TISSUE THICKNESS COMPENSATORS FOR CIRCULAR SURGICAL STAPLERS

• US 20160287249A1
• Filed: 06/13/2016
• Published: 10/06/2016
• 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: Smith, Bret W., Alexander, Johnny H. III, Henderson, Cortney E., Miller, Christopher C., Measamer, John P., Schmid, Katherine J., Shelton, Frederick E. IV, Mutchler, Stephanie A., Cropper, Michael S.
• Granted Patent: US 10,363,031 B2
• Time in Patent Office: Days
• 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 17/072 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 17/1155 Circular staplers comprising a plurality of staples
• CPC Class Codes: A61B 17/2909 Handles
• 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 2017/00818 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 2017/00889 antimicrobial, disinfectant
• CPC Class Codes: A61B 2017/00893 pharmaceutically effective
• CPC Class Codes: A61B 2017/00898 expandable upon contact with fluid
• CPC Class Codes: A61B 2017/00991 Telescopic means
• CPC Class Codes: A61B 2017/0641 having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/07214 : Stapler heads
• 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 2017/07285 : characterised by its cutter
• CPC Class Codes: A61B 2017/2908 : Multiple segments connected by articulations
• CPC Class Codes: A61B 2017/2919 : details of linkages or pivot points
• 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 2017/2932 : Transmission of forces to jaw members
• CPC Class Codes: A61B 2017/2933 : camming or guiding means
• CPC Class Codes: A61B 2017/2936 : Pins in guiding slots
• CPC Class Codes: A61B 2017/2946 : Locking means
• CPC Class Codes: A61B 2017/320052 : Guides for cutting instruments by marking A61B2090/395
• CPC Class Codes: A61B 2090/037 : with a frangible part, e.g. by reduced diameter
• CPC Class Codes: A61B 2090/08021 : of the patient or his organs
• CPC Class Codes: A61B 2090/0807 : Indication means
• 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 46/10 : specially adapted for instruments, e.g. microscopes
• CPC Class Codes: A61B 46/17 : closed at the distal end

Abstract

Tissue thickness compensators for use with circular surgical staplers. Various tissue thickness compensators are disclosed for deployment between a stapler head of a surgical circular stapler and an anvil attached thereto to accommodate variances in tissue thickness during stapling. Some tissue thickness compensator arrangements include means and configurations for deploying healing agents for enhancing the healing process.

Claims

1. A tissue thickness compensator for use with a circular surgical stapler including a staple cartridge with a cartridge deck and an anvil movably supported relative to the staple cartridge such that a staple forming surface of the anvil is in confronting relationship relative to the cartridge deck and a tissue cutting member axially advanceable out of the staple cartridge toward the anvil, the tissue thickness compensator comprising:

a compressible, bioabsorbable annular body member configured to be supported between the staple forming surface and the cartridge deck; and

an attachment member coupled to the compressible body member and configured for attachment to the anvil to retain the compressible body member between the staple forming surface and the cartridge deck.

2. The tissue thickness compensator of claim 1, wherein the attachment member comprises a cut washer attached to the compressible body member and configured for removable attachment to the anvil, the cut washer including a frangible portion corresponding to the tissue cutting member such that a cutting edge of the tissue cutting member may be axially driven therethrough.

3. The tissue thickness compensator of claim 1, wherein the attachment member comprises a hood extending over a distal end of the anvil and attached to the compressible body member such that the compressible body member is retained adjacent to the staple forming surface.

4. The tissue thickness compensator of claim 3, wherein the hood is movably attached to the anvil.

5. The tissue thickness compensator of claim 4, wherein the compressible body portion includes at least one side wall and wherein the hood is movable from a neutral position wherein the hood covers the at least one side wall to a deployed position wherein the at least one side wall is uncovered.

6. The tissue thickness compensator of claim 5, wherein the hood is biased into the neutral position.

7. The tissue thickness compensator of claim 1, wherein the attachment member comprises a deformable bead attached to the compressible body member.

8. The tissue thickness compensator of claim 7, wherein the deformable bead extends around a perimeter of the compressible body member.

9. The tissue thickness compensator of claim 7, wherein the deformable bead is constructed from a burstable material.

10. The tissue thickness compensator of claim 9, wherein the deformable bead contains a liquid material.

11. The tissue thickness compensator of claim 10, wherein the liquid material is selected from the group of liquid materials consisting of saline liquid, a liquid healing agent and an anti-microbial liquid.

