second unformed height, and wherein said first unformed height is different than said second unformed height;

a first tissue thickness compensator, wherein said first tissue thickness compensator comprises polyglycolic acid, wherein said first tissue thickness compensator extends across said longitudinal slot between said first deck surface and said second deck surface, wherein said first tissue thickness compensator comprises a first portion on a first side of said longitudinal slot and a second portion on said first side of said longitudinal slot, wherein said first portion is positioned closer to said longitudinal slot than said second portion, wherein said first portion is aligned with said first staple cavities and is configured to be captured within said first staples along with tissue having a variable thickness, wherein said second portion is aligned with said second staple cavities and is configured to be captured within said second staples along with tissue having a variable thickness, and wherein said first portion is configured to assume different compressed thickness in response to the varying thickness of the tissue;

a first proximal anchor; and

a first distal anchor, wherein said first proximal anchor and said first distal anchor are configured to releasably hold said first tissue thickness compensator to said cartridge body, and wherein said first proximal anchor and said first distal anchor are configured to be incised to release said first tissue thickness compensator from said cartridge body;

a second tissue thickness compensator, wherein said second tissue thickness compensator comprises polyglycolic acid, wherein said second tissue thickness compensator is configured to be captured within said first staples and said second staples along with the tissue having a variable thickness, and wherein said second tissue thickness compensator is configured to assume different compressed thickness in response to the varying thickness of the tissue;

a second proximal anchor;

a second distal anchor, wherein said second proximal anchor and said second distal anchor are configured to releasably hold said second tissue thickness compensator to said anvil, and wherein said second proximal anchor and said second distal anchor are configured to be incised to release said second tissue thickness compensator from said anvil; and

a joint configured to rotatably connected said staple cartridge to said surgical instrument.

2. The surgical instrument of claim 1, wherein said longitudinal slot is configured to receive a cutting member.

3. A surgical stapler, comprising:

an anvil, wherein said anvil comprises a forming surface comprising a longitudinal row of first forming pockets and a longitudinal row of second forming pockets;

a firing member comprising a bottom cam and a top cam, wherein said bottom cam comprises a resilient pad, and wherein said top cam is configured to engage said anvil;

a cutting member;

a staple cartridge, wherein said staple cartridge is movable relative to said anvil between a first position and a second position, and wherein said staple cartridge comprises;

a cartridge body, comprising;

a deck, comprising;

a slot configured to receive a cutting member;

a first deck surface positioned on a first side of said slot; and

a second deck surface positioned on a second side of said slot;

a bottom portion positioned opposite said deck;

a longitudinal row of first staple cavities, wherein said first forming pockets are positioned relative to said first staple cavities when said staple cartridge is in said second position; and

a longitudinal row of second staple cavities, wherein said second forming pockets are positioned relative to said second staple cavities when said staple cartridge is in said second position, and wherein each said staple cavity comprises an opening in said deck;

a metal support extending under said bottom portion, wherein said metal support comprises a bottom cam surface configured to be engaged by said bottom cam of said firing member to position said cartridge body relative to said anvil;

a plurality of first staple drivers movable between an unfired position and a fired position, wherein each said first staple driver comprises a first support cradle, and wherein a first distance is defined between each said first support cradle and a first forming pocket when said first staple drivers are in said unfired position;

a plurality of second staple drivers movable between an unfired position and a fired position, wherein each said second staple driver comprises a second support cradle, wherein a second distance is defined between each said second support cradle and a second forming pocket when said second staple drivers are in said unfired position, and wherein said first distance is different than said second distance;

a plurality of first staples, wherein each said first staple is positioned in a said first staple cavity and supported by a said first support cradle, wherein said first staples comprise a first unformed height, and wherein said first staples are formed to a first formed height against said anvil;

a plurality of second staples, wherein each said second staple is positioned in a said second staple cavity and supported by a said second support cradle, wherein said second staples comprise a second unformed height, wherein said second staples are formed to second formed height against said anvil, wherein said first unformed height is less than said second unformed height, and wherein said first formed height is less than said second formed height;

a first tissue thickness compensator, wherein said first tissue thickness compensator comprises polyglycolic acid, wherein said first tissue thickness compensator extends across said slot, wherein said first tissue thickness compensator comprises a first portion comprising a first uncompressed height positioned over a portion of said first deck surface and a second portion comprising a second uncompressed height positioned over another portion of said first deck surface, and wherein said first tissue thickness compensator is configured to be captured within said first staples and said second staples along with tissue having a variable thickness and assume different compressed heights within different said first staples and said second staples, wherein said first portion is configured to assume first compressed thicknesses in response to the variable thickness of the tissue, wherein said second portion is configured to assume second compressed thicknesses in response to the variable thickness of the tissue, and wherein said first portion is positioned closer to said slot than said second portion;

a first proximal tether; and

a first distal tether, wherein said first proximal tether and said first distal tether are configured to restrain said first tissue thickness compensator to said cartridge body, and wherein said first proximal tether and said first distal tether are configured to be incised by said cutting member to release said first tissue thickness compensator from said cartridge body;

a second tissue thickness compensator, wherein said second tissue thickness compensator comprises polyglycolic acid, wherein said second tissue thickness compensator extends across said forming surface of said anvil, wherein said second tissue thickness compensator is configured to be captured within said first staples and said second staples along with the tissue having a variable thickness, and wherein said second tissue thickness compensator is configured to assume different compressed thicknesses in response to the varying thickness of the tissue;

a second proximal tether;

a second distal tether, wherein said second proximal tether and second said distal tether are configured to releasably hold said second tissue thickness compensator to said anvil, and wherein said second proximal tether and second said distal tether are configured to be incised by said cutting member to release said second tissue thickness compensator from said anvil; and

a joint configured to rotatably connect said staple cartridge to said surgical stapler.

4. The surgical stapler of claim 3, wherein said first deck surface defines a first support plane and said second deck surface defines a second support plane, and wherein said first support plane is not parallel to said second support plane.

5. The surgical stapler of claim 4, wherein said first portion of said first tissue thickness compensator comprises a first tissue-contacting surface, wherein said first tissue-contacting surface defines a first top plane, wherein said second portion of said first tissue thickness compensator comprises a second tissue-contacting surface, wherein said second tissue-contacting surface defines a second top plane, and wherein said first top plane is not parallel to said second top plane and wherein said first portion and said second portion are positioned on said first side of said slot.

6. The surgical stapler of claim 5, wherein said first support plane is parallel to said first top plane, and wherein said second support plane is parallel to said second top plane.

7. The surgical stapler of claim 5, wherein said first support plane is not parallel to said first top plane, and wherein said second support plane is not parallel to said second top plane.

8. The surgical stapler of claim 3, wherein said first deck surface defines a first support contour and said second deck surface defines a second support contour, and wherein neither said first support contour nor said second support contour are flat.

9. The surgical stapler of claim 8, wherein said first portion of said first tissue thickness compensator comprises a first tissue-contacting surface, wherein said first tissue-contacting surface defines a first top contour, wherein said second portion of said first tissue thickness compensator comprises a second tissue-contacting surface, wherein said second tissue-contacting surface defines a second top contour, and wherein neither said first top contour nor said second top contour are flat.

10. The surgical stapler of claim 9, wherein said first support contour is parallel to said first top contour, and wherein said second support contour is parallel to said second top contour.

11. The surgical stapler of claim 9, wherein said first support contour is not parallel to said first top contour, and wherein said second support contour is not parallel to said second top contour.

12. A surgical instrument, comprising:

an end effector;

an anvil, wherein said anvil comprises a forming surface comprising a longitudinal row of first forming pockets and a longitudinal row of second forming pockets;

a firing member comprising a bottom cam and a top cam, wherein said bottom cam comprises a resilient pat, and wherein said top cam is configured to engage said anvil;

a cutting member;

a staple cartridge, wherein said staple cartridge is movable relative to said anvil between a first position and a second position, and wherein said staple cartridge comprises;

a cartridge body, comprising;

a proximal end;

a distal end, wherein said cartridge body defines a longitudinal axis extending between said proximal end and said distal end;

a deck surface extending between said proximal end and said distal end, wherein said deck surface comprises a contour extending along said longitudinal axis between said proximal end and said distal end, wherein one of said proximal end and said distal end is positioned above the other of said proximal end and said distal end;

a bottom portion positioned opposite said deck surface;

a longitudinal row of first staple cavities extending between said proximal end and said distal end, wherein said first forming pockets are positioned relative to said first staple cavities when said end effector is in a closed position; and

a longitudinal row of second staple cavities extending between said proximal end and said distal end, wherein said second forming pockets are positioned relative to said second staple cavities when said end effector is in said closed position, and wherein each said first staple cavity and said second staple cavity comprises an opening in said deck surface;

a metal support extending under said bottom portion, wherein said metal support comprises a bottom cam surface configured to be engaged by said bottom cam of said firing member to position said cartridge body relative to said anvil;

a plurality of first staple drivers movable between an unfired position and a fired position, wherein each said first staple driver comprises a first support cradle, and wherein a first distance is defined between each said first support cradle and a said first forming pocket when said first staple drivers are in said unfired position;

a plurality of second staple drivers movable between an unfired position and a fired position, wherein each said second staple driver comprises a second support cradle, wherein a second distance is defined between each said second support cradle and a said second forming pocket when said second staple drivers are in said unfired position, and wherein said first distance is different than said second distance;

a plurality of first staples, wherein each said first staple is positioned in a said first staple cavity, wherein said first staples comprise a first unformed height, and wherein said first staples are formed to a first formed height;

a plurality of second staples, wherein each said second staple is positioned in a said second staple cavity, wherein said second staples comprise a second formed height, wherein said second staples are formed to a second formed height, wherein said first unformed height is less than said second unformed height, and wherein said first formed height is less than said second formed height;

a first tissue thickness compensator positioned against said deck surface, wherein said first tissue thickness compensator comprises polyglycolic acid, wherein said first tissue thickness compensator is configured to be captured within said first staples and said second staples and assume different compressed heights within different said staples;

a first proximal restraint; and

a first distal restraint, wherein first said proximal restraint and said first distal restraint are configured to hold said first tissue thickness compensator to said cartridge body, and wherein said first proximal restraint and said first distal restraint are configured to be sequentially incised to release said first tissue thickness compensator from said cartridge body;

a second tissue thickness compensator positioned against said forming surface, wherein said second tissue thickenss compensator comprises polyglycolic acid, wherein said second tissue thickness compensator is configured to be captured within said first staples and said second staples and assume different compressed heights within different said staples;

a second proximal restraint;

a second distal restraint, wherein second said proximal restraint and said second distal restraint are configured to hold said second tissue thickness compensator to said anvil, and wherein said second proximal restraint and said second distal restraint are configured to be sequentially incised to release said second tissue thickness compensator from said anvil; and

a joint configured to rotatably connect said staple cartridge to said end effector.

13. The surgical instrument of claim 12, wherein said proximal end is positioned above said distal end, wherein said first tissue thickness compensator comprises a proximal portion removably positioned over said proximal end of said deck and a distal portion removably positioned over said distal end of said deck, and wherein said first tissue thickness compensator comprises a proximal thickness at said proximal portion which is thinner than a distal thickness at said distal portion.

14. The surgical instrument of claim 12, wherein said first tissue thickness compensator comprises a top surface, and wherein said top surface is flat.

15. A surgical instrument, comprising:

an end effector;

an anvil;

a firing member comprising a bottom cam and a top cam, wherein said bottom cam comprises a resilient pad, and wherein said top cam is configured to engage said anvil;

a cutting member; and

a staple cartridge, wherein said staple cartridge is movable relative to said anvil between a first position and a second position, wherein said staple cartridge comprises;

a cartridge body, comprising;

a deck;

a longitudinal channel;

a longitudinal row of first staple cavities defined in said deck;

a plurality of first staples, wherein each said first staple comprises a first unfired height, and wherein a said first staple is positioned in each said first staple cavity;

a longitudinal row of second staple cavities defined in said deck;

a plurality of second staples, wherein each said second staple comprises a second unfired height, wherein said second unfired height is different than said first unfired height, and wherein a said second staple is positioned in each said second staple cavity; and

a bottom portion positioned opposite said deck;

a metal support extending under said bottom portion, wherein said metal support comprises a bottom cam surface configured to be engaged by said bottom cam of said firing member to position said cartridge body relative to said anvil;

a first tissue thickness compensator, wherein said first tissue thickness compensator comprise polyglycolic acid, wherein said first tissue thickness compensator comprises a first portion having a first uncompressed thickness and a second portion having a second uncompressed thickness, wherein said first portion is aligned with said first staple cavities and is configured to be captured within said first staples along with tissue having a variable thickness, wherein said second portion is aligned with said second staple cavities and is configured to be captured within said second staples along with tissue having a variable thickness, wherein said first portion is configured to assume different compressed thicknesses in response to the varying thickness of the tissue, and wherein said first portion is positioned closer to said longitudinal channel than said second portion;

a first proximal anchor;

a first distal anchor, wherein said first proximal anchor and said first distal anchor are configured to restrain said first tissue thickness compensator to said cartridge body, and wherein said first proximal anchor and said first distal anchor are configured to be sequentially incised to release said first tissue thickness compensator from said cartridge body;

a second tissue thickness compensator positioned against a forming surface of said anvil, wherein said first tissue thickness compensator comprises polyglycolic acid, and wherein said second tissue thickness compensator is configured to be captured within said first staples and said second staples;

a second proximal anchor;

a second distal anchor, wherein said second proximal anchor and said second distal anchor are configured to releasable retain said second tissue thickness compensator to said anvil; and

a joint configured to rotatably connect said staple cartridge to said end effector.

16. The surgical instrument of claim 15, wherein said first tissue thickness compensator is comprised of a porous material.

17. The surgical instrument of claim 16, wherein said porous material comprises a porosity of 85% or more.

18. The surgical instrument of claim 15, further comprising a staple driver which is configured to move at least one said first staple and at least one said second staple toward said anvil simultaneously.

19. The surgical instrument of claim 15, further comprising:

a row of third staple cavities defined in said deck;

a plurality of third staples, wherein each said third staple comprises a third unfired height, wherein said third unfired height is different than said first unfired height and said second unfired height, wherein a said third staple is positioned in each said third staple cavity; and

wherein said first tissue thickness compensator comprises a third portion having a third uncompressed thickness which is aligned with said third staple cavities and is configured to be captured within said third staples.

20. The surgical instrument of claim 19, further comprising a staple driver which is configured to move at least one said first staple, at least one said second staple, and at least one said third staple toward said anvil simultaneously.