CN103153209B - Compressible fastener cartridge - Google Patents

Abstract

The invention discloses a fastener cartridge which can comprise a compressible, collapsible, and/or crushable cartridge body and fasteners embedded within the cartridge body 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 the first jaw can be positioned opposite a second jaw, or anvil. The anvil can be engaged with the fastener cartridge to compress, collapse, and/or crush the cartridge body and deform, or otherwise deploy, the fasteners contained therein. As the fasteners are deformed or deployed, the fasteners can capture at least a portion of the cartridge body therein along with at least a portion of the tissue being fastened. In various embodiments, the cartridge body can comprise a plurality of layers wherein at least one of the layers can be detached from the other layers and removed from the surgical site.

Description

The fastener cartridge that can be compressed

Background technology

Technical field

The present invention relates to a kind of surgical instruments, and in various embodiments, the present invention relates to be designed to cutting With the surgery cuts and suture instruments and its nail bin of suture tissue.

Background technology

Endoscopic surgical apparatus is frequently preferred over traditional open surgical device, because less otch is often reduced Post-operative recovery time and complication.Therefore, to suitable for end effector is accurately provided at through the sleeve pipe of trochar Endoscopic surgical apparatus at required surgical site has carried out significant exploitation.These distal end effectors are with various Mode engages tissue to realize diagnosis or therapeutic effect（Such as chamber endo-cutter stapler, grasper, cutter, stitching unstrument, clamp Device, into device, the medicine/gene treatment delivery apparatus and energy device using ultrasonic wave, RF, laser etc.）.

In many endoscopic surgical applications, it is desirable to using only with the end for completing size needed for particular surgeries Actuator.End effector is less, and the visualization of operative site is better.Less end effector also can be in tight quarters In more smoothly enter and manipulate.The designer of this end effector faces many when attempting and developing little end effector Challenge.The little end effector of manufacture and more particularly manufacture are designed to cut and suture the little chamber inscribe of tissue The ability of slot clutch is actuated to the restriction of power size, and the actuating power is typically made necessary to rows of staple formation. This actuating power changes also with the thickness and composition of processed tissue.For example, the tissue for cutting and suturing thickness is usual Need bigger actuating power.However, cutting and to suture the desired actuating power of relatively thin tissue less.Therefore, many existing chambers Endo-cutter stapler generally adopts strong anvil block closed-system and staple driving system, the anvil block closed-system and the seam Nail drive system can adapt to the tissue thickness of particular range.However, this device is usually not suitable for processing relatively thin tissue.

Previous chamber endo-cutter stapler device generally also staple driven and in tissue on otch is per side into Cutting tissue during shape.Although this device is highly effective for the operation of cutting and fastening tissue is needed, but it cannot Make surgeon that securing member be installed in the case where tissue is not cut.Equally, although developing various forms of radial type chambers Endo-cutter stapler improving entrance, but the element generally adopted in this device must substantially be large enough to hold can be from dress The shank put produces and transmits the structure of enough percussion force and closing force to end effector.Therefore, this end effector It is usually excessive and internal tight quarters cannot be efficiently entering.

Accordingly, it is desirable to provide can solve the problem that the surgery cuts and suture instruments and cartridge device of above-mentioned many challenges.

The some shortcomings part that presently, there are in the art just to illustration discussed above, and should not regard as It is the negative to right.

The content of the invention

In at least one form, nail bin may include multiple staples, and each of which staple includes base portion and prolongs from base portion That what is stretched can deform leg；The ground floor being made up of the material that can collapse, wherein leg can be deformed being positioned in ground floor；Adhere to The second layer of ground floor；And the third layer of the second layer is removedly adhered to, wherein third layer includes multiple staple slits, and And wherein staple basis are positioned in the staple slit.

In at least one form, fastener cartridge may include multiple securing members, each of which securing member include base portion and From the tissue capture portion that base portion extends；By can the first laminates for constituting of conquassation material, wherein tissue capture portion is positioned in the In one laminates；It is attached to the second laminates of the first laminates；And removably it is attached to the third layer of the second laminates Compound, wherein third layer compound include multiple receiving slits, and wherein fastener base is positioned in the receiving slit.

In at least one form, a kind of method for loading staple to nail bin may include following steps：By multiple seams Nail is positioned in transfer blade, and the transfer blade includes multiple chambers that can accommodate staple；The staple cartridge body that will be compressed relative to Transfer blade is positioned；By gripper shoe against the staple cartridge body positioning that can be compressed；Compression step, i.e. the staple cartridge body that will be compressed exists Compress between gripper shoe and transfer blade；And inserting step, i.e. in the staple cartridge body that staple insertion can be compressed.

Description of the drawings

By combine accompanying drawing with reference to the embodiment of the present invention following explanation, the present invention above and other feature and advantage and Its implementation will become more apparent, and be better understood invention itself, wherein：

Fig. 1 is the sectional view of the surgical instrument embodiment of the present invention；

Figure 1A is the perspective view of one embodiment that can be implanted into nail bin of the present invention；

Figure 1B -1E illustrate the part for clamping and suturing tissue of the end effector of various embodiments of the invention and The present invention's can be implanted into nail bin embodiment；

Fig. 2 is that the decomposition assembling of a part for the end effector embodiment of the present invention and surgery suturing appliance embodiment is cutd open View；

Fig. 3 is the side front view of the anvil block embodiment of the present invention；

Fig. 4 is the sectional view of a part for shank assembly shown in Fig. 1；

Fig. 5 is the partial sectional view of shank assembly shown in Fig. 1 that line 5-5 in Fig. 1 is intercepted；

Fig. 6 is the perspective view of a part for the percussion transmission embodiment of the present invention；

Fig. 7 is the partial sectional view of shank assembly shown in Fig. 1 that line 7-7 in Fig. 1 is intercepted；

Fig. 8 is the partial sectional view of a part for shank assembly shown in Fig. 7 that line 8-8 in Fig. 7 is intercepted；

Fig. 9 be the present invention surgical instrument embodiment after end effector is connected to the spine of surgical instruments and The end effector is locked to the sectional view before the spine；

Fig. 9 A are the zoomed-in views of the end effector shown in Figure 10 and a part for surgical instruments；

Figure 10 is section view of the surgical instruments shown in Fig. 9 after end effector is locked to the spine of surgical instruments Figure；

Figure 10 A are the zoomed-in views of the end effector shown in Figure 10 and a part for surgical instruments；

Figure 11 is the clamping slideway that the surgical instruments shown in Fig. 9 and Figure 10 has been advanced anvil block in the first percussion adapter Sectional view after the starting point in portion；

Figure 11 A are the zoomed-in views of end effector shown in Figure 11 and a part for surgical instruments, wherein its anvil block with Accommodate in a organized way between nail bin；

Figure 12 is that the surgical instruments shown in Fig. 9 to Figure 11 is above pushed away in the clamping slideway portion of anvil block in the first percussion adapter Sectional view after entering；

Figure 12 A are the zoomed-in views of the end effector shown in Figure 12 and a part for surgical instruments；

Figure 13 be surgical instruments shown in Fig. 9 to Figure 12 the first percussion adapter advance on staple formation slideway from And in the sectional view that can be implanted into after being fully formed staple in nail bin；

Figure 13 A are the zoomed-in views of the end effector shown in Figure 13 and a part for surgical instruments；

Figure 14 be surgical instruments shown in Fig. 9 to Figure 13 the first percussion adapter advance on staple formation slideway from And can be implanted into be fully formed staple in nail bin after and in knife bar along being longitudinally propelling through cuing open after end effector View；

Figure 14 A are the zoomed-in views of the end effector shown in Figure 14 and a part for surgical instruments；

Figure 15 is the other end actuator embodiment and the one of the ridge component of surgical instrument embodiment of the present invention of the present invention Partial view sub-anatomy；

Figure 16 is that end effector embodiment shown in Figure 15 is in an open position and be attached to surgical instrument embodiment Partial sectional view；

Figure 17 is another broken section of the end effector embodiment shown in Figure 15 and Figure 16 in fully clamped position Figure；

Figure 18 is that the end effector embodiment shown in Figure 15 to Figure 17 is in complete firing position and in distal tip structure Another partial sectional view before part propulsion；

Figure 19 is that the end effector embodiment shown in Figure 15 to Figure 18 is in complete firing position and in distal tip structure Part be fully advanced after another partial sectional view；

Figure 20 is the sectional view of a part for another shank assembly embodiment of the present invention；

Figure 21 is the partial sectional view of a part for shank assembly shown in Figure 20 that line 21-21 in Figure 20 is intercepted；

Figure 22 is the partial sectional view of a part for shank assembly shown in Figure 20 that line 22-22 in Figure 20 is intercepted；

Figure 23 is the partial sectional view of a part for shank assembly shown in Figure 20 that line 23-23 in Figure 20 is intercepted；

Figure 24 is the sectional view of a part for another shank assembly embodiment of the present invention；

Figure 25 is the part that the other end actuator embodiment of the present invention is connected to surgical instrument embodiment of the present invention Partial cut away side views, its end effector supports the surgery nail bin embodiment of the present invention, and the anvil of end effector Seat is in an open position；

Figure 26 is end effector shown in Figure 25 another partial cut away side views in the close position；

Figure 27 is end effector shown in Figure 25 and Figure 26 when knife bar begins to pass end effector and is pushed into Another partial cut away side views；

Figure 28 is another office of end effector shown in Figure 25 to Figure 27 when knife bar is partly advanced through wherein Portion's cross sectional side view；

Figure 29 is the part that the other end actuator embodiment of the present invention is connected to surgical instrument embodiment of the present invention Partial cut away side views, its end effector supports another surgery nail bin embodiment of the present invention, and end effector Anvil block it is in an open position；

Figure 30 is another part section of end effector shown in Figure 29 when knife bar is partly advanced through wherein Side view；

Figure 31 is the sectional view of another surgical instrument embodiment of the present invention, and the anvil block of its end effector is in open position Put；

Figure 32 is the decomposition group of a part for the end effector embodiment shown in Figure 31 and surgery suturing appliance embodiment Dress sectional view；

Figure 33 is the top view of a part for the Slender axles assembly of the end effector shown in Figure 31 and surgical instruments, wherein Some are shown partially in the cross section that the 33-33 in Figure 31 along the line is intercepted；

Figure 34 is the top view of a part for the end effector of surgical instruments shown in Figure 31 and Slender axles assembly, wherein certain In being shown partially in cross section；

Figure 35 is another top view of a part for the end effector of surgical instruments shown in Figure 31 and Slender axles assembly, its End effector is orientated in radial type and end effector is in an open position；

Figure 36 is another top view of end effector shown in Figure 35, and its end effector is in closure or clamps position Put；

Figure 37 is the zoomed-in view of a part for end effector shown in Figure 36 and surgical instrument embodiment；

Figure 38 is the sectional view of a part for the shank assembly of surgical instruments shown in Figure 31；

Figure 39 is another sectional view of a part for shank assembly shown in Figure 38 that line 39-39 in Figure 38 is intercepted；

Figure 40 is the partial, exploded perspective view of the joint ball of various embodiments of the present invention and socket structure；

Figure 41 is the end effector of another surgical instrument embodiment in non-articulated formula orientation of the present invention and elongated The top view of a part for shaft assembly；

Figure 42 is another top view when being partially in articulated position of end effector shown in Figure 41 and Slender axles assembly；

Figure 43 is the sectional view of another surgical instrument embodiment of the invention；

Figure 44 is the partial sectional view of a part for the radial type shaft assembly of surgical instrument embodiment shown in Figure 43；

Figure 44 A are the sectional views of a part for radial type shaft assembly shown in Figure 44；

Figure 44 B are another sectional views of another part of radial type shaft assembly shown in Figure 44；

Figure 44 C are another sectional views of another part of radial type shaft assembly shown in Figure 44；

Figure 44 D are another sectional views of another part of radial type shaft assembly shown in Figure 44；

Figure 44 E are another sectional views of another part of radial type shaft assembly shown in Figure 44；

Figure 44 F are another sectional views of another part of radial type shaft assembly shown in Figure 44；

Figure 45 is the partial sectional view of radial type shaft assembly shown in Figure 44 that line 45-45 in Figure 44 is intercepted；

Figure 46 is the partial sectional view of radial type shaft assembly shown in Figure 44 that line 46-46 in Figure 44 is intercepted；

Figure 47 is another sectional view of surgical instruments shown in Figure 43, wherein the end effector of the surgical instruments is shown in Completely in articulated position；

Figure 48 is the sectional view of end effector shown in Figure 47, and wherein corrugated tube shape covering extends across articulated joint；

Figure 49 is the sectional view of the shank assembly of another surgical instrument embodiment of the invention；

Figure 50 is the decomposition assembling view of end effector shown in Figure 49 and the distal end of Slender axles assembly；

Figure 51 is another sectional view of the part of end effector shown in Figure 50 and Slender axles assembly, its end effector It is in an open position；

Figure 52 is another sectional view of the part of end effector and Slender axles assembly, and its end effector is in closure Position；

Figure 53 is another sectional view of end effector shown in Figure 49 to Figure 52 and slender axles, and wherein cutter component is in complete Firing position；

Figure 54 is end effector shown in Figure 51 to Figure 53 perspective view in an open position；

Figure 55 is the sectional view of end effector shown in Figure 51 to Figure 54 that line 55-55 in Figure 51 is intercepted；

Figure 56 is the fragmentary, perspective view of the Slender axles assembly of another embodiment of the present invention, and the Slender axles assembly is attached to this The end effector embodiment of invention；

Figure 57 is the partial sectional view of the shank assembly of another surgical instrument embodiment of the invention；

Figure 58 is the section view of Figure 56 that the line 58-58 in Figure 57 is intercepted and a part for Slender axles assembly shown in Figure 57 Figure；

Figure 59 is the zoomed-in view of a part for shank assembly shown in Figure 57；

Figure 60 is the sectional view of the distal portions of Slender axles assembly shown in Figure 56 to Figure 59；

Figure 61 is the fragmentary, perspective view of the Slender axles assembly of another embodiment of the present invention, and the Slender axles assembly is attached to this The end effector embodiment of invention；

Figure 62 is the sectional view of a part for the reconfigurable axle section of slender axles shown in Figure 61；

Figure 63 is the fragmentary, perspective view of the Slender axles assembly of another embodiment of the present invention, and the Slender axles assembly is attached to this The end effector embodiment of invention；

Figure 64 is the sectional view of the shank assembly of another surgical instrument embodiment of the invention；

Figure 65 is the section view of Figure 63 that the line 65-65 in Figure 64 is intercepted and a part for Slender axles assembly shown in Figure 64 Figure；

Figure 66 is the zoomed-in view of a part for shank assembly shown in Figure 64；

Figure 67 is the sectional view of a part for reconfigurable axle section shown in Figure 63, wherein each tubulose chain link of the part Portion is substantially along aligned；

Figure 68 is the sectional view of a part for reconfigurable axle section shown in Figure 63 and Figure 67, wherein each pipe of the part Shape chain section is with substantially curved（It is non-coaxial）Orientation alignment；

Figure 69 be the present invention replacement nail bin embodiment perspective view, the nail bin be arranged on the present invention surgery cuts and In stitching devices embodiment；

Figure 70 is the top view of the surgery nail bin of Figure 69 shown devices and elongated passageway；

Figure 71 is the top view of another surgery nail bin embodiment of the present invention, and the surgery nail bin is arranged on the end of the present invention In the elongated passageway of portion's actuator embodiment；

Figure 72 is the upward view of the anvil block embodiment of the present invention；

Figure 73 is the fragmentary, perspective view for forming multiple staples of a part for staple line embodiment of the present invention；

Figure 74 be staple line embodiment shown in Figure 73 in its staple by connecting with the anvil block of surgery cuts and stitching devices Touch and another fragmentary, perspective view after shaping；

Figure 75 is the fragmentary, perspective view for forming the replacement staple of a part for another staple line embodiment of the invention；

Figure 76 is the fragmentary, perspective view for forming the replacement staple of a part for another staple line embodiment of the invention；

Figure 77 is the fragmentary, perspective view for forming the replacement staple of a part for another staple line embodiment of the invention；

Figure 78 is the sectional view of the end effector embodiment of the present invention, and the end effector embodiment supports the present invention Nail bin embodiment；

Figure 79 is the elongated passageway portion of end effector shown in Figure 78 after removing and can be implanted into staple cartridge body portion and staple Sectional view；

Figure 80 is the sectional view of the end effector embodiment of the present invention, and the end effector support present invention's is another Nail bin embodiment；

Figure 81 is the partial sectional view of the surgery suturing appliance embodiment of the present invention, wherein in the surgery suturing appliance Nail bin is supported in end effector, so that nail bin locking system marches to unlocked position；

Figure 82 is another partial sectional view of surgery suturing appliance shown in Figure 81, wherein nail bin remove from end effector and Nail bin locking system is in the locked position；

Figure 83 A-83D describe the change for being positioned at the surgical staple that can be collapsed in staple cartridge body according at least one embodiment Shape；

Figure 84 A are the figures for illustrating the staple being positioned in energy conquassation staple cartridge body；

Figure 84 B are to illustrate energy conquassation staple cartridge body shown in Figure 84 A by the figure of anvil block conquassation；

Figure 84 C are to illustrate energy conquassation staple cartridge body shown in Figure 84 A by the figure of the further conquassation of anvil block；

Figure 84 D are to illustrate that the energy conquassation nail bin of staple shown in Figure 84 A in configuration is fully formed and shown in Figure 84 A is in The figure of complete conquassation state；

Figure 85 is to illustrate the staple that positions against nail bin stayed surface and illustrate between staple and nail bin stayed surface The figure of potential relative motion；

Figure 86 is the sectional view of nail bin stayed surface, and the nail bin stayed surface includes slit or groove, for stable figure Staple shown in 85；

Figure 87 is the sectional view of the staple according at least one alternative embodiment, and the staple includes overmolding Bizet and can accommodate the bizet a part slit or groove；

Figure 88 is the top view of the nail bin according at least one embodiment, and the nail bin is collapsed staple cartridge body including embedding energy In staple；

Figure 89 is the front view of nail bin shown in Figure 88；

Figure 90 is the front view of the nail bin according at least one embodiment, and the nail bin is included around being positioned at the nail that can collapse The protective layer of the intrinsic staple in storehouse；

Figure 91 is the sectional view of nail bin shown in Figure 90 that line 91-91 in Figure 90 is intercepted；

Figure 92 is the front view of the nail bin according at least one embodiment, and the nail bin includes extending energy at least in part The staple of the outside of staple cartridge body of collapsing and the protective layer around the staple cartridge body；

Figure 93 is the sectional view of nail bin shown in Figure 92 that line 93-93 in Figure 92 is intercepted；

Figure 94 is the partial cutaway view of the nail bin according at least one embodiment, and the nail bin includes embedding at least in part Enter the staple that can be collapsed in staple cartridge body, the staple is at least partially situated in the staple lacuna in the staple cartridge body；

Figure 95 is the sectional view of nail bin shown in Figure 94 that line 95-95 in Figure 94 is intercepted；

Figure 96 is the partial cutaway view of the nail bin according at least one embodiment；

Figure 97 is the partial cutaway view of the nail bin according at least one embodiment, and the nail bin includes embedding at least in part Enter the staple and the connection staple that can collapse in staple cartridge body and the alignment matrix for making the staple relative to each other align；

Figure 98 is the sectional view of nail bin shown in Figure 97 that line 98-98 in Figure 97 is intercepted；

Figure 99 is the partial cutaway view of the internal layer that can compress staple cartridge body；

Figure 100 is to illustrate the figure that the internal layer shown in Figure 99 is compressed between transfer blade and gripper shoe；

Figure 101 is to illustrate the figure that staple is inserted in the compressed internal layer shown in Figure 100；

Figure 102 is to illustrate the figure that gripper shoe shown in Figure 100 is removed from internal layer；

Figure 103 is illustrated including internal layer shown in Figure 99 and the figure of the sub-component of staple shown in the Figure 101 being inserted in outer layer；

Figure 104 is to illustrate that outer layer shown in Figure 103 is sealed to form the figure of sealing nail bin；

Figure 105 is the sectional view of sealing nail bin shown in Figure 104；

Figure 106 is the sectional view of the nail bin according at least one embodiment and staple cartridge channel；

Figure 107 is figure of the part in deformation state for illustrating nail bin shown in Figure 106；

Figure 108 is the front view of the end effector of surgical stapling device, and the end effector includes in an open position Anvil block and the nail bin that is positioned in staple cartridge channel；

Figure 109 is the front view of end effector shown in Figure 108, and it illustrates anvil block in the close position and is compressed in Nail bin between anvil block and staple cartridge channel；

Figure 110 is the front view of end effector shown in Figure 108, and it illustrates nail bin shown in Figure 108 with alternative position In staple cartridge channel；

Figure 111 is the sectional view of the end effector of surgical stapling device, and the end effector includes being located at staple cartridge channel It is interior to compress nail bin and be attached to one piece of backing material of anvil block；

Figure 112 is the sectional view of end effector shown in Figure 111, and it illustrates anvil block in the close position；

Figure 113 is the sectional view of alternative embodiment of the end effector of surgical stapling device, and the end performs Device includes the nail bin with impermeable stratum；

Figure 114 is the sectional view of another alternative embodiment of the end effector of surgical stapling device；

Figure 115 is the sectional view of alternative embodiment of the end effector of surgical stapling device, and the end performs Device includes staged anvil block and the nail bin including staged warehouse；

Figure 116 is the sectional view of another alternative embodiment of the end effector of surgical stapling device；

Figure 117 is the sectional view of alternative embodiment of the end effector of surgical stapling device, and the end performs Device includes inclined tissue contacting surface；

Figure 118 is the sectional view of another alternative embodiment of the end effector of surgical stapling device, the end Actuator includes inclined tissue contacting surface；

Figure 119 is the sectional view of alternative embodiment of the end effector of surgical stapling device, and the end performs Device includes the support insert for supporting nail bin；

Figure 120 is the sectional view of alternative embodiment of the end effector of surgical stapling device, and the end performs Device includes the nail bin with multiple energy compression layers；

Figure 121 is the sectional view of alternative embodiment of the end effector of surgical stapling device, and the end performs Device includes the nail bin with staged energy nail bin support member；

Figure 122 is the sectional view of another alternative embodiment of the end effector of surgical stapling device, the end Actuator includes the nail bin with staged energy nail bin support member；

Figure 123 is the sectional view of alternative embodiment of the end effector of surgical stapling device, and the end performs Device includes the nail bin of the tissue contacting surface with bending；

Figure 124 is the sectional view of alternative embodiment of the end effector of surgical stapling device, and the end performs Device includes the nail bin with inclined tissue contacting surface；

Figure 125 is the sectional view that can compress nail bin, and the nail bin that can compress includes staple and at least one that is wherein stored with Medicament；

Figure 126 is to illustrate that the nail bin that can compress shown in Figure 125 is compressed and the figure after the staple deformation accommodated in it；

Figure 127 is the partial cutaway view of the nail bin according at least one embodiment；

Figure 128 is the sectional view of nail bin shown in Figure 127；

Figure 129 is the perspective view for being implanted into nail bin according at least one alternative embodiment；

Figure 130 is the sectional view that nail bin is implanted into shown in Figure 129；

Figure 131 is the perspective view of alternative embodiment of nail bin, and the nail bin includes what is extended from the outer layer of nail bin Can deformation element；

Figure 132 is the perspective view of alternative embodiment of nail bin, and the nail bin includes being assembled to outside the nail bin of internal layer Layer；

Figure 133 is the sectional view of alternative embodiment of nail bin, the nail bin include multiple staples, can compression layer, And degreasing cotton layer；

Figure 134 is the perspective view of degreasing cotton layer shown in Figure 133；

Figure 135 is the absorbent cotton that is partitioned into from the degreasing cotton layer shown in Figure 133 and aligns with the groove in absorbent cotton The perspective view of staple；

Figure 136 is the perspective view of the two connected absorbent cotton from degreasing cotton layer shown in Figure 133；

Figure 137 be the absorbent cotton support frame of degreasing cotton layer shown in Figure 133 removed from the absorbent cotton that is partitioned into it is saturating View；

Figure 138 is the decomposition diagram of the alternative embodiment that can compress nail bin, and the nail bin that can compress includes Staple and the system for driving staple against anvil block；

Figure 138 A are the partial cutaway views of alternative embodiment of nail bin shown in Figure 138；

Figure 139 is the sectional view of nail bin shown in Figure 138；

Figure 140 is the nail bin that can traverse shown in Figure 138 and makes the front view of sledge that staple advances towards anvil block；

Figure 141 is the figure for illustrating staple driver, and the sledge that the staple driver can be by shown in Figure 140 is lifted towards anvil block；

Figure 142 is the excision view of the nail bin according at least one alternative embodiment, and the nail bin includes being located at Staple in staple driver；

Figure 143 is the sectional view when nail bin shown in Figure 142 is located in staple cartridge channel；

Figure 144 is the sectional view of nail bin shown in Figure 142, and it is illustrated the anvil block for moving to closing position and is become by anvil block The staple being contained in nail bin of shape；

Figure 145 is the sectional view of nail bin shown in Figure 142, and it illustrates the staple moved upwards towards anvil block；

Figure 146 is the perspective view of alternative embodiment of nail bin, and the nail bin includes each flexible side of connection nail bin Band；

Figure 147 is the perspective view of sledge and cutting element component；

Figure 148 is the staple for being shown with sledge and cutting element component shown in Figure 147 to lift nail bin shown in Figure 142 Figure；

Figure 149 is to illustrate the ability to engage staple and lift the sledge of staple towards anvil block and sledge is distad transported The figure of dynamic block sytem；

Figure 150 A-150C illustrate the process inserted staple in staple bizet；

Figure 151 is the sectional view of the nail bin for including support plate or retainer；

Figure 152 is the partial sectional view that can compress nail bin according at least one alternative embodiment；

Figure 153 is figure when illustrating that nail bin shown in Figure 152 is in implanting state；

Figure 154 is the partial cutaway view that can compress nail bin according at least one alternative embodiment；

Figure 155 is the partial sectional view of nail bin shown in Figure 154；

Figure 156 is figure when illustrating that nail bin shown in Figure 154 is in implanting state；

Figure 157 is the partial sectional view of the energy conquassation nail bin according at least one alternative embodiment；

Figure 158 is that the local excision of the nail bin that can collapse including multiple energy crushable members according at least one embodiment regards Figure；

Figure 159 is perspective view when energy crushable member shown in Figure 158 is in non-collapsed state；

Figure 160 is perspective view when energy crushable member shown in Figure 159 is in collapsed state；

Figure 161 A are the partial sectional views of the end effector of surgery suturing appliance, the end effector include jaw, The staple cartridge channel relatively positioned with the jaw and the nail bin in the staple cartridge channel, wherein the jaw includes It is attached to the reservation matrix of jaw；

Figure 161 B are the partial sectional views of end effector shown in Figure 161 A, its illustrate towards staple cartridge channel advance jaw, By anvil block and retain matrix compression nail bin and staple, the staple extend through at least in part positioned at retain matrix with Tissue between nail bin；

Figure 161 C are the partial sectional views of end effector shown in Figure 161 A, its illustrate the jaw in final position and with The reservation matrix of the staple engagement shown in Figure 161 B；

Figure 161 D are the partial sectional views of end effector shown in Figure 161 A, and it illustrates jaw and staple cartridge channel away from being planted The nail bin for entering is advanced with matrix is retained；

Figure 162 be according at least one alternative embodiment reservation matrix retaining holes perspective view, the guarantor Box out including multiple holding members, for the fastener leg that engagement extends through the retaining holes；

Figure 163 be according at least one alternative embodiment reservation matrix retaining holes perspective view, the guarantor Box out including six holding members；

Figure 164 be according at least one alternative embodiment reservation matrix retaining holes perspective view, the guarantor Box out including eight holding members；

Figure 165 be according at least one alternative embodiment reservation matrix retaining holes perspective view, the guarantor Box out including multiple holding members, for the fastener leg that engagement extends through the retaining holes；

Figure 166 be according at least one alternative embodiment reservation matrix retaining holes perspective view, the guarantor Box out including six holding members；

Figure 167 be according at least one alternative embodiment reservation matrix retaining holes perspective view, the guarantor Box out including eight holding members；

Figure 168 be according at least one alternative embodiment reservation matrix retaining holes perspective view, the guarantor Box out including the multiple holding members being stamped to form by sheet metal；

Figure 169 be according at least one alternative embodiment reservation matrix retaining holes perspective view, the guarantor Matrix is stayed to include the multiple holes extended along the periphery of the retaining holes；

Figure 170 is the top view of the retaining holes of the reservation matrix according at least one alternative embodiment；

Figure 171 is the top view of the retaining holes of the reservation matrix according at least one alternative embodiment；

Figure 172 is the top view of the retaining holes of the reservation matrix according at least one alternative embodiment；

Figure 173 is the top view of the retaining holes of the reservation matrix according at least one alternative embodiment；

Figure 174 is the top view of the retaining holes of the reservation matrix according at least one alternative embodiment；

Figure 175 is the top view of the retaining holes of the reservation matrix according at least one embodiment, and the retaining holes includes prolonging Extend the reservation lug in the retaining holes；

Figure 176 be according at least one alternative embodiment reservation matrix retaining holes top view, the guarantor Box out including the reservation lug extended in the retaining holes；

Figure 177 is the perspective view of fastening system, and the fastening system includes the reservation that multiple staples are engaged with the staple The alignment matrix of matrix and the staple that can align；

Figure 178 is the perspective view for retaining matrix shown in Figure 177；

Figure 179 is the perspective view of alignment matrix shown in Figure 177；

Figure 180 is the partial top view retained when matrix is engaged with the staple shown in Figure 177 shown in Figure 177；

Figure 181 is the partial bottom view retained when matrix is engaged with the staple shown in Figure 177 shown in Figure 177；

Figure 182 is the partial elevation view of fastening system shown in Figure 177；

Figure 183 is the fragmentary, perspective view of fastening system shown in Figure 177；

Figure 184 is the partial sectional view retained when matrix is engaged with the staple shown in Figure 177 shown in Figure 177；

Figure 185 is the partial sectional view of fastening system shown in Figure 177；

Figure 186 is the perspective view of fastening system shown in Figure 177, and the fastening system also includes being assembled to the protection of staple leg Property cap；

Figure 187 is the bottom perspective view of fastening system structure shown in Figure 186；

Figure 188 is the fragmentary, perspective view of fastening system structure shown in Figure 186；

Figure 189 is the partial sectional view of fastening system structure shown in Figure 186；

Figure 190 is the front view of the end effector according at least one embodiment, and the end effector includes being in The jaw of open position, the reservation matrix in jaw and multiple protectiveness caps and the nail bin in staple cartridge channel；

Figure 191 is front view when end effector shown in Figure 190 is in the close position；

Figure 192 is front view when end effector shown in Figure 190 is in firing position；

Figure 193 is the front view retained when matrix and protectiveness cap are assembled to the nail bin shown in Figure 190 shown in Figure 190；

Figure 194 is the detail drawing of structure shown in Figure 193；

Figure 195 is the front view of end effector shown in Figure 190, and it illustrates jaw in an open position and positioned at reservation Relatively thin tissue between matrix and nail bin；

Figure 196 is the front view of end effector shown in Figure 190, and it illustrates against the tissue shown in Figure 195 and is in and closes Close the jaw of position；

Figure 197 is the front view of end effector shown in Figure 190, and it is illustrated in firing position to retain matrix with nail Capture between storehouse shown in Figure 195 compared with the jaw of thin tissue；

Figure 198 is that reservation matrix and protectiveness cap are assembled to the nail bin shown in Figure 190 and make shown in Figure 195 shown in Figure 190 Thin tissue it is therebetween when front view；

Figure 199 is the detail drawing of structure shown in Figure 198；

Figure 200 is the section view of the protectiveness cap on staple leg top according at least one alternative embodiment Figure；

Figure 20 1 is the perspective view of the multiple protectiveness caps being embedded in material piece；

Figure 20 2 is the perspective view of jaw, and the jaw includes multiple depressed parts for multiple protectiveness caps are contained in Wherein；

Figure 20 3 is the detail drawing of a part for jaw, and the part includes being located in jaw shown in Figure 20 2 for covering Protectiveness cap thin slice；

Figure 20 4 is the section view of the protectiveness cap on staple leg top according at least one alternative embodiment Figure, wherein the protectiveness cap includes internal profiled surface；

Figure 20 5 is another sectional view of protectiveness cap shown in Figure 20 4, and it illustrates the staple deformed against profiled surface Leg；

Figure 20 6 is the top view of the alternative embodiment for retaining matrix, and the reservation matrix includes multiple connected Matrix element；

Figure 20 7 is the top view of the alternative embodiment for retaining matrix, and the reservation matrix includes multiple connected Matrix element；

Figure 20 8 is the top view of the alternative embodiment for retaining matrix, and the reservation matrix includes multiple connected Matrix element；

Figure 20 9 is the top view of the alternative embodiment for retaining matrix array, and the reservation matrix array includes many Individual connected matrix element；

Figure 21 0 is the top view of the alternative embodiment for retaining matrix, and the reservation matrix includes multiple connected Matrix element；

Figure 21 1 is the exploded view of the jaw for including retaining matrix, and the reservation matrix includes that covering can be compressed；

Figure 21 2 is the detail drawing for retaining matrix shown in Figure 21 1；

Figure 21 3 be include retain matrix fastening system partial sectional view, the reservation matrix include can compression layer and Encapsulate multiple units of one or more medicine；

Figure 21 4 is to illustrate that staple leg pierces through the figure of unit shown in Figure 21 3 when engaging with reservation matrix；

Figure 21 5 is the partial sectional view of the fastening system for including retaining matrix, and the reservation matrix includes can compression layer；

Figure 21 6 is the front view of fastener cartridge plug-in package, and the fastener cartridge plug-in package includes clamper, first tight Firmware storehouse and the second fastener cartridge；

Figure 21 7 is the front view of the end effector of surgical stapling device, and the surgical stapling device includes the first jaw and the Two jaws, second jaw is shown in open configuration；

Figure 21 8 is the front view of end effector shown in Figure 21 7, and it illustrates the second jaw and use in closed configuration In for the first jaw load the first storehouse and for the second jaw load the second storehouse Figure 21 6 shown in fastener cartridge plug-in package；

Figure 21 9 is the front view of end effector shown in the Figure 21 8 for having loaded, and it illustrates the storehouse removed from end effector Plug-in package, the second jaw for being again at open configuration and the tissue between the first jaw and the second jaw；

Figure 22 0 is front view of the end effector loaded shown in Figure 21 9 in percussion configuration；

Figure 22 1 is the front view in the first storehouse in implanting state and the second storehouse；

Figure 22 2 is the front view of end effector shown in Figure 21 7, and it exemplifies according at least one enforcement and still clamps with first The part in the first storehouse of mouth engagement；

Figure 22 3 is the front view of alternative embodiment of fastener cartridge plug-in package, the fastener cartridge insertion group Part includes clamper, the first fastener cartridge and the second fastener cartridge；

Figure 22 4 is used to the figure that the first jaw of end effector loads the first storehouse and loads the second storehouse for the second jaw The front view of fastener cartridge plug-in package shown in 223；

Figure 22 5 is the sectional view for having loaded end effector shown in Figure 22 4；

Figure 22 6 is including bottom jaw and the perspective of the surgical stapling device of top jaw according at least one embodiment Figure, some parts of wherein surgical stapling device are removed；

Figure 22 7 is the perspective view of surgical stapling device shown in the Figure 22 6 for having removed top jaw；

Figure 22 8 is the perspective view of the slidably anvil block system of the top jaw of surgical stapling device shown in Figure 22 6, described to slide Dynamic anvil block system includes the first slidably anvil block and the second slidably anvil block；

Figure 22 9 is the end-view of slidably anvil block system shown in Figure 22 8；

Figure 23 0 is the top view of slidably anvil block system shown in Figure 22 8；

Figure 23 1 is the figure for illustrating the slidably anvil block system shown in Figure 22 8 in non-cock；

Figure 23 2 be illustrate first of slidably anvil block system shown in Figure 22 8 slidably anvil block in non-firing position and position Figure of the staple in bottom jaw in non-deployed position；

Figure 23 3 is the staple that is shown in bottom jaw the first slidably anvil in guidewire lumen and shown in Figure 23 2 Seat is pulled to nearside so that the figure of the staple leg deformation of first group of staple；

Figure 23 4 is to illustrate shown in Figure 23 3 that first group of staple is deformed into the figure of the state of being badly deformed；

Figure 23 5 be illustrate second of slidably anvil block system shown in Figure 22 8 slidably anvil block be pushed to distally so that second The figure of group staple leg deformation；

Figure 23 6 is the fragmentary, perspective view of the anvil block including multiple forming pits according at least one embodiment；

Figure 23 7 is the cross sectional end view of anvil block shown in Figure 23 6；

Figure 23 8 is the figure for illustrating the first step of forming pit shown in manufacture Figure 23 6；

Figure 23 9 is the figure for illustrating the second step of forming pit shown in manufacture Figure 23 6；

Figure 24 0 is the top view of the forming pit structure of anvil block shown in Figure 23 6；

Figure 24 1 is to illustrate the figure for manufacturing the first step of the manufacturing process of anvil block；

Figure 24 2 is the figure for illustrating the second step of manufacturing process shown in Figure 24 1；And

Figure 24 3 is the figure for illustrating the third step of manufacturing process shown in Figure 24 1.

In described these schemas, corresponding reference symbol represents corresponding part.Example as shown herein is with one kind Form illustrates the preferred embodiments of the present invention, should not be not understood as this example limiting the scope of the present invention by any way.

Specific embodiment

Present applicant also possesses following U.S. Patent application, and these patent applications are carried on the same day with the application Hand over, and each is all each integrally incorporated by reference herein：

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Surgical Stapling Instrument With A Variable Staple Forming System ", attorney END6848USNP/100533；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Surgical Stapling Instrument With Interchangeable Staple Cartridge Arrangements ", attorney END6849USNP/ 100534；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Surgical Cutting and Fastening Instruments With Separate and Distinct Fastener Deployment and Tissue Cutting Systems ", attorney END6839USNP/100524；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Surgical Stapling Instrument With Compact Articulation Control Arrangement ", attorney END6847USNP/100532；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Jaw Closure Arrangements For Surgical Instruments ", attorney END6736USNP/100060；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Surgical Instruments With Reconfigurable Shaft Segments ", attorney END6734USNP/100058；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Surgical Staple Cartridges Supporting Non-Linearly Arranged Staples and Surgical Stapling Instruments With Common Staple-Forming Pockets ", attorney END6735USNP/100059；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Surgical Staple Cartridges With Detachable Support Structures and Surgical Stapling Instruments With Systems For Preventing Actuation Motions When a Cartridge is Not Present ", attorney docket Number END6855USNP/100540；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Implantable Fastener Cartridge Having a Non-Uniform Arrangement ", attorney END6840USNP/100525；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Implantable Fastener Cartridge Comprising a Support Retainer ", attorney END6841USNP/100526；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Implantable Fastener Cartridge Comprising Multiple Layers ", attorney END6842USNP/100527；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Selectively Orientable Implantable Fastener Cartridge ", attorney END6843USNP/100528；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Implantable Fastener Cartridge Comprising Bioabsorbable Layers ", attorney END6856USNP/100541；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Fasteners Supported By a Fastener Cartridge Support ", attorney END6858USNP/100543；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Collapsible Fastener Cartridge ", generation Reason people file number END6859USNP/100544；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Fastener System Comprising a Plurality of Connected Retention Matrix Elements ", attorney END6860USNP/ 100546；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Fastener System Comprising a Retention Matrix and an Alignment Matrix ", attorney END6861USNP/100547；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Fastener System Comprising a Retention Matrix ", attorney END6862USNP/100548；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Fastening Instrument For Deploying A Fastener System Comprising a Retention Matrix ", attorney END6863USNP/ 100549；

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Fastener System Comprising a Retention Matrix and a Cover ", attorney END6864USNP/100550；And

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _, entitled " Fastener System Comprising a Plurality of Fastener Cartridges ", attorney END6865USNP/100551.

Some exemplary embodiments are will now be described, to understand the knot of apparatus as disclosed herein and method on the whole Structure, function, manufacture and purposes.One or more examples of these embodiments are illustrated in accompanying drawing.The ordinary skill people of this area Member will be understood that it is nonrestrictive exemplary enforcement to specifically describe and be illustrated in the apparatus and method in accompanying drawing herein Example, and the scope of multiple embodiments of the present invention is limited only by the appended claims.One exemplary embodiment is illustrated The feature for illustrating or describing, can be combined with the feature of other embodiments.This modification and version are intended to include Within the scope of the present invention.

" various embodiments ", " some embodiments ", " one embodiment " or " embodiment " that this specification is quoted in the whole text etc., Refer to that the specific features with reference to embodiment description, structure or characteristic are included at least one embodiment.Therefore, this explanation Phrase " in various embodiments " that book occurs in the whole text, " in certain embodiments ", " in one embodiment " or " in embodiment In " etc. be not necessarily all referring to identical embodiment.Additionally, in one or more embodiments, specific features, structure or characteristic can Combine in any suitable way.Therefore, without limitation, the concrete spy for illustrating with reference to one embodiment or describing Levy, the feature that structure or characteristic can whole or in part with one or more of the other embodiment, structure or characteristic are combined.It is this to repair Reshaping formula and version are intended to be included within the scope of the present invention.

Terms used herein " nearside " and " distally " are for the clinician of manipulation of surgical apparatus shank.Art Language " nearside " refers to the part near clinician, and term " distally " refers to the part away from clinician.Should also Understand, for the sake of succinct and clear, accompanying drawing can be combined herein and uses such as " vertical ", " level ", "up" and "down" etc Spatial terminology.However, surgical instruments is used in many directions and position, and these terms and nonrestrictive and/or exhausted To.

There is provided various exemplary means and method to perform laparoscopic type and minimally invasive surgical procedures.However, this area In those of ordinary skill will readily appreciate that, various method and devices disclosed herein can be used for many surgical procedures and Using（Including the application for example in combination with open surgery operation）In.With continued reference to this specific embodiment, ability Those of ordinary skill in domain will be further understood that various apparatuses disclosed herein can be inserted by any way in vivo, for example Otch or puncturing hole by natural cavity, in by being formed at tissue etc..The working portion or end effector portion of apparatus Can be plugged directly in patient's body or can be inserted by the entrance device with service aisle, the end effector of surgical instruments and Slender axles can be advanced by the service aisle.

Referring to accompanying drawing, wherein in all views, the similar element of similar digitized representation, Fig. 1 is illustrated can put into practice this The surgical instruments 10 of the specific multiple beneficial effect of invention.Surgery suturing appliance 10 is designed to manipulate and/or activates The various forms of surgery suturing appliance 10 and the end effector 12 of size can be operatively attached to.In the reality shown in Fig. 1 and Fig. 2 In applying example, for example end effector 12 includes elongated passageway 14, and the elongated passageway 14 forms the lower jaw 13 of end effector 12. Elongated passageway 14 can support " can be implanted into " nail bin 30 and support the upper jaw as end effector 12 with can also moving 15 anvil block 20.

In various embodiments, elongated passageway 14 for example can be processed by 300＆400 series 17-4＆17-7 stainless steels, titanium etc. Form, and spaced-apart sidewalls 16 can be formed with.Anvil block 20 for example can be by the processing such as 300＆400 series 17-4＆17-7 stainless steels, titanium Into, and can have staple formation lower surface, the staple formation lower surface is generally indicated as 22 and is formed with multiple seams Nail shapes pit 23.Referring to Figure 1B -1E.In addition, anvil block 20 has is divided into two-part slideway from the proximad projection of anvil block 20 Component 24.Anvil block pin 26 from each horizontal lateral process of slide assemblies 24, to be contained in the side wall 16 of elongated passageway 14 in correspondence In slit or opening 18, so as to being conducive to that for anvil block pin 26 ground can be moved or being attached pivotally to the respective slots or opening 18。

The various forms of nail bins that can be implanted into can be used together with the various embodiments of surgical instruments disclosed herein.Below Specific nail bin configuration and construction will be discussed in more detail.Can plant however, illustrating in the embodiment shown in Figure 1A and Fig. 9-14 Enter nail bin 30.In at least one embodiment, nail bin 30 has body 31, and multiple rows of unfashioned gold is supported by body 31 Category staple 32, body 31 is by the hemostatic material that can be compressed（Such as oxidized regenerated cellulose（ORC）Or the bubble of energy bio-absorbable Foam）Composition.In at least certain embodiments, to prevent staple impacted and prevent hemostatic material during introducing and position fixing process It is activated, whole storehouse can be coated with or be enclosed with the biodegradable film 38 of energy, such as with trade markThe six cyclic ketones films of sale Or with polyglycerol sebacate（PGS）Film or with by PGA（Polyglycolic acid, with trade mark Vicryl sales）、PCL（Polycaprolactone）、 PLA or PLLA（PLA）、PHA（Polyhydroxyalkanoatefrom）、PGCL（Poliglecaprone 25, with trade mark Monocryl sales）Or by Other biodegradable films of energy that the compound of PGA, PCL, PLA, PDS is formed, the film is only just permeable in rupture.Nail Being sized to of the body 31 in storehouse 30 is removably supported in elongated passageway as depicted 14 so that when the quilt of anvil block 20 Drive when contacting with the formation of nail bin 30, each of which staple 32 is alignd with corresponding staple formation pit 23.

In use, once end effector 12 is positioned adjacent to target tissue, end effector 12 is just manipulated to target Tissue capture is clamped between the top surface 36 of nail bin 30 and the staple forming face 22 of anvil block 20.Staple 32 is in the following way Shaping：The motion anvil block 20 in the path of elongated passageway 14 is arranged essentially parallel to, so that staple forming face 22 and more particularly Staple formation pit 23 therein substantially simultaneously contacts the top surface 36 of nail bin 30.As anvil block 20 is continued on to nail bin 30 In, the leg 34 of staple 32 contacts corresponding staple formation pit 23 in anvil block 20, and staple formation pit 23 is used to make staple Leg 34 bends so that staple 32 is configured to " B shapes ".Anvil block 20 will further compressed joint towards the further traveling of elongated passageway 14 Nail 32 simultaneously makes staple 32 be configured to required final forming height " FH ".

Above-mentioned staple formation process is substantially illustrated in Figure 1B -1E.For example, Figure 1B illustrates end effector 12, and it hits Tissue " T " is between anvil block 20 and the top surface 36 that can be implanted into nail bin 30.Fig. 1 C illustrate the initial clamped position of anvil block 20, wherein Anvil block 20 is closed up to target tissue " T ", and target tissue " T " is clamped between anvil block 20 and the top surface 36 of nail bin 30.Figure 1D illustrates initial staple formation, and wherein anvil block 20 has started to compress nail bin 30 so that the leg 34 of staple 32 begins through anvil block Staple formation pit 23 in 20 and shape.Fig. 1 E illustrate through target tissue " T " and are in the staple 32 of final shaped state, are Anvil block 20 has been removed for the sake of clear.Once staple 32 shapes and be fastened to target tissue " T ", surgeon just marches to anvil block 20 Open position, to enable warehouse 31 and staple 32 remain attached to target tissue when end effector 12 is withdrawn from from patient.When When two jaws 13,15 are clamped jointly, end effector 12 makes all of staple shape simultaneously.Remaining " by conquassation " body material Material 31 is used as styptic（ORC）And staple line strengthening agent（PGA, PDS or any of above other film compositions 38）.Further, since Staple 32 never needs to leave warehouse 31 during shaping, thus staple 32 be changed into during shaping deformity possibility it is minimum Change.As used herein, term " can be implanted into " refers to that in addition to staple, the warehouse material for supporting staple also would be held in Absorb in patient's body and finally by patient body.This nail bin that can be implanted into can be different from prior art and end effector is protected The chamber structure held together and therewith remove.These " can remove " nail bin and generally include staple driving device assembly, therefore It is much bigger than the end effector of the present invention, and the end effector of the present invention is designed to unique with reference to some of the invention And the new nail bin embodiment that can be implanted into is used.

In various being embodied as, end effector 12 can be connected to the Slender axles assembly projected from shank assembly 100 40.End effector 12（In closure）And Slender axles assembly 40 can have similar shape of cross section, and its size is set Determining into can operatively through trocar tube or the service aisle in another access instruments form.As used herein, term " can be operated Pass through " refer to that at least a portion of end effector and Slender axles assembly by passage or tube opening insertion or can may pass through logical Road or tube opening, and can be if necessary in being manipulated to complete surgery stitching operation to it in passage or tube opening.In some realities In applying example, when in the closed position, the jaw 13 and 15 of end effector 12 can provide circular for end effector Shape of cross section is beneficial to passage/opening that it passes through circle.It is contemplated, however, that the end of various embodiments of the present invention performs Device and Slender axles assembly embodiment have other shape of cross sections, so as to may pass through the entrance with non-circular transverse cross-section Passage and opening.Therefore, the overall dimension of the cross section of the end effector of closure by with end effector by the passage for passing through Or the size of opening is related.Therefore, an end effector is for example referred to alternatively as " 5mm " end effector, and this refers to that it can At least it is of about operationally the opening of 5mm through diameter.

In various embodiments of the present invention, the external diameter of Slender axles assembly 40 can be with end effector in the close position 12 external diameter is substantially the same.For example, 5mm end effectors can be connected to the Slender axles assembly 40 with 5mm cross-sectional diameters. However, with continued reference to this specific embodiment, it will be apparent that, various embodiments of the present invention can be effectively combined difference The end effector of size is used.For example, 10mm end effectors could attach to the slender axles with 5mm cross-sectional diameters.Phase Instead, for the entrance opening of 10mm or bigger or the application of passage is wherein provided, Slender axles assembly 40 can have 10mm（Or It is bigger）Cross-sectional diameter, but can also activate 5mm or 10mm end effectors.Therefore, the external diameter of outer shaft 40 can be attached to The external diameter of the end effector 12 of the closure of outer shaft 40 is identical or different.

As illustrated, Slender axles assembly 40 is distally extending generally along straight line from shank assembly 100, to limit longitudinal axis Line A-A.In various embodiments, for example Slender axles assembly 40 may be about 9-16 inches（229-406mm）It is long.However, elongated Shaft assembly 40 may be configured as other length, and in other embodiments, can have joint or in other words in Slender axles assembly 40 Saying can be conducive to end effector 12 to be hinged relative to the other parts of axle or shank assembly, below will discuss in more detail State it.In various embodiments, Slender axles assembly 40 includes ridge component 50, and the ridge component extends to end from shank assembly 100 Actuator 12.The near-end of the elongated passageway 14 of end effector 12 has a pair of reservation lugs 17 from its projection, this pair of guarantors Stay lug 17 be sized to be accommodated in corresponding lug opening or support 52, the lug opening or support 52 are put Put in the distal end of ridge component 50, so that end effector 12 can removedly couple Slender axles assembly 40.Ridge component 50 can It is made up of such as 6061 or 7075 aluminium, stainless steel, titanium etc..

In various embodiments, shank assembly 100 includes pistol grasping type housing, and the pistol grasping type housing can be added Work is into two or more parts in order to assembling.For example, shank assembly as depicted 100 includes right hand housing member 102 With left hand housing member 104（Fig. 5,7 and 8）, the right hand housing member and left hand housing member are by polymer or plasticity material Material is molded or in other words processes, and is designed to be fitted to each other together.This housing member 102 and 104 can By snap arrangement that is being molded wherein or in other words being formed, nail and pod and/or by adhesive, screw It is attached together.Ridge component 50 has near-end 54, and flange 56 is formed with the near-end.Flange 56 can be rotationally supported within In groove 106, the groove to the fit ribs 108 of inner process from housing member 102, each of 104 from forming.This structure Ridge component 50 is conducive to be attached to shank assembly 100, while enabling ridge component 50 relative to shank assembly 100 along 360 ° of paths Around longitudinal axis A-A rotations.

It can further be shown that ridge component 50 is supported through axle bush 60 and by axle bush 60 such as in Fig. 1 and Fig. 4, The axle bush are revolvably attached to shank assembly 100.Axle bush 60 have proximal flange 62 and distal lip 64, and this is near Side flange and distal lip limit rotated trench 65, and the rotated trench can rotate the leading edge portion 101 of shank assembly 100 Ground is accommodated therebetween.This structure enables axle bush 60 to rotate around longitudinal axis A-A relative to shank assembly 100.Ridge structure Part 50 by ridge pin 66 not revolvably pin joint to axle bush 60.In addition, turn knob 70 is attached to axle bush 60.One In embodiment, turn knob 70 has hollow mounting flange portion 72, and being sized to of the hollow mounting flange portion 72 will be pacified A part for dress axle bush 60 is accommodated wherein.In various embodiments, turn knob 70 can by such as glass or carbon filled nylon, Merlon,Etc. processing, and axle bush 60 are attached to also by ridge pin 66.In addition, to the guarantor of inner process In the radial groove 68 for staying flange 74 to be formed in mounting flange portion 72 and can extend to be formed in axle bush 60.Cause This, surgeon by firmly grasping turn knob 70 and can be such that it rotates relative to shank assembly 100, and make ridge component 50（And it is attached It is connected to the end effector 12 of ridge component 50）Rotate along 360 ° of paths around longitudinal axis A-A.

In various embodiments, anvil block 20 is held in open position by anvil block spring 21 or other bias structures, such as Fig. 1, Shown in Fig. 9 A, Figure 10 A and Figure 11 A.Anvil block 20 can by trigger system from open position optionally move to it is various closure or Clamped position and firing position, the trigger system is generally designated as 109.Trigger system 109 includes " firing member " 110, in various embodiments, " firing member " 110 includes hollow firing tube 110.Hollow firing tube 110 can be in ridge component 50 It is axially movable, therefore forms the outside of Slender axles assembly 40.Firing tube 110 can be by polymer or other suitable materials processings Form, and with the near-end 112 of the percussion yoke 114 for being attached to trigger system 109.Referring to Fig. 4.In various embodiments, for example Percussion yoke 114 can be by the near-end 112 of overmolding to firing tube 110.However, other fastener constructions may also be employed.

Such as can be seen that in Fig. 1 and Fig. 4, percussion yoke 114 can be revolvably supported in support lining ring 120, the support Lining ring can be axially movable in shank assembly 100.In various embodiments, support lining ring 120 has a pair and extends laterally Fin 122, being sized to of the pair of fin can be slidably received in fin slit 103 and 105, the fin Slit 103 and 105 is respectively formed in left hand housing member 102 and right hand housing member 104.Referring to Fig. 7.Therefore, lining is supported Circle 120 can axially slide in shank housing 100, while enabling percussion yoke 114 and firing tube 110 relative to support lining ring 120 and surround longitudinal axis A-A rotation.As can be seen in Figure 4, firing tube 110 is provided with longitudinal slit 111, so that Ridge pin 66 can be extended in ridge component 50 through longitudinal slit 111, while being conducive to the axial direction in ridge component 50 of firing tube 110 Advance on ground.

Trigger system 109 also includes firing trigger 130, and the firing trigger is used to control firing tube 110 in ridge component Axial direction traveling on 50.Referring to Fig. 1.This kind of the moving to along distal direction of firing tube 110 carries out firing phase interaction with anvil block 20 Axially-movable is referred to herein as " percussion motion ".As can be seen in Figure 1, firing trigger 130 passes through pivot pin 132 and ground can be moved or shank assembly 100 is pivotally coupled to.Biased using torsionspring 135 firing trigger 130 away from The pistol grip portion 107 of shank assembly 100 and reach " opening " or the original position not activated.Such as can see in Fig. 1 and Fig. 4 Go out, firing trigger 130 has top 134, and the top is attached in which can move（Pin joint）To percussion chain link 136, the percussion chain link Can the attachment of motion ground（Pin joint）To support lining ring 120.Therefore, firing trigger 130 is from original position（Fig. 1 and Fig. 9）Court and handle The adjacent end position of the pistol grip portion 107 of parts 100（Figure 14）Motion will make percussion yoke 114 and firing tube 110 Along distal direction " DD " motion.Motion of the firing trigger 130 away from the pistol grip portion 107 of shank assembly 100（Reversing Under the biasing of spring 135）Percussion yoke 114 and firing tube 110 will be made to move along proximal direction " PD " in ridge component 50.

Various embodiments of the present invention can be used together with the nail bin that can be implanted into of different size and configuration.For example, when with When one percussion adapter 140 is used in combination, surgical instruments 10 can be with the about 20mm length that nail bin 30 can be implanted into for support（Or tool There are other length）5mm end effectors 12 be used together.This end effector size can be particularly well-suited in for example real The dissection of existing opposite fine and management of blood vessels.However, following article is discussed in more detail, for example also can be by the way that the first percussion be held in the mouth Connect son 140 to be replaced by the second percussion adapter 150 and combined surgical instruments 10 with the end effector and nail bin of other sizes Use.In further embodiments, Slender axles assembly 40 can be attached to the end effector of only a kind of form or size.Here In class embodiment, such as pressure surface 146 or 158（Generally it is individually positioned in percussion adapter 140,150）By overall landform Into in the distal end of firing tube 110-according to the specific dimensions of end effector being used therewith depending on.

As can be seen that in fig. 2, the first percussion adapter 140 is substantially hollow and with the first spring 142, should First spring can extend in the distal end 116 of the opening of firing tube 110.First retainer button 144 is formed at the first bullet In spring portion 142, and it is sized to be accommodated in retaining holes 117, and the retaining holes is arranged on the distal portion of firing tube 110 In point.Referring to Fig. 1 and Fig. 2.Therefore, it is that the first percussion adapter 140 is dismantled from firing tube 110, user only needs pressure to protect Holder button 144 withdraws from firing tube 110 away from retaining holes 117 and by the first percussion adapter 140.Also can see in fig. 2 Go out, the first percussion adapter 140 has an inner pressure surfaces 146, the inner pressure surfaces can be divided into two with anvil block 20 The slide assemblies 24 for dividing join.

In various being embodied as, two-part slide assemblies 24 are divided into including a zygodont 45 on anvil block 20, it is described One zygodont accommodates groove by blade（It is not shown）It is spaced apart.Each pointed tooth 45 is respectively provided with proximal face 27, when anvil block 20 is in During closing position, proximal face 27 is arranged essentially parallel to the bottom of elongated passageway 14.Subsequently, proximal face 27 is transitted to away near The clamping slideway 28 of side surface 27.Referring to Fig. 3.Clamping slideway 28 is oriented to relative to 27 one-tenth angles of pinching of proximal face " A ". In various embodiments, for example the angle of pinching " A " may be about 15 degree to 30 degree.Following article is discussed in more detail, when the first percussion During the contact clamping slideway 28 of first pressure surface 146 of adapter 140, anvil block 20 will be moved towards elongated passageway 14, more specifically Say, move towards the nail bin 30 in elongated passageway 14.With the further distal motion of the first percussion adapter 140, first pressure Surface 146 contacts the staple formation slideway 29 on each anvil block pointed tooth 45, and anvil block 20 is further driven into nail bin 30, from And shape the staple 32 in nail bin 30.Also shown in FIG. 3, staple formation slideway 29 is relative to clamping slideway 27 with forming angle " B " is orientated.In various embodiments, for example forming angle " B " may be about 5 degree to 20 degree.On the slide assemblies 24 of anvil block 20 also There can be inclined lower surface 25（Such as angle " C " is of about 5 to 40 degree）So that when anvil block 20 is in an open position, incline The surface of lower surface 25 enable the opening limit that anvil block 20 is switched to 15 degree（Angle " β " in Figure 11 A）.

A kind of method for end effector 12 to be removably connected to into ridge component 50 will be explained now.By by carefully Start connection process in the lug support 52 retained in the insertion ridge component 50 of lug 17 on long-channel 14.Subsequently, surgery doctor The raw traveling firing trigger 130 of pistol grip 107 towards housing unit 100, is hit with distally advancing firing tube 110 and first The proximal part 47 that adapter 140 exceedes elongated passageway 14 is sent out, so as to lug 17 is maintained in its respective support 52.Referring to Figure 10 and Figure 10 A.First percussion adapter 140 is referred to herein as " coupled position " relative to this kind of position of lug 17. Various embodiments of the present invention can also have end effector locked component 160, for being attached to ridge in end effector 12 Firing trigger 130 is locked after component 50 in place.

More particularly, with reference to Fig. 5, Fig. 7 and Fig. 8, one embodiment of end effector locked component 160 includes protecting Pin 162 is stayed, the retaining pin is supported in the top 134 of firing trigger 130 in which can move.Retain spring 166 by retaining pin 162 carry out spring biasing towards left hand housing member 104.When firing trigger 130 is in deactivated（Starting）During position, retaining pin 162 are biased to and carry out adjacent contact with initial ratchet 163, and the initial ratchet is from left hand housing member 104 to inner process.Referring to Fig. 7 and Fig. 8.As described above, firing tube 110 must be distally advanced first to coupled position, and in coupled position, the first percussion In the lug support 52 that adapter 140 is maintained at the reservation lug 17 of end effector 12 in ridge component 50.Surgeon is led to Cross from original position and pull firing trigger 130 towards pistol grip 107 and percussion adapter 140 is distally advanced to connection Position.When firing trigger 130 is started actuating, retaining pin 162 is entered while carrying out and contacting with initial ratchet 163 Line slip, till the first percussion adapter 140 is marched to coupled position by firing tube 110, now retaining pin 162 is biased To in the latch well 164 being formed in left hand housing member 104.Referring to Fig. 8.In various embodiments, when retaining pin 162 is entered When in latch well 164, pin 162 can send audible " clicker " sound or other sound, and can provide end for surgeon and hold Row device 12 has been " locked " to the haptic indication in ridge component 50.As long as in addition, intentionally retaining pin 162 is not biased out into locking Chamber 164, surgeon just will not unintentionally activate firing trigger 130 to start to make 32 one-tenth of staple in end effector 12 Shape.Similarly, if firing trigger 130 of surgeon's release in coupled position, retaining pin 162 triggers can percussion Device 130 is maintained at the position, with prevent firing trigger 130 be back to original position and therefore from ridge component 50 release end hold Row device 12.

In various being embodied as, percussion trigger release button 167 is arranged on the left shell component of shank assembly 100 In 104, enable the surgeon to intentionally discharge retaining pin 162, so that firing trigger 130 can be further actuated Or it is back to original position.Referring to Fig. 5, Fig. 7 and Fig. 8.Percussion trigger release button 167 is arranged on locking with being moved In chamber 164 and it is biased by the spring to un-activated position（Fig. 8）.When percussion trigger release button 167 is pressed inwardly, its meeting Contact retaining pin 162 simultaneously makes retaining pin 162 move out outside latch well 163, so that firing trigger 130 can further be swashed It is living.

As described hitherto, surgical instruments 10 can be used as the grasp device of manipulation/position tissue.In trigger 130 are unlocked（Release button 167 is kept by pressure）Afterwards, firing trigger 130 is towards the further of pistol grip portion 107 Motion will make percussion adapter 140 contact the clamping slideway 28 on anvil block 20.With the pressure gauge face of the first percussion adapter 146 slide in clamping slideway 28, and anvil block will be moved in elongated passageway 14 towards nail bin 30.Therefore, surgeon can be towards nail bin 30 manipulate anvil block 20 away from nail bin 30, and firmly grasp therebetween and to discharge tissue staple formation is not made.

Various embodiments of the present invention may also include trigger system locking press button 137, and trigger system locking press button 137 is pivoted Be attached to shank assembly 100.Referring to Fig. 1 and Fig. 4.In one form, trigger system locking press button 137 has in its distal end The breech lock 138 of upper formation, the breech lock is oriented to the engagement of breech lock 138 percussion when firing release button and being in the first position latching Yoke 114.Such as can be seen that in Fig. 1 and Fig. 4, late spring 139 is used to for trigger system locking press button 137 to be biased to the first breech lock Position（Figure 11 and Figure 12）.As explained in more detail below, breech lock 138 is used to engage percussion yoke 114 at the following moment：Now The position of the percussion yoke 114 in ridge component 50 corresponding to wherein the first percussion adapter 140 pressure surface 146 will towards distally to The point of the propulsion of clamping slideway 28 of anvil block 20.It should be appreciated that as the first percussion adapter 140 is axially in clamping slideway 28 Propulsion, anvil block 20 will be moved along path so that staple forming face portion 22 is arranged essentially parallel to the top surface 36 of nail bin 30.

After end effector 12 is connected to ridge component 50, opened by depressing trigger system locking press button 137 first Beginning staple formation process so that percussion yoke 114 can in ridge component 50 further distal motion and most at last anvil block 20 is pressed In being reduced to nail bin 30.Referring to Figure 13.After pressure trigger system locking press button 137, surgeon continues towards pistol grip 107 activate firing trigger 130, slide in corresponding staple formation so as to the pressure surface 146 of the first staple lining ring 140 be driven On road 29, contacted with forcing anvil block 20 to form with the staple 32 in nail bin 30.Trigger system locking press button 137 is prevented outside Section doctor is ready to start by mistake to shape staple 32 before staple formation process.In such embodiment, surgeon must Trigger system locking press button 137 must be depressed before firing trigger 130 can be further actuated to start staple formation process.

Surgical instruments 10 optionally can be used only as tissue apposition device.However, various embodiments of the present invention also can be wrapped Tissue diced system is included, the tissue diced system is generally designated as 170.In at least one form, tissue diced system 170 include cutter component 172；Cutter component 172 can be made from the near-end phase with end effector 12 by activating cutter actuating trigger 200 Adjacent unactuated position（Fig. 1 and Fig. 9-13）Selectively propel to actuated position（Figure 14）.Cutter component 172 is by energy motion twelve Earthly Branches Support is in ridge component 50 and is attached to knife bar 180 or in other words from the projection of knife bar 180.Cutter component 172 can be big by for example having In 38HRC（With the Rockwell hardness that C indexing is represented）Hardness 420 or 440 stainless steels process and can have be formed at it Tissue cutting edge 176 on distal end 174, and the slit 31 in anvil block 20 can be slidably extended through and in nail bin 30 The slit 33 being centrally located, to cut through the tissue being clamped in end effector 12.Referring to Figure 14 A.As can be seen in Figure 4, Knife bar 180 extends through ridge component 50 and has proximal part 182.Proximal part 182 in a driving manner with Cutter conveyer 190 Interact, the Cutter conveyer can be operatively attached to knife actuating trigger 200.In various embodiments, knife propulsion triggering Device 200 is attached to pivot pin 132 so that knife actuating trigger 200 can be carried out in the case where activating firing trigger 130 Pivot or in other words activated.In various embodiments, first cutter tooth wheel 192 is also attached to pivot pin 132 so that knife is advanced The actuating of trigger 200 also pivots first cutter tooth wheel 192.Percussion is attached between first cutter tooth wheel 192 and shank housing 100 Return spring 202, by knife actuating trigger 200 original position or unactuated position are biased to.Referring to Fig. 1 and Fig. 4.

Referring to Fig. 5 and Fig. 6, the various embodiments of Cutter conveyer 190 also include the second cutter tooth wheel 194, second cutter tooth Wheel be revolvably supported on second gear axle 193 and with the bridle joint of first cutter tooth wheel 192.Second cutter tooth wheel 194 and the 3rd cutter tooth 196 bridle joints are taken turns, the 3rd gear shaft is supported on the 3rd gear shaft 195.4th cutter tooth wheel 198 is also supported on the 3rd gear On axle 195.4th cutter tooth wheel 198 can in a driving manner engage a series of gear teeths on the near-end of knife bar 180 Or ring 184.Therefore, this structure enables 4th cutter tooth wheel 198 axially to drive along distal direction " DD " or proximal direction " PD " Moving knife bar 180, while making trigger shaft 180 rotate around longitudinal axis A-A relative to 4th cutter tooth wheel 198.Therefore, surgeon can Knife actuating trigger 200 is pulled by the pistol grip 107 towards shank assembly 100 and trigger shaft 180 is axially advanced simultaneously Most all morning distally promotes cutter component 172.

Various embodiments of the present invention also include cutter locking system 210, and cutter locking system 210 prevents pushing away for cutter component 72 Enter, unless firing trigger 130 has been pulled to complete firing position（Figure 13 and Figure 14）.Therefore, this structure will prevent knife The activation of propulsion system 170, except sewing-free is fired or formed in tissue first.As can be seen in Figure 1, knife locking system The various of system 210 are embodied as including cutter securing rod 211 that the cutter securing rod 211 is pivotally supported the hand in shank assembly 100 In pistol grip 107.Cutter securing rod 211 has activated end 212, when firing trigger 130 is in complete firing position, swashs Active end 212 can be engaged by firing trigger 130.In addition, cutter securing rod 211 has on the other end thereof keeps suspension hook 214, should Keep suspension hook that the latch bar 216 on the first cutting gear 192 can be engaged in suspension hook mode.Will using Lock spring 218 Cutter securing rod 211 is biased to " locking " position.In " locking " position, suspension hook 214 is kept to keep connecting with latch bar 216 Close, so as to prevent the actuating of knife actuating trigger 200, unless firing trigger 130 is in complete firing position.Referring to Fig. 9.

To explain with reference to Fig. 9,9A, 10,10A, 11,11A, 12,12A, 13,13A, 14 and 14A now for operating this The various methods of at least one surgical instrument embodiment of invention.With reference to Fig. 1, Fig. 9 and Fig. 9 A it is understood that when knife bar 172 is in When shown " starting " position or unactuated position, tissue cutting edge 176 makes adjacent to the distal end of the first percussion adapter 140 Obtain sharp tissue cutting edge 176 and be not exposed to user.It is manufactured into and single form or size in Slender axles assembly End effector be used together（For example wherein it is provided without percussion adapter 140,150）Alternative embodiment in, knife The cutting edge 176 of bar 172 is remotely located by neighbouring firing tube, equally to prevent tissue cutting edge in these embodiments 176 are exposed to user.

Fig. 9 and 9A are illustrated by the way that the reservation lug 17 on end effector 12 to be inserted the lug support 52 in ridge component 50 In and the end effector 12 that is attached to after ridge component 50.As shown in figure 9, firing trigger 130 is in unactuated position Or original position, and end effector 12 is not yet locked to ridge component 50 by the first percussion adapter 140.“P_O" represent the One percussion adapter 140 starts the distance that firing trigger 130 can advance before traveling in the clamping slideway portion 28 of anvil block 20. Knife actuating trigger 200 is also at the unactuated position of locking.

Figure 10 and Figure 10 A illustrate that firing trigger 130 is being advanced its end effector 12 by the first percussion linking Son 140 is locked to the position after the position of ridge component 50.This position referred to herein as " couples " position.When in connection When connecing position, retaining pin 162 is by snap-fastener to latch well 164（Fig. 8）In, show so as to provide end effector 12 for surgeon In the sense of hearing and haptic indication that are locked to ridge component 50.Until surgeon intentionally depresses percussion trigger release button 167（Fig. 5, Fig. 7 and Fig. 8）So that retaining pin 62 is biased out outside latch well 164, firing trigger 130 could be caused further It is dynamic.The distance that the distal end 141 of the first percussion adapter 140 has been advanced is represented as distance " l "（Figure 10 A）, and percussion yoke 114 The respective distances advanced in ridge component 50 are represented as distance " l ' ".Figure 11 and Figure 11 A are illustrated in release button（Do not show Go out）It is depressed and surgeon has activated firing trigger 130 first percussion adapter 140 is marched to the folder on anvil block 20 The position of firing trigger 130 after the starting point of tight slideway 28.As can be seen that in these figures, anvil block spring 21 is by anvil block 20 It is biased to open position.The traveling of the distal end of the first percussion adapter 140 is represented as distance " l₁", and percussion yoke 114 exists The respective distances advanced in ridge component 50 are represented as distance " l '₁”.Figure 12 and Figure 12 A illustrate the first percussion adapter 140 Position after the starting point of the staple formation slideway 29 of anvil block 20 is advanced.This positional representation is before staple formation starts Obtainable maximum grip amount.This position is referred to herein as " maximum grip position ".As can be seen that in fig. 12, percussion yoke 114 have contacted the breech lock 138 in percussion trigger release button 137, therefore until percussion trigger release button 137 is depressed When, percussion yoke 114 could be distally advanced further.As can be seen that in fig. 12, the base of staple forming face 22 of anvil block 20 Parallel to the top surface 31 of nail bin 30 in sheet.Between the staple formation portion 22 of anvil block 20 and the top holding surface of elongated passageway 14 Distance is represented as " C_max”.In various embodiments, for each nail bin 30 with the body 31 for being substantially identical thickness Speech, C_maxIt may be, for example, 0.085 inch to 0.144 inch（About 2.15mm to 3.65mm）.In at least one embodiment, example As storehouse thickness can be more than about 0.01 inch to 0.03 inch of staple size（About 0.25mm to 0.76mm）.First percussion linking Son 140 is represented as " l from original position to total distance that this maximum grip position is advanced₂", and percussion yoke 114 is in ridge structure The respective distances advanced on part 50 are represented as " l '₂”.Figure 13 and Figure 13 A illustrate that percussion yoke 114 is in complete firing position When position, in complete firing position, the staple 32 in nail bin 30 is fully formed.When at that position, anvil block 20 The distance between top holding surface of staple formation portion 22 and elongated passageway 14 is represented as " C_min”.In various embodiments, Leg is of about 0.075 inch to 0.134 inch during for for supporting unshaped（About 1.90mm to 3.40mm）It is long（Figure 1A In distance " UF "）And complete forming height when being fully formed for example is of about 0.025 inch to 0.04 inch（About 0.63mm to 1.01mm）（Including the distance " FF " in Fig. 1 D）Staple nail bin for, " C_min" can be such as about 0.015 Inch is to 0.030 inch（About 0.38mm to 0.76mm）.First percussion adapter 140 fires completely position from original position to this Put the total distance advanced and be represented as " l₃", and the respective distances that percussion yoke 114 has been advanced in ridge component 50 are expressed For " l '₃”.Equally can be seen that in fig. 13, firing trigger 130 is in complete firing position and has contacted cutter securing rod 211 Activated end 212, makes it depart from the latch bar 216 on the first cutting gear 192 to bias holding suspension hook 214.

One of crosscutting, especially blood vessel crosscutting step maximum for difficulty in any surgical operation.In laparoscopic type In environment, crosscutting difficulty is bigger, this is because if there is any failure, then whole operation may need almost to change immediately Into open surgery, to prevent catastrophic event.Therefore, it is desirable to can optionally be cut after deployment staple using one kind Cut the surgery suturing appliance of tissue.Various embodiments of the present invention disclosure satisfy that this demand.

It is " fired " in staple（Shaping）After into target tissue, surgeon can depress percussion trigger release button 167, so that firing trigger 130 can be back to original position under the bias of torsionspring 135, so that anvil block 20 Open position can be biased downwards in the bias of spring 21.When in open position, surgeon can withdraw from end and hold Row device 12 and leave the nail bin 30 and staple 32 that can be implanted into.Wherein end effector is inserted through passage, service aisle etc. In the application for entering, surgeon will make anvil block 20 be back to closing position by activating firing trigger 130, so that end is held Row device 12 can be withdrawn by by the passage or service aisle.If however, surgeon wants to be cut after percussion staple Target tissue is cut, then surgeon activates in the above described manner knife actuating trigger 200, reached through target tissue with trigger shaft 72 The end of end effector, as shown in Figure 14,14A.Figure 14 is illustrated in the various of the end effector/nail bin for different length The amount of exercise of knife actuating trigger 200 in embodiment, wherein knife bar 72 have been advanced into the position of percussion completely in end effector 12 Put.Subsequently, the releasable knife actuating trigger 200 of surgeon, so that percussion return spring 202 incites somebody to action can percussion conveyer Knife bar 72 is back to starting（Deactivated）Position（Figure 13,13A）.Once knife bar 72 is back to original position, surgeon just may be used End effector jaw 13,15 is opened, the storehouse 30 that can be implanted into is released in patient's body and subsequently end is withdrawn from from patient's body Portion's actuator 12.Therefore, this surgical instruments of the invention is conducive to use to pass through relatively small service aisle and passage And be inserted into it is little can be implanted into nail bin, while not cutting tissue or if necessary in percussion for surgeon provides percussion staple Also the selection of tissue is cut after staple.

As described above, surgical instruments 10 can be used in combination with other end effectors for the nail bin for supporting other sizes, institute Stating the cartridge of other sizes has the staple of other sizes and number.Figure 15-19 illustrates the use of end effector 12 ', end Portion's actuator 12 ' can be operatively supported nail bin 30 ', and the staple 32 ' that the nail bin has is more than the staple 32 in nail bin 30.Example Such as, the staple 32 in nail bin 30 may be about 0.080 inch to 0.085 inch（About 2.03mm to 2.15mm）Staple, and Staple 32 ' in nail bin 30 ' may be about 0.075 inch（About 1.90mm）.In various embodiments, nail bin 30 ' is longer than nail Storehouse 30.For example, nail bin 30 may be about 0.78 inch（About 20mm）It is long；And nail bin 30 ' may be about 1.57 inches（About 40mm）It is long.Figure 15 is the decomposition view of the distal end 55 of end effector 12 ', the second percussion adapter 150 and ridge component 50.Such as Can be seen that in fig .15, elongated passageway 14 ' has slit or opening with a pair side walls 16 ' spaced apart in every side wall 16 ' 18 ', the slit or opening are sized to receive corresponding anvil block pin 26 '.Anvil block 20 ' can be common with elongated passageway 14 ' End effector 12 ' is formed, the overall diameter of the end effector will allow for end effector 12 ' through with least about 0.20 Inch（About 5.0mm）The opening of diameter.Anvil block 20 ' also has staple formation portion 22 ' and is divided into two-part slide assemblies 24 ', multiple staple formation pits are formed with the staple formation portion 22 ', and it is divided into two-part slide assemblies 24 ' from anvil The proximally projection of seat 20 '.The near-end 15 ' of elongated passageway 14 ' is with a pair of reservation lugs 17 ' from its projection, this pair of reservations Being sized to of lug is accommodated in corresponding lug support 52 set in ridge component 50.

As can be seen that in fig .15, there is the second percussion adapter 150 substantially hollow body 151 and nearside to serve as a contrast Circle portion 152, has the holding projection 154 for extending internally in nearside lining ring portion 152.Between body 151 and nearside lining ring portion 152 Slit 156 is provided with, so that lining ring portion 152 can be biased relative to body 151, is beneficial to and projection 154 will be kept to insert In retaining holes 117 in firing tube 110.It is that the second percussion adapter 150 is dismantled from firing tube 110, surgeon needs pressure Nearside lining ring portion 152 with by keep projection 154 remove outside retaining holes 117 so that the second percussion adapter 150 can be towards distally It is pulled away from firing tube 110.

In various embodiments, anvil block 20 ' is divided into two-part skid assemblies with two-part slide assemblies 24 ' are divided into Part 24 ' is respectively provided with proximal face 27 ', the mistake of proximal face 27 ' with each of a zygodont 45 ', the pair of pointed tooth 45 ' Cross to the clamping slideway 28 ' away from proximal face 27 '.Referring to Figure 15.Clamping slideway 28 ' is oriented to relative to proximal face 27 ' angled " A ' ".In various embodiments, such as angle " A ' " may be about 50 to 30 degree.Following article is discussed in more detail State, when the second pressure surface 158 of the second percussion adapter 150 contacts clamping slideway 28 ', anvil block 20 ' will be towards elongated passageway 14 ' motions, more particularly, move towards the nail bin 30 ' in elongated passageway 14.Referring to Figure 17.When the second percussion adapter 150 is entered During one step distal motion, second pressure surface 158 contacts the staple formation slideway 29 ' on anvil block pointed tooth 45, with further court Nail bin 30 ' drives anvil block 20 ', so that the staple 32 in nail bin 30 shapes.Referring to Figure 18.Staple formation slideway 29 ' is oriented " B ' " is at an angle of into relative to clamping slideway 27 '.In various embodiments, such as angle " B ' " may be about 5 to 20 degree.Slideway Spring can be provided between component 24 ' and the bottom of elongated passageway 14 '（It is not shown）, anvil block 20 ' is biased to into open position.

Figure 16 to be illustrated and the second percussion adapter 150 is advanced into into rising for clamping slideway portion 28 ' towards distally in surgeon The position of the second percussion adapter 150 after point.Firing trigger 130 is with above in connection with described in the first percussion adapter 140 Mode controlling the operation of the second percussion adapter 150.Figure 17 illustrates the second percussion adapter 150 in fully clamped position When position.Figure 18 illustrate the second percussion adapter 150 in complete firing position when position；In the complete firing position In, the staple 32 ' in nail bin 30 ' has passed through clamped tissue（It is not shown）And shape.

As described above, the ratio of nail bin 30 ' can be implanted into, to be implanted into nail bin 30 long.Therefore, as shown in figure 15, end effector 12 ' Also distally cutter component 124 is included, the distally cutter component is supported in elongated passageway 14 ' in which can move.Distally cutter component 124 has Cutting edge 125 and portions of proximal 126 in a organized way, the portions of proximal can be engaged by knife bar 72.Therefore, if surgeon thinks Will staple by percussion after cutting tissue, then surgeon need firing trigger 200 activated as described above, to drive towards distally Moving knife bar 172 makes its contact distally cutter component 124, so as to drive distally cutter component 124 through organizing, as shown in figure 19.Distally There can be at least one retainer portion in cutter component 124, the retainer portion can pass through the correspondence shaping in elongated passageway 14 ' Slit（It is not shown）And slide.This structure makes end effector 12 ' to open in staple formation and after tissue is cut. Distally cutter component 124 is maintained in anvil block 20 ' and is removed together with end effector 12 ' when being withdrawn by from patient's body.

Therefore, the various embodiments of surgical instruments 10 have single suturing mechanism and tissue cutting mechanism so that surgery Doctor can suture tissue under conditions of tissue is not cut.The various embodiments of suture instruments of the present invention can successfully with can hit The various sizes of end effector for sending out different size sum purpose staple is used together.Surgical instruments can be by including the He of apparatus 10 Providing, the second percussion adapter 150 makes apparatus to the kit form of the first percussion adapter 140 and the second percussion adapter 150 Can be used in firing various sizes of can be implanted into nail bin.

The nail bin that the various unique and new embodiment employings of the present invention can be compressed, the nail bin that can be compressed is supported and is in Substantially fixed position is for by the staple of anvil block shaping contact.Stitch with the surgery in prior art using staple driving element Close structure different, the staple in the nail bin of various embodiments of the invention is not driven in anvil block.In the various enforcements of the present invention In example, anvil block is driven in unfashioned staple.The staple formation degree for being obtained is driven in staple depending on anvil block Degree.This structure allows a surgeon to adjust shaping or the size of percussion pressure applied to staple, so as to change The final forming height of staple.

In various embodiments, apply to the amount of the percussion motion of the anvil block that can advance to depend on the actuating journey of firing trigger Degree.For example, if surgeon goes for the staple of only part shaping, only need towards pistol grip 107 partially inwardly Pressure firing trigger.Want to obtain more staple formations, surgeon only needs further to compress firing trigger so that anvil Seat is further driven to be contacted to form with staple.As used herein, term " shaping contact " refers to staple forming face Or staple formation pit has contacted the end of staple leg and has had started to that leg is shaped or bent to shaping position.Staple formation Degree refers to the staple leg degree being folded and the forming height for finally referring to staple referred to above.It is common in this area Technical staff will be further understood that, because when percussion motion is applied to anvil block 20, anvil block 20 is with substantially parallel with nail bin Relation moved, so staple substantially simultaneously shapes and with substantially the same forming height.

Figure 20-23 is illustrated using alternative surgical instruments 10 of staple height indicator assemblies 220.In various enforcements In example, staple height indicator assemblies 220 include indicator rod 222, and indicator rod 222 is attached to the upper of firing trigger 130 Portion 134, pivotally to move together with top 134.When firing trigger 130 is towards the pivot of pistol grip 107 of shank assembly 100 When turning so that anvil block 20 is compacted in nail bin 30 as mentioned above, the form 223 that can pass through in left hand housing member 104 observes finger Show device rod 222.In such embodiment, staple height indicator assemblies 220 also include be formed in left hand housing member 104 and Corresponding to a series of ratchets 24,26,28 of the three phases of staple formation.Specifically, once firing trigger 130 is initial Ground is activated, and retaining pin 162 just enters line slip while contacting with initial ratchet 163, until firing tube 110 will fire rank Connect son 140 or 150 be advanced into above-mentioned latched position till, now retaining pin 162 is biased to and is formed at left hand housing member 104 In latch well 164 in.When surgeon wants to start to close jaw 13,35 of end effector 12, holding need to be depressed and released Button 167 is put, so that firing trigger 130 can be further actuated.When percussion trigger release button 167 is pressed inwardly When, it can contact retaining pin 162 and retaining pin 162 is moved out outside latch well 163, so that firing trigger 130 can be swashed It is living.As described above, surgeon can be firmly grasped and be grasped using the bottom jaw 13 of end effector 12 and top jaw 15 now Vertical tissue.When surgeon want start staple formation process when, percussion trigger release button 167 need to be depressed, so as to Surgeon continues to enable percussion yoke 114 advance towards distally when depressing firing trigger 130.

Being pushed further into of firing trigger 130 can make anvil block 20 march to be formed with the staple 32 in nail bin 30 and connect Touch.As firing trigger 130 is depressed further, the flush end 165 of retaining pin 162 will slide away from initial ratchet 163 and connect The first ratchet 224 corresponding to the first staple formation amount is touched, the first staple formation amount is by the in left hand housing member 104 One staple height symbol 230 is represented.Referring to Figure 20.As illustrated, the first staple height symbol 230 just starts shaping including staple Picture.This stage of staple formation can be identified using other symbol/marks.When retaining pin 162 engages the first ratchet 224 When, the audible click of surgeon.Retaining pin 162 also can be external by firing trigger 130 with the engagement of the first ratchet 224 Section doctor provides certain touch feedback.In addition, can pass through the watch window 223 adjacent with the first height staple symbol 230 observing To staple height indicator rod 222.If surgeon wants to make the staple 32 in nail bin further shape, by being formed at Release button 240 in second side body component 104 is pressing retaining pin 162 so that it departs from the first ratchet 224.Various In embodiment, for example release button 240 can be integrally formed in left hand housing member 104, hinge part using hinge part 242 240 is a part for left hand housing member 104.This structure enables release button 240 to be pressed against the end of retaining pin 162 In 165, so that end 165 is moved and is departed from any one of the first ratchet 224, the second ratchet 226 and the 3rd ratchet 228. Once retaining pin 162 is pressed into outside the first ratchet 224, firing trigger 130 just can be further depressed, until retaining pin Till 162 the second staple formation ratchets 226 of engagement.This position of firing trigger 130 causes anvil block 20 further to move, with Staple formation contact is carried out with the staple 32 in nail bin 30.Equally, the snap-fastener of retaining pin 162 is into the second staple formation ratchet 226, And provide the sense of hearing and touch feedback of the firing trigger 130 in the second staple formation position for surgeon.When in the position When putting, staple height indicator rod 222 can pass through watch window 223 and be observed and neighbouring second staple height symbol 232. If surgeon wants to make the staple 32 in nail bin 30 further shape, by depressing release button 240 reservation is pressed Pin 162 makes it depart from the second ratchet 226.Subsequently, can further depress firing trigger 130, until retaining pin 162 engagement with Till the 3rd corresponding staple formation ratchet 228 of the final stage of staple formation.Equally, the snap-fastener of retaining pin 162 is to the 3rd seam In nail shaping ratchet 228, and the sense of hearing and tactile of the firing trigger 130 in the 3rd staple formation position is provided for surgeon Feedback.When at that position, staple height indicator rod 222 can pass through watch window 223 and be observed and neighbouring staple Height symbol 234.After staple formation is desired amount, surgeon can bias retaining pin 162 away from the 3rd staple Height ratchet 228, so that firing trigger 130 can be back to original position.Or, if it is desired, surgeon subsequently may be used Started above-mentioned tissue cutting operation before firing trigger 130 is back to into original position.

Figure 24 illustrate the staple height indicator assemblies for being wherein generally designated as 220 ' do not include with various staples into A series of alternative embodiment of the corresponding ratchets of shape.However, this embodiment includes staple height indicator rod 222 and sees Examine window 223.Therefore, surgeon can be supervised by monitoring the position of staple height indicator rod 222 through watch window 223 Depending on the staple formation amount for being reached.This embodiment does not include above-mentioned staple height indicator symbol 230,232 and 234.In addition, This embodiment may also comprise the unshaped staple symbol 229 corresponding with original position, and in the original position, staple 32 is still Do not begin through anvil block 20 and shape.In addition, this embodiment will be operated in the same manner as described above.

Figure 25 and 26 illustrates alternative end effector 12 ", except the following difference that can accommodate knife bar 172 ' it Outward, end effector 12 " are similar to above-mentioned end effector 12 '.Knife bar 172 ' is connected to knife bar 180 or from the projection of knife bar 180, And in addition operated in the way of above in connection with described in knife bar 172.However, in this embodiment, knife bar 172 ' Long enough is traversing end effector 12 " whole length, therefore end effector 12 " in be provided without single distal blade structure Part.Crosscutting component 173 ' and crosscutting component 175 ' are formed with knife bar 172 '.Crosscutting component 173 ' is oriented to slide Corresponding elongated slot 250 in crosscutting anvil block 20 dynamicly ", and crosscutting component 175 ' is oriented to traverse end effector 12 " elongated slot 252 in elongated passageway 14 ".It is also equipped with departing from slit in anvil block 20 "（It is not shown）So that work as knife bar 172 ' are driven to end effector 12 " in end position when, crosscutting component 173 ' falls through corresponding slit, with Make anvil block 20 " open position can be marched to, so as to the tissue that sutures and cut depart from.Anvil block 20 " can in addition with Above-mentioned anvil block 20 is identical, and elongated passageway 14 " can be in addition identical with above-mentioned elongated passageway 14.

In these embodiments, anvil block 20 " are by spring or other Unclosing structures（It is not shown）It is biased to fully open position （Figure 25）.Anvil block 20 " by percussion adapter 150 carry out in the above described manner axial direction advance and open position with clamp completely Move between position.Once percussion adapter 150 is advanced into fully clamped position（Figure 26）, surgeon just can be subsequently with above-mentioned Mode makes knife bar 172 towards distally " propulsion.If surgeon wants for end effector to carry out manipulating tissue as grasp device, Then percussion adapter can proximally be moved, to allow anvil block 20 " away from elongated passageway 14 " motion, such as the dotted line institute in Figure 27 Show.In this embodiment, when knife bar 172 " towards distally move when, crosscutting component 173 ' and crosscutting component 175 ' are while pull Anvil block 20 " and elongated passageway 14 ", with knife bar 172 " is through end effector 12 " required staple is reached when advancing towards distally Shaping.Referring to Figure 28.Therefore, in this embodiment, staple formation is that occur simultaneously with tissue cutting, but staple itself can be in knife Bar 172 " sequentially shapes when being driven towards distally.

Figure 29 and 30 is illustrated with anvil block 20 " end effector 12 " use, anvil block 20 " for example by stainless steel, titanium, PGA（Polyglycolic acid）Or other absorbable plastic processings are formed, and it is to a certain extent flexible.These figures are also showed that Retain the use of matrix 6250 and alignment matrix 6206, below will be clarified in more detail.Such as can be seen that in Figure 29, work as knife bar 172 " through anvil block 20 " towards distally driven when, anvil block 20 " flexing is to being fully formed position.

It is desirable or advantageously using following surgery cuts and suture instruments, the surgery in many surgery applications Cutting and suture instruments have the end effector that can be hinged relative to Slender axles assembly.However, of the prior art can Articulated instrument into compact area ability usually due to the size of component and construction for being hinged to end effector And be limited.Figure 31-40 illustrates another surgical instrument embodiment of the present invention, and the surgical instruments can make end effector relative It is hinged in slender axles, and the surgical instruments is hinged control structure in shank assembly using relative compact.

The surgical instruments 310 of this embodiment is substantially similar to above-mentioned various surgical instrument embodiments 10, and difference exists Radial type shaft assembly 312 is adopted in, this embodiment, is beneficial to relative to elongated longitudinal axis A-A optionally positioning end Portion's actuator 12.Although being described herein surgical instruments 310 is used in combination with the end effector 12 of the above-mentioned type, but this It is in field one of ordinary skill appreciates that, surgical instruments 310 also can be used in combination with actuation ends with the second percussion adapter 150 Portion's actuator 12 ' or other end effector structures.Such as can be seen that in Figure 31 and Figure 32, radial type shaft assembly 312 includes remote Side axle assembly portion 314, the distal shaft assembly portion is pivotally coupled to proximal shaft assembly portion 316, and the proximal shaft assembly portion can be operated Be connected to shank assembly 100.In various embodiments, for example distally shaft assembly 314 includes distally ridge component 320, the distally There are a pair of lug supports 322 for lug 17 is accommodated wherein in ridge component.Referring to Figure 32.Distally ridge component 320 has There is near-end 324, the near-end includes pivot base 326, the pivot base has the pivot pin 328 from its projection.

Such as can be seen that in Figure 32, proximal shaft assembly portion 316 includes proximal spine section 330, proximal spine section 330 has near Side pivot base and the knife guide rail 332 for being attached to the nearside pivot base.Knife guide rail 332 can for example using adhesive or other Fastener constructions and weld or be attached to proximal spine segment 330.Be provided with pivot hole 334 in nearside pivot base knife guide rail 332 with Pivot pin 328 is revolvably accommodated wherein, so that distal spine segment 320 can be relative to proximal spine segment 330 around the first pivot Axis FA-FA is pivoted, the substantially transverse longitudinal axis A-A of the first pivotal line FA-FA.Surgical instruments 310 also includes distally Percussion pipeline section 370, the distally percussion pipeline section is pivotally coupled to a pair of firing tube chain links 380,382, with around second axis SA- SA pivotally advances.Distally percussion pipeline section 370 has keeper bore 372, for by the retainer of the first percussion adapter 140 Button 144 is accommodated wherein.The pair of firing tube chain link 380,382 is pivotally coupled to nearside firing tube 390, with relative to Nearside firing tube 390 moves pivotally around the 3rd pivot axis TA-TA.Referring to Figure 32.

In various embodiments, nearside firing tube 390 is attached to turn knob 400, and turn knob 400 is revolvably attached To shank assembly 100.Referring to Figure 31, Figure 38 and Figure 39.Turn knob 400 can be formed by polymer or molded of plastic material, and The flange part 404 that may include central part 402 and be spaced apart with central part 402.The leading edge portion 101 of shank assembly 100 is received Between central part 402 and flange part 404, so that turn knob 400 can be relative to shank assembly 100 around longitudinal axis A-A Rotation.In other embodiments, turn knob 400 can be formed by other suitable materials processings.In the embodiment shown, nearside Firing tube 390 and proximal spine segment 330 are non-respectively to be attached to turn knob 400 to motion.Such as can be seen that in Figure 38 and Figure 39, Proximal spine segment 330 and nearside firing tube 390 are by the pin joint of pin 406 to turn knob 400.Therefore, surgeon can be by rotation Rotate button 400 to be rotated and relative to shank assembly 100 along 360 degree of paths around longitudinal axis A-A rotary ends actuator 12.

Referring to Figure 37, Figure 38 and Figure 40, in various embodiments, end effector 12 can by a pair of articulated elements 420, 430 and it is hinged ball 440 and is optionally hinged relative to longitudinal axis A-A, the pair of articulated element 420,430 is attached To distally pivot base 326, and it is hinged in the pod 408 that ball 440 is revolvably supported in turn knob 400.Various In embodiment, articulated element 420,430 for example may include the cable being processed into by many cable wires, Nitinol, titanium etc..First or right Side articulated element 420 has distal end 422, is formed with lug 424 on the distal end, and being sized to of the lug can press In being fitted on the first cable attachment hole 327 set in distally pivot base 326.Equally, second or left side articulated element 430 have There is distal end 432, lug 434 is formed with the distal end, being sized to of the lug 434 can be press-fitted into distally pivot In pedestal 326 in the second set cable attachment hole 329.Referring to Figure 37.Therefore, structure can be hinged by drawing first or right side Part 420 is making end effector 12 around first axle FA-FA（Figure 35 and Figure 36）Be pivoted to right side, and can by drawing second or Left side articulated element 430 come make end effector 12 around first axle FA-FA be pivoted to left side.In various embodiments, right side Articulated element 420 can be slidingly received in the right side cable slots 336 formed in proximal spine segment 330, and left side is hinged Component 430 can be slidingly received in the left side cable slots 338 in proximal spine segment 330.

Reference picture 38-40, the first articulated element 420 has near-end 426, and forging on near-end 426 has or is in other words attached There is holding ball 428, keep ball 428 to be contained in the first reservation slit 442 being hinged in ball 440, being hinged ball 440 can rotate Be supported in the pod 401 in turn knob 400.Equally, the second articulated element 430 has near-end 436, forges on the near-end There is or is in other words attached with holding ball 438, the holding ball can be accommodated in the second reservation slit 444 being hinged in ball 440 It is interior.Most can especially find out such as in Figure 40, be hinged ball 440 and also have through the actuator slits 446 for being hinged ball 440, the actuating Device slit is conducive to forming straightway passage for nearside percussion pipeline section 390 wherein.As shown in figure 38, actuator slits 446 can be tapered from wider opening portion 448,450 to the passage 452 being hinged in the center of ball 440, and the passage allows nearside Percussion pipeline section 390 passes through in sliding manner.As discussed further below, it is hinged ball 440 revolvably or is pivotally supported In pod 401, and from neutral position（It is shown in solid in Figure 38）Optionally move to first and be hinged control position Control position is hinged with second（It is shown in broken lines in Figure 38）.It is hinged ball 440 to be also axially movable in pod 401.

Such as can be seen that in Figure 40, surgical instruments 310 may include the locking device for being generally designated as 453, for Ball 440 will be hinged to be locked in neutral position, first be hinged control position and second be hinged control any one of position.Each In planting embodiment, locking device 453 includes a series of locking pawl sections 454, and a series of locking pawl sections 454 are placed on hinge Receive on 440 and can coordinate with the lock rib 410 being formed in depressed part 408, the depressed part is formed at central part 402 In, the central part is oriented in the pod region 401 of turn knob 400.Actuator channel 412 extends through central part 402 and align with the actuator slits 446 being hinged in ball 440, pipeline section is fired with the nearside accommodated through actuator channel 412 390.Such as can be seen that in Figure 38 and Figure 39, actuator ball spring 456 is kept on central part 414 in the spring of turn knob 400 Propulsion is hinged ball 440 proximally to bias so that locking pawl 454 is entered with the lock rib 410 in central part 402 with hold mode Row engagement.

For the benefit of apply pivotal motion to being hinged ball 440, what is extended laterally for a pair is hinged handle 458,460 from being hinged ball 440 Diametrically opposite direction projection.In various embodiments, be hinged ball 440 for example can be filled out by packless, glass-filled, carbon Filling, mineral-filled etc. Merlon, nylon,Process, and be hinged machinable on ball 440 or molding There is locking pawl 454.It is hinged handle 458,460 and can be attached to by modes such as press-fit, welding and is hinged ball 440.This locking dress Put to enable to be hinged ball 440 and be locked to neutral position or any one of the first articulated position or the second articulated position.Once Surgeon will be hinged ball 440 and move to and reach the desired articulated position of end effector, and surgeon is just releasably hinged ball 440, so that actuator ball spring 456 can be biased proximally is hinged ball 440 so that in locking pawl 454 and central part 402 Lock rib 410 is with hold mode engagement.In various embodiments, the size of actuator ball spring 456 can be configured to work as and be hinged End effector when being forced to retract by trochar or similar opening, being hinged ball 440 can spring back to neutral position.This Outward, the use for being hinged handle 458,460 makes it possible to be hinged degree come " fine setting " according to specific surgery application.

Such as can be seen that in Figure 38, first is hinged handle or right side is hinged handle 458 through the right slot in turn knob 400 416 projections, and second be hinged handle or left side is hinged handle 460 through the projection of left slot 418 in turn knob 400.To make End effector 12 is hinged relative to longitudinal axis A-A, and surgeon needs to be axially movable along distal direction " DD " first Right side is hinged handle 458 and left side is hinged handle 460, so that locking of the locking pawl 454 from the central part 402 of turn knob 400 Rib 410 departs from.Subsequently, surgeon can by along the motion hinged handle 458,460 of desired orientation applying to articulated element 420,430 Plus pivotal motion and make to be hinged ball 440 and be pivoted.For example, end effector 12 can be in the following manner made to be switched to right side： Handle 458 is hinged along proximal direction " PD " motion right side, and handle 460 is hinged along distal direction " DD " motion left side, to cut with scissors to right side Connection member 420 applies drawing motion（Pivotal motion）And left side articulated element 430 is applied to promote motion.Similarly, can pass through In the following manner makes end effector 12 be switched to left side：Handle 460 is hinged along proximal direction " PD " motion left side, and along distal direction " DD " motion right side is hinged handle 458, to apply drawing motion to left side articulated element 430（Pivotal motion）And structure is hinged to right side Part 420 applies to promote motion.Right side is hinged handle 458 and left side is hinged the various range of movement of handle 460 and is shown in Figure 38 with dotted line. Consequently, it is possible to end effector 12 for example can most preferably be positioned at various being at an angle of by adjustment angle clockwise or counterclockwise Position in, and rotated need not Slender axles assembly 40 or other motion.Figure 35 illustrates angle α, in various embodiments, angle α can be 0 ° to 45 °.

The various embodiments of surgical instruments 310 include supporting slit 333 through knife and being supported on moving hollow Knife bar 472 in proximal spine section 330, knife supports slit 333 from narrow portions of proximal 335 to wide distal part 337 in cone Shape, so that knife bar 472 can support slit 333 and flexing around knife, so as to adapt to end effector 12 around longitudinal axis A-A's It is hinged.Referring to Figure 37.In various embodiments, knife bar 472 can be processed by the stainless steel of such as 300 or 400 series, and can With the tissue cutting edge 476 being formed on its distal end.It can further be shown that knife bar 472 can slidably be worn such as in Figure 37 The cutter slit 473 crossed in distally pivot base 326.The near-end 478 of knife bar 472 is attached to the knife for extending through proximal spine segment 330 Bar 480, so as to as mentioned above in a driving manner engagement fires conveyer 190.Referring to Figure 31.Retaining pin 406 extends to nearside Longitudinal slit 392 in percussion pipeline section 390（Figure 38）In and through the hole 339 in proximal spine segment 330（Figure 39）And enter knife bar In longitudinal slit 482 in 480, so that nearside percussion pipeline section 390 and knife bar 480 can be relative to proximal spine segment 330 and shanks Component 100 is axially movable.Therefore, surgeon can be by operating in the above described manner knife actuating trigger 200 come optionally Knife bar 472 is operated to cut tissue.

Various articulated structures be disclosed in that on May 7th, 2010 is filing an application, authorize Frederick E.Shelton IV and The U.S. Patent application of entitled " Laparoscopic Devices With Articulating End Effectors " No.12/775,809（Attorney END6755USNP）And on May 7th, 2010 it is filing an application, authorize Frederick The U.S. Patent application of E.Shelton IV et al. and entitled " Bendable Shaft For Handle Positioning " No.12/775,699（Attorney END6756USNP）In, the disclosure of each of above-mentioned U.S. Patent application It is incorporated herein by reference respectively.Figure 41 and Figure 42 illustrate alternative radial type shaft assembly 490, the radial type axle group Part 490 is substantially the same with radial type shaft assembly 340 and is operated in essentially the same way, and difference is centre Percussion pipeline section 492 instead of the firing tube chain link 380 employed in radial type shaft assembly 340.Such as can see in Figure 41 and Figure 42 Go out, centre percussion pipeline section 492 distally fires pipeline section 370 and extends to nearside percussion pipeline section 390.In various embodiments, it is middle Percussion pipeline section 492 can by nylon,Or other flexiplasts are processed.In various embodiments, middle firing tube Section 492 has the compression spines 494 of two Longitudinal extendings, and the rib section 496 multiple spaced apart being spaced apart by space 498 is from compression Spine 494 extends to form substantially hollow pipeline section, and other elements and knife bar of the ridge component can operatively through described Substantially hollow pipeline section.Spine 494 can proximally fire pipeline section 390 and distad fire the transmission compression motion of pipeline section 370, institute The size for stating compression motion be enough to anvil block 20 be activated to complete firing position, while enabling end effector 12 relative to vertical Optionally it is hinged to axis A-A.Centre percussion pipeline section 492 has distal portions 491 and portions of proximal 493, the distal portion 491 are divided to be attached to distally percussion pipeline section for example, by pin, sleeve, the snap arrangement of fluting etc., the portions of proximal 493 passes through phase Same or similar device is attached to nearside percussion pipeline section 390.In this embodiment, end effector 12 can for example by clockwise Or counterclockwise adjustment angle and be most preferably positioned in various angled positions, and revolved need not Slender axles assembly 490 Turn or other motions.Figure 42 illustrates angle [alpha], and in various embodiments, angle [alpha] can be 0 ° to 45 °.

Figure 43-47 illustrates another surgical instrument embodiment of the present invention.In addition to the various differences of described below, this enforcement The surgical instruments 510 of example is substantially similar to above-mentioned surgical instrument embodiment 310.Although be described herein surgical instruments 510 being It is used in combination with the end effector 12 of the above-mentioned type, but those skilled in the art will be understood that, surgical instruments Can be used in combination with actuation ends portion actuator 12 ' or can be combined with other end effector structures with the second percussion adapter 150 Use.The various embodiments of surgical instruments 510 include radial type shaft assembly 512, are beneficial to relative to longitudinal axis A-A selectivity Ground retaining tips actuator 12.Such as can be seen that in Figure 43 and Figure 44, radial type shaft assembly 512 includes distally ridge component 520, should There are a pair of lug supports 522 for lug 17 is accommodated wherein in the ridge component of distally.Distally ridge component 520 has near-end 521, the near-end is pivotally coupled to the distal end 531 of proximal spine segment 530.Specifically, the near-end 521 of distal spine segment 520 has For supporting a pair distal spine pointed tooths 523 spaced apart of swivel pin 524, the swivel pin 524 to extend through proximal spine segment 530 Distal end 531, to limit hinge axes AA-AA of substantially transverse longitudinal axis A-A.Referring to Figure 46.

In various embodiments of the present invention, end effector 12 can be hinged to a variety of taking around longitudinal axis A-A To.For example, the angle [alpha] in Figure 47 ' can be in the range of 180 ° to 90 °.End effector 12 is connected to by least one The articulated element 550 of articulated links 540 and be hinged.Articulated links 540 are pivotally coupled to distally by distal pin 542 The distal end 521 of ridge section 520.Referring to Figure 43.Articulated links 540 are pivotally coupled to hinge bar 550 by being hinged lever pin 554 Distal end 552, as shown in figure 46.Such as can be seen that in Figure 43, articulated element 550 extends through radial type shaft assembly 512 and has Near-end 556, the near-end 556 is extended in turn knob 560, and the turn knob 560 is revolvably connected to shank assembly 100. The near-end 556 of articulated element 550 is connected to and is hinged control member or button 558, and the control member or button 558 of being hinged can be slided It is connected to turn knob 560 dynamicly to carry out selective axially traveling relative to turn knob 560.Therefore, along distal direction " DD " slides axially and is hinged button 558 end effector 12 will be made to carry out pivot around longitudinal axis A-A in the method shown in Figure 47 Turn.To make end effector be back to its end effector to be aligned in coaxial manner the initial non-hinge on longitudinal axis A-A Position is connect, surgeon only need to be on turn knob 560 along proximal direction " PD " sliding actuator button 558.

As some of above-described embodiment embodiment, turn knob 560 can not be rotationally coupled to axle bush 570, axle bush 570 are revolvably attached to shank assembly 100.Referring to Figure 43 and Figure 47.Axle bush 570 have nearside convex Edge 572 and distal lip 574, define rotated trench 575, by shank group between the proximal flange 572 and distal lip 574 The leading edge portion 101 of part 100 is revolvably accommodated therebetween.This structure enables axle bush 570 relative to shank assembly 100 rotate around longitudinal axis A-A.The not revolvably pin joint or in other words of proximal spine segment 530（Welding, using adhesive etc.）It is attached It is connected to axle bush 570 so that turn knob 560 can make end effector 12 around longitudinal axis around the rotation of longitudinal axis A-A Line A-A rotates.It should be appreciated that this structure can be conducive to end effector 12 to rotate around longitudinal axis A-A along 360 ° of paths.

Also there is this embodiment distally to fire tube section 580, and distally percussion tube section 580 is connected to the first percussion adapter 140 and can be axially movable on distal spine segment 520.Specifically, the retainer button 144 in the first percussion adapter 140 It is accommodated in the above described manner in the keeper bore 581 in distally percussion pipeline section 580.It is remote by being attached to that distally fires pipeline section 580 Flank attack is sent out at least one firing member of pipeline section 580 and is activated.In a preferred embodiment, distally fires pipeline section 580 by attached A pair of percussion bands 582,584 for being connected to distally percussion pipeline section 580 are activated.Percussion band 582,584 is attached to band base 585, the band Base is connected to nearside percussion pipeline section 590, and the nearside percussion pipeline section 590 is attached in the above described manner percussion yoke 114.Cover pipe 592 also on proximal spine segment 530 propulsion be connected in parallel to turn knob 560 to rotate together with turn knob 560.Nearside firing tube 590 and band base 585 can relative to cover pipe 592 be axially movable.Percussion band 582,584 can be slidably received in distal spine structure In lateral tape channel 526 in part 520, as shown in Figure 44 C.In various embodiments, each include can be by for percussion band 582,584 The thin flexure member that such as stainless steel is processed, and be able to promote distally percussion pipeline section 580, so as to above-mentioned side Staple 32 during formula activates or close anvil block 20 to enable implantation nail bin 30 shapes.By pulling firing trigger in the above described manner 130 and realize percussion cable 582,584 actuating.Firing trigger 130 can pull percussion cable when being back to original position 582nd, 584 and make the first percussion adapter 140 anvil block 20 be pulled to open position or move to the first percussion adapter 140 Wherein spring（It is not shown）Anvil block 20 is biased at the position of open position.

Surgical instruments 510 may also include knife 534, and knife 534 is supported on the knife in distal spine segment 520 and supports narrow in which can be moved In groove 528.Referring to Figure 44 B.In various embodiments, knife bar 534 can be processed by such as 300 or 400 stainless steels etc., and can With the tissue cutting edge 535 being formed on its distal end.Knife bar 534 is attached to can be processed by the stainless steel of 300 or 400 series Knife-band 536.Knife-band can for example include 0.007 inch to 0.012 inch of stainless steel band material, the stainless steel band Material is more harder than bar.Knife cable 536 extends through distally ridge component 520, and proximal spine segment 530 is attached to knife bar 480, As mentioned above in a driving manner engagement fires conveyer 190 to the knife bar.Therefore, surgeon can be by operating in the above described manner Knife actuating trigger 200 is optionally operating knife bar 534 to cut tissue.Various embodiments may also be employed covering for corrugated tube shape The lid component 594 is polluted with preventing dust, tissue, chip etc. to articulated joint.Referring to Figure 48.

Figure 49-53 illustrates another surgical instrument embodiment of the present invention.In addition to difference explained below, this enforcement The surgical instruments 610 of example is substantially similar to above-mentioned surgical instrument embodiment 10.Surgical instruments 610 can be activated can with two The end effector 612 of motion jaw 613,615.In various embodiments, end effector 612 is connected to from shank assembly The Slender axles assembly 655 of 100 projections.Referring to Figure 49.Slender axles assembly 655 includes elongated ridge component 658 and elongated closure Tube assembly 680, elongated closure tube assembly 680 can be axially movable on ridge component 658 along proximal direction and distal direction.Such as Shown in figure, Slender axles assembly 655 is along longitudinal axis A-A from shank assembly 100 generally as the crow flies towards distally extension.Various In embodiment, Slender axles assembly 655 may be about 9 inches to 16 inches（About 228.8mm to 406.4mm）It is long.However, elongated Shaft assembly 655 also can be configured to other length.

Referring to Figure 50 and Figure 51, in various embodiments, the lower jaw 613 of end effector 612 includes elongated passageway 614, and upper jaw 615 includes anvil block 620.Elongated passageway 614 has a pair side walls 616 spaced apart, the pair of interval The side wall 616 opened is respectively terminated in closed end upwardly or end 618.Elongated passageway 614 can by such as 17-4 or The stainless steel of 400 series is processed, and its size can be configured to be operatively supported wherein nail bin 630 or its The nail bin of its form.Anvil block 620 can be processed by 416,17-4,17-7 stainless steel etc..In at least one embodiment, for example End effector 612（When in the closed position）And each there is Slender axles assembly 655 maximum outside diameter can be grasped with allowing device Make ground through with least about 8mm to 12mm（About 0.31 inch to 0.47 inch）The opening of diameter.However, end performs Device 612 and Slender axles assembly 655 can have other diameters and shape.End effector 612 also includes distal spine segment 660, distally Ridge section 660 can be removably coupled to the distal end of proximal spine segment 670, be as described further below.

Anvil block 620 has staple formation portion 622, and multiple staple formation pits are formed with staple formation portion 622.In addition, Anvil block 620 has and is divided into two-part closure 624, and the closure includes at least one and preferably includes a pair and extend downwardly Closed end 625.Such as can be seen that, at least one embodiment, closed end 625 and elongated passageway 614 in Figure 50-53 Corresponding closed end or end 618 by pivot pin 626 pivotally the distal spine segment 660 of pin joint to ridge component 658 point For the ridge ear 633 of two-part distal end 662（Figure 55）So that when viewed from the side, closed end 625 and closed end 618 Formation is generally designated as 628 movable " scissor-shaped " closing structure.In other embodiments, anvil block 620 can be moved Be connected to elongated passageway 614.

The various embodiments of end effector 612 also include axially movable knife assembly 640, and knife assembly 640 includes Knife plate 642, knife plate 642 includes the knife bar 644 being spaced apart towards a pair of distally projection from knife plate 642, the pair of spaced apart Knife bar 644 can axially slide between the ridge ear 663 of distal spine segment 660.Referring to Figure 55.Cutter component 646 is attached to or changes Word is said and is formed on the distal end of knife bar 644.In various embodiments, knife bar 644 and cutter component 646 can be by such as 300 or 400 The stainless steel of series is processed.Tissue cutting edge 648 is formed with the distal end of cutter component 646.The bottom of cutter component 646 649 can engage staple driving sledge 650, and the staple driving sledge is supported in slender axles 614 in which can move.Staple driving sledge 650 are positively retained at the slit in elongated passageway 614 or slot configurations（It is not shown）In, it is beneficial to staple driving sledge 650 from starting Position（Figure 50-52）It is axially movable to end position（Figure 53）, while remaining attached to elongated passageway 614.Staple driving sledge There are one or more staple driving surfaces 652, the staple driving surface is oriented to engage nail bin in a driving manner on 650 Staple 632 in 630, and cutter component 646 through end effector 612 when advancing towards distally towards anvil block 620 staple into Shape portion 622 drives up staple 632.

Additionally, in various embodiments, distally ridged nut 668 is revolvably connected to the near-end 664 of distal spine segment 660, Revolvably to advance around longitudinal axis A-A relative to near-end 664.Distally ridged nut 668 has a pair lugs for extending internally 669, being sized to of the pair of lug 669 for extending internally can be contained in proximal spine section 670 from shank group In corresponding lug slit 674 in the distal end 672 of the projection of part 100, so that distal spine segment 660 can be relative to proximal spine section 670 rotations.Such as can be seen that in Figure 49, the pin joint of proximal spine segment 670 is to turn knob 70（By pin 66）, the turn knob 70 with Aforesaid way is revolvably attached to shank assembly 100, is beneficial to end effector 612 around longitudinal axis A-A along 360 ° of paths Rotated.

Such as can be seen that in Figure 49, on the near-end 671 of proximal spine section 670 flange 676 is formed with.Flange 676 can revolve It is supported in groove 106 with turning, the groove is from the shape of fit ribs 108 from housing member 102, each of 104 to inner process Into.This structure is conducive to for proximal spine segment 670 being attached to shank assembly 100, while enabling proximal spine segment 670 relative to handle Parts 100 rotate along 360 ° of paths around longitudinal axis A-A.Proximal closure tube segment 682 can be by polymer or other suitable materials Material is processed and can have near-end 683, and the near-end 683 is attached to percussion yoke 114, and the percussion yoke 114 is with above-mentioned various sides Formula construction is simultaneously arranged in shank assembly 100 in which can move.In various embodiments, for example percussion yoke 114 can be by overmolding To the near-end 683 of proximal closure tube segment 682.However, other fastener constructions may also be employed.As described above, percussion yoke 114 can quilt In being rotationally supported at support lining ring 120, the support lining ring 120 can be axially movable in shank assembly 100.Such as in Figure 49 In can be seen that, proximal closure tube segment 682 is provided with longitudinal slit 681, so that ridge pin 66 can be through longitudinal slit 681 In extending to proximal spine segment 670, while being conducive to proximal closure tube segment 682 that axial traveling is carried out on distal spine segment 670.

Such as can be seen that in Figure 49, firing trigger 130 has pivotable relative to percussion chain link 636,638（Pin joint）'s Top 134, percussion chain link 636,638 is pivotable relative to support lining ring 120（Pin joint）.Therefore, firing trigger 130 is towards shank The motion of the pistol grip portion 107 of component 100 will make percussion yoke 114 and proximal closure tube segment 682 along proximal direction " PD "（ It is shown in broken lines in Figure 49）Motion.The fortune of fixture and firing trigger 130 away from the pistol grip portion 107 of shank assembly 100 It is dynamic that percussion yoke 114 and firing tube 110 will be made to move along proximal direction " DD " on proximal spine segment 670.

Such as can be seen that in Figure 50-53, proximal closure tube segment 682 has distal end 684, and distal end 684 can be attached to distally The near-end 692 of closure pipeline section 690.In the embodiment shown, distal closure tube segment 690 can be by being threadedly attached to nearside closure The distal end 684 of pipeline section 682.There is tapered drive member 696, this gradually becomes in the distal end 694 of distal closure tube segment 690 Thin drive member 696 can join with scissors-like closing structure 628 so that when distal closure tube segment 690 is in Figure 51 institutes During the position for showing, one or more the end effector springs 617 between elongated passageway 614 and anvil block 620 are used for anvil Seat 620 is biased to the open position shown in the figure.However, when distal closure tube segment 690 is pulled along proximal direction " PD ", gradually The drive member 696 for attenuating can contact scissors-like closing structure 628, so that jaw 613（Elongated passageway 614）With 615（Anvil block 620）Pivot towards each other.Referring to Figure 52 and Figure 53.

Surgical instruments 610 may also include knife propulsion system 639, and knife propulsion system 639 includes extending through proximal spine section 670 knife bar 700 simultaneously has the proximal part 702 for joining with percussion conveyer 190 in a driving manner, fires conveyer 190 can be operatively attached in the above described manner knife actuating trigger 200.Therefore, surgeon can be by pulling in the above described manner Knife actuating trigger 200 and make knife bar 700 towards distally advance.Such as can be seen that in Figure 52 and Figure 53, knife bar 700 have be divided into two Partial distal end 704, this is divided into two-part distal end including upper toolholder section 706 and lower toolholder section 708, the upper toolholder section 706 Knife plate 642 can be engaged with lower toolholder section 708.Such as can be seen that in Figure 51-54, upper toolholder section 706 can pass through ridged nut 668 In upper slit 773 and slide, and lower toolholder section 708 can pass through ridged nut 668 in lower slit 775 and slide.

It is using surgical instruments 610, by the way that the lug 669 on ridged nut 668 is inserted into right with it in proximal spine section 670 End effector 612 is attached to into the distal end 672 of proximal spine section 670 in the lug support 674 answered.Referring to Figure 50.Subsequently, Surgeon or clinician can be relative to the rotary end actuators 612 of Slender axles assembly 655, by distal closure tube segment 690 It is screwed on proximal closure tube segment 682, so as to form closure tube assembly 680.There can be nail bin 630 in end effector 612, or Person clinician at this moment or after a while can be attached to nail bin in elongated passageway 614.Once end effector 612 is attached to surgery The Slender axles assembly 655 of apparatus 610, surgeon can be by extending to the entrance passage in patient's body（For example pass through trochar Or endoscope etc., or by otch-in the situation of open surgery）Insertion end effector 612 and Slender axles assembly 655, To firmly grasp the target tissue between end effector jaw 613,615.As above-mentioned various embodiments, by relative to shank group The pistol grip 107 of part 100 manipulates firing trigger 130 to close jaw 613,615.Once target tissue is grasped in end Between actuator jaw 613,615, surgeon just can be incited somebody to action by the way that anvil block 620 is compacted in nail bin 630 in the above described manner Staple 632 " percussion " is formed in target tissue.If operation need not cut target tissue, surgeon can subsequently discharge percussion Trigger 130, to allow that anvil block 620 moves to open position（Under the bias movement from spring 617）, so as to hold from end The release of row device 612 can be implanted into nail bin 630.Subsequently, surgeon can again close end effector jaw 613,615, to allow End effector 612 into passage or service aisle by being withdrawn by.If however, surgeon wants to cut staple line 632 Between target tissue, then surgeon can fire knife assembly 640 by operating knife actuating trigger 200 in the above described manner, with Cutter component 648 is driven to pass through target tissue towards distally.As cutter component 648 is moved through end effector 612 towards distally, cutter component 648 can contact staple driving sledge 650, and the staple driving sledge is used to further drive staple 632 so that its staple with anvil block 620 Profiled surface 622 forms contact, so that staple 632 further shapes.Referring to Figure 53.Subsequently, surgeon can open End effector 612 with from end effector 612 discharge cutting/suture target tissue and nail bin 630 can be implanted into.

Therefore, by closing unique and new closure tubular construction of end effector jaw towards distally motion closed tube Make it possible to using less closing structure, while still keeping producing the ability for making the big closing force needed for staple formation.Separately Outward, such embodiment of the invention does not cut the spirit of tissue for surgeon provides the suture in the application without the need for cutting tissue Activity.

Figure 56-60 illustrates alternative surgical instrument embodiment 810, in addition to difference discussed below, surgery Apparatus embodiment 810 is substantially the same with surgical instruments 610.Surgical instruments 810 for example includes flexible ridge component 820, the flexibility Ridge component has near-end, has flange 822 on the near-end, and the flange is revolvably contained in groove 106, the groove 106 are formed from the housing member 102, each of 104 of self-forming shank assembly 100 to the fit ribs 108 of inner process.Referring to Figure 57 and Figure 58.This mounting structure is conducive to flexible ridge component 820 revolvably to move relative to shank assembly 100.Each In planting embodiment, flexible ridge component 820 can be by such as nylon, acronitrile-butadiene-styrene（ABS）, Merlon, liquid crystal gather Compound, stainless steel, titanium etc. are processed, and can be used together with the end effector 612 of the above-mentioned type.

Surgical instruments 810 also includes being generally designated 830 Slender axles assembly.In various embodiments, for example carefully Long axis component 830 includes restructural shaft part 840 and nearside shaft part 844.Such as can be seen that in Figure 56, for example restructural shaft part 840 There can be distally that lining ring 842 is installed, distally installation lining ring for example move attached by the non-energy such as adhesive, welding, securing member It is connected to a part for flexible ridge component 820.Restructural shaft part 840 can wherein reconfigurable section 840 of all parts it is basic On be mutually aligned with coaxial manner（That is, it forms substantially straight hollow tubular structure）Linear configuration with it is wherein reconfigurable Select between the configuration that at least a portion in the part of section 840 is not alignd with coaxial manner or linear mode with another part Reconstruct to selecting property.In the embodiment shown in Figure 56, for example restructural shaft part 840 can be by nylon, acronitrile-butadiene-styrene （ABS）, Merlon etc. process, and can have multiple ribs 846, the plurality of rib 846 is conducive to section 840 from linear or same The orientation of axle alignment is reconstructed to non-linear or non-coaxial（It is for example wriggling, bending etc.）This orientation is orientated and keeps, directly To user's hand or by using other surgical instruments（Such as grasp device etc.）To reconstruct shaft part 840.Therefore, restructural axle 840 " can passively be hinged " of section, this refers to that the device is not equipped with the articulated mounting being hinged for active control section 840.

In various embodiments, proximal shaft section 844 is for example connected to reconfigurable axle area by interlocking structure or pin Section 840, and for being conducive to reconfigurable axle section 840 to be revolvably attached to shank assembly 100.In at least one embodiment In, for example nearside shaft part 844 is connected to axle bush 60, and the axle bush are revolvably attached in the above described manner shank assembly 100.Referring to Figure 57 and Figure 59.

Additionally, in various embodiments, closure pipeline section 832 is arranged on flexible ridge component 820, to scratch in which can be moved Optionally move on property ridge component 820.Referring to Figure 56 and Figure 60.Such as can be seen that in Figure 60, at least one embodiment, Closure pipeline section 832 and ridge component 820 be respectively formed with relative flange part 833,821, enabling prevent close pipeline section 832 from Slip on ridge component 820, while keeping being arranged on ridge component 820 with moving.In various embodiments, flexible enclosed member 848 are connected to percussion yoke 114 or the part including percussion yoke 114.Referring to Figure 57 and Figure 59.Flexible enclosed member 848 can be by Such as stainless steel etc. is processed and can have the elongated slot 834 extended through in ridge component 820 to be connected to closure pipeline section 832 distal portions 849.This structure is conducive to making closure pipeline section 832 by activating firing trigger 130 in the above described manner Move along distal direction " DD " and proximal direction " PD " on ridge component 820.

Such as can be seen that in Figure 56, surgical instruments 810 can make together with end effector 612 above described in detail With.Specifically, can be narrow by corresponding lug in the distal end 825 that the lug 669 on ridged nut 668 is inserted ridge component 820 End effector 612 is removably connected to into flexible ridge component 820 in groove 825.Referring to Figure 60.Close the remote of pipeline section 832 End 835 can in the above described manner by being threadedly attached to the near-end 692 of distal closure tube segment 690.

In at least one embodiment, surgical instruments 810 also includes knife propulsion system 639, and knife propulsion system 639 includes prolonging Extend through the knife bar 700 of ridge component 820 and there is the proximal part 702 for joining with percussion conveyer 190 in a driving manner, hit Sending out conveyer 190 can be operatively attached in the above described manner knife actuating trigger 200.Therefore, more than surgeon can pass through The mode of stating pulls knife actuating trigger 200 and knife bar 700 is advanced towards distally.Knife bar 700 have be divided into two-part distal end 704, this is divided into two-part distal end 704 including upper toolholder section 706 and lower toolholder section 708, the upper toolholder section 706 and lower knife bar Section 708 can be in engagement end portion actuator 612 knife plate 642.Referring to Figure 60.

It is using surgical instruments 810, by the way that the lug 669 on ridged nut 668 is inserted into corresponding lug support 825 In and end effector 612 is attached to into the distal end 823 of ridge component 820.Subsequently, surgeon or the rotatable end of clinician Actuator 612 is closed on pipeline section 832 so that distal closure tube segment 690 is screwed to.There can be nail bin 630 in end effector 612, Or clinician at this moment can be attached to nail bin in elongated passageway 614.Once end effector 612 is attached to surgical instruments Restructural shaft part 840 just can be configured so that each Slender axles assembly part by 810 elongate closure tube component 830, surgeon With coaxial manner alignment, with by extending to opening or service aisle in patient's body（For example by trochar or endoscope etc., Or by otch-in the situation of open surgery）Insertion.Subsequently, surgeon can reconstruct restructural shaft part 840 so that Its each several part is not mutually aligned with coaxial manner, will be attached to the end effector of restructural shaft part 840 relative to target tissue 612 are oriented in desired position.As above-mentioned various embodiments, by relative to the pistol grip of shank assembly 100 107 manipulate firing triggers 130 to close jaw 613,615.Once target tissue is grasped in end effector jaw 613,615 Between, surgeon just can by the above described manner by anvil block 620 be compacted in nail bin 630 and by staple 632 " percussion " or into Shape is in target tissue.If operation need not cut target tissue, surgeon can subsequently discharge firing trigger 130, to allow Anvil block 620 moves to open position（Under the bias movement from spring 617）, so as to plant from the release of end effector 612 Enter nail bin 630.Subsequently, surgeon can again close end effector jaw 613,615 and weight is carried out to restructural shaft part 840 Structure, to allow end effector 612 by being withdrawn by into passage or service aisle.If however, surgeon wants to cut Target tissue between slot staple line 632, then surgeon can be by operating in the above described manner knife actuating trigger 200 to fire knife Component 640, to drive cutter component 648 to pass through target tissue towards distally.As cutter component 648 is through end effector 612 towards distally Motion, cutter component 648 can contact staple driving sledge 650, and the staple driving sledge is used to further drive staple 632 so that itself and anvil The staple forming face 622 of seat 620 forms contact, so that staple 632 further shapes.Subsequently, surgeon can beat Open end actuator 612 with from end effector 612 discharge cutting/suture target tissue and nail bin 630 can be implanted into.

Figure 61 and 62 illustrates another surgical instrument embodiment 810 ', surgical instrument embodiment 810 ' and above-mentioned surgical instruments 810 embodiments are substantially the same, and difference is that reconfigurable axle section 850 includes operating for Slender axles assembly 830 ' Be connected to the part of shank assembly 100, for operating end effector 612.In various embodiments, restructural shaft part 850 include that multiple tubulose chain links 852 of ground interconnection can be moved.Each tubulose chain link 852 can for example by with or without glass Or nylon, the acronitrile-butadiene-styrene of carbon filling（ABS）, Merlon etc. processes, and can have tubular body portion 854.Spherical or spherical coupling portion 856 can be formed with tubular body portion 854, the spherical or spherical coupling portion have through Ridge receiving channel 858 therein.In addition, tubulose ridge receiving channel 858 extends to be formed in tubular body portion 854 hollow holding In nest 860, being sized to of the hollow pod accommodates the spherical coupling portion 856 of adjacent tubular chain link 852 in which can move. The size of spherical coupling portion 856 is configured to allow spherical coupling portion 856 by being buckled in wherein and keep relative to pod 860 Wherein the substantially straight desired configuration of shaft part can have curved configuration to its axis 850（Figure 62）Or serpentine shape configuration （Figure 61）Configuration.

Although the size of spherical coupling portion 856 and pod 860 can relative to each other be set to forms therebetween little rubbing Power is wiped, section 850 is maintained in expectation orientation till external force is applied to it, but the enforcement shown in Figure 60 and Figure 61 Example adopts locking system 862, and by each tubulose chain link 852 desired configuration is releasably held or be immovably locked in together In.As can be seen that in these figures, locking device 862 is included in its one end 853 and is formed about on the periphery of tubulose chain link 852 At least oneth, preferably multiple flexible latch tubercles or component 864.In a preferred embodiment, using 4 breech lock tubercles 864.Other embodiments can have 1,2,3 or more than 4 breech lock tubercles 864.Each tubulose chain link 852 also includes and neighbouring chain Save the corresponding locking component 866 of each breech lock tubercle 864 of 852 other ends 865.There is breech lock in each locking component 866 Recess 868 is accommodated, the breech lock accommodates recess and can releasedly accommodate the correspondence being formed on adjacent tubular chain link 852 wherein A part for breech lock tubercle 864.

It is, using surgical instruments 810 ', in the above described manner end effector 612 need to be attached to into the distal end of ridge component 820 823.The distal closure tube segment 690 of end effector 612 is screw-coupled on closure pipeline section 832.Once end effector 612 is attached to The elongate closure tube component 830 of surgical instruments 810 ', then surgeon restructural shaft part 850 can be configured so that each slender axles Components are alignd with coaxial manner, with by extending to opening or service aisle in patient's body（For example by trochar or Endoscope etc., or by otch-in the situation of open surgery）Insertion.Subsequently, surgeon can be for example with grasper Tool 869 is constructed to the movable chain link 852 of restructural shaft part 850 to expect to be orientated, and subsequently by each chain link 852 Appropriate locking tubercle 864 is pressed into its corresponding breech lock and accommodates in recess 868, and each chain link 852 is locked in expectation orientation. Referring to Figure 62.As above-mentioned various embodiments, percussion is manipulated by the pistol grip 107 relative to shank assembly 100 and is touched Send out device 130 to close jaw 613,615.Once target tissue is grasped between end effector jaw 613,615, surgeon Just by staple 632 " percussion " or can be formed in target tissue by the way that anvil block 620 is compacted in nail bin 630 in the above described manner. If operation need not cut target tissue, surgeon can subsequently discharge firing trigger 130, to allow that anvil block 620 is moved to Open position（Under the bias movement from spring 617）, so as to nail bin 630 can be implanted into from the release of end effector 612.With Afterwards, surgeon can close again end effector jaw 613,615 and using promptly apparatus 869 by each locking tubercle 864 from Its corresponding breech lock is accommodated and removed in recess 868, to allow that each chain link 852 aligns, so as to allow that device can be logical by entering Road or service aisle and be withdrawn by.If however, surgeon wants to cut the target tissue between staple line 632, surgery doctor Life can fire knife assembly 640 by operating knife actuating trigger 200 in the above described manner, to drive cutter component 648 to wear towards distally Cross target tissue.As cutter component 648 is moved through end effector 612 towards distally, cutter component 648 can contact staple driving sledge 650, the staple driving sledge is used to further drive staple 632 so that it is formed with the staple forming face 622 of anvil block 620 Contact, so that staple 632 further shapes.Subsequently, surgeon can open end effector 612 with from end effector Target tissue and nail bin 630 can be implanted into that 612 releases are cut/sutured.

Figure 63-68 illustrates another surgical instrument embodiment 810 ", except the reconfigurable axle section 870 and phase of Slender axles assembly Outside the locking system 882 of pass, surgical instrument embodiment 810 " it is substantially the same with above-mentioned surgical instrument embodiment 810,810 '. In various embodiments, restructural shaft part 870 includes that the multiple tubulose chain links 872 that can move ground interconnection are connected in parallel to nearside shaft part 871, the nearside shaft part is connected to axle bush 60, and the axle bush 60 are rotationally supported within as described in detail shank group In part 100.Each tubulose chain link 872 can for example by nylon, acronitrile-butadiene-styrene（ABS）, the processing such as Merlon and Into, and can have tubular body portion 874.Referring to Figure 67.Spherical or spherical coupling portion can be formed with tubular body portion 874 876, spherical or spherical coupling portion 876 has the ridge receiving channel 878 for passing through and extending.In addition, tubulose ridge is accommodated leading to Road 878 is extended in the hollow pod 880 being formed in tubular body portion 854, and being sized to of the hollow pod can transport The spherical coupling portion 876 of adjacent tubular chain link 872 is accommodated dynamicly.The size of spherical coupling portion 876 is relative to the quilt of pod 880 It is set to and allows that spherical coupling portion 876 is substantially in line by being buckled in wherein and remain at restructural shaft part 870（Figure 67）Desired configuration to its axis 870 can have bending（Figure 68）Or the configuration of serpentine shape configuration.

Although at least one embodiment, the size of spherical coupling portion 876 and pod 880 can relative to each other be set Determine into and form little frictional force therebetween, the tubulose chain link 872 of reconfigurable axle section 870 is maintained at into straight in expectation orientation To external force is applied to it, but the embodiment shown in Figure 63-68 adopts locking system 882, by each tubulose chain link 872 1 Rise releasably hold or it is non-can motion be locked in desired configuration.Such as can be seen that in Figure 67 and Figure 68, locking device 882 Including the tubulose chain link 872 extended through in diametrically opposed location at least one and preferably two can selectively expand Lock capsule 884.In various embodiments, locking capsule 884 for example can be processed by nylon membrane etc. and can be accommodated from pressurized stream The pressure fluid in body source 886.In the embodiment shown in Figure 64, source of pressurised fluid 886 includes fluid pump structure 888, the fluid Pump configuration 888 can be supplied air under pressure in lock capsule 884.Specifically, at least one embodiment, flow Body pump configuration 888 includes the wherein cylinder 889 with piston 890.Piston 890 have around its periphery O-ring or other Sealing structure 891 is simultaneously attached to helical pump shank 892, and the helical pump shank 892 is threadedly engaged a part for shank assembly 100. Therefore, by the way that pump shank 892 is screwed in shank assembly 100, the air in cylinder 890 can under pressure by from cylinder 890 services 893 for extending to manifold component 894 and be pumped, the manifold component is accommodated on ridge component 820.Can lead to Cross turn pump shank 894 in opposite direction and air pressure is released in lock capsule 884.

Such as can be seen that in Figure 65, manifold component 894 includes being sealed on every side by O-ring or other seals 896 Annular manifold region 895.Annular manifold region 895 connects with supply pipeline 897, and the supply pipeline extends through nearside shaft part 871 are connected in parallel to lock capsule 884 or the discharging in lock capsule 884.This structure is used to extremely lock Pressurized air supply in capsule 884, together When be conducive to ridge component 820 revolvably to move around longitudinal axis A-A relative to shank assembly 100.As used herein, term " pressure fluid " may include such as air, salting liquid or preferably glycerine.In alternative embodiment, tubular element Can be filled with the low-down rubber of hardness or elastomer.When pressure is applied to elastomeric material, elastomeric material can deform to fill Space and with the much the same mode lock shaft of fluid embodiment.

It is using surgical instruments 810 ", in the above described manner end effector 612 need to be attached to into the distal end of ridge component 820 ' 823.The distal closure tube segment 690 of end effector 612 is screw-coupled on closure pipeline section 832.Once end effector 612 is attached to The Slender axles assembly 830 of surgical instruments 810 " ", then surgeon restructural shaft part 870 can be configured so that each slender axles group Part part 830 " is alignd with coaxial manner, with by extending to opening or service aisle in patient's body（For example pass through trochar Or endoscope etc., or by otch-in the situation of open surgery）Insertion.Subsequently, surgeon can adopt and for example firmly grasp Apparatus is constructed to the movable chain link 872 of restructural shaft part 870 to expect orientation.Once restructural shaft part 870 was orientated in the phase In hoping orientation, then surgeon subsequently can be threaded to pump shank 892 in shank housing 100 to pressurize to lock capsule 884, so as to can The chain link 872 of motion is locked in position as shown in Figure 66.As above-mentioned various embodiments, by relative to shank assembly 100 pistol grip 107 manipulates firing trigger 130 to close jaw 613,615.Once target tissue is grasped in end and holds Between row device jaw 613,615, surgeon just be able to will be stitched by the way that anvil block 620 is compacted in nail bin 630 in the above described manner 632 " percussions " of nail are formed in target tissue.If operation need not cut target tissue, surgeon can subsequently discharge percussion and touch Device 130 is sent out, to allow that anvil block 620 moves to open position（Under the bias movement from spring 617）, so as to perform from end The release of device 612 can be implanted into nail bin 630.Subsequently, surgeon can again close end effector jaw 613,615 and by along phase Anti- direction turn pump shank 892 and discharge the pressure in lock capsule 884.Can be using promptly apparatus by movable chain link 872 Regulate and control to the orientation of substantially co-axially align（Figure 67）Or enable devices to from patient's body be withdrawn by desired other directions.So And, if surgeon wants to cut the target tissue between staple line 632, surgeon can be by operating in the above described manner knife Actuating trigger 200 firing knife assembly 640, to drive cutter component 648 to pass through target tissue towards distally.As cutter component 648 is worn Cross end effector 612 to move towards distally, cutter component 648 can contact staple driving sledge 650, the staple driving sledge is used for further Staple 632 is driven so that it is formed with the staple forming face 622 of anvil block 620 contacts so that staple 632 further into Shape.Subsequently, surgeon can open end effector 612 to discharge the target tissue and energy of cutting/suture from end effector 612 Implantation nail bin 630.

Various embodiments including reconfigurable axle section disclosed herein are improved to be hinged using lockable and connect significantly Traditional be hinged surgical instruments structure of head.Placement of the end effector of this surgical instruments at crosscutting position is generally limited Make to 1 or 2 free degree.Various embodiments of the present invention cause the possible position scope of end effector wider and therefore make outer Section doctor has greater flexibility when by single entrance use device.

The various surgery nail bins of the present invention and unique and new structure of surgical instruments enable the staple in the nail bin Enough it is arranged in one or more line linearly or nonlinearly.A plurality of this staple line can be provided with every side of elongated slot, The elongated slot is centrally disposed in nail bin, for accommodating tissue cutting element through the elongated slot.One In kind of arrangement mode, such as staple into a line can be substantially parallel to the staple in adjacent staple line but inclined with it From.In further embodiments, one or more staple line can be essentially nonlinear.In other words, in staple line at least The base portion of one staple can be along substantially extending with the crosscutting axis of base portion of other staples in same staple line.For example, such as Hereafter will be discussed in more detail, in alternative embodiment, the staple line on every side of elongated slot there can be sawtooth Shape outward appearance.The reason for this nonlinear staple arrangement mode is feasible is that staple is not driven upwardly into anvil block.Conversely, In these various embodiments, anvil block is formed with the end of no motion of staple and contacted.With wherein staple reality by upwards Compared with driving in the various linear staple line row mode employed in the nail bin of the prior art that contact is formed with anvil block, this Planting nonlinear staple arrangement mode can use less staple to obtain preferably tissue tightening results.

Figure 69 illustrates the use of the surgery nail bin embodiment 900 in the end effector embodiment 612 ' of the present invention.End Actuator 612 ' can be used in combination in above-mentioned various modes with surgical instruments 610.In addition to described below difference, end performs Device 612 ' can be identical with above-mentioned end effector 612.Such as can be seen that in Figure 69 and Figure 70, the embodiment tool of surgery nail bin 900 There is warehouse 902, the warehouse has the elongated slot 904 being centrally located, the elongated slot is extended to and distal end through near-end 903 605 adjacent regions.Elongated slot 904 can allow surgical instruments 610 during tissue cutting actions are carried out in the above described manner Knife body 646 be axially movable through elongated slot 904.In at least one embodiment, warehouse 902 is by such as oxidation regeneration Cellulose（ORC）Or for example by PGA（Polyglycolic acid, with trade mark Vicryl sales）、PCL（Polycaprolactone）, PLA or PLLA（It is poly- Lactic acid）、PDS（PPDO）、PHA（Polyhydroxyalkanoatefrom）、PGCL（Poliglecaprone 25, with trade mark Monocryl Sell）Or the hemostatic material group that the foam of energy bio-absorbable that processes of the compound of PGA, PCL, PLA and PDS etc. can compress Into, it is described can compression hemostatic material in be supported by unshaped staple 922 formation line 920,930.However, warehouse 902 Can by for by unfashioned staple 922 be supported on expect orientation in so that anvil block 910 with shape staple 922 contact when not into The other materials that the staple 922 of shape can be compressed are processed.As above-mentioned various other embodiments, nail bin 900 is to plant It is entering and be left and be attached to the tissue that is sewn after suture operation is completed.In at least certain embodiments, to prevent Staple 922 is impacted and prevents hemostatic material to be activated during introducing and position fixing process, and whole storehouse 900 can be coated with or wrap up In the biodegradable film 906 of energy, such as with trade markThe six cyclic ketones films or polyglycerol sebacate of sale（PGS）Film, Or for example by PGA（Polyglycolic acid, with trade mark Vicryl sales）、PCL（Polycaprolactone）, PLA or PLLA（PLA）、PHA（It is poly- Hydroxy alkane acid ester）、PGCL（Poliglecaprone 25, with trade mark Monocryl sales）Or the compound shape of PGA, PCL, PLA, PDS Into film, the film is only just permeable in rupture.Being sized to of the warehouse 902 of nail bin 900 is removably supported In the elongated passageway 614 of end effector 612 '.

In the embodiment shown in Figure 69, Figure 73 and Figure 74, surgery nail bin 900 can operatively the one of elongated slot 904 The First Line 920 for supporting staple 922 to be formed on individual cross side 907, and support on another cross side 909 of elongated slot 904 The second line 930 that staple 922 is formed.In various embodiments, staple 922 can be by such as titanium, titanium alloy（Such as 6Al-4V titaniums, 3al-2.5V titaniums）, stainless steel and other metal materials process and with staple basis 924 and from the projection of staple basis 924 Two upright staple legs 926.Tissue-piercing tips 928 can be formed with each staple leg 926.The formed in staple 922 In one line 920, the staple basis 924 of at least one staple 922 and the staple basis bracing of another staple 922.At one preferably Embodiment in, in addition to the base portion 924 of the last staple 922 on each end of the first staple line 920, each staple The bracing of staple basis 924 of 922 staple basis 924 staple 922 adjacent with two.Referring to Figure 73.Therefore, the first staple line 920 have substantially nonlinear shape.More particularly, when viewed from above, the first staple line 920 has and substantially saws The outward appearance of profile of tooth.

Such as can be seen that in Figure 72, anvil block 90 has two longitudinal seam nail shapes pits 912 for sequentially forming, each longitudinal direction Staple formation pit 912 has substantially zigzag shape corresponding with the shape of the First Line 920 of the formation of staple 922, makes When proper anvil block 910 forms contact with staple 922, the leg 926 of staple 922 shapes as shown in Figure 74.Therefore, a seam Same pit is shared with the proximal leg of next staple in the vertical in the distally leg of nail.This structure can form more dense Pit pattern, even up to staple itself interacted（For example across folding each other）Degree.In prior art Staple bowl configurations in, in general, between one group of pit and next group of pit must have 0.005 inch to 0.015 English Metal/space between very little.However, such embodiment for example of the invention has 0 to 0.02 inch of interference/bracing interval knot Structure（Substantially, a-0.020 "）, this is because a staple coordinates with next staple.This structure makes it possible in identical Space includes having more 15% to 30% staple.Additionally, when each staple is interlocked, reducing to the demand of multiple lateral staple lines. Existing structure adopts three row's staples generally on every side of tissue cut line, to prevent from there is the open road that blood can flow through Footpath.The possibility that interlocking staple line forms the path that blood can flow through is less.The various interlocking staple structures of the present invention are provided Another clear advantage be related to the improvement " rupture strength " related to the size for tearing power needed for staple line opening.

Another staple formation bowl configurations of the present invention may include shared staple formation pit.As used herein, term " shared staple formation pit " is referred to, and is wherein individually formed pit to arrange for each leg of each preform staple Prior art anvil design it is different, forming pit can make all staple formations in single staple line.

Figure 75 illustrates another staple embodiment 922 ', and wherein base portion 924 ' is beneficial to each base portion 924 ' with offset portion 928 Carry out more close bracing.As described above, nail bin 900 has the staple being supported on the second horizontal side 909 of elongated slot 904 922 the second line 930.Second line 930 of staple 922 is substantially the same with the First Line 920 of staple 922.Therefore, anvil block 910 Share staple formation pit 912 with second corresponding to the second staple line 930, with the shaping contact of the second staple line 930.So And, in alternative embodiment, the second line 930 of staple 922 may can be different from shape and on staple number First staple line 920.

Figure 71 illustrates surgery nail bin 900 ', in addition to the line 920 ', 930 ' of the formation of staple therein 922 is supported on, surgery Nail bin 900 ' is substantially the same with above-mentioned nail bin 900.For example, in this embodiment, the line 920 ' of staple 922 relative to each other by It is set such that the substantially transverse at least one another adjacent staple 922 of base portion axis S-S of at least one staple basis 924 Base portion axis S-S of staple basis 924.When viewed from above, this predetermined staple pattern includes substantially zigzag Arrangement.In the embodiment shown in Figure 76, there can be base support member by overmolding in addition on each base portion 924 of staple 922 927, as shown in the figure.In various embodiments, base support member 927 can be by the plastics of such as nonabsorable（Such as polyethers ether Ketone " PEEK "）Or absorbable plastics（Such as polyglycolic acid " PGA ", PLA " PLA " or " PLLA ", PPDO “PDS”、PCL（Polycaprolactone）、PHA（Polyhydroxyalkanoatefrom）、PGCL（Poliglecaprone 25, with trade mark Monocryl sales）Or The various compound mixtures of PGS, PDS, PLA, PGA and PCL）Process.Base support member 927 is conducive to not making seam Make to be interlocked between each staple in the case of following closely itself bracing.Therefore, this structure can be handed in the leg for not making staple itself Staple formation is made in the case of taking for " B " shape or " W " shape of falling.However, because bizet is connected by base support member, therefore be preced with Work as the staple of bracing in portion.This structure allows that the pit for combining has two independent roads for each leg Footpath.

Embodiment shown in Figure 77 adopts staple line 920 ", in staple line 920 " in, the leg 926 of adjacent staple 922 leads to Cross to mould or alternate manner is attached to the coupling portion 929 of leg 926 and is linked together.Each coupling portion 929 can be by example Such as polyether-ether-ketone " PEEK " or absorbable plastics（For example it is polyglycolic acid " PGA ", PLA " PLA " or " PLLA ", poly- to dioxy Cyclohexanone " PDS ", PCL（Polycaprolactone）、PHA（Polyhydroxyalkanoatefrom）、PGCL（Poliglecaprone 25, with trade mark Monocryl Sell）Or the various compound mixtures of PGS, PDS, PLA, PGA and PCL）Process.When viewed from above, this staple Line 920 " is with substantially zigzag outward appearance.Although with reference to making together with end effector 612 ' and surgery suturing appliance 610 For explaining various surgical staple embodiments 900,900 ', it being understood, however, that nail bin 900,900 ' can effectively with institute above The various other end effectors stated and surgical instruments are used together, and are wherein provided with appropriate staple in the anvil block of these apparatuses Forming pit, to reach desired staple formation amount when anvil block is moved to and forms contact with staple.

Figure 78 and 79 illustrates that another surgery nail bin 940 being supported in the elongated passageway 14 of surgical instruments of the present invention 10 is implemented Example.In at least one embodiment, surgery nail bin 940 includes warehouse 942, and the warehouse has the elongated slot 944 being centrally located, The elongated slot extends at least partially through warehouse 942.Elongated slot 944 can in the above described manner carry out tissue cutting behaviour The knife body that surgical instruments 10 is allowed during work is axially movable through elongated slot 944.In various embodiments, warehouse 942 By such as oxidized regenerated cellulose（ORC）The hemostatic material that foam of energy bio-absorbable of above-mentioned or following types etc. can compress Composition, is supported by the line 946,948,950 and 952 of the formation of unshaped staple 922 in the hemostatic material.In at least some of reality In applying example, to prevent staple 922 impacted and preventing hemostatic material to be activated during introducing and position fixing process, whole storehouse 940 In being coated with or being wrapped in the biodegradable film 954 of energy, such as with trade markThe six cyclic ketones films of sale or the polyglycereol last of the ten Heavenly stems Two acid esters（PGS）Film or for example by PGA（Polyglycolic acid, with trade mark Vicryl sales）、PCL（Polycaprolactone）, PLA or PLLA （PLA）、PHA（Polyhydroxyalkanoatefrom）、PGCL（Poliglecaprone 25, with trade mark Monocryl sales）Or PGA, PCL, The film that the compound of PLA, PDS is formed, the film is only just permeable in rupture.

In the embodiment shown in Figure 78, storehouse 940 also includes being connected to the storehouse supporting member 960 of warehouse 942.In various realities In applying example, the processing of the rigid metal such as any alloy that storehouse supporting member 960 can be formed by such as titanium, stainless steel, aluminium, above-mentioned material Form, and can be partially embedded in warehouse 942.In various embodiments, storehouse supporting member 960 can be kept just by such as film 954 Position.In other embodiments for needing restricted combination, can be sporadically using cyanoacrylate adhesive come by two units Part " gluing " is together.In further embodiments, warehouse 942 can be heated and simultaneously " weld " or " melting " is to storehouse supporting member 960.In various embodiments, storehouse supporting member 960 formed warehouse 942 lower surface at least a portion with elongated passageway 14 coordinate.In a preferred embodiment, storehouse supporting member 960 has one or more snap arrangements 962 from its projection, For storehouse supporting member 960 is releasably attached to into elongated passageway 14.Snap arrangement/the securing member that can be taken other form Storehouse supporting member 960 is releasably attached to elongated passageway 14 by structure.

In various embodiments, be formed with storehouse supporting member 960 a series of support ridges 964,966,968,970,972, 974 and 976, with the base portion 924 to the staple 922 in staple line 946,948,950 and 952 provide to a certain degree laterally Support.Therefore, at least certain embodiments, support ridge is substantially coextensive with staple line.Figure 80 illustrates alternative nail Storehouse embodiment 940 ', nail bin embodiment 940 ' is substantially the same with storehouse 940, and difference is that nail bin embodiment 940 ' includes Respectively from support ridge 964,966,968,970,972 and 976 projections providing staple 922 the upright wing of extra lateral support Piece portion 978,979,980,981,982 and 983.In various embodiments, fin part can be formed as one with storehouse supporting member 960 Body, and it highly can be about 1/2 or less of storehouse height.Therefore, in a preferred embodiment, for example it is any for supporting The rising structure of foam all cannot be extended to more than the solid height of foam.Therefore, if storehouse is designed to for example in quilt The 1/3 of its original height is compressed to during percussion, then fin is by the 66% of the uncompressed height uncompressed height that arrives on the way down Between 10%.

In use, once staple 922 is shaped by contacting anvil block 20 in the above described manner, then anvil block 20 is opened and is incited somebody to action End effector 12 is pulled away from sutured tissue.When end effector 12 is pulled away from into sutured tissue, warehouse 942 keeps tight Gu separate to sutured tissue and subsequently with the storehouse supporting member 960 for remaining coupled to elongated passageway 14.In various embodiments In, the color of storehouse supporting member 960 is different from the color and the color of elongated passageway 14 of the material for including warehouse 942.It is this It is arranged as surgeon and the instruction that can easily recognize that there is no nail bin in end effector is provided.Therefore, surgeon will not By mistake attempt in the case where new nail bin is not installed in end effector again insertable into/use end effector.For this purpose, Surgeon only needs to depart from the snap arrangement of storehouse supporting member 960 from elongated passageway 14, so that the storehouse of new nail bin 940 supports Component 960 can be placed in elongated passageway 14.Although explaining nail bin 940,940 ' with reference to surgical instruments 10, but should manage Solution, under conditions of without departing substantially from the spirit and scope of the invention, these storehouses can be effectively many other outer with disclosed herein Section's apparatus embodiment is used together.

Figure 81 and 82 illustrates that surgical instrument embodiment 10 combines the use of end effector 990, is connected to decapacitation campaign Outside elongated passageway 14 or the closed-lock device 991 that is in other words supported in elongated passageway 14, end effector 990 with it is upper State end effector 12 substantially the same.In various embodiments, closed-lock device 991 is included with distal end 993 and near-end 994 lock arm 992.Lock arm 992 is pivotally coupled to elongated passageway around pivot member or lug 995.Distal portions have The leaf spring 996 or other biasing members of distal portions are attached to so that lock arm 992 is biased to into actuating or latched position；Activating Or in latched position, near-end 994 engages the distal end 141 of the first percussion lining ring 141 to prevent the first percussion lining ring 140 from pushing away towards distally Proceed to " percussion " position.However, when nail bin 30 is provided with elongated passageway 14, it is non-that nail bin 30 moves to can lock arm 992 In actuating or non-locked position so that percussion lining ring 140 can be advanced beyond lock arm 992 towards distally, be fired with completing staple Journey.Referring to Figure 81.

When in locking position, percussion lining ring 140 cannot be pushed into towards distally and complete percussion process.In addition, percussion Trigger 130 cannot be advanced into complete firing position, and in complete firing position, cutter securing rod 210 moves to unlocked position, from And enable surgeons to knife bar 172 and advance.Therefore, when there is no storehouse in end effector 990, closed-lock device 991 are in the locked position, and this eventually prevents knife bar 172 from advancing.Therefore, unless there is storehouse 30 in end effector 990, otherwise Surgeon cannot make the propulsion of knife bar 172 cut tissue.It should be appreciated that in the condition without departing substantially from the spirit and scope of the invention Under, above-mentioned closed-lock device 991 can be effectively incorporated in many surgical instrument embodiments disclosed herein.

In various embodiments, nail bin may include warehouse and the multiple staples being stored in warehouse.In use, will can follow closely Storehouse is introduced in operative site and is located on the side of handled tissue.In addition, can be by staple formation anvil positioning in group On the opposite side knitted.In various embodiments, anvil block can be carried by the first jaw and nail bin can be carried by the second jaw, wherein the One jaw and/or the second jaw can be moved towards another jaw.Once nail bin and anvil block are positioned relative to tissue, then can be from nail bin Staple is projected in body so that staple can pierce tissue and contact staple formation anvil block.Once staple is disposed from staple cartridge body, Then staple cartridge body can be removed from operative site.In various embodiments disclosed herein, at least a portion of nail bin or nail bin In can be implanted with staple.In at least one such embodiment, following article is more fully described, and nail bin may include warehouse, when When anvil block moves to closing position from open position, the warehouse can by anvil block compression, conquassation and/or collapse.Work as warehouse Compressed, conquassation and/or when collapsing, the staple in warehouse can be deformed by anvil block.Alternatively, it is used for Supporting the jaw of nail bin can move to closing position towards anvil block.In any one of two kinds of situations, in various embodiments, work as seam When nail is at least partially situated in warehouse, staple can be deformed.In certain embodiments, staple can not be shot up from nail bin, And in certain embodiments, staple can be shot up together with a part for warehouse from nail bin.

Referring now to Figure 83 A-83D, the nail bin that can be compressed,（Such as nail bin 1000）For example may include to compress, can be implanted into Warehouse 1010, in addition, the multiple staples 1020 in energy nail bin support member 1010 are illustrated in Figure 83 A-83D（But in figure only One staple 1020 is shown）.Figure 83 A illustrate the nail bin 1000 supported by nail bin supporting member or staple cartridge channel 1030, wherein nail bin 1000 are shown at uncompressed state.In this uncompressed state, anvil block 1040 is accessible or not contact tissue T.Make With in, anvil block 1040 can move to contact tissue T from open position（As shown in Figure 83 B）And tissue T is against warehouse 1010 Position.Even if tissue T can be located against the tissue contacting surface 1019 of staple cartridge body 1010 by anvil block 1040, but be joined again See Figure 83 B, staple cartridge body 1010 can be subject to little（If any）Compression stress or pressure so that staple 1020 is positively retained at not Shaping or non-cock.As shown in Figure 83 A and Figure 83 B, staple cartridge body 1010 may include one or more layers, and staple 1020 staple leg 1021 may pass through these layers and upwardly extend.In various embodiments, warehouse 1010 may include ground floor 1011, The second layer 1012, third layer 1013 and the 4th layer 1014, the wherein second layer 1012 can be positioned in ground floor 1011 and third layer Between 1013, wherein third layer 1013 can be positioned between the second layer 1012 and the 4th layer 1014.In at least one embodiment In, the base portion 1022 of such as staple 1020 can be positioned in the chamber 1015 in the 4th layer 1014, and staple leg 1021 can be from Base portion 1022 is upwardly extended and through the 4th layer 1014, third layer 1013 and the second layer 1012.In various embodiments, it is each Leg 1021 can be deformed may include end, such as sharp end 1023, such as when nail bin 1000 is in uncompressed state, cutting edge of a knife or a sword The end 1023 of profit for example can be positioned in the second layer 1012.In at least one such embodiment, end 1023 can not prolong Extend and/or through ground floor 1011, wherein at least one embodiment, when nail bin 1000 is in uncompressed state, end End 1023 can be not projecting through tissue contacting surface 1019.In certain embodiments, it is sharp when nail bin is in uncompressed state End 1023 can be positioned in third layer 1013 and/or any other suitable layer.In various alternative embodiments In, the warehouse of nail bin can have any fitness number target zone, such as less than four layers or more than four layers.

In various embodiments, following article is more fully described, and ground floor 1011 can be by backing material and/or plasticity material Material（Such as PPDO（PDS）And/or polyglycolic acid（PGA））Constitute, and the second layer 1012 can be inhaled by energy is biological The foamed material of receipts and/or the hemostatic material that can be compressed（Such as oxidized regenerated cellulose（ORC））Constitute.In various embodiments In, one or more in ground floor 1011, the second layer 1012, third layer 1013 and the 4th layer 1014 can protect staple 1020 Hold in staple cartridge body 1010, and staple 1020 can be made to keep being mutually aligned in addition.In various embodiments, third layer 1013 Can be by backing material or quite incoercible or non-elastic material is constituted, the material can be by the staple leg of staple 1020 1021 are relative to each other held in place.Additionally, allow to be made up of the foam or elastomeric material that can compress, positioned at third layer The second layer 1012 in 1013 opposite sides and the 4th layer 1014 can also stablize or reduce the motion of staple 1020.In some realities In applying example, the staple end 1023 of staple leg 1021 can be at least partially embedded in ground floor 1011.In at least one such reality In applying example, ground floor 1011 and third layer 1013 collaboratively and firmly can be held in place staple leg 1021.At least In one embodiment, ground floor 1011 and third layer 1013 can respectively by energy bioabsorbable material（For example with trade name Vicryl The polyglycolic acid of sale（PGA）, PLA（PLA、PLLA）, PPDO（PDS）, polyhydroxyalkanoatefrom（PHA）、 With the Poliglecaprone 25 that trade name Monocryl is sold（PGCL）, polycaprolactone（PCL）, and/or PGA, PLA, PDS, PHA, The compound of PGCL, and/or PCL）The thin slice of formation is constituted, and the second layer 1012 and the 4th layer 1014 can respectively by least one Plant hemostatic material or agent is constituted.

Although ground floor 1011 can be what is can compressed, but the second layer 1012 substantially can be pressed more than ground floor 1011 Contracting.For example, the energy compressibility of the second layer 1012 can be ground floor 1011 about twice, about three times, about four times, about five times and/ Or about ten times.In other words, for the power for giving, the compression degree of the second layer 1012 can be the about twice of ground floor 1011, about three Again, about four times, about five times, and/or about ten times.In certain embodiments, the energy compressibility of the second layer 1012 can be in ground floor Between 1011 about twice and about ten times.In at least one embodiment, multiple air gaps can be defined in the second layer 1012, wherein The amount and/or size of the air gap in the second layer 1012 can be controlled to provide the expectation compression of the second layer 1012.With it is similar to the above, Although third layer 1013 can be what is can compressed, but the 4th layer 1014 can substantially have more energy compressibility than third layer 1013. For example, the 4th layer 1014 of energy compressibility can be the about twice of third layer 1013, about three times, about four times, about five times, and/or about Ten times.In other words, for the power for giving, the 4th layer 1014 of compression degree can be third layer 1013 about twice, about three times, about Four times, about five times, and/or about ten times.In certain embodiments, the 4th layer 1014 of energy compressibility can be in the pact of third layer 1013 Between twice and about ten times.In at least one embodiment, multiple air gaps can be defined in the 4th layer 1014, wherein the 4th layer The amount and/or size of the air gap in 1014 can be controlled to provide the 4th layer 1014 of expectation compression.In various scenarios, may be used By compression ratio（That is, the distance that layer is compressed for the power of given size）To express the energy compressibility of warehouse or warehouse layer.Example Such as, compared with the layer compared with little compressible, the layer with high compression rate is for applying to the compression stress of the given size of this layer Bigger distance will be compressed.For so, the second layer 1012 has higher compression ratio than ground floor 1011；Similarly, There is higher compression ratio than third layer 1013 for four layer 1014.In various embodiments, the second layer 1012 and the 4th layer 1014 Identical compression ratio can be made up of and can had identical material.In various embodiments, the second layer 1012 and the 4th layer 1014 Can be made up of the material with different compression ratios.Similarly, ground floor 1011 and third layer 1013 can be made up of identical material And can have an identical compression ratio.In certain embodiments, ground floor 1011 and third layer 1013 can be by with different compression ratios Material constitute.

When anvil block 1040 is advanced towards its closing position, anvil block 1040 can contact tissue T and tissue T and nail bin 1000 applied Compressive forces, as shown in Figure 83 C.In this case, anvil block 1040 can push down on warehouse 1010 towards nail bin supporting member 1030 Top surface or tissue contacting surface 1019.In various embodiments, nail bin supporting member 1030 may include storehouse stayed surface 1031, storehouse Stayed surface 1031 can work as the tissue contacting surface 1041 that nail bin 1000 is compressed in storehouse stayed surface 1031 and anvil block 1040 Between when support nail bin 1000.Due to the pressure applied of anvil block 1040, warehouse 1010 can be compressed and anvil block 1040 can contact Staple 1020.More particularly, in various embodiments, the downward motion of the compression of warehouse 1010 and tissue contacting surface 1019 Pierce through the ground floor 1011 of warehouse 1010, pierce through tissue T and in anvil block 1040 in the end 1023 that staple leg 1021 can be made In forming pit 1042.When warehouse 1010 is further compressed by anvil block 1040, end 1023 is accessible to limit forming pit 1042 wall, and therefore leg 1021 can be deformed inward or crimp, such as shown in Figure 83 C.When staple leg 1021 is deformed, Equally as shown in Figure 83 C, the base portion 1022 of staple 1020 can contact nail bin supporting member 1030 or be supported by nail bin supporting member 1030. In various embodiments, as described in more detail below, nail bin supporting member 1030 may include multiple supporting constructions, such as staple Support trenches, slit or groove 1032, the plurality of supporting construction can be worked as support when staple 1020 is deformed staple 1020 or extremely The base portion 1022 of few staple 1020.Equally as shown in Figure 83 C, apply that to the compression stress of staple cartridge body 1010 the 4th layer 1014 can be made In chamber 1015 collapse.In addition to chamber 1015, staple cartridge body 1010 may also include one or more spaces（Such as space 1016）, For example in one or more of spaces can be positioned with or no-fix has the part of staple, one or more of spaces can Warehouse 1010 is allowed to collapse.In various embodiments, chamber 1015 and/or space 1016 can collapse, so as to limit chamber and/or sky The wall of gap bends downwards and contacts the layer below chamber and/or space of storehouse stayed surface 1031 and/or contact warehouse 1010.

In comparison diagram 83B and Figure 83 C, it is clear that the second layer 1012 and the 4th layer of 1014 pressure applied by anvil block 1040 Compression pressure substantially compresses.It may also be noted that ground floor 1011 and third layer 1013 are also compressed.Close when anvil block 1040 moves to it When closing position, anvil block 1040 can continue further pressure by pushing down on tissue contacting surface 1019 towards nail bin supporting member 1030 Contracting warehouse 1010.When warehouse 1010 is further compressed, anvil block 1040 can make staple 1020 be deformed into it and be fully formed shape （As shown in Figure 83 D）.Referring to Figure 83 D, the leg 1021 of each staple 1020 can be downward towards the base portion 1022 of each staple 1020 Deformation, so that tissue T, ground floor 1011, the second layer 1012, third layer 1013 and the 4th layer 1014 of part capture are existed Can deform between leg 1021 and base portion 1022.In comparison diagram 83C and Figure 83 D, the more obvious second layer 1012 and the 4th layer 1014 are further significantly compression by the compression pressure that anvil block 1040 is applied.In comparison diagram 83C and Figure 83 D it may also be noted that One layer 1011 and third layer 1013 are also further compressed.After staple 1020 is fully shaped completely or at least, anvil block 1040 can be lifted away from tissue T, and nail bin supporting member 1030 can away from and/or depart from nail bin 1000 move.Such as Figure 83 D Shown, used as consequence of the above, warehouse 1010 can be implanted with staple 1020.In various embodiments, implanted warehouse 1010 Can be along staple line supporting tissue.In some cases, the styptic that accommodates in implanted warehouse 1010 and/or any other suitable Suitable medicine can process tissue over time.Styptic as above can reduce the group for suturing and/or being cut Blood is woven, while the behavior tissue that enters that bonding agent or tissue adhesive can be over time provides intensity.The warehouse 1010 being implanted into Can be by such as ORC（Oxidized regenerated cellulose）, albumen substrate, with trade name Vicryl sell polyglycolic acid（PGA）, PLA （PLA or PLLA）, PPDO（PDS）, polyhydroxyalkanoatefrom（PHA）, with trade name Monocryl sell it is poly- Caprone 25（PGCL）, polycaprolactone（PCL）, and/or the material such as the compound of PGA, PLA, PDS, PHA, PGCL, and/or PCL Constitute.In some cases, warehouse 1010 may include the antibiosis and/or antibacterial material of the possibility that can reduce surgical site infection Material, such as collargol and/or triclosan.

In various embodiments, each layer of warehouse 1010 can be connected with each other.In at least one embodiment, using at least A kind of adhesive（Such as fibrin and/or protein hydrogel）The second layer 1012 is adhered to into ground floor 1011, by third layer 1013 adhere to the second layer 1012, and adhere to third layer 1013 by the 4th layer 1014.In certain embodiments, although not showing Go out, but each layer of warehouse 1010 can be linked together by interlocked mechanical structure.In at least one such embodiment, first Layer 1011 and the second layer 1012 can each include corresponding interlocking structure, such as tenon groove structure and/or dovetail structure.It is similar Ground, the second layer 1012 and third layer 1013 can each include corresponding interlocking structure, while third layer 1013 and the 4th layer 1014 can each include corresponding interlocking structure.In certain embodiments, although not shown, but nail bin 1000 can be wrapped for example One or more rivets are included, one or more of rivets can extend across one or more layers of warehouse 1010.At least one In individual such embodiment, each rivet may include the first end or head of the positioning of adjacent first layer 1011 and adjacent to the 4th layer 1014 and position the second head, the described 4th layer the second end or the second end shape by rivet that can be assembled into rivet Into.Due to the energy compression property of warehouse 1010, at least one embodiment, such as rivet energy nail bin support member 1010, so that riveting The head of nail can be recessed relative to the tissue contacting surface 1019 of warehouse 1010 and/or lower surface 1018.At least one this In class embodiment, each rivet can be by the polyglycolic acid for example sold with trade name Vicryl（PGA）, PLA（PLA or PLLA）、 PPDO（PDS）, polyhydroxyalkanoatefrom（PHA）, with trade name Monocryl sell Poliglecaprone 25 （PGCL）, polycaprolactone（PCL）, and/or the compound of PGA, PLA, PDS, PHA, PGCL, and/or PCL etc. can bio-absorbable Material is constituted.In certain embodiments, in addition to by the staple 1020 accommodated in warehouse 1010, each layer of warehouse 1010 can It is not connected with each other.In at least one such embodiment, the frictional engagement between staple leg 1021 and warehouse 1010 for example can be by Each layer of warehouse 1010 keeps together, once and staple formation, then each layer can be trapped in staple 1020.In some realities In applying example, at least a portion of staple leg 1021 may include to increase the thick of the frictional force between staple 1020 and warehouse 1010 Roughened surface or rough coatings.

As described above, surgical instruments may include the first jaw and the second jaw, the first jaw includes nail bin supporting member 1030, Second jaw includes anvil block 1040.In various embodiments, described in greater detail below, nail bin 1000 may include one or many Individual reservation structure, it is simultaneously therefore that nail bin 1000 is releasable that one or more of reservation structures can engage nail bin supporting member 1030 Remain to nail bin supporting member 1030.In certain embodiments, can be by least one adhesive（For example, fibrin and/or Protein hydrogel）Nail bin 1000 is adhered to into nail bin supporting member 1030.In use, at least one situation, especially exist In laparoscopic type and/or endoscopic procedure, for example the second jaw is moveable to the closing position relative with the first jaw so that First jaw and the second jaw can be inserted in operative site by trochar.In at least one such embodiment, sleeve pipe Pin can limit the hole of about 5mm or intubation, and the first jaw and the second jaw can be inserted into by the hole or intubation.In some realities In applying example, the second jaw is moveable to the partial closed position and closing position between in an open position, the part closure Tolerable first jaw in position and the second jaw are inserted into through trochar, and need not make the seam accommodated in staple cartridge body 1010 Nail 1020 deforms.In at least one such embodiment, when the centre position that the second jaw is closed in its part, anvil block 1040 can not apply compression stress to staple cartridge body 1010, and in some other embodiments, when the second jaw is closed in its part During the centre position of conjunction, anvil block 1040 can compress staple cartridge body 1010.Although the energy when anvil block 1040 is in this centre position Compression staple cartridge body 1010, but anvil block 1040 can by halves compress staple cartridge body 1010, so that the contact staple of anvil block 1040 1020 and/or cause staple 1020 deformed by anvil block 1040.Once the first jaw and the second jaw are inserted into by trochar In operative site, then the second jaw can be opened again, and anvil block 1040 and nail bin 1000 can as mentioned above relative to target group Knit and positioned.

Referring now to Figure 84 A-84D, in various embodiments, the end effector of surgical stapling device may include to be located at anvil block Nail bin 1100 can be implanted between 1140 and nail bin supporting member 1130.With it is similar to the above, anvil block 1140 may include contact tissue table Face 1141, nail bin 1100 may include tissue contacting surface 1119, and nail bin supporting member 1130 may include that nail bin can be supported 1100 stayed surface 1131.Referring to Figure 84 A, tissue T is positioned to the group against nail bin 1100 using anvil block 1140 Knit contact surface 1119 and deform nail bin 1100, and when anvil block 1140 is in this position, tissue contacting surface 1141 can be positioned so that and be can be positioned so that with distance 1101a of nail bin stayed surface 1131, and tissue contacting surface 1119 With distance 1102a of nail bin stayed surface 1131.Subsequently, referring now to Figure 84 B, when anvil block 1140 is towards nail bin supporting member 1130 During motion, anvil block 1140 can push down on the first of the top surface of nail bin 1100 or tissue contacting surface 1119 and nail bin support member 1110 Layer 1111 and the second layer 1112.Refer again to Figure 84 B, when layer 1111 and layer 1112 are compressed, the second layer 1112 can by conquassation, And the leg 1121 of staple 1120 can pierce ground floor 1111 and enter tissue T.In at least one such embodiment, staple 1120 can be positioned at least partially in the staple cavity in the second layer 1112 or space 1115, and when the second layer 1112 is compressed When, staple cavity 1115 can collapse and therefore allow that the second layer 1112 is collapsed around staple 1120.In various embodiments, second Layer 1112 may include covering part 1116, the covering part may extend away on staple cavity 1115 and around or at least partly surround seam Nail cavity 1115.Figure 84 B are illustrated and are pressed downward the covering part 1116 burst into staple cavity 1115.In certain embodiments, the second layer 1112 may include one or more weakening parts, and one or more of weakening parts can be conducive to collapsing for the second layer 1112. In various embodiments, this weakening part may include for example be conducive to warehouse 1110 to carry out the controllable cut collapsed, wear Hole, and/or thin cross section.In at least one embodiment, ground floor 1111 may include that staple leg 1121 can be conducive to wear One or more weakening parts of saturating ground floor 1111.In various embodiments, may include for example can be with for this weakening part Cut, perforation, and/or thin cross section that staple leg 1121 aligns or at least substantially aligns.

Figure 84 A are referred again to, when the non-firing position that anvil block 1140 is closed in part, anvil block 1140 can be positioned so that With distance 1101a of storehouse stayed surface 1131 so that define gap therebetween.This gap can be by with nail bin height 1102a Nail bin 1100 and tissue T filling.When anvil block 1140 is moved downward to compress nail bin 1100, Figure 84 B are referred again to, tissue connects The distance between tactile surface 1141 and storehouse stayed surface 1131 can be limited apart from 1101a by being shorter than apart from 1101b.In various feelings In shape, between the tissue contacting surface 1141 and storehouse stayed surface 1131 of anvil block 1140 can by the gap limited apart from 1101b More than original undeformed nail bin height 1102a.Referring now to Figure 84 C, when anvil block 1140 is moved to closer to storehouse support table During face 1131, the second layer 1112 can continue to collapse and the distance between staple leg 1121 and forming pit 1142 can reduce.It is similar The distance between ground, tissue contacting surface 1141 and storehouse stayed surface 1131 can be decreased to apart from 1101c, in various embodiments In, apart from 1101c can greater than, equal to or less than original not deformed storehouse height 1102a.Referring now to Figure 84 D, anvil block 1140, Final firing position is moveable to, in final firing position, staple 1120 is fully formed or is at least shaped to expectation height Degree.In this position, the tissue contacting surface 1141 of anvil block 1140 can be with distance 1101d of storehouse stayed surface 1131, its It is middle that original not deformed storehouse height 1102a can be shorter than apart from 1101d.It is same as shown in Figure 84 D, staple cavity 1115 can completely or extremely It is few substantially to collapse, and the second layer 1112 that staple 1120 can completely or at least substantially be collapsed is surrounded.In various situations In, anvil block 1140 can be moved subsequently away from nail bin 1100.Once anvil block 1140 departs from from nail bin 1100, then warehouse 1110 can be such as It is stretched in various positions again at least in part（That is, the position between adjacent staple 1120）In.In at least one embodiment In, the warehouse 1110 of conquassation may not again be stretched with elastic type.In various embodiments, the staple 1120 of shaping and in addition Warehouse 1110 between adjacent staple 1120 can apply pressure or compression stress to tissue T, and this can provide various beneficial Therapeutic effect.

As described above, referring again to the embodiment shown in Figure 84 A, each staple 1120 may include the staple leg extended from it 1121.Although it is to include two staple legs 1121 that staple 1120 is shown, but it is possible with may include a staple leg or work Include more than two staple legs for another selection（Such as three staple legs or four staple legs）Various staples.As schemed Shown in 84A, each staple leg 1121 can be embedded in the second layer 1112 of warehouse 1110 so that staple 1120 is fixed on the second layer In 1112.In various embodiments, staple 1120 can be inserted in the staple cavity 1115 of warehouse 1110 so that staple leg 1121 The advancing in chamber 1115 in base portion 1122 of end 1123.In various embodiments, after end 1123 is inserted into chamber 1115, End 1123 can be pressed in covering part 1116 and cut the second layer 1112.In various embodiments, staple 1120 can be close The enough depths being sealed in the second layer 1112 so that staple 1120 is not moved or at least substantially not relative to the second layer 1112 Motion.In certain embodiments, staple 1120 can be sealed to the enough depths in the second layer 1112 so that the quilt of base portion 1122 In positioning or embedded staple cavity 1115.In various other embodiments, base portion 1122 can not be positioned or be embedded in the second layer 1112 In.Figure 84 A are referred again to, in certain embodiments, base portion 1122 can extend below the lower surface 1118 of warehouse 1110. In some embodiments, base portion 1122 can be bearing in storehouse stayed surface 1130 or directly abut storehouse stayed surface 1130 and position. In various embodiments, storehouse stayed surface 1130 may include from its extension and/or be limited to supporting construction therein, wherein at least In one such embodiment, the base portion 1122 of staple 1120 can be positioned in one or more in such as nail bin supporting member 1130 Support in support trenches, slit or groove 1132 or by one or more of support trenches, slit or groove 1132, following article will It is more fully described.

To being described further above, referring now to Figure 85, the base portion 1122 of staple 1120 can directly abut nail bin The stayed surface 1131 of support member 1130 and position.In various embodiments, circular or arch is included including wherein staple basis 1122 The embodiment of shape lower surface 1124, such as staple basis 1122 can be moved or slided along nail bin stayed surface 1131.Work as anvil block 1140 staple leg 1121 is compressed against during staple formation process end 1123 when this slip can occur.In some embodiments In, as mentioned above and referring now to Figure 86, may include that one or more support slits 1132 in nail bin supporting member 1130, described one Individual or multiple support slits 1132 can be eliminated or at least reduced relative between staple basis 1122 and storehouse stayed surface 1131 Motion.In at least one such embodiment, it is each support slit 1132 can be limited by surface profile, the surface profile and Match positioned at the profile for supporting the staple lower surface in slit 1132 or at least substantially match.For example, shown in Figure 86 The lower surface 1124 of base portion 1122 may include circular or at least substantially circular surface, and support slit 1132 also may be used Including circular or at least substantially circular surface.In at least one such embodiment, for limiting the surface of slit 1132 Can be limited by the radius of curvature more than or equal to the radius of curvature for limiting lower surface 1124.Although slit 1132 can be helped prevent Or the sliding relative movement between reduction staple 1120 and nail bin supporting member 1130, but slit 1132 is also prevented from or reduces Relative rotary motion between staple 1120 and nail bin supporting member 1130.More particularly, at least one embodiment, slit 1132 can be closely received base portion 1122, to prevent or reducing rotation of the staple 1120 around axis 1129, such as so that seam Nail 1120 will not rotate or distort when being deformed.

In various embodiments, further to being described above, each staple 1120 can be by round or at least basic The upper wire rod for circle is formed.In certain embodiments, the leg of each staple and base portion can be by with non-circular cross sections（Example Such as rectangular cross section）Wire rod formed.In at least one such embodiment, nail bin supporting member 1130 may include corresponding not rounded Shape slit（Such as rectangular slot）, the non-circular slit can accommodate the base portion of this staple.Referring now to Figure 87, various In embodiment, each staple 1120 may each comprise bizet 1125 of the overmolding to base portion 1122（Such as bizet 1125）, its In each bizet 1125 can be positioned in the support slit in nail bin supporting member 1130.In at least one such embodiment In, each bizet 1125 may each comprise the cross section of such as square and/or rectangle, and the cross section can be contained in and for example follow closely In the slit 1134 of the square and/or rectangle in storehouse support member 1130.In various embodiments, bizet 1125 can be biological by energy The plastics of absorption（The polyglycolic acid for example sold with trade name Vicryl（PGA）, PLA（PLA or PLLA）, it is poly- to dioxy ring Hexanone（PDS）, polyhydroxyalkanoatefrom（PHA）, with trade name Monocryl sell Poliglecaprone 25（PGCL）, polycaprolactone （PCL）, and/or the compound of PGA, PLA, PDS, PHA, PGCL, and/or PCL）Constitute, and can enclose for example, by injection molding method Formed around the base portion 1122 of staple 1120.Various bizets and the method for forming various bizets are disclosed in September 29 in 2006 Entitled " the SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS that day files an application FOR SECURING TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME” U.S. Patent Application Serial Number 11/541,123 in.Figure 87 is referred again to, slit 1134 may also include introduction part or oblique angle 1135, the introduction part or oblique angle can be conducive to bizet 1125 being inserted in slit 1134.In various embodiments, nail bin is worked as 1100 when being assembled to nail bin supporting member 1130, and the base portion and/or bizet of staple 1120 can be positioned in slit 1134.At certain In a little embodiments, when nail bin 1100 is assembled to nail bin supporting member 1130, the bizet 1125 of staple 1120 can be with slit 1134 Alignment.In at least one such embodiment, bizet 1125 can not be entered in slit 1134, until opposite joint nail leg 1121 applies pressure The base portion and/or bizet of contracting power and staple 1120 is pushed down in slit 1134.

Referring now to Figure 88 and Figure 89, in various embodiments, nail bin,（For example, nail bin 1200）May include to compress and energy The warehouse 1210 of implantation, warehouse 1210 includes outer layer 1211 and internal layer 1212.With it is similar to the above, nail bin 1200 may include be located at storehouse Multiple staples 1220 in body 1210.In various embodiments, each staple 1220 may each comprise base portion 1222 and from base portion 1222 one or more staple legs 1221 for extending.In at least one such embodiment, staple leg 1221 can be inserted into internal layer In 1212 and being sealed to for example determines the lower surface 1218 of the adjacent and/or neighbouring internal layer 1212 of the base portion 1222 of staple 1220 Position.In the embodiment shown in Figure 88 and Figure 89, internal layer 1212 does not include the staple cavity for the part that can accommodate staple 1220, And in other embodiments, internal layer 1212 may include this staple cavity.In various embodiments, to further being retouched above State, internal layer 1212 can be by the energy compression material that can allow that warehouse 1210 is collapsed when compressive load is applied to it（For example can give birth to Foam and/or oxidized regenerated cellulose that thing absorbs（ORC））Constitute.In various embodiments, internal layer 1212 can be by for example including PLA（PLA）And/or polyglycolic acid（PGA）Freeze dried foam constitute.ORC can be commercially available with trade name Surgicel and can Including the fabric of pine（As surgical sponge）, pine fiber（As cotton balls）And/or foam.In at least one embodiment In, internal layer 1212 can by wherein include and/or applied atop have medicine（Such as cryodesiccated fibrin ferment and/or fibrin） Material constitute, the medicine for example can by the fluid water in patient's body activate and/or activate.In at least one such embodiment In, cryodesiccated fibrin ferment and/or fibrin are positively retained at such as Vicryl（PGA）In matrix.However, in some situations In, such as when nail bin 1200 is inserted in the operative site in patient's body, activable medicine can be activated by mistake.Again Referring to Figure 88 and Figure 89, in various embodiments, outer layer 1211 can be by water impervious or at least water is substantially impermeable Material constitute so that liquid does not contact or at least substantially do not contact internal layer 1212, until warehouse 1210 is compressed and staple After leg is penetrated after outer layer 1211 and/or outer layer 1211 is cut open in some way.In various embodiments, outer layer 1211 can By backing material and/or plastic material（Such as PPDO（PDS）And/or polyglycolic acid（PGA））Constitute.At some In embodiment, outer layer 1211 may include the wrappage of wrappage around internal layer 1212 and staple 1220.More particularly, it is real at least one In applying example, staple 1220 can be inserted in internal layer 1212 and outer layer 1211 and around the subgroup for including internal layer 1212 and staple 1220 Part and be wrapped and be subsequently sealed.

Referring now to Figure 90 and Figure 91, in various embodiments, nail bin,（For example, nail bin 1300）May include to compress and energy The warehouse 1310 of implantation, warehouse 1310 includes outer layer 1311 and internal layer 1312.With it is similar to the above, nail bin 1300 may also include and be located at Staple 1320 in warehouse 1310, each of which staple 1320 may each comprise base portion 1322 and from one of the extension of base portion 1322 Or multiple legs 1321.Similar to nail bin 1200, the base portion 1322 of staple 1320 can be under the lower surface 1318 of internal layer 1312 Fang Yanshen, and outer layer 1311 can surround base portion 1322.In at least one such embodiment, outer layer 1311 can have enough Flexibility is surrounding each staple basis 1322 so that outer layer 1311 conforms to the profile of base portion 1322.Figure 89 is referred again to, extremely In a few alternative embodiment, outer layer 1211 can have enough rigidity so that its surround base portion 1222 extend and not Conform to each base portion 1222.In any case, in various embodiments, outer layer 1311 can be positioned in the base of staple 1320 Portion 1322 and the nail bin stayed surface for supporting nail bin 1300（Such as stayed surface 1031 or 1131）Between.At least one In such embodiment, outer layer 1311 can be positioned in base portion 1322 with the support slit being limited in nail bin stayed surface（For example Slit 1032 or 1132）Between.In at least one such embodiment, to being described further above, outer layer 1311 can Limit the motion of base portion 1322 and/or the coefficient of friction between increase base portion 1322 and nail bin stayed surface and/or support slit To reduce relative motion therebetween.Referring now to Figure 92 and Figure 93, in various alternative embodiments, nail bin,（For example Nail bin 1400）Outer layer can by halves around the staple that is located therein.In at least one such embodiment, in staple 1420 The insertion warehouse 1410 of staple leg 1421 in before, can compress the outer layer 1411 of the warehouse 1410 that simultaneously can be implanted into can be assembled to it is interior Layer 1412.Used as consequence of the above, the base portion 1422 of staple 1420 may extend away in the outside of outer layer 1411, and at least one In such embodiment, such as base portion 1422 can be positioned directly in the support slit 1032 in nail bin stayed surface 1031 or 1131 or In 1132.In various embodiments, when staple leg 1421 is inserted through outer layer 1411, staple leg 1421 can cut outer layer 1411. In various situations, the hole formed by staple leg 1421 can be closely around staple leg 1421 so that staple leg 1421 and outer layer Leak between 1411 few（If present）Fluid, this can reduce or prevent in staple cartridge body 1410 accommodate medicine Prematurely activated and/or leaked out the possibility of warehouse 1410.

As described above, referring again to Figure 88 and Figure 89, the leg 1221 of staple 1220 can be embedded in warehouse 1210, and is stitched The base portion 1222 of nail 1220 can stretch out from the lower surface 1218 of internal layer 1212.In various embodiments, to carrying out above Further describe, internal layer 1212 may not include the staple cavity that can accommodate staple 1220.Referring now to Figure 94 and Figure 95, various In other embodiments, nail bin（Such as nail bin 1500）The warehouse 1510 that may include to compress and can be implanted into, the warehouse includes can At least one of staple cavity 1515 of staple 1520 is accommodated wherein.In at least one such embodiment, staple 1520 The top of staple leg 1521 can be embedded in internal layer 1512, and the bottom of staple leg 1521 and base portion 1522 can be positioned in staple cavity In 1515.In certain embodiments, base portion 1522 can be fully located in staple cavity 1515, and in certain embodiments, base portion 1522 can extend at least in part below the lower surface 1518 of internal layer 1512.With it is similar to the above, outer layer 1511 can surround interior Layer 1512 and the staple 1520 in internal layer 1512.Referring now to Figure 96, in some other embodiments, nail bin 1600 can be wrapped Include the staple 1620 in the staple cavity 1615 in the warehouse 1610 that can be compressed and can be implanted into, wherein at least the one of staple 1620 Part is not surrounded by outer layer 1611.In at least one such embodiment, each staple 1620 may each comprise embedding at least in part The base portion 1622 for entering the staple leg 1621 in internal layer 1612 and stretching out around outer layer 1611.

Referring now to Figure 97 and Figure 98, in various embodiments, nail bin,（For example, nail bin 1700）May include to compress and energy The warehouse 1710 of implantation and the multiple staples 1720 being at least partially situated in warehouse 1710.Warehouse 1710 may include outer layer 1711st, internal layer 1712 and alignment matrix 1740, the alignment matrix can align staple 1720 and/or the guarantor in warehouse 1710 Hold in place.In at least one embodiment, internal layer 1712 may include the depressed part that can wherein accommodate alignment matrix 1740 1741.In various embodiments, alignment matrix 1140 can be press-fitted in depressed part 1741 and/or in other words using at least one Adhesive（For example, fibrin and/or protein hydrogel）It is suitably secured to internal layer 1712.In at least one embodiment, Depressed part 1741 enables to the lower surface 1742 of alignment matrix 1740 and aligns with the lower surface 1718 of internal layer 1712 or extremely Few substantial alignment.In certain embodiments, the lower surface 1742 of alignment matrix can be relative to the bottom table of the second layer 1712 Face 1718 is recessed and/or extends from lower surface 1718.In various embodiments, each staple 1720 may each comprise base portion 1722 And one or more legs 1721 extended from base portion 1722, it is right that at least a portion of wherein staple leg 1721 can extend across Neat matrix 1740.Alignment matrix 1740 may also include and for example extend through multiple holes therein and/or slit, the plurality of hole And/or slit can wherein accommodate staple leg 1721.In at least one such embodiment, each hole can closely hold Receive staple leg 1721 so that very little occurs between staple leg 1721 and the side wall in hole（If any）Relative motion.At certain In a little embodiments, alignment matrix hole can not extend completely through alignment matrix 1740, and when staple leg 1721 is pushed through During alignment matrix 1740, staple leg 1721 can need to cut alignment matrix 1740.

In certain embodiments, alignment matrix 1740 can be made up of the plastic body for moulding, at least one embodiment, The plastic body of the molding is harder than internal layer 1712 and/or outer layer 1711 or energy compressibility is lower.It is such at least one In embodiment, alignment matrix 1740 can be by plastic material and/or any other suitable material（Such as PPDO （PDS）And/or polyglycolic acid（PGA））Constitute.In certain embodiments, alignment matrix 1740 can be assembled to internal layer 1712, and Subsequently staple leg 1721 can be inserted through in alignment matrix 1740 and embedded internal layer 1712.In various embodiments, alignment matrix 1740 Lower surface 1742 may include one or more grooves for the base portion 1722 that can at least in part accommodate staple 1720, narrow Groove or groove.With it is similar to the above, outer layer 1711 can be placed in the subgroup including internal layer 1712, alignment matrix 1740 and staple 1720 Around part.Alternatively, outer layer 1711 can be placed in the sub-component including internal layer 1712 and alignment matrix 1740 Around, wherein staple 1720 can subsequently be inserted through outer layer 1711, alignment matrix 1740 and internal layer 1712.In any case, make For consequence of the above, internal layer 1712, alignment matrix 1740, and/or outer layer 1711 can be held in place staple 1720, until And/or in staple 1720 in the above described manner by deflection.In at least one such embodiment, alignment matrix 1740 can be used for Staple 1720 is held in place before in the implanted patient's body of nail bin 1700, and along staple after nail bin 1700 is implanted Line fixing organization.In at least one embodiment, such as staple 1720 can be fixed in alignment matrix 1740 and not be embedded into In internal layer 1712 and/or outer layer 1711.

Referring now to Figure 99-105, in various embodiments, can be by compression internal layer 1812, by staple（For example, staple 1820）Nail bin is assembled in insertion internal layer 1812 and with the wrapping inner layer 1812 of outer layer 1811（For example, nail bin 1800）.Main ginseng See Figure 99, the internal layer 1812 that can be compressed is shown as including to be limited at multiple staple cavities 1815 therein, but it can also be envisaged that goes out As mentioned above wherein internal layer 1812 is not including the other embodiments of staple cavity.Referring now to Figure 100, the internal layer 1812 that can be compressed can It is positioned between transfer plate 1850 and gripper shoe 1860 and is compressed in the compressive surfaces 1852 and gripper shoe of transfer plate 1950 Between 1860 compressive surfaces 1862.As shown in Figure 100, the top surface and lower surface of internal layer 1812 can be pressed toward each other Contracting, and in response to this, internal layer 1812 can expand laterally outward.In certain embodiments, internal layer 1812 can be compressed into example At about 1/3rd of its original height height, and can be with e.g., from about 0.06 in its compressive state " to about 0.08 " height or thickness between.Same as shown in Figure 81, transfer plate 1850 may also include in multiple staple wells 1853 Multiple staples（Such as staple 1820）.In addition, transfer plate 1850 may also include multiple drivers 1851, the plurality of driver 1851 can upwards release staple 1820 outside staple well 1853.Referring now to Figure 101, using driver 1851 by staple 1820 staple leg 1821 pushes in the internal layer 1812 of compression and passes through the internal layer 1812 of compression.In various embodiments, Driver 1851 is enabled to when staple 1820 is fully deployed from the staple well 1853 of transfer plate 1850, driver 1851 Top surface be oriented to flush with the compressive surfaces 1852 of transfer plate 1850 or at least almost flush.In certain embodiments, together As shown in Figure 101, gripper shoe 1860 may include multiple receiving holes 1861 to sample, and the plurality of receiving hole 1861 can be in staple leg 1821 are pushed through after internal layer 1812, and receiving hole 1861 accommodates staple leg 1821 or at least end of staple leg 1821. Wherein internal layer 1812 has been compressed in the embodiment being shorter than at the height of the height of staple 1820, receiving hole 1861 or similar structures Can be required, therefore when staple 1820 is projected completely from staple well 1853, staple leg 1821 can be from the internal layer of compression 1812 top surface projection.In some other embodiments, internal layer 1812 can be compressed at the height higher than the height of staple 1820, Therefore the receiving hole 1861 in gripper shoe 1860 is not needed.

Referring now to Figure 102, after staple 1820 is inserted in internal layer 1812, gripper shoe 1860 can be away from transfer plate 1850 and advance, to allow that internal layer 1812 reduces pressure.In this case, internal layer 1812 can again extend to it with elastic type It is original or at least close to original uncompressed height.When internal layer 1812 stretches again, the height of internal layer 1812 can increase to super Cross the height of staple 1820 and the staple leg 1821 of staple 1820 is no longer from the top surface projection of internal layer 1812.In various scenarios, Receiving hole 1861 can be held in place staple leg 1821, have moved to remote enough at least up to gripper shoe 1860 and make leg 1821 are no longer in receiving hole 1861.In this case, in receiving hole 1861 can be helped when internal layer 1812 stretches again Staple 1820 in layer 1812 keeps alignment relative.In various scenarios, internal layer 1812 and the staple 1820 that is located therein can be wrapped Enclosed tool component 1801, referring now to Figure 103, sub-component 1801 can be for example inserted in outer layer 1811.In at least one such reality In applying example, outer layer 1811 may include to be limited at chamber therein 1802, and chamber 1802 can wherein accommodate sub-component 1801.Each In planting situation, using instrument（Such as tweezers 1855）Outer layer 1811 is pulled to sub-component 1801.Referring now to Figure 104, Once sub-component 1801 is fully located in outer layer 1811, then outer layer 1811 can be sealed.In various embodiments, using external A part for layer 1811 applies heat energy and carrys out sealable outer 1811.More particularly, at least one embodiment, outer layer 1811 can It is made up of plastic material, wherein the openend of outer layer 1811 can be heated by one or more heated element or iron 1856, with Just the periphery of the openend of outer layer 1811 is combined and/or is sealed.Referring now to Figure 105, at least one such reality In applying example, the redundance 1857 of outer layer 1811 can be removed, and subsequently can be as described herein using nail bin 1800.

As described above, nail bin can be located in nail bin attachment and/or be fixed to nail bin attachment.Referring now to Figure 106, and Figure 107, in various embodiments, nail bin attachment may include staple cartridge channel（Such as staple cartridge channel 1930）, the staple cartridge channel energy It is enough to accommodate nail bin wherein（Such as nail bin 1900）At least a portion.In at least one embodiment, staple cartridge channel 1930 can Including bottom support surface 1931, the first lateral support wall 1940 and the second lateral support wall 1941.In use, nail bin 1900 can be positioned in staple cartridge channel 1930 so that nail bin 1900 against and/or adjacent bottom stayed surface 1931 position, and Between the first lateral support wall 1940 and the second lateral support wall 1941.In certain embodiments, the first lateral support wall 1940 and second can define sideshake between lateral support wall 1941.In at least one such embodiment, nail bin 1900 Lateral width 1903 is may include, lateral width 1903 is same as and/or is wider than the side limited between supporting walls 1940 and 1941 To gap so that the warehouse 1910 that can be compressed and can be implanted into of nail bin 1900 can be securely fitted between wall 1940 and 1941. In some other embodiments, the lateral width 1903 of nail bin 1900 can be shorter than between the first side wall 1940 and second sidewall 1941 The gap for being limited.In various embodiments, at least a portion of wall 1940 and 1941 and bottom support surface 1931 can be by The metal passage of punching press is limited, and at least one embodiment, lateral support wall 1940 and/or lateral support wall 1941 are extremely A few part can be by flexible material（Such as elastomeric material）Constitute.Referring primarily to Figure 106, the first side wall of staple cartridge channel 1930 1940 and second sidewall 1941 can be by from the upwardly extending rigid element 1933 of bottom support surface 1931 and from rigid portion 1933 upwardly extending flex sections 1934 are divided to constitute.

In various embodiments, to being described further above, the warehouse 1910 of nail bin 1900 can be by one or more The layer that can be compressed（For example, ground floor 1911 and the second layer 1912）Constitute.When warehouse 1910 by anvil block compress in the above described manner to During by bottom support surface 1931, the sidepiece of warehouse 1910 can laterally extend.Wherein nail bin 1930 is made up of rigid sidewalls Embodiment in, rigid sidewalls can prevent or at least limit warehouse 1910 lateral extension, therefore warehouse 1910 in can produce it is aobvious The internal pressure or stress of work amount.In the embodiment that at least a portion of nail bin 1930 is made up of flexible side walls, flexible side walls Laterally flexing and can allow that the sidepiece of warehouse 1910 laterally stretches, so as to reduce inside pressure produced in warehouse 1910 Power or stress.Do not include that side wall or included side wall are relatively shorter than in the embodiment of nail bin in warehouse channel, the sidepiece of nail bin Ground can be not inhibited or be at least substantially not inhibited laterally extending.Referring now to Figure 107, in any case, nail bin, Passage 2030 may include side wall 2040 and 2041, and the side wall 2040 and 2041 can be completely by flexible material（Such as elastomer material Material）Constitute.Staple cartridge channel 2030 may also include the lateral narrow of the side extension of the bottom support surface 2031 along staple cartridge channel 2030 Groove 2033, the lateral slit can wherein accommodate at least a portion of simultaneously fixed sidewall 2040 and 2041.In some embodiments In, side wall 2040 and 2041 can be fixed in slit 2033 via snap-fitted and/or press-fit structure, and at least some reality In applying example, side wall 2040 and 2041 can be fixed in slit 2033 by one or more adhesive.In at least one embodiment In, side wall 2040 and 2041 can be dismantled during use from bottom support surface 2031.In any case, when in warehouse 2010 When being implanted with staple 2020, the warehouse 2010 that can be compressed and can be implanted into can be dismantled from side wall 2040 and 2041 and/or departed from.

Referring now to Figure 108, in various embodiments, surgical instruments may include axle 2150 and prolong from the distal end of axle 2150 The end effector stretched.With it is similar to the above, end effector may include staple cartridge channel 2130, can be in open position and closing position Between move anvil block 2140 and the nail bin 2100 between staple cartridge channel 2130 and anvil block 2140.It is also similarly to Text, warehouse 2110 and the multiple staples 2120 in warehouse 2110 that nail bin 2100 may include to compress and can be implanted into. In various embodiments, staple cartridge channel 2130 may include bottom support surface 2131, distal end 2135 and near-end 2136, the nail bin 2100 can position against bottom support surface 2130.In at least one embodiment, as shown in Figure 108, nail bin 2100 can be wrapped First end 2105 and the second end 2106 are included, the first end can be positioned in the distal end 2135 of staple cartridge channel 2130, The second end 2106 can be positioned in the near-end 2136 of staple cartridge channel 2130.In various embodiments, staple cartridge channel 2130 distal end 2135 may include that at least one distal end retains structure（For example retain wall 2137）；Similarly, near-end 2136 can be wrapped Include at least one proximal-end retention structure（For example retain wall 2138）.In at least one such embodiment, distally retains wall 2137 Retaining with nearside can define gap between wall 2138, the gap can be equal to or less than the length of nail bin 2100 so that work as nail When storehouse 2100 is inserted in staple cartridge channel 2130, nail bin 2100 can be securely fitted in staple cartridge channel 2130.

Refer again to Figure 88 and Figure 89, in various embodiments, nail bin（For example, nail bin 1200）May include flat or at least Substantially flat tissue contacting surface 1219.In at least one such embodiment, the staple cartridge body 1210 of nail bin 1200 can Including first end 1205 and the second end 1206, the first end can be limited by the first height or thickness 1207, and described the Two ends 1206 can be limited by the second height or thickness, wherein the first height 1207 can be equal to or substantially equal at least second is high Degree 1208.In certain embodiments, warehouse 1210 can between first end 1205 and the second end 1206 include it is constant or At least substantially constant height or thickness.In at least one such embodiment, tissue contacting surface 1219 can be parallel or extremely The lower surface 1218 of warehouse 1210 is arranged essentially parallel to less.Figure 108 is referred again to, in various embodiments, nail bin 2100 The first end 2105 of warehouse 2110 can be limited by the first height 2107, and first height is different from the second of the second end 2106 Highly 2108.In the embodiment shown, the first height 2107 is more than the second height 2108, but in alternative embodiment In, the second height 2108 can be more than the first height 2107.In various embodiments, the height of warehouse 2110 can be in first end Linearly and/or geometrically reduce between 2105 and the second end 2106.In at least one such embodiment, in first end The tissue contacting surface 2119 extended between 2105 and the second end 2106 can along first end 2105 and the second end 2106 it Between limit angle be orientated.In at least one such embodiment, tissue contacting surface 2119 can be not parallel to warehouse 2110 lower surface 2118 and/or it is not parallel to the stayed surface 2131 of staple cartridge channel 2130.

Figure 108 and Figure 109 is referred again to, in various embodiments, anvil block 2140 may include tissue contacting surface 2141, when When anvil block 2140 is in the close position, tissue contacting surface 2141 can parallel to or at least substantially parallel to staple cartridge channel 2130 Stayed surface 2131, as shown in Figure 109.When anvil block 2140 is in the close position, anvil block 2140 can be to nail bin 2100 The compression degree of first end 2105 is more than the second end 2106, this is because the height of first end 2105 is higher, and second End 2106 it is highly relatively low.In some cases, including the tissue T being wherein located between tissue contacting surface 2119 and 2141 In the distal end place of end effector in situation with constant or at least substantially constant thickness, tissue T and storehouse 2100 The pressure of generation can be more than in the pressure produced by the proximal end of end effector.More particularly, when anvil block 2140 and nail bin When tissue T between 2100 has the thickness of substantial constant, positioned at the distal end 2145 of anvil block 2140 and the first of nail bin 2100 The degree that tissue T between end 2105 is compressed can be more than the second end of the near-end 2146 positioned at anvil block 2140 and nail bin 2100 Tissue T between portion 2106.In various embodiments, pressure can be produced in the tissue T between the near-end of end effector and distal end Power gradient.More particularly, at least one embodiment, when the tissue T between anvil block 2140 and nail bin 2100 has substantially The height of upper constant thickness and nail bin 2100 from end effector distal-to-proximal linearly reduce when, the pressure in tissue T Power can linearly reduce from the distal end of end effector to the near-end of end effector.Similarly, at least one embodiment, When the height that the tissue T between anvil block 2140 and nail bin 2100 has the thickness of substantial constant and nail bin 2100 is performed from end When device distal-to-proximal geometrically reduces, the pressure in tissue T can be from the distal end of end effector to the near of end effector End geometrically reduces.

Figure 108 is referred again to, in various embodiments, the tissue T between nail bin 2100 and anvil block 2140 can not have There is constant thickness throughout which.In at least one this situation, positioned at near-end 2146 and the nail bin 2100 of anvil block 2140 The second end 2106 between tissue T can be thicker than first end 2105 positioned at the distal end 2145 of anvil block 2140 and nail bin 2100 Between tissue T.Therefore, in this case, thicker tissue T can be usually located on the relatively low near-end 2106 of nail bin 2100 Side, and relatively thin tissue T can be usually located at the higher top of distal end 2105.In use, the percussion lining ring 2152 of axle 2150 Can advance towards distally along axle ridge 2151 so that percussion lining ring 2152 engages the cam part 2143 of anvil block 2140, and makes anvil block 2140 Rotate towards nail bin 2100, as shown in Figure 109.Once anvil block 2140 is rotated to the position for closing completely, then tissue T can be compressed in Between tissue contacting surface 2119 and 2141, although and nail bin 2100 height can the near-end of end effector and distal end it Between it is non-constant, but it can be constant or at least substantially constant in tissue T to apply to the pressure or compression stress of tissue T. More particularly, when relatively thin tissue T can be with nail bin 2100 higher height correlation and thicker tissue T can be with nail bin 2100 Relatively low height correlation when, the cumulative height or height sum of tissue T and nail bin 2100 can the near-end of end effector with It is constant or at least substantially constant, therefore being compressed in cumulative height to this cumulative height of anvil block 2140 between distal end Can be constant or at least substantially constant.

Figure 108 and Figure 109 is referred again to, in various embodiments, nail bin 2100 may include asymmetric configuration.At least one In individual such embodiment, height of such as nail bin 2100 at its first end 2105 can be higher than nail bin 2100 in its second end Height at 2106.In certain embodiments, nail bin 2100 and/or staple cartridge channel 2130 may include one or more alignment and/ Or retaining structure, one or more of alignment and/or reservation structure are able to ensure that nail bin 2100 only in one direction（That is, its Direction of the middle first end 2105 in the distal end 2135 of staple cartridge channel 2130 and in the second end 2106 proximally-located 2136） It is positioned in staple cartridge channel 2130.In various alternative embodiments, nail bin 2100 and/or staple cartridge channel 2130 may include One or more alignment and/or reservation structure, one or more of alignment and/or reservation structure can allow the edge of nail bin 2100 More than one direction is positioned in staple cartridge channel 2130.Referring now to Figure 110, such as nail bin 2100 can be positioned in staple cartridge channel In 2130, so that the first end 2105 of nail bin 2100 can be positioned in the near-end 2136 of staple cartridge channel 2130 and the second end 2106 can be positioned in distal end 2135.Therefore, in various embodiments, the nail bin 2100 of lower height can neighbouring distally reservation Wall 2137 is positioned, and the nail bin 2100 of high height can retain wall 2138 and position adjacent to nearside.In at least one such embodiment In, nail bin 2100 can suitably be arranged with the distal end of end effector have thicker portion and in end effector What the applying of the tissue T with thinner part was constant or at least substantially constant in near-end adds compaction forces.In various embodiments, Nail bin 2100 for example can be optionally orientated in staple cartridge channel 2130.In at least one such embodiment, nail bin 2100 Alignment and/or retain structure can be for symmetrical, and surgeon can be along the direction shown in such as Figure 108 and Figure 110 Nail bin 2100 is orientated in staple cartridge channel 2130.

To further describing above, the warehouse 2110 that can be implanted into may include longitudinal axis 2109, when nail bin 2100 is determined When position is in staple cartridge channel 2130, longitudinal axis 2109 can extend between the near-end of end effector and distal end.In various realities In applying example, the thickness of warehouse 2110 can substantially reduce between first end 2105 and the second end 2106 along longitudinal axis 2109 And/or substantially increase.In at least one such embodiment, the distance between lower surface 2118 and tissue contacting surface 2119 Or height can substantially reduce between first end 2105 and the second end 2106 and/or substantially increase.In certain embodiments, The thickness of warehouse 2110 can both increase or reduce along longitudinal axis 2109.In at least one such embodiment, warehouse 2110 Thickness may include one or more parts increased on thickness and one or more parts that can reduce on thickness.Again It is secondary referring to figure Z, in various embodiments, nail bin 2100 may include the multiple staples 2120 being positioned in.In use, as above Described, when anvil block 2140 moves to closing position, staple 2120 can deform.In certain embodiments, each staple 2120 can With identical or at least substantially identical height.In at least one such embodiment, can for example from the bottom of staple basis Portion measures the height of staple to the top or end of staple highest leg.

In various embodiments, the staple in nail bin can have different staple heights.In at least one such embodiment In, nail bin may include first group of staple and second group of staple with the second staple height with the first staple height, described First group of staple is positioned in the Part I of the warehouse that can be compressed, and second group of staple is positioned in the warehouse that can be compressed Part II in.In at least one embodiment, the first staple height can be higher than the second staple height, and first group of staple During the first end 2105 of nail bin 2100 can be positioned in, and second group of staple can be positioned in the second end 2106.As Another selection, first group of higher staple can be positioned in the second end 2106 of nail bin 2100, and relatively low second Group staple can be positioned in first end 2105.In certain embodiments, using multiple staple groups, each of which group is each With different staple heights.In at least one such embodiment, the with middle staple height the 3rd group can be at first group It is positioned in warehouse 2110 between staple and second group of staple.In various embodiments, it is each in the staple line in nail bin Staple can each include different staple heights.In at least one embodiment, the highest staple in staple line can be positioned in Staple on the first end of staple line and minimum can be positioned on the opposite end of the staple line.It is such at least one In embodiment, the staple between highest staple and minimum staple can be disposed so that staple height for example in highest staple Decline between minimum staple.

Referring now to Figure 111, in various embodiments, the end effector of surgical stapling device may include anvil block 2240, nail Warehouse channel 2230 and the nail bin 2200 supported by staple cartridge channel 2230.The storehouse that nail bin 2200 may include to compress and can be implanted into Body 2210 and the multiple staples being positioned in warehouse 2210（Such as staple 2220a and staple 2220b）.In various embodiments In, staple cartridge channel 2230 may include storehouse stayed surface 2231 and multiple staples for being limited in storehouse stayed surface 2231 support narrow Groove（For example support slit 2232a and 2232b）.In at least one such embodiment, nail bin 2200 may include staple 2220a Two inner rows of two outer skiddings and staple 2220b, wherein supporting slit 2232a to support staple 2220a, and support Slit 2232b can support staple 2220b.Referring to Figure 111 and Figure 112, anvil block 2240 may include to be limited at therein multiple Staple formation pit 2242, the plurality of staple formation pit 2242 can work as anvil block 2240 towards nail bin 2200 move when it is described many Individual staple formation pit 2242 accommodates staple 2220a and 2220b and deforms it.In at least one such embodiment, support The lower surface of slit 2232a with top surface first distance 2201a of staple formation pit 2242, and can support slit The lower surface of 2232b can be with top surface second distance 2201b of staple formation pit 2242.In at least one such enforcement In example, due to having elevated step in the stayed surface 2231 for wherein defining support slit 2232b, therefore slit is supported 2232b is positioned closer to anvil block 2240.Due to different apart from 2201a and 2201b, therefore in various embodiments, seam The outer skidding of nail 2220a and the internal layer row of staple 2220b can be deformed into different forming heights.In various scenarios, it is deformed into The staple of differing formed height can apply different clamping pressure or power to the tissue T that sutured.Over and above what is described above, staple There can be different unshaped staple heights originally.Figure 111 is referred again to, at least one such embodiment, outer layer seam The initial unshaped height of nail 2220a can be more than the initial unshaped height of inner side staple 2220b.Such as Figure 111 and Figure 112 institutes Show, unshaped highly can also have the shaping less than outside staple 2220b less than inner side staple 2220b of outside staple 2220a Highly.In various alternative embodiments, inner side staple 2220b can have high higher than the unshaped of outside staple 2220a Spend and there is the deformation staple height less than outside staple 2220a.

In various embodiments, to being described further above, anvil block 2240 is moveable to closing position（Such as Figure 112 It is shown）, so as to nail bin support member 2210 and make staple 2220a and 2220b deformation.In certain embodiments, including Figure 111 and Tu The surgical stapling device of end effector shown in 112 for example may also include cutting element, and the cutting element can be crosscutting positioned at anvil Tissue T between seat 2240 and nail bin 2200.In at least one such embodiment, anvil block 2240, staple cartridge channel 2230 and/or Nail bin 2200 can limit slit, and the slit can slidingly receive wherein cutting element.More specifically, anvil block 2240 Slot portion 2249 is may include, staple cartridge channel 2230 may include slot portion 2239, and nail bin 2200 may include slot portion 2203, when Anvil block 2240 it is in the close position or at least substantially close position when, slot portion 2249, slot portion 2239 and slot portion 2203 can be mutually aligned or at least substantially align.In various embodiments, anvil block 2240 be closed and staple 2220a, After 2220b deformations, cutting element can be from the near-end of end effector towards the distal movement of end effector.It is real at least one In applying example, cutting element can be moved with the incoherent mode of staple deformation process.In certain embodiments, cutting element can be Advance while staple deforms.In any case, at least one embodiment, cutting element can be along positioned at staple Path incised tissue between the inner row that 2220b is formed.

In various embodiments, as shown in Figure 112, inner side staple 2220b can be shaped to less than outside staple 2220a Highly, wherein inner side staple 2220b can apply larger clamping pressure to organize adjacent with the line of cut that cutting element is formed Power or power.In at least one such embodiment, the larger clamping pressure or power that inner side staple 2220b is formed can provide various Beneficial therapeutic effect, for example, make to be cut open tissue T and reduce bleeding, and the less clamping pressure that outside staple 2220a is formed Power can provide flexibility in the tissue of suture.Figure 111 and Figure 112 is referred again to, in various embodiments, anvil block 2240 may be used also Including at least one piece backing material for being attached to anvil block 2240（Such as backing material 2260）.In at least one such embodiment In, the leg of staple 2220a, 2220b can work as nail bin 2200 and compress and subsequently contact the seam in anvil block 2240 by anvil block 2240 During nail shapes pit 2242, backing material 2260 is cut and/or through in backing material 2260 in the leg of staple 2220a, 2220b Hole.When the leg of staple 2220a, 2220b deforms, the leg can again contact and/or cut backing material 2260. In various embodiments, backing material 2260 can improve the hemostatic capability that sutures tissue and/or provide intensity to be sutured tissue.

Figure 111 and Figure 112 is referred again to, in various embodiments, the lower surface of warehouse 2210 may include staged wheel Exterior feature, the stepped profile is matched with the stepped profile of storehouse stayed surface 2231 or at least substantially matched.In some enforcements In example, the lower surface of warehouse 2210 can deform to match or at least substantially match the profile of storehouse stayed surface 2231.Now Referring to Figure 113, in various embodiments, similar to the end effector of end effector shown in Figure 111 positioning is for example may include Nail bin 2300 wherein.Nail bin 2300 may include the body that can be compressed and can be implanted into internal layer 2312 and outer layer 2311 2310, wherein to being described further above, at least one embodiment, outer layer 2311 can be by water impervious material Constitute.In various embodiments, outer layer 2311 can around staple 2220a, 2220b extend and can be located at respectively staple 2220, 2220b and support are between slit 2232a, 2232b.Referring now to Figure 114, in various embodiments, hold similar to shown in Figure 111 The end effector of portion's actuator for example may include the nail bin 2400 being positioned in.Similar to nail bin 2300, nail bin 2400 The warehouse 2410 that can be compressed and can be implanted into may include internal layer 2412 and outer layer 2411；However, at least one embodiment, warehouse Cutting element slit wherein is may not include in 2410.In at least one such embodiment, cutting element can need for example to pass through at it Nail bin and internal layer 2412 and/or outer layer 2411 are cut when being pushed into.

Referring now to Figure 115, in various embodiments, the end effector of surgical stapling device may include anvil block 2540, nail Warehouse channel 2530 and the nail bin 2500 being positioned in staple cartridge channel 2530.With it is similar to the above, nail bin 2500 may include to compress And the outer skidding and the inner row of staple 2220b of the warehouse 2510, staple 2220a that can be implanted into.Staple cartridge channel 2530 may include Flat or at least substantially flat storehouse stayed surface 2531 and the staple being limited in storehouse stayed surface 2531 support slit 2532. Multiple staple formation pits that anvil block 2540 may include stepped surface 2541 and be limited in stepped surface 2541（For example Forming pit 2542a and 2542b）.With it is similar to the above, forming pit 2542a and support slit 2532 between can define distance, The distance is more than forming pit 2452b and supports the distance between slit 2532.In various embodiments, anvil block 2540 may be used also Including one piece of backing material 2560 of the stepped surface 2541 for being attached to anvil block 2540.In at least one such embodiment, Backing material 2560 can conform to or at least substantially conform to stepped surface 2541.In various embodiments, backing material 2560 can be by least one adhesive（For example, fibrin and/or protein hydrogel）Removably it is attached to surface 2541. In certain embodiments, warehouse 2510 may also include staged profile, and at least one embodiment, the staged profile is put down Row in or at least substantially parallel to the stepped surface 2541 of anvil block 2540.More particularly, at least one embodiment, Anvil block 2540 may include the ladder 2548 extended towards nail bin 2500, and wherein ladder 2548 may include ladder height, and the ladder is high Degree is equal to or is substantially equal at least the ladder height of the ladder 2508 extended from warehouse 2510.In at least one such embodiment In, as consequence of the above, for example can the amount that can be trapped in the first staple 2220a of nail bin support member 2510 may differ from pressing Contracting warehouse 2510 can be trapped in the amount in the second staple 2220b.

Referring now to Figure 116, in various embodiments, end effector may include anvil block 2640, staple cartridge channel 2530, with And the nail bin 2600 between anvil block 2640 and staple cartridge channel 2530.The warehouse that nail bin 2600 may include to compress and can be implanted into 2610, warehouse 2610 includes internal layer 2612, outer layer 2611 and the multiple staples being positioned in warehouse 2610（Such as staple 2220a and 2200b）.In various embodiments, anvil block 2640 can include multiple staple formation pits 2642 on surface 2641, And staple cartridge channel 2530 may include the multiple staple formation slits 2532 being limited in stayed surface 2531.As shown in Figure 116, Anvil faces 2641 can parallel to or at least substantially parallel to storehouse stayed surface 2531, each of which forming pit 2642 can quilt It is positioned to support slit 2532 at a distance of equal or at least substantially equal distance with relative and corresponding staple.Various In embodiment, the staple included by nail bin 2600 can have it is identical or at least substantially the initial unshaped staple height of identical with And it is identical or at least substantially identical shaping staple height.In some other embodiments, outside staple line may include staple 2220a and inner side staple line may include staple 2220b, wherein as described above, staple 2220a and 2220b can have it is different not Shaping staple height.When anvil block 2640 moves to closing position towards nail bin 2600, staple 2220a and 2220b can be shaped as Make staple 2220a and 2220b that there is identical or at least substantially identical shaping staple height.In at least one such enforcement In example, as consequence of the above, identical or at least can be accommodated in outside staple 2220a and inner side staple 2220b of shaping The energy nail bin support member 2610 of substantially the same amount；However, when outside staple 2220a has higher than inner side staple 2220b not When shaping staple height but can have identical to shape staple height, for example, clamping pressure produced in staple 2220a of outside Power can be more than clamping pressure produced in staple 2220b of inner side.

Referring now to Figure 117, in various embodiments, the end effector of surgical stapling device may include anvil block 2740, nail Warehouse channel 2530 and the nail bin 2700 being positioned in staple cartridge channel 2530.With it is similar to the above, nail bin 2700 may include to compress And the warehouse 2710 that can be implanted into, warehouse 2710 includes internal layer 2712, outer layer 2711 and multiple seams for being positioned in warehouse 2710 Nail（Such as staple 2220a and 2220b）.In at least one embodiment, the thickness of warehouse 2710 may pass through its width and occur Change.In at least one such embodiment, warehouse 2710 may include central part 2708 and sidepiece 2709, wherein central part 2708 Thickness can be more than sidepiece 2709 thickness.In various embodiments, the most thick part of warehouse 2710 can be located at central part At 2708, and the most thin part of warehouse 2710 can be located at sidepiece 2709.In at least one such embodiment, warehouse 2710 Thickness can be gradually reduced between central part 2708 and sidepiece 2709.In certain embodiments, the thickness of warehouse 2710 can be Linearly and/or geometrically reduce between central part 2708 and sidepiece 2709.In at least one such embodiment, warehouse 2710 Tissue contacting surface 2719 may include it is more inclined or angled than two of drop downwards towards sidepiece 2709 from central part 2708 Surface.In various embodiments, anvil block 2740 may include two inclined or angled surfaces, it is described two inclined or into The surface of angle parallel to or at least substantially parallel to inclined tissue contacting surface 2719.In at least one embodiment, Anvil block 2740 may also include at least one piece backing material 2760 of the inclined surface for being attached to anvil block 2740.

In various embodiments, to being described further above, the inner side staple line in nail bin 2700 may include higher Staple 2220a, and outside staple line may include relatively low staple 2220b.In at least one embodiment, higher staple 2220a can be positioned in thicker central part 2708 and/or adjacent with central part 2708, and staple 2220b can be positioned in It is in sidepiece 2709 and/or adjacent with sidepiece 2709.In at least one such embodiment, as consequence of the above, higher seam Nail 2220a can more be implanted into the material of warehouse 2710 than relatively low staple 2220b capture.This situation can make staple 2220a applies bigger clamping pressure than staple 2220b to tissue T.In certain embodiments, although higher staple 2220a In the material of more warehouses 2710 is captured than relatively low staple 2220b, yet with staple formation pit 2742a and 2742b has inclined structure, therefore higher staple 2220a has higher shaping staple than relatively low staple 2220b Highly.Desired clamping pressure is reached in the tissue that staple 2220a and 2220b are captured using this Consideration, its In as a result, the clamping pressure in such as staple 2220a can be more than, less than or equal to staple 2220b to tissue apply folder Compaction forces.In various alternative embodiment of end effector shown in Figure 117, relatively low staple 2220b can be positioned Can be positioned in the thicker central part 2708 of warehouse 2710 and/or adjacent to central part 2708, and higher staple 2220a In relatively thin sidepiece 2709 and/or adjacent side portion 2709.Although additionally, nail bin 2700 is depicted as including inner side and external latasuture Staple, but nail bin 2700 may include additional staple line, such as staple between inner side staple line and outside staple line Row.In at least one such embodiment, for example in the middle of staple line unshaped staple height can between staple 2220a not into Between shape staple height and the unshaped staple height of staple 2220b, and the shaping staple height of middle staple line can be between Between the shaping staple height of staple 2220a and the shaping staple height of staple 2220b.

Referring now to Figure 118, in various embodiments, the end effector of surgical stapling device may include anvil block 2840, nail Warehouse channel 2530 and the nail bin 2800 being positioned in staple cartridge channel 2530.With it is similar to the above, nail bin 2800 may include to compress And the warehouse 2810 that can be implanted into, warehouse 2810 includes internal layer 2812, outer layer 2811 and multiple seams for being positioned in warehouse 2810 Nail（Such as staple 2220a and 2220b）.In at least one embodiment, the thickness of warehouse 2810 may pass through its width and occur Change.In at least one such embodiment, warehouse 2810 may include central part 2808 and sidepiece 2809, wherein central part 2808 Thickness be smaller than the thickness of sidepiece 2809.In various embodiments, the most thin part of warehouse 2810 can be located at central part At 2808, and the most thick part of warehouse 2810 can be located at sidepiece 2809.In at least one such embodiment, warehouse 2810 Thickness can gradually increase between central part 2808 and sidepiece 2809.In certain embodiments, the thickness of warehouse 2810 can be Linearly and/or geometrically increase between central part 2808 and sidepiece 2809.In at least one such embodiment, warehouse 2810 Tissue contacting surface 2819 may include from central part 2808 towards sidepiece 2809 upwards than drop two it is inclined or angled Surface.In various embodiments, anvil block 2840 may include two inclined or angled surfaces, it is described two inclined or into The surface of angle parallel to or at least substantially parallel to inclined tissue contacting surface 2819.In at least one embodiment, Anvil block 2840 may also include at least one piece backing material 2860 of the inclined surface for being attached to anvil block 2840.In various embodiments In, to being described further above, the outside staple line in nail bin 2800 may include higher staple 2220a, and inner side Staple line may include relatively low staple 2220b.In at least one embodiment, higher staple 2220a can be positioned in thicker Sidepiece 2809 in and/or it is adjacent with sidepiece 2809, and staple 2220b can be positioned in central part 2808 and/or and center Portion 2808 is adjacent.In at least one such embodiment, used as consequence of the above, higher staple 2220a is than relatively low seam Nail 2220b captures can more be implanted into the material of warehouse 2810.

As discussed above concerning Figure 111 embodiment described in, for example, staple cartridge channel 2230 may include stepped support surface 2231, stepped support surface 2231 can be supported on staple 2220a and 2220b at differing heights relative to anvil block 2240. In various embodiments, staple cartridge channel 2230 can be made up of metal, and the ladder in stayed surface 2231 can be for example, by grinding Mill is operated and is formed in stayed surface 2231.Referring now to Figure 119, in various embodiments, the end of surgical instruments performs Device may include staple cartridge channel 2930, and the staple cartridge channel includes the support insert 2935 being positioned in.More particularly, extremely In few one embodiment, staple cartridge channel 2930 can be formed to make it have for example flat or at least substantially flat stayed surface 2931, the stayed surface can support insert 2935, the support insert include for by staple 2220a of nail bin 2200 and 2220b is supported on the stepped surface at differing heights.In at least one such embodiment, insert 2935 may include flat Or at least substantially flat lower surface, the lower surface can position against stayed surface 2931.Insert 2935 may be used also Including slit, groove or groove 2932a and 2932b is supported, support slit, groove or groove 2932a and 2932b can be by staples 2220a and 2220b are respectively supported at differing heights.With it is similar to the above, insert 2935 may include to be limited at knife therein Slit 2939, cutter slit 2939 can allow that cutting element is passed through.In various embodiments, staple cartridge channel 2930 can be by phase Same or different from support insert 2935 material is constituted.In at least one such embodiment, staple cartridge channel 2930 and support The both of which of insert 2935 for example can be made up of metal, and in other embodiments, staple cartridge channel 2930 can for example by metal structure Into, and support insert 2935 for example can be made up of plastics.In various embodiments, support insert 2935 can be fastened And/or be welded in staple cartridge channel 2930.In certain embodiments, support insert 2935 can be snap-fitted and/or be press-fitted into In staple cartridge channel 2930.In at least one embodiment, support insert 2935 can be fixed on into staple cartridge channel using adhesive In 2930.

Referring now to Figure 120, in various embodiments, the end effector of surgical stapling device may include anvil block 3040, nail Warehouse channel 3030 and the nail bin 3000 that can be compressed and can be implanted in staple cartridge channel 3030.With similar to the above, anvil block 3040 may include to be limited at multiple staple formation pits 3042 therein and can be slidably received in cutting element Cutter slit therein 3049.It is also similarly to above, staple cartridge channel 3030 may include that being limited at multiple staples therein supports Slit 3032 and also cutting element can be slidably received in cutter slit therein 3039.In various embodiments, follow closely Storehouse 3000 may include ground floor 3011, the second layer 3012 and the multiple staples being positioned in nail bin 3000（Such as staple 3020a and 3020b）.In at least one embodiment, the unshaped staple height of staple 3020a can be higher than staple 3020b not Shaping staple height.In various embodiments, ground floor 3011 can be made up of the first energy compression material, and the second layer 3012 can It is made up of the second energy compression material.In certain embodiments, the compression ratio of the first energy compression material can be higher than the second energy staypak Material, and in some other embodiments, the compression ratio of the first energy compression material can be less than the second energy compression material.At least one In embodiment, the first energy compression material can be made up of the elastomeric material that can include the first flexible ratio, and second can staypak Material can be made up of the elastomeric material that can include the second flexible ratio, and second flexible ratio is different from the described first elasticity ratio Rate.In various embodiments, the flexible ratio of the first energy compression material can be more than the flexible ratio of the second energy compression material.At certain In a little other embodiments, the flexible ratio of the first energy compression material is smaller than the flexible ratio of the second energy compression material.Various In embodiment, the first energy compression layer can include the first rigidity, and the second energy compression layer can include the second rigidity, wherein first is firm Degree is different from the second rigidity.In various embodiments, the rigidity of the first energy compression layer can be more than the rigidity of the second energy compression layer. In some other embodiments, the rigidity of the first energy compression layer is smaller than the rigidity of the second energy compression layer.

Figure 120 is referred again to, in various embodiments, the second layer 3012 of nail bin 3000 may pass through its width comprising constant Or at least substantially constant thickness.In at least one embodiment, the thickness of ground floor 3011 may pass through its width and send out Changing.In at least one such embodiment, ground floor 3011 may include one or more ladders 3008, and ladder 3008 can be Some parts of warehouse 3010（Such as central part）The thickness of middle increase warehouse 3010.Refer again to Figure 120, relatively low staple 3020b can be positioned in ladder 3008（That is the thicker portion of warehouse 3010）In or align with ladder 3008, and higher seam Nail 3020a can be positioned in the thinner part of warehouse 3010 or align with the thinner part.In various embodiments, as The thicker portion of warehouse 3010 and the result of thinner part, the rigidity of the inner row formed along staple 3020b of warehouse 3010 can More than the rigidity of the outer skidding formed along staple 3020a.In various embodiments, ground floor 3011 may be connected to the second layer 3012.In at least one such embodiment, ground floor 3011 and the second layer 3012 may include interlocking structure, the interlocking structure Layer 3011 and 3012 can be kept together.In certain embodiments, ground floor 3011 may include the first laminates and second Layer 3012 may include the second laminates, wherein the first laminates can adhere to the second laminates by one or more adhesive. In various embodiments, nail bin 3000 may include cutter slit 3003, and cutter slit 3003 can slidingly receive wherein cutting Component.

Referring now to Figure 121, in various embodiments, nail bin 3100 may include to compress the warehouse 3110 that simultaneously can be implanted into, Warehouse 3110 includes individual layer energy compression material and the multiple staples being positioned in warehouse 3110（For example, staple 3020b）.Extremely In few one embodiment, the thickness of warehouse 3110 may pass through its width and change.In at least one such embodiment, warehouse 3110 steps 3108 that may include the side extension along warehouse 3110.Referring now to Figure 122, in various embodiments, nail bin 3200, The warehouse 3210 that may include to compress and can be implanted into, the warehouse 3210 includes individual layer energy compression material and is positioned at warehouse 3210 In multiple staples（Such as staple 3020b）.In at least one embodiment, the thickness of warehouse 3210 may pass through its width and become Change.In at least one such embodiment, warehouse 3210 may include the step 3208 extended along the central part of warehouse 3210.Now Referring to Figure 123, in various embodiments, the warehouse 3310 that nail bin 3300 may include to compress and can be implanted into, wherein with phase above Seemingly, the thickness of warehouse 3310 may pass through its width and change.In at least one embodiment, the thickness of warehouse 3310 can be in warehouse Geometrically increase between 3310 sidepiece and central part.In at least one such embodiment, the thickness of warehouse 3310 can be by encircleing Shape or the profile of bending limit and may include the tissue contacting surface 3319 of arch or bending.In certain embodiments, warehouse 3310 thickness and the profile of tissue contacting surface 3319 can be by such as one radius of curvature or alternatively by many Individual radius of curvature is limited.Referring now to Figure 124, in various embodiments, the storehouse that nail bin 3400 may include to compress and can be implanted into, Body 3410, the thickness of its middle warehouse 3410 can be linearly or at least substantially linear between the sidepiece of warehouse 3410 and central part Ground increase.

Referring now to Figure 125, in various embodiments, the warehouse 3510 that nail bin 3500 may include to compress and can be implanted into And the multiple staples 3520 in warehouse 3510.The warehouse 3510 that can be implanted into may include the first internal layer 3512, the second internal layer 3513 and outer layer 3511.In at least one embodiment, the first internal layer 3512 can include first thickness and the second internal layer 3513 Second thickness can be included, wherein the second internal layer 3513 can be thicker than the first internal layer 3512.In at least one alternative embodiment In, the first internal layer 3512 can be thicker than the second internal layer 3513.In another alternative embodiment, the first internal layer 3512 and second Internal layer 3513 can have identical or at least substantially identical thickness.In certain embodiments, each staple 3520 may include base Portion 3522 and from base portion 3522 extend one or more can deform leg 3521.In various embodiments, each leg 3521 may include the end 3523 in embedded first internal layer 3511, and in addition each base portion 3522 of staple 3520 can be embedded in second In layer 3512.In at least one embodiment, the first internal layer 3512 and/or the second internal layer 3513 may include to be stored therein to A kind of few medicine, and in various embodiments, the first internal layer 3512 and the second internal layer 3513 can be encapsulated and sealed to outer layer 3511, So that medicine can just flow out staple cartridge body 3510 after only outer layer 3511 is pierced through by staple 3520.More particularly, to above It is described further, the tissue that can be abutted against the tissue contacting surface 3519 against nail bin 3500 and position pushes down on anvil Seat so that warehouse 3510 is compressed and surface 3519 is towards staple end 3523 and at least in part in the direction of staple end 3523 times Lower motion so that end 3523 makes outer layer 3511 rupture or pierce through outer layer 3511.The rupture of outer layer 3511 is made in staple leg 3521 Afterwards, at least one medicine M can flow out the warehouse 3510 around staple leg 3521.In various scenarios, the extra pressure of warehouse 3510 Contracting can be by additional medicine M extrusion warehouses 3510, as shown in Figure 126.

Figure 125 is referred again to, in various embodiments, outer layer 3511 may include water impervious or at least substantially not Permeable integument, the integument can 1）Prevent medicine from prematurely flowing out nail bin 3500；And 2）Prevent from for example performing the operation Fluid in position is prematurely entered in nail bin 3500.In certain embodiments, the first internal layer 3512 may include to store or absorb May include to store or be absorbed in the second medicine therein in the first medicine therein, and the second internal layer 3513, wherein the second medicine Thing may differ from the first medicine.In at least one embodiment, warehouse 3510 make outer layer 3511 rupture initial compression it is usual The first internal layer 3512 can be made to discharge the first medicine, and the subsequent compression of warehouse 3510 discharges generally can the second internal layer 3513 Go out the second medicine.However, in such embodiment, some parts of the first medicine and the second medicine can be released simultaneously, but most The major part of the medicine being just released can be made up of the first medicine, and the major part of the medicine being subsequently released can be by the second medicine Thing is constituted.In certain embodiments, to being described further above, the first internal layer 3512 can be by having than the second internal layer 3513 The material of bigger energy compressibility is constituted so that can be less than subsequent compression power or the initial compression force or pressure of pressure can be in first Initial deflection amount bigger in the second internal layer of producing ratio 3513 in layer 3512.This larger in first internal layer 3512 is initially scratched What song amount can make the first medicine discharged from the first internal layer 3512 is partially larger than the discharged from the second internal layer 3513 Two medicines.In at least one embodiment, the first internal layer 3512 is than the second internal layer 3513 more porous and/or more flexible. In at least one such embodiment, the first internal layer 3512 may include to be limited at multiple holes therein or space 3508, and Second internal layer 3513 may include to be limited at multiple holes therein or space 3509, wherein in various embodiments, the energy of hole 3508 Enough by the first medicament storage in the first internal layer 3512, and hole 3509 can be by the second medicament storage in the second internal layer 3513 In.In certain embodiments, the size and density in the hole 3509 in the internal layer 3513 of hole 3508 and second in the first internal layer 3512 Can be selected to provide results needed as herein described.

Figure 125 and Figure 126 is referred again to, in various embodiments, in outer layer 3511, the first internal layer 3512, and/or second Layer 3513 can be made up of the material of energy bio-absorbable.In at least one embodiment, the first internal layer 3512 can be biological by the first energy The material of absorption is constituted, and the second internal layer 3513 can be made up of the material of the second energy bio-absorbable, and outer layer 3511 can be by the 3rd The material of energy bio-absorbable is constituted, wherein the material of the first energy bio-absorbable, the material, and/or the 3rd of the second energy bio-absorbable The material of energy bio-absorbable can be made up of different materials.In certain embodiments, first can the material of bio-absorbable can be with the , by bio-absorbable, the material of the second energy bio-absorbable can be with the second speed by bio-absorbable, and the 3rd biological can inhale for one speed The material of receipts can be with third speed by bio-absorbable, and wherein first rate, the second speed, and/or third speed can be different.Extremely In few such embodiment, when material with specific speed by bio-absorbable when, this speed can be defined as in unit The amount of the interior quality of materials absorbed by patient body.It is well known that the body of different patients can be absorbed not with different speed With material, therefore this speed can be expressed as Mean Speed to explain this changeability.In any case, with it is slower Speed is compared, and faster speed can be the absorbed speed of more quality within the unit interval.Refer again to Figure 125 and Tu 126, in various embodiments, the composition of the constituent material of the first internal layer 3512 and/or the second internal layer 3513 than outer layer 3511 Material is quickly by bio-absorbable.In at least one such embodiment, the first internal layer 3512 and/or the second internal layer 3513 can be by Can the foam of bio-absorbable, tissue seal, and/or hemostatic material（Such as oxidized regenerated cellulose（ORC））Constitute, and outward Layer 3511 can be by backing material and/or plastic material（The polyglycolic acid for example sold with trade name Vicryl（PGA）, PLA （PLA、PLLA）, PPDO（PDS）, polyhydroxyalkanoatefrom（PHA）, with trade name Monocryl sell poly- card General grand 25（PGCL）, polycaprolactone（PCL）, and/or the compound of PGA, PLA, PDS, PHA, PGCL, and/or PCL）Constitute. In such embodiment, the first internal layer 3512 and/or the second internal layer 3513 for example can directly process tissue and can reduce tissue bleeding, Wherein outer layer 3514 can provide long-term structural support and can be slower speed by bio-absorbable.

To being described further above, due to the speed of the energy bio-absorbable of outer layer 3511 it is slower, therefore outer layer 3511 Can be in staple line organization healing when supporting tissue or in structure strengthen tissue.In certain embodiments, the first internal layer 3512 and second the constituent material of one of them of internal layer 3513 than another one constituent material quickly by bio-absorbable.Extremely In few one embodiment, the one layer therein initial release that treatment material can be provided, and another layer can provide identical treatment material The sustained release of material and/or different treatment materials.In at least one such embodiment, treatment material can be released from layer 3512,3513 The speed put may depend on the absorbability of the bottom for wherein absorbing or being dispersed with medicine.For example, at least one embodiment In, including the comparable substrate including the second internal layer 3513 of substrate of the first internal layer 3512 is quickly by bio-absorbable, therefore for example Medicine can be faster than the speed of the release from the second internal layer 3513 from the speed that the first internal layer 3512 discharges.In various embodiments, One or more Tong Guo at least one adhesives as described herein, in the layer 3511,3512 and 3513 of warehouse 3510（Example Such as, fibrin and/or protein hydrogel）Adhere to each other.In certain embodiments, adhesive can be water soluble and can work as The connection between each layer is discharged when nail bin 3500 is implanted and/or after implanted certain time.In at least one such enforcement In example, adhesive can be than outer layer 3511, the first internal layer 3512, and/or the second internal layer 3513 quickly by bio-absorbable.

Referring now to Figure 127 and Figure 128, in various embodiments, nail bin,（For example, nail bin 3600）May include warehouse 3610, warehouse 3610 include can the ground floor 3611 that compressed, be attached to ground floor 3611 the second layer 3612 and be attached to the Two layer 3612 of the energy compression layer 3613 that can be removed.In at least one such embodiment, for example ground floor 3611 can be by can press The foamed material of contracting is constituted, and the second layer 3612 may include the laminated material that ground floor 3611 is adhered to using one or more adhesive Material, and third layer 3613 may include that using what one or more adhesive removably adhered to the second layer 3612 bubble can be compressed Foam material.In various embodiments, nail bin 3600 may also include the multiple staples in warehouse 3610（Such as staple 3620）. In at least one such embodiment, such as each staple 3620 may include be located at third layer 3613 in base portion 3622 and from Base portion 3622 through the second layer 3612 and extend upwardly in ground floor 3611 one or more can deform leg 3621.Make With in, to being described further above, the top surface 3619 of staple cartridge body 3610 can be pushed down on by anvil block, until staple leg Till 3621 penetrate top surface 3619 and target tissue and contact anvil block.After staple leg 3621 is badly deformed, anvil block can be away from nail Move in storehouse 3600 so that the energy compression layer of nail bin 3600 can stretch again at least in part.In various scenarios, staple passes through group Tissue bleeding can be made when knitting and inserting.In at least one embodiment, third layer 3613 can be by absorbing material（Such as albumen water-setting Glue）Constitute, the absorbing material can absorb blood from the tissue being sewn.In addition to above or as replacement above, the 3rd Layer 3613 can be by hemostatic material and/or tissue seal（Such as freeze-dried fibrin ferment and/or fibrin）Constitute, institute Stating hemostatic material and/or tissue seal can reduce tissue bleeding.In certain embodiments, third layer 3613 can be to ground floor 3611 and the second layer 3612 structural support is provided, wherein third layer 3613 can by can bio-absorbable material and/or can not be biological The material of absorption is constituted.In any case, in various embodiments, after nail bin 3610 is implanted, third layer 3613 can Dismantle from the second layer 3612.Wherein third layer 3613 includes having and can be implanted in the embodiment of the material of quality, surgery doctor Life may choose whether to remove the third layer 3613 of warehouse 3610.In at least one embodiment, third layer 3613 can be with entirety Form is removed from the second layer 3612.

In various embodiments, ground floor 3611 can be made up of the first foamed material, and third layer 3613 can be by second Foamed material is constituted, and the second foamed material may differ from the first foamed material.In at least one embodiment, the first foamed material There can be the first density and the second foamed material there can be the second density, wherein the first density may differ from the second density. In at least one such embodiment, the second density can be higher than the first density, wherein as a result, third layer 3613 is than ground floor 3611 energy compressibility is less or with lower compression ratio.In at least one alternative embodiment, the first density can Higher than the second density, wherein as a result, ground floor 3611 is less than the energy compressibility of third layer 3613 or with lower Compression ratio.Referring now to Figure 129 and Figure 130, in various embodiments, similar to nail bin 3600, nail bin 3700 may include warehouse 3710, the warehouse 3710 includes that first can the froth bed 3711 that compressed, the second layer 3712, Yi Jineng that is attached to ground floor 3711 Be attached to the second layer 3712 with removing the can dismantle the 3rd can compression foam layer 3713.In at least one such embodiment, Third layer 3713 may include that multiple staples accommodate slit or otch 3709, and the plurality of staple accommodates slit or pattern 3709 can divide At least a portion of staple 3620 can not be wherein accommodated（Such as staple basis 3622）.In certain embodiments, staple 3620 can slide in staple accommodates slit 3709, or in other words, third layer 3713 can for example when nail bin 3700 is against target When organizing and positioning and compressed by anvil block, third layer 3713 is slided relative to staple 3620.In at least one embodiment, accommodate Slit 3709 can make staple 3620 and accommodate slit 3709 side wall between there is space.In at least one such embodiment In, used as consequence of the above, when staple 3620 deforms, staple 3620 can not be by the part capture of third layer 3713 at it In, as shown in Figure 129 and Figure 130.In some other embodiments, staple accommodates the end of the neighbouring second layer 3712 of slit 3709 End can be by the part closure of third layer 3713, therefore when staple 3620 deforms, at least a portion of third layer 3713 can quilt Capture is in staple 3620.In any case, third layer 3713 for example may include one or more perforation and/or cut 3708, one or more of perforation and/or cut 3708 can allow third layer 3713 with two parts or more parts from the It is removed for two layer 3712, as shown in Figure 129.In Figure 129, a portion of third layer 3713 is shown to pass through instrument 3755 Remove.In various embodiments, perforation 3708 can be arranged along the line in the middle of the first staple line and the second staple line.

Figure 129 and Figure 130 is referred again to, in various embodiments, the base portion 3622 of staple 3620 can be located at receiving slit In 3709, wherein at least one embodiment, the side wall energy for accommodating slit 3709 enough contacts staple leg 3621 and by staple leg 3621 are releasably held in positioning.In certain embodiments, although not shown, but third layer 3713 may include around seam The elongated slot of all staples in staple line.In at least one such embodiment, including the nail bin of four staple lines for example can be wrapped Include the elongated slot alignd with each staple line in nail bin bottom.To being described further above, nail bin 3600 and/or nail At least a portion in storehouse 3700 can be in implanted patient's body, and at least a portion of nail bin can be removed from patient's body.Again Referring to Figure 129 and Figure 130, at least one embodiment, ground floor 3711 and the second layer 3712 can be trapped in staple 3620 It is interior and can be implanted together with staple 3620, and third layer 3713 is removed or dismantles optionally from nail bin 3700.Each In kind of situation, remove and be implanted into the part of nail bin and can reduce the amount of the material that patient body must absorb, this can provide various Beneficial therapeutic effect.In the situation for for example passing through laparoscopic type instrument 3755 by the part dismounting of nail bin and removing, institute The nail bin part of dismounting can pass through trochar（Such as trochar with 5mm holes）It is removed from operative site.In some enforcements In example, warehouse may include the layer that more than one can be removed.For example, warehouse 3710 may include the 4th layer, its middle warehouse 3710 Third layer 3713 can be made up of hemostatic material, and the 4th layer can be made up of supporting layer.In at least one such embodiment, outward Section doctor can for example remove supporting layer and subsequently choose whether to remove hemostatic layer.

Referring now to Figure 131, in various embodiments, nail bin,（For example, nail bin 3800）May include warehouse 3810, warehouse 3810 include outer layer 3811 and internal layer 3812.Internal layer 3812 can be made up of the foamed material that can be compressed, and outer layer 3811 can be extremely Partially wrapped up around internal layer 3812.In at least one embodiment, outer layer 3811 may include Part I 3811a and Part II 3811b, the Part I can be positioned on the first side of internal layer 3812, and the Part II can be positioned at internal layer On 3812 the second side, wherein Part I 3811a and Part II 3811b can pass through flexible hanger（Such as hinge 3809）Even Connect.In at least one such embodiment, can be to the first side of internal layer 3812 and/or at least one adhesive of the second side coating （For example, fibrin and/or protein hydrogel）So that some parts of outer layer 3811 are fixed to into the first side and/or the second side. In various embodiments, outer layer 3811 may include one or more fastening members extended from it.In at least one such enforcement In example, outer layer 3811 may include that from the side of outer layer 3811 extending and can be placed in the multiple energy that can be compressed in internal layer 3812 becomes Shape leg 3821.In at least one such embodiment, leg 3821 can not be from the second lateral process of internal layer 3812, and at least In one alternative embodiment, leg 3821 can at least in part from the projection of internal layer 3812.When the warehouse 3810 that can be compressed When being compressed, in use, leg 3821 can pierce through the Part II 3811b of internal layer 3812 and outer layer 3811.In some realities In applying example, the Part II 3811b of outer layer 3811 may include to be limited at hole therein（Such as hole 3808）, the hole can hold Receive staple leg 3821.In certain embodiments, at least some of nail bin 3800 may include cutter slit 3803, the cutter slit energy It is enough to slidingly receive cutting element wherein.In at least one such embodiment, cutter slit 3803 can be not entirely through storehouse The thickness of body 3810 and extend, therefore when cutting element is moved relative to warehouse 3810, cutting element can cut warehouse 3810.

Referring now to Figure 132, in various embodiments, similar to nail bin 3800, nail bin 3900 may include warehouse 3910, storehouse Body 3910 includes internal layer 3812 and outer layer 3811, wherein outer layer 3811 may include neighbouring internal layer 3812 the first side and position the The a part of 3811a and Part II 3811b positioned adjacent to the second side of internal layer 3812.In at least one embodiment, With it is similar to the above, outer layer 3811 may include one or more fastening members extended from it.In at least one such embodiment, Outer layer 3811 may include from the side of outer layer 3811 to extend and can be placed in can compress in internal layer 3812 multiple can deform leg Portion 3921.In certain embodiments, it is each to deform at least one suspension hook or barb that leg 3921 may include from its projection 3923, at least one suspension hook or barb 3923 can engage the Part II 3811b of outer layer 3811 and therefore by outer layer 3811 remain to internal layer 3812.In at least one such embodiment, barb 3923 can be from the second lateral process of internal layer 3812 And extend through the hole 3808 in the Part II 3811b of outer layer 3811 so that the appearance of the engageable outer layer 3811 of barb 3923 Outer layer 3811 is simultaneously locked onto internal layer 3812 by face.To construct nail bin 3900, internal layer 3812 can be at least partially compressed, so as to fall Hook is from the projection of internal layer 3812 and access aperture 3808.In at least one such embodiment, such as when nail bin 3900 is inserted into nail When in storehouse, nail bin 3900 can be by precommpression at least in part.In certain embodiments, to being described further above, leg 3921 at least a portion can be embedded in the Part I 3811a of outer layer 3811, wherein at least one embodiment, outer layer 3811 can be by plastic material（Such as PPDO（PDS）And/or polyglycolic acid（PGA））Constitute, and the plasticity Material can surround at least a portion overmolding of leg 3921.

Referring now to Figure 133-137, in various embodiments, nail bin,（For example, nail bin 4000）May include warehouse 4010, storehouse Body 4010 includes the ground floor 4011 that can be compressed, the second layer 4012 and the multiple staples 4020 being positioned in warehouse 4010.Ginseng See Figure 135, in certain embodiments, each staple 4020 may include base portion 4022 and from base portion 4022 extend at least one Leg 4023 can be deformed.Referring to Figure 133, at least one embodiment, nail bin 4000 can be positioned in staple cartridge channel 4030 with Between the anvil block 4040 of the end effector of surgical stapling device, the second layer 4012 of its middle warehouse 4010 and/or staple 4020 Base portion 4022 can be positioned against staple cartridge channel 4030.Referring now to Figure 134, in various embodiments, the second layer 4012 may include One layer of absorbent cotton 4060, one layer of absorbent cotton 4060 is interconnected amongst one another by absorbent cotton support frame 4061.At least one this In class embodiment, absorbent cotton 4060 and absorbent cotton support frame 4061 can be by the plastic materials for moulding（Such as polyglycolic acid （PGA））Constitute.Each absorbent cotton 4060 may include one or more holes or slit 4062, one or more of holes or slit 4062 can accommodate and extend through staple leg 4021 therein, as shown in Figure 135 and Figure 136.Each absorbent cotton 4060 can also be wrapped Include and be limited at receiving slit 4063 therein, the receiving slit can accommodate the base portion 4022 of staple 4020.Refer again to figure 134, in various embodiments, absorbent cotton 4060 and/or absorbent cotton support frame 4061 may include multiple cuts, perforation or similar Structure, the plurality of cut, perforation or similar structures can allow absorbent cotton 4060 at desired location from absorbent cotton carriage Frame 4061 is disassembled.Similarly, referring to Figure 136, one or more absorbent cotton 4060 for example can be along including perforation and/or cut 4064 line is connected with each other.In use, the froth bed 4011 that can be compressed can be positioned against target tissue T, and warehouse 4010 Can be compressed by anvil block 4040 so that anvil block 4040 deforms can staple 4020.When staple 4020 deforms, each staple 4020 Staple leg 4021 can by tissue T, a part for ground floor 4011 and absorbent cotton 4060 capture deformation staple in.When When staple cartridge channel 4030 is moved away from the nail bin 4060 being implanted into, for example absorbent cotton support frame 4061 can tear open from absorbent cotton 4060 Unload and/or each absorbent cotton 4060 can be dismantled each other certainly.In some cases, when staple 4020 is become in the above described manner by anvil block 4040 During shape, absorbent cotton 4060 can be dismantled from framework 4061 and/or each other.

In various embodiments described herein, when anvil block moves to closing position, the staple of nail bin can be complete by anvil block Full shaping.Referring now to Figure 138-141, in various other embodiments, nail bin,（Such as nail bin 4100）Staple can by fortune Move to closing position anvil block and make staple towards closure anvil block motion staple driver system and deform.Nail bin 4100 can Including the warehouse 4110 that can be compressed, the warehouse 4110 that can be compressed for example by foamed material and can be at least partially situated at and can compress Multiple staples 4120 in warehouse 4110 are constituted.In various embodiments, staple driver system may include driver clamper 4160th, the multiple staple drivers 4162 and cartridge tray 4180 in driver clamper 4160, the cartridge tray can be by Staple driver 4162 is maintained in driver clamper 4160.In at least one such embodiment, staple driver 4162 Can be positioned in one or more slits 4163 in driver clamper 4160, the side wall of wherein slit 4163 can help court Anvil block boots up staple driver 4162.In various embodiments, staple 4120 can be supported on narrow by staple driver 4162 In groove 4163, wherein at least one embodiment, when staple 4120 and staple driver 4162 are in its non-firing position, Staple 4120 can be fully located in slit 4163.In some other embodiments, at staple 4120 and staple driver 4162 When its non-firing position, at least a portion of staple 4120 may pass through the openend 4161 of slit 4163 and upwardly extend.Now Referring primarily to Figure 139, at least one such embodiment, the base portion of staple 4120 can be positioned in driver clamper 4160 It is interior, and the end of staple 4120 can embedding energy compression warehouse 4110 in.In certain embodiments, about the three of staple 4120 / mono- height can be positioned in driver clamper 4160, and the height of about 2/3rds of staple 4120 can quilt It is positioned in warehouse 4110.Referring to Figure 138 A, at least one embodiment, for example nail bin 4100 can also around warehouse 4110 and Driver clamper 4160 and including water impervious integument or film 4111.

In use, for example, nail bin 4100 can be located in staple cartridge channel, and anvil block can move to closure towards nail bin 4100 Position.In various embodiments, when anvil block moves to its closing position, the warehouse of anvil block accessible simultaneously compression energy compression 4110.In certain embodiments, when anvil block is in its closing position, anvil block can not contact staple 4120.In some other realities In applying example, when anvil block moves to its closing position, the leg of the accessible staple 4120 of anvil block simultaneously makes at least in part staple 4120 deformations.In any case in both cases, nail bin 4100 may also include one or more sledges 4170, it is one or Multiple sledges 4170 can be longitudinally propelling on edge in nail bin 4100 so that sledge 4170 can subsequently engage staple driver 4162 and make staple Driver 4162 and staple 4120 are moved towards anvil block.In various embodiments, sledge 4170 can be in cartridge tray 4180 and staple driving Slide between device 4162.Wherein the closure of anvil block has made in the embodiment that the forming process of staple 4120 starts, staple 4120 Moving upwards towards anvil block can complete forming process and make staple 4120 be deformed into height or at least desired height that it is fully formed Degree.Wherein the closure of anvil block is not made in the embodiment that staple 4120 deforms, and staple 4120 is moved upwards towards anvil block can be started simultaneously Complete forming process and make staple 4120 be deformed into height or at least desired height that it is fully formed.In various embodiments In, sledge 4170 can be advanced to the distal end of nail bin 4100 from the near-end of nail bin 4100 so that in the distal end of nail bin 4100 Before staple 4120 is fully formed, the staple 4120 in the near-end of nail bin 4100 is fully formed.Referring to Figure 140, at least In one embodiment, sledge 4170 can each include at least one angled or inclined surface 4711, described at least one one-tenth Angle or inclined surface 4711 can lift staple driver in the slid underneath of staple driver 4162 and as shown in Figure 141 4162。

In various embodiments, to being described further above, staple 4120 can be formed, so as to by tissue T extremely At least a portion of the energy nail bin support member 4110 of a few part and nail bin 4100 is captured wherein.After staple 4120 shapes, The anvil block and staple cartridge channel 4130 of surgical stapling device can be moved away from the nail bin 4100 being implanted into.In various scenarios, storehouse dish 4180 can jointing nail warehouse channel 4130 in a position-stable manner, wherein as a result, when staple cartridge channel 4130 is pulled away from the storehouse being implanted into During body 4110, storehouse dish 4180 can self energy compression warehouse 4110 dismantle.Refer again to Figure 138, in various embodiments, storehouse dish 4180 may include relative side wall 4181, and the warehouse 4110 can be removably positioned between relative side wall 4181.Extremely In few such embodiment, the warehouse 4110 that can be compressed can be compressed between side wall 4181 so that warehouse during use 4110 can be removably retained between side wall 4181 and when storehouse dish 4180 are pulled away from, warehouse 4110 can be released from storehouse dish 4180 Depart from putting.In at least one such embodiment, driver clamper 4160 may be connected to storehouse dish 4180 so that work as storehouse dish 4180 from operative site be removed when, driver holder 4160, driver 4162, and/or sledge 4170 are positively retained at storehouse dish In 4180.In some other embodiments, driver 4162 can be shot up and stay in Surgery from driver clamper 4160 In position.In at least one such embodiment, each driver 4162 can be by the polyglycolic acid for example sold with trade name Vicryl （PGA）, PLA（PLA or PLLA）, PPDO（PDS）, polyhydroxyalkanoatefrom（PHA）, with trade name The Poliglecaprone 25 that Monocryl sells（PGCL）, polycaprolactone（PCL）, and/or PGA, PLA, PDS, PHA, PGCL, and/or The material of the energy bio-absorbable such as compound of PCL is constituted.In various embodiments, driver 4162 could attach to staple 4120, So that driver 4162 is deployed with staple 4120.In at least one such embodiment, each driver 4162 may include for example The groove of the base portion of staple 4120 can be accommodated, wherein at least one embodiment, the groove with press-fit and/or can be taken Button fit system accommodates staple basis.

In certain embodiments, to being described further above, driver clamper 4160 and/or sledge 4170 can be from storehouses It is shot up in disk 4180.In at least one such embodiment, sledge 4170 can storehouse dish 4180 and driver clamper 4160 it Between slide so that advance when sledge 4170 to drive up when staple driver 4162 and staple 4120, sledge 4170 can also make driving Device clamper 4160 is moved upward to outside storehouse dish 4180.In at least one such embodiment, driver clamper 4160 and/ Or sledge 4170 can be by the polyglycolic acid for example sold with trade name Vicryl（PGA）, PLA（PLA or PLLA）, it is poly- to dioxy Cyclohexanone（PDS）, polyhydroxyalkanoatefrom（PHA）, with trade name Monocryl sell Poliglecaprone 25（PGCL）, gather oneself in Ester（PCL）, and/or the compound of PGA, PLA, PDS, PHA, PGCL, and/or PCL etc. can the material of bio-absorbable constitute.Each In planting embodiment, sledge 4170 can be integrally formed and/or be attached to driving rod or cutting element, the driving rod or cutting element Sledge 4170 is promoted through nail bin 4100.In such embodiment, sledge 4170 can not be shot up from storehouse dish 4180 and can with it is outer Section's stitching unstrument keeps together, and is not attached in the other embodiments of driving rod in sledge 4170, and sledge 4170 can stay in Surgery In position.In any case, to being described further above, the energy compressibility of warehouse 4110 may be allowed in surgical stapling device Thicker nail bin used in end effector, this is because when the anvil block of stitching unstrument is closed, warehouse 4110 can compress or collapse. In certain embodiments, the result for being deformed at least in part as the staple when anvil block is closed, can use higher staple（Example Such as have about 0.18 " staple of staple height）, such as wherein about 0.12 " staple height can be positioned in can compression layer 4110 In, and wherein can compression layer 4110 can have about 0.14 " uncompressed height.

Referring now to Figure 142-145, in various embodiments, nail bin,（For example, nail bin 4200）May include the storehouse that can be compressed Body 4210, the multiple staples 4220 in energy nail bin support member 4210 and multiple flexible lateral supports 4234.Now Referring to Figure 143, in various embodiments, nail bin 4200 can be positioned in the middle of anvil block 4240 and staple cartridge channel 4230, wherein In at least one embodiment, lateral support component 4234 could attach to staple cartridge channel 4230.Move downward to press when anvil block 4240 Contracting warehouse 4210 and make at least in part staple 4220 deform when, as shown in Figure 144, the sidepiece of warehouse 4210 can laterally expand And push out lateral support component 4234.In at least one such embodiment, lateral support component 4234 could attach to storehouse Body 4210, and when warehouse 4210 laterally expands as mentioned above, lateral support component 4234 can be dismantled from warehouse 4210, such as Shown in Figure 144.In at least one embodiment, lateral support component 4234 can be using at least one adhesive（For example, fiber egg White and/or protein hydrogel）Adhere to warehouse 4210.With it is similar to the above, anvil block 4240 close when can only partially make staple 4220 deformations, wherein can be by advancing one or more sledges 4270 to complete staple 4220 through nail bin 4200 as shown in Figure 145 Shaping.Referring now to Figure 147 and Figure 148, in various embodiments, sledge 4270 can be cut component 4280 from nail bin 4200 Near-end is advanced to the distal end of nail bin 4200.In at least one such embodiment, cutting element 4280 may include cutting element or Knife 4283, the cutting element or knife 4283 may pass through tissue T and/or the warehouse 4210 that can compress and advance.In some enforcements In example, cutting element 4280 may include cam member 4282, and cam member 4282 can be pushed away along the outer surface of jaw 4230 and 4240 Enter and the jaw is moved or is held in place.In various embodiments, as consequence of the above, staple 4220 can be in tissue T While being cut open or at least substantially while being shaped to its net shape.In at least one such embodiment, sledge 4270 Distally can be positioned in relative to knife 4283 so that tissue T is just cut open when the propulsive units only in tissue is sutured completely.

Figure 147 and Figure 148 is referred again to, in various embodiments, sledge 4270 may include single slidable member, described Slidable member is advanced together by cutting element 4280.In at least one such embodiment, sledge 4270 can be accommodated in nail bin In 4200, and cutting element 4280 can be advanced in nail bin 4200 by percussion rod 4281 so that cutting element 4280 engages sledge 4270 and towards distally advance sledge 4270.In certain embodiments, each sledge 4270 can be connected with each other.In both cases any one In situation, each sledge 4270 may include angled surface or cam 4271, and the angled surface or cam 4271 can be carried Rise the staple 4220 alignd in staple line.In certain embodiments, angled surface 4271 can be with the shape of cutting element 4280 It is integrally formed.Figure 147 and Figure 148 is referred again to, at least one embodiment, each staple 4200 may include base portion and bizet 4229, at least one energy deformation element extends from base portion, and the overmolding of bizet 4229 is to the base portion and/or energy of staple 4200 Position at least a portion of deformation element and/or around described at least a portion.In various embodiments, for example this hat Portion 4229 can be directly driven by sledge 4270.More particularly, at least one embodiment, the energy of bizet 4229 of staple 4220 It is enough to cause in the case that no-fix has staple driver between the angled surface 4271 of sledge 4270 and bizet 4229, angulation The surface 4271 of degree can contact bizet 4229 and slide directly below in bizet 4229.In such embodiment, each bizet The 4229 angled or inclined surfaces for including at least one cooperation, the angled or inclined table of at least one cooperation Face can be engaged by the angled surface 4271 of sledge 4270 so that when sledge 4270 is in 4220 slid underneath of staple, cooperation into Angled surface can drive up staple 4220.

Referring now to Figure 146, in various embodiments, nail bin,（For example, nail bin 4300）May include the body that can be compressed 4310 and multiple staples 4320 for being positioned in the body 4310 that can be compressed.With it is similar to the above, nail bin 4300 may include flexibility Lateral supports 4334, the flexible lateral supports could attach to staple cartridge channel and/or adhere to the body that can be compressed 4310.In addition to person mentioned above, flexible lateral supports 4334 can be connected by one or more pillars or connecting elements 4335 It is connected to together, one or more of pillars or connecting elements 4335 can keep together lateral supports 4334.Make With in, connecting elements 4335 is prevented from or at least suppresses lateral supports 4334 prematurely to dismantle from warehouse 4310.At some In embodiment, connecting elements 4335 can be after nail bin 4300 be compressed by anvil block, and the connecting elements is by lateral supports 4334 Keep together.In such embodiment, lateral supports 4334 can resist the lateral expansion or displacement of the sidepiece of warehouse 4310. In certain embodiments, cutting element（Such as cutting element 4280）Cutting element 4280 can be worked as in warehouse 4310 towards distally During motion, cutting element can crosscutting connecting elements 4335.In at least one such embodiment, cutting element 4280 can be towards remote Side promotes one or more sledges（Such as sledge 4270）, to make staple 4320 shape against anvil block.The bootable cutting of sledge 4270 Blade 4283 so that cutting element 4280 will not crosscutting connecting elements 4335, until the staple 4320 of neighbouring connecting elements 4335 Till being fully formed or being at least shaped to Desired Height.In various scenarios, connecting elements 4335 is assisted with lateral supports 4334 Work can prevent or at least reduce the lateral movement of energy nail bin support member 4310 and while prevent from or at least reduce to be located in warehouse 4310 Staple 4320 lateral movement.In this case, connecting elements 4335 can be held in place staple 4320, until staple 4320 deform, and connecting elements 4335 can be then cut out discharging the sidepiece of warehouse 4310.As described above, lateral supports 4334 may be connected to staple cartridge channel, therefore after nail bin 4300 is implanted, lateral supports 4334 can be together with staple cartridge channel It is removed from operative site.In certain embodiments, lateral supports 4334 can be constituted and can be left on by the material that can be implanted into In operative site.In at least one embodiment, connecting elements 4335 can be positioned in the middle of warehouse 4310 and tissue T, and In connecting elements 4335 from after the dismounting of lateral supports 4334, connecting elements 4335 can keep implantation within a patient.At least In one such embodiment, connecting elements 4335 can be made up of the material that can be implanted into, and in certain embodiments, connecting elements 4335 can for example by constituting with the identical material of lateral support component 4334.In various embodiments, connecting elements 4335 and/or Lateral supports 4334 can be by the polyglycolic acid for example sold with trade name Vicryl（PGA）, PLA（PLA or PLLA）, it is poly- Lanthanum Isopropoxide（PDS）, polyhydroxyalkanoatefrom（PHA）, with trade name Monocryl sell Poliglecaprone 25（PGCL）、 Polycaprolactone（PCL）, and/or the flexible energy bio-absorbable such as the compound of PGA, PLA, PDS, PHA, PGCL, and/or PCL Material is constituted.In various embodiments, connecting elements may include the material sheet for connecting each lateral supports 4334.At certain In a little embodiments, nail bin may include the connecting elements of the top surface for extending through warehouse 4310 and the bottom table around warehouse 4310 Face and the connecting elements that extends.

Referring now to Figure 149, in various embodiments, nail bin may include staple（For example, staple 4420）, the staple can Including the Wire rod portion being inserted in crown moieties.In at least one embodiment, Wire rod portion can be by metal（Such as titanium and/or stainless Steel）And/or plastics（Such as PPDO（PDS）And/or polyglycolic acid（PGA））Constitute.In at least one embodiment In, crown moieties can be by metal（Such as titanium and/or stainless steel）And/or plastics（Such as PPDO（PDS）And/or it is poly- Glycolic（PGA））Constitute.In certain embodiments, the Wire rod portion of each staple 4420 may include base portion 4422 and from base portion 4422 extend can deform leg 4421, the crown moieties of each of which staple 4420 may include bizet 4429, and bizet 4429 can At least a portion of base portion 4422 is accommodated wherein.Referring now to Figure 150 A-150C, it is each portion for assembling each staple 4420 Point, during the leg 4421 of Wire rod portion can be inserted the opening 4426 in bizet 4429, its split shed 4426 can be by leg 4421 Guide into base compartment 4427.Wire rod portion can be also inserted in bizet 4429 so that leave base compartment 4427 and line in leg 4421 The base portion 4422 in material portion is entered in base compartment 4427.In at least one such embodiment, base compartment 4427 enables to work as base Portion 4422 enter base compartment 4427 when, Wire rod portion rotates in bizet 4429 so that staple leg 4421 point to upwards or at least Direction essentially upward.Figure 149 is referred again to, in various embodiments, bizet 4429 may include from hole 4425, from hole 4425 Staple leg 4421 can wherein be accommodated.

In various embodiments, to being described further above, surgical stapling device may include sledge 4470, and sledge 4470 can Traverse nail bin 4400 and staple cartridge channel 4430 and the staple 4420 accommodated towards in anvil block traveling warehouse 4410.In various situations In, sledge 4470 can move to the distal end of warehouse channel 4430 from the near-end of staple cartridge channel 4430, to be implanted into warehouse 4410 and staple 4420.In some cases, the regracting of sledge 4470 or the near-end of warehouse channel 4430 is returned to, and another nail bin 4400 can be inserted In entering warehouse channel 4430.Once new nail bin 4400 is positioned in warehouse channel 4430, then sledge 4470 can be advanced again towards distally. In various embodiments, surgical stapling device may include one or more latch-up structures, and one or more of latch-up structures can be No-fix prevents sledge 4470 from advancing towards distally again in warehouse channel 4430 in the case of having new nail bin 4400.Refer again to figure 149, at least one such embodiment, staple cartridge channel 4430 may include to lock shoulder 4439, and the locking shoulder is prevented from Or sledge 4470 is at least limited towards distally motion.More particularly, sledge 4470 can unless sledge 4470 by lift structure 4428 at least Shoulder 4439 is partly up lifted beyond, otherwise sledge 4470 adjoins shoulder 4439, and lift structure 4428 is for example in nail bin 4400 Extend between interior recent side staple 4420.In other words, when there is no recent side staple 4420 in new nail bin 4400, sledge 4470 cannot advance.Therefore, do not exist when there is used nail bin 4400 in warehouse channel 4430 or in warehouse channel 4430 and appoint During what nail bin 4400, sledge 4470 cannot be advanced in warehouse channel 4430.

Referring now to Figure 151, to being described further above, nail bin,（For example, nail bin 4500）Nail bin can be positioned in In passage 4530 and may include the warehouse 4510 that can be compressed, the multiple staples 4520 being positioned in warehouse 4510 and storehouse dish or Retainer 4580.In various embodiments, the warehouse 4510 that can be compressed may include outer layer 4511 and internal layer 4512, wherein at least In one embodiment, outer layer 4511 can in a sealing fashion surround internal layer 4512.In at least one such embodiment, outer layer 4511 Can extend between internal layer 4512 and storehouse dish 4580.In some other embodiments, outer layer 4511 can be only partially about internal layer 4512, and at least one such embodiment, outer layer 4511 and storehouse dish 4580 can collaboratively be surrounded or at least substantially wrapped Enclose internal layer 4512.In various embodiments, to being described further above, staple 4520 can be supported by storehouse dish 4580, wherein Storehouse dish 4580 may include to support one or more staples of staple 4520 to support passage.In certain embodiments, storehouse dish 4580 could attach to warehouse 4510, wherein at least one such embodiment, warehouse 4510 can be in the relative of storehouse dish 4580 Laterally compressed between the wall of side.In various embodiments, the side wall of storehouse dish 4580 can laterally support warehouse 4510, at least In one such embodiment, storehouse dish 4580 may include from bottom support 4583 to extend upwardly to or many in warehouse 4510 Individual wall or fin 4582.In at least one such embodiment, one or more slits or passage, institute are may include in warehouse 4510 Stating one or more slits or passage can accommodate wall 4582 and/or interlock with wall 4582.In various embodiments, wall 4582 can Partly or almost all extend through warehouse 4510.In at least one such embodiment, wall 4582 can be in staple 4520 Nail bin 4500 is extended longitudinally through between the first row and the second row of formation volume of staple 4520 of formation.

In various embodiments, warehouse 4510 and/or storehouse dish 4580 may include that cooperation retains structure, and the cooperation retains knot Structure can provide snap-fitted between storehouse dish 4580 and warehouse 4510.In certain embodiments, nail bin 4500 can be positioned in storehouse In passage 4530 so that storehouse dish 4580 position and/or be attached to warehouse channel 4530 against warehouse channel 4530.It is real at least one In applying example, storehouse dish 4580 can be removably coupled to warehouse channel 4530 so that compressed and stitched by anvil block 4540 in nail bin 4500 After the deformation of nail 4520, storehouse dish 4580 can be dismantled from warehouse channel 4530 and can be implanted together with warehouse 4510.At least one In such embodiment, storehouse dish 4580 can be by the polyglycolic acid for example sold with trade name Vicryl（PGA）, PLA（PLA or PLLA）, PPDO（PDS）, polyhydroxyalkanoatefrom（PHA）, with trade name Monocryl sell Poliglecaprone 25（PGCL）, polycaprolactone（PCL）, and/or the compound of PGA, PLA, PDS, PHA, PGCL, and/or PCL etc. can bio-absorbable Material constitute.In certain embodiments, surgical stapling device may also include firing lock and/or driver, the firing lock And/or driver can be in storehouse dish 4580 in staple cartridge channel 4530 and bottom driving surface middle slip, the bottom drives table Face can lift or project storehouse dish 4580 from warehouse channel 4530.In certain embodiments, warehouse 4510 can removably join It is connected to storehouse dish 4580 so that after nail bin 4500 is compressed by anvil block 4540 and staple 4520 deforms, warehouse 4510 can be from storehouse dish 4580 dismountings.In at least one such embodiment, storehouse dish 4580 can keep engaging warehouse channel 4530 in a position-stable manner so that storehouse Disk 4580 is removed together with warehouse channel 4530 from operative site.In certain embodiments, surgical stapling device may also include percussion Mechanism and/or driver, the firing lock and/or driver can drive table on warehouse 4510 in cartridge tray 4580 and bottom Face middle slip, the bottom driving surface can lift or project warehouse 4510 from storehouse dish 4580.It is such at least one In embodiment, nail bin 4500 may also include the staple driver in the middle of storehouse dish 4580 and staple 4520 so that work as percussion lock Structure towards distally slide when, staple driver and staple 4520 can be driven upwardly towards anvil block.In at least one such embodiment, Staple driver can be at least partially embedded in the warehouse 4510 that can be compressed.

In various embodiments, with it is similar to the above, nail bin 4500 may include latch-up structure, and the latch-up structure is prevented from Or cutting element is at least limited towards distally motion, unless be positioned with the nail bin 4500 not fired in staple cartridge channel 4530.At certain In a little embodiments, cartridge tray 4580 may include for example for being lifted up cutting element and exceeding it in staple cartridge channel 4530 The surface of locking surface.In there is no the situation including the nail bin 4500 of storehouse dish 4580 in warehouse channel 4530 wherein, structure is cut Part cannot be advanced.In at least one embodiment, in nail bin 4500 recent side staple and/or any other suitable staple can Including surface is lifted, cutting element can be lifted beyond locking surface by the lifting surface completely.Over and above what is described above or replace For mentioned above, each several part of nail bin 4500 can be made up of the material with different colours.In such embodiment, surgeon Can visually identify and when there is the nail bin for not firing and/or firing in staple cartridge channel 4530.In at least one such reality In applying example, the outer layer 4511 of warehouse 4510 can have the first color, and storehouse dish 4580 can have the second color, and staple cartridge channel 4530 can have the 3rd color.If surgeon sees the first color, surgeon may know that and be deposited in staple cartridge channel 4530 In the storehouse 4500 not fired；If surgeon sees the second color, surgeon may know that in staple cartridge channel 4530 exist The storehouse 4500 of percussion and need to remove remaining storehouse dish 4580；And if surgeon sees the 3rd color, then surgeon May know that any part that nail bin 4500 is not remained with warehouse channel 4530.

Referring now to Figure 152, in various embodiments, nail bin,（For example, nail bin 4600）May include to compress and can be implanted into Warehouse 4610 and multiple staples 4620 for being positioned in warehouse 4610.Warehouse 4610 may include outer layer 4611 and internal layer 4612.In certain embodiments, internal layer 4612 may include to be limited at multiple pits therein（Such as pit or chamber 4615）, institute Stating multiple pits can be conducive to collapsing for warehouse 4610.In at least one such embodiment, internal layer 4612 may include corrugated Or the dot matrix of honeycomb configuration, the dot matrix can bear compression stress or pressure, as long as the compression stress or pressure are less than specific Threshold value.When not less than threshold value, internal layer 4612 can be with regard to the compression stress or the pressure that are applied and with linear or at least base Linear rate deformation in sheet.After compression stress or pressure exceed threshold value, internal layer 4612 can due to compressive load quilt suddenly Crush to big deflection and collapse or bend.In various embodiments, the dot matrix of internal layer 4612 can be by being connectable to together Multiple subgrades 4612a constitute.In at least one embodiment, each subgrade 4612a may include multiple alternate ditches and ridge or Ripple, the plurality of alternate ditch can align with the alternate ditch of adjacent sublayers 4612a with ridge or ripple with ridge.It is such at least one In embodiment, the ditch of the first subgrade 4612a can be positioned so that adjacent with the ridge of the second subgrade 4612a；Similarly, the first subgrade The ridge of 4612a can be positioned so that adjacent with the ditch of the second subgrade 4612a.In various embodiments, adjacent subgrade 4612a can lead to Cross at least one adhesive（For example, fibrin and/or protein hydrogel）Adhere to each other and/or adhere to outer layer 4611.Figure 153 illustrate after warehouse 4610 has been collapsed and staple 4620 has deformed to capture against warehouse 4610 and keeps tissue T Nail bin 4600.

Referring now to Figure 154-156, in various embodiments, nail bin,（For example, nail bin 4700）May include to compress and energy The warehouse 4710 of implantation and the multiple staples 4720 being positioned in warehouse 4710.With it is similar to the above, warehouse 4710 may include outer Layer 4711 and internal layer 4712, wherein internal layer 4712 may include multiple subgrades 4712a.Equally with similar to the above, each subgrade 4712a Alternate ditch 4717 and ridge 4718 are may include, the alternate zastrugi can be mutually aligned to limit pit or chamber therebetween 4715.In at least one such embodiment, ditch 4717 and/or ridge 4718 can be along being parallel to each other and/or parallel to longitudinal axis The axis of line 4709 extends.In various embodiments, staple 4720 can align in multiple staple lines, and the plurality of staple line can Extend along axis being parallel to each other and/or parallel to longitudinal axis 4709.Figure 152 and Figure 153 is referred again to, is available for various In the embodiment of selection, the staple 4620 accommodated in warehouse 4600 can extend along axis, the axis across or perpendicular to by The axis that the ditch and ridge of subgrade 4612a is limited.Figure 154-156 are referred again to, staple 4720 can extend across ditch 4717 and ridge 4718, the wherein frictional force between staple 4720 and subgrade 4712a can be maintained at staple 4720 in warehouse 4710.In some realities In applying example, the plurality of subgrade 4712a can be by backing material and/or plastic material（Such as PPDO（PDS）With/ Or polyglycolic acid（PGA））Constitute, staple 4720 for example can be maintained at upright by the backing material and/or plastic material Orientation, and/or by staple 4720 be kept into relative to each other as shown in Figure 154 and Figure 155 align.Figure 156 is illustrated in warehouse 4710 collapse and staple 4720 deforms to capture against warehouse 4710 and keep the nail bin 4700 after tissue T.

Figure 154-156 are referred again to, in various embodiments, when warehouse 4710 is compressed, warehouse 4710 can be flexibly Or collapsed with elastic type.In at least one such embodiment, when warehouse 4710 is compressed, ditch 4717 and ridge 4718 are every Ripple formed in one subgrade 4712a can be by graduation or at least substantially by graduation, and this can make institute between ditch 4717 and ridge 4718 Collapse or at least substantially collapse in the chamber 4715 of restriction.In various scenarios, when removing compression stress or pressure from warehouse 4710 Afterwards, at least some of the warehouse or warehouse can again stretch flexibly or with elastic type.It is such at least one In embodiment, when warehouse 4710 is compressed, the connection between the ditch 4717 and ridge 4718 of adjacent sublayers 4712a can keep not receiving Damage or it is at least substantially intact so that after compression stress is removed from warehouse 4710, subgrade 4712a can bias ditch 4717 with Ridge 4718 makes it away from itself each other and therefore warehouse 4710 is stretched again at least in part.In certain embodiments, storehouse is worked as When body 4710 is compressed, it can deform in plastic manner or by conquassation, therefore compression stress or pressure are being removed from warehouse 4710 Afterwards, warehouse 4710 can not stretch again.Referring now to Figure 157, in certain embodiments, nail bin,（Such as nail bin 4800）Can wrap The warehouse 4810 of energy conquassation is included, the warehouse of the energy conquassation includes outer layer 4811 and internal layer 4812, and wherein internal layer 4812 may include ripple Line shape, honeycomb configuration dot matrix, the dot matrix has the multiple pits or chamber 4815 for limiting wherein.In various embodiments In, limiting the wall of the dot matrix of internal layer 4812 may include one or more reductions or thin cross section 4819, one or many It is capable of the wall of tolerance bound fixed point battle array and ruptures when warehouse 4810 is compressed in individual reduction or thin cross section 4819.In this situation In, when nail bin 4800 is implanted, warehouse 4810 can be by conquassation.

Referring now to Figure 158-160, in various embodiments, nail bin,（For example, nail bin 4900）For example may include warehouse 4910, warehouse 4910 includes outer layer 4911 and the multiple energy crushable members being positioned between the top and bottom of outer layer 4911 4912.Referring primarily to Figure 158 and Figure 159, nail bin 4900 may also include multiple staples 4920, and each of which staple 4920 can be determined Position is in energy crushable member 4912.More particularly, it is each can crushable member 4912 may include Part I 4912a, second Divide 4012b and Part III 4012c, the Part I 4912a, Part II 4012b and Part III 4012c can cooperate Ground limits wherein chamber 4915, and the chamber can accommodate staple 4920.In use, to being described further above, nail bin 4900 can be positioned in staple cartridge channel and can apply compression stress to tissue contacting surface 4919 with nail bin support member 4910.Work as tissue When contact surface 4919 is moved downward, energy crushable member 4912 can collapse.In this case, it is each can crushable member 4912 Part II 4912b can be collapsed in corresponding Part I 4912a；Similarly, the 3rd of each energy crushable member 4912 4912c is divided to be collapsed in corresponding Part II 4912b.When warehouse 4910 is compressed and energy crushable member 4912 is collapsed, Staple 4920 in energy crushable member 4912 can deform, as shown in Figure 160.In various embodiments, each unit that can collapse The Part II 4912b of part 4912 with corresponding Part I 4912a is frictionally engaged and/or can be press-fitted in corresponding first In the 4912a of part so that once the compression stress that energy crushable member 4912 applies is exceeded it is used for Part I 4912a and second Part 4912b is maintained at its extended position（Figure 159）In retention, then Part I 4912a and Part II 4912b can be opened Beginning relative to each other enters line slip.Similarly, the Part III 4912c of each energy crushable member 4912 can be carried and frictionally engaged Corresponding Part II 4912b and/or it is press-fitted in corresponding Part II 4912b so that once to can crushable member 4912 The compression stress of applying exceedes for Part II 4912b and Part III 4912c to be maintained at into its extended position（Figure 159）In Retention, then Part II 4912b and Part III 4912c can start relative to each other to enter line slip.

In many embodiments as herein described, multiple staples are may include in nail bin.In various embodiments, this staple Metal wire rod that can be by substantially U-shaped configuration is deformed into and with two staple legs is constituted.It is contemplated that wherein staple can be wrapped Include various configuration（For example it is joined together and two or more wire rods with three or more staple legs）Other Embodiment.In various embodiments, one or more wire rods for forming staple may include circle or at least substantially round Cross section.In at least one embodiment, staple wire may include any other suitable cross section, for example square and/or The cross section of rectangle.In certain embodiments, staple can be made up of plastic wire.In at least one embodiment, staple can be by The metal wire rod for being coated with plastics is constituted.In various embodiments, in addition to staple or as the replacement of staple, storehouse may include to appoint The securing member of what proper types.In at least one such embodiment, this securing member may include pivotable arm, and the arm exists Can be folded when being engaged by anvil block.In certain embodiments, it is available to be divided into two-part securing member.In at least one such reality In applying example, nail bin may include multiple first fastener portions, and anvil block may include multiple second fastener portions；When anvil block is against nail Storehouse and when being compressed, the second fastener portion is connected to the first fastener portion.In certain embodiments, as described above, can be in nail bin It is interior to advance sledge or driver to complete the forming process of staple.In certain embodiments, sledge or driving can be advanced in anvil block Device, connects to move downwardly to one or more formed parts with relative nail bin and staple or the securing member in nail bin Close.

In various embodiments described herein, nail bin may include four staple lines being stored therein.At least one In embodiment, four staple lines can be configured to two inner side staple lines and two outside staple lines.At least one this In class embodiment, inner side staple line and outside staple line can be positioned in the first side of the cutting element in nail bin or cutter slit On；Similarly, inner side staple line and outside staple line can be positioned on the second side of cutting element or cutter slit.In some realities In applying example, nail bin may not include cutting element slit wherein；However, as the replacement of nail bin slit, this kind of nail bin may include can be by The specified portions that cutting element cuts.In various embodiments, each inner side staple line can be placed in nail bin so that its with cut Cut component slit equidistantly or to be at least substantially equally spaced.Similarly, each outside staple line can be placed in nail bin, So that it equidistantly or is at least substantially equally spaced with cutting element slit wherein.In various embodiments, nail bin may include It is stored in nail bin more or less than four staple lines.In at least one embodiment, nail bin may include six staple lines.Extremely In few such embodiment, nail bin can include three staple lines on the first side of cutting element slit wherein, and in cutting structure Include three staple lines on second side of part slit.In certain embodiments, nail bin may include odd number staple line.For example, follow closely Storehouse can include two staple lines on the first side of cutting element slit wherein, and including three on the second side of cutting element slit wherein Individual staple line.In various embodiments, staple line may include with identical or at least substantially identical unshaped staple height Staple.In some other embodiments, one or more staple lines may include there is different unshaped seams from other staples The staple of staple height.In at least one such embodiment, such as the staple on the first side of cutting element slit wherein can have the One unshaped height, and the staple on the second side of cutting element slit wherein can have the second unshaped height, and described second is not Forming height is different from the described first height.

Referring now to Figure 161 A-161D, in various embodiments, the end effector of surgical stapling device may include：Storehouse is attached Socket part（For example, staple cartridge channel 5030）；Fastener cartridge（For example, nail bin 5000）, removably in staple cartridge channel 5030；With And jaw 5040, relatively position with nail bin 5000 and staple cartridge channel 5030.Nail bin 5000 may include can compression body 5010 and Multiple staples 5020, and/or any other suitable securing member being at least partially situated in energy compression body 5010.At least In one such embodiment, each staple 5020 may include base portion 5022 and from the upwardly extending leg 5021 of base portion 5022, Wherein at least a portion of leg 5021 can be embedded in warehouse 5010.In various embodiments, energy compression body 5010 can be wrapped Top surface or tissue contacting surface 5019 and lower surface 5018 are included, wherein lower surface 5018 can propping up against staple cartridge channel 5030 Support surface 5031 and position and supported by stayed surface 5031.With it is similar to the above, stayed surface 5031 for example may include to be defined Multiple support slits 5032 wherein（Figure 161 D）, it is the plurality of to support slit 5032 to accommodate and support staple 5020 Base portion 5022.In various embodiments, the end effector of surgical stapling device may also include reservation matrix（For example retain matrix 5050）, the reservation matrix can engage staple 5020 and retain tissue capture between matrix and staple 5020.At least In one such embodiment, retaining matrix 5050 can be removably attached to jaw 5040.In use, once nail bin 5000 In being positioned in staple cartridge channel 5030, then jaw 5040 and be attached to the reservation matrix 5050 of jaw 5040 can be towards the He of nail bin 5000 Staple cartridge channel 5030 is moved.In at least one embodiment, jaw 5040 can be moved downward along axis 5099 so that work as jaw During 5040 closure, jaw 5040 and staple cartridge channel 5030 are remained parallel to each other or at least substantially parallel.More particularly, extremely In few such embodiment, jaw 5040 can be closed, so as to when jaw 5040 is moved towards nail bin 5000, retain matrix 5050 tissue contacting surface 5051 parallel to or at least substantially parallel to the tissue contacting surface 5019 of nail bin 5000.

Referring now to Figure 161 A, in various embodiments, retaining matrix 5050 can be detachably fixed to jaw 5040, So that when reservation matrix 5050 is attached to jaw 5040, to retain and there is very little between matrix 5050 and jaw 5040（If If having）Relative motion.In at least one embodiment, jaw 5040 may include that one or more retain structure, one Or multiple reservation structures can will retain matrix 5050 and be held in place.In at least one such embodiment, retain matrix 5050 Can be snap-fitted and/or it be press-fitted in jaw 5040.In certain embodiments, matrix will be retained using at least one adhesive 5050 adhere to jaw 5040.In any case, jaw 5040 is moveable to and wherein retain the contact tissue T of matrix 5050 and group In knitting the position that T is positioned against the tissue contacting surface 5019 of nail bin 5000.When tissue T is located against nail by jaw 5040 During storehouse 5000, the energy compression body 5010 of the nail bin 5000 can be compressed or can not be compressed by it by jaw 5040.In two kinds of feelings In any one situation in shape, in various embodiments, the leg 5021 of staple 5200 can be not passed through the tissue of nail bin 5000 and connect The projection of tactile surface 5019, as shown in Figure 161 A.Additionally, it is same as shown in Figure 161 A, do not engage staple matrix 5050 is retained In the case of 5020, jaw 5040 can keep tissue T against energy compression body 5010.The tolerable surgery doctor of such embodiment Life repeatedly opens and closes jaw 5040, so that end effector is obtained for example in the case where tissue T is not damaged in Surgery Required location in position.It is contemplated, however, that other embodiments, wherein staple end 5023 can be in warehouse 5010 by anvil block 5040 From the projection of tissue contacting surface 5019 before compression.Referring now to Figure 161 B, once end effector is suitably positioned, then clamp Mouth 5040 can be moved downward towards staple cartridge channel 5030 so that energy compression body 5010 is compressed by anvil block 5040, and tissue is connect Tactile surface 5019 is pushed down relative to staple 5020.When tissue contacting surface 5019 is pushed down, staple leg 5021 End 5023 can pierce tissue contacting surface 5019 and pierce through at least a portion of tissue T.In this case, matrix is retained 5050 can be positioned in the top of staple 5020 so that retain the retaining holes 5052 of matrix 5050 and the end 5023 of staple leg 5021 Alignment is at least substantially alignd.

Referring now to Figure 161 C, when reservation matrix 5050 is pushed down on along axis 5099, the staple leg of staple 5020, 5021 can enter in retaining holes 5052.In various embodiments, the side wall of the engageable retaining holes 5052 of staple leg 5021.At some In embodiment, described in greater detail below, retaining matrix may include to extend in retaining holes 5052 and/or around retaining holes 5052 one or more holding members, one or more of holding members being capable of joint close nail leg 5021.In two kinds of situations In any one situation in, staple leg 5021 can be maintained in retaining holes 5052.In various scenarios, the end of staple leg 5021 End 5023 can enter in retaining holes 5052 and can carry the side wall for frictionally engaging holding member and/or hole 5052.When reservation square Battle array 5050 towards the base portion 5022 of staple 5020 promoted when, staple leg 5021 can be slided relative to side wall and/or holding member It is dynamic.As consequence of the above, force of sliding friction can be produced between staple leg 5021 and reservation matrix 5050, wherein this slip rubs Wiping power can resist reservation matrix 5050 and be inserted in staple 5020.In various embodiments, when reservation matrix 5050 is along staple During 5020 staple 5021 slide downward of leg, retain force of sliding friction between matrix 5050 and staple 5020 can for constant or It is at least substantially constant.In certain embodiments, due to such as staple leg 5021, retaining holes 5052, and/or reservation is extended to In hole 5052 and/or around the holding member change in size and geometry of retaining holes 5052；When reservation matrix 5050 is along staple During 5021 slide downward of leg, force of sliding friction can increase and/or reduce.In various embodiments, the energy distilled edition of nail bin 5000 Body 5010 also can be resisted in the reservation insertion staple 5020 of matrix 5050.More particularly, energy compression body 5010 can for example by bullet Property material constitute, the elastomeric material can to retain matrix 5050 apply drag；When the distance that energy compression body 5010 is compressed During increase, the drag increase.In at least one such embodiment, make the increase that drag is