12. A tissue thickness compensator for use with a circular surgical stapler including a stapler head supporting a surgical staple cartridge therein that supports at least one annular row of staples and an anvil including an anvil body and anvil shaft that is removably attachable to the stapler head, the tissue thickness compensator comprising an annular compressible bioimplantible body member configured to be supported on the anvil shaft between the surgical staple cartridge and anvil body, the body member including at least one annular row of staple leg openings therein corresponding to each of the at least one annular rows of staples in the staple cartridge and an alignment arrangement corresponding to at least one alignment feature on the anvil shaft such that when the compressible body member is installed on the anvil shaft, each of the staple leg openings therein correspond to a staple in the staple cartridge.

13. The tissue thickness compensator of claim 12, wherein the annular body member includes a central portion and wherein the alignment arrangement comprises an opening through the central portion for receiving the anvil shaft therethrough and a plurality of alignment notches for receiving the alignment features on the anvil shaft.

14. The tissue thickness compensator of claim 13, wherein the staple leg openings are formed through an annular outer ring portion of the annular body member that is attached to the central portion by radially extending spokes.

15. A tissue thickness compensator for use with a circular surgical stapler including a stapler head supporting a surgical staple cartridge therein that supports at least one annular row of staples therein and an anvil including an anvil body and anvil shaft that is removably attachable to the stapler head, the tissue thickness compensator comprising an annular compressible biocompatible body member configured to be supported on the anvil shaft between the surgical staple cartridge and anvil body, the body member including at least one annular pocket therein supporting a healing agent therein.

16. The tissue thickness compensator of claim 15, wherein the at least one annular pocket comprises two coaxial annular pockets wherein each pocket corresponds to an annular row of staples in the staple cartridge.

17. The tissue thickness compensator of claim 15, wherein the annular compressible body member comprises a first compressible bioabsorbable layer laminated to a second compressible bioabsorbable layer with the at least one annular pocket formed therebetween.

18. A tissue thickness compensator for use with a circular surgical stapler including a stapler head supporting a surgical staple cartridge therein that supports at least one annular row of staples therein and an anvil including an anvil body and anvil shaft that is removably attachable to the stapler head, the tissue thickness compensator comprising an annular compressible body member comprising:

an annular outer ring portion of compressible bioabsorbable material having a first cross-sectional profile;

a central bioabsothable body portion extending inside of the annular outer ring portion and including a second cross-sectional profile that differs from the first cross-sectional profile; and

an opening in the central body portion for receiving the anvil shaft therethrough.

19. A tissue thickness compensator for use with a circular surgical stapler including a stapler head supporting a surgical staple cartridge therein that supports at least one annular row of staples therein and an anvil including an anvil body and anvil shaft that is removably attachable to the stapler head, the tissue thickness compensator comprising an annular compressible bioabsothable body member comprising:

a first annular disc;

a second annular disc; and

an annular array of compressible fins between the first and second annular discs and being attached thereto.

20. The tissue thickness compensator of claim 19, wherein at least some of the compressible fins have a healing agent thereon.

21. A tissue thickness compensator for use with a circular surgical stapler including a stapler head supporting a surgical staple cartridge therein that supports at least one annular row of staples therein and an anvil including an anvil body and anvil shaft that is removably attachable to the stapler head, the tissue thickness compensator comprising:

an annular compressible body member defining a first annular face and a second opposed annular face;

a first plurality of bioabsorbable spikes protruding from the first annular face; and

a second plurality of bioabsorbable spikes protruding from the second annular face.

22. A tissue thickness compensator for use with a circular surgical stapler including an elongated shaft that includes a stapler head that supports a surgical staple cartridge therein and an anvil including an anvil body and anvil shaft that is removably attachable to the stapler head, the tissue thickness compensator comprising:

an annular compressible bioabsorbable body member; and

an attachment member coupled to the compressible body member and configured for retaining engagement with the stapler head to support the compressible body member between the staple cartridge and the anvil body.

23. The tissue thickness compensator of claim 22, further comprising:

an introducer comprising;

an elongated sheath configured to receive the elongated shaft and stapler head therein, the elongated sheath including a distal end configured to support the tissue thickness compensator therein for seating engagement with the stapler head; and

a releasable cap on the distal end portion of the elongated sheath, the releasable cap movable from a closed position to an open position wherein the stapler head and tissue thickness compensator is advanceable out through the distal end of the sheath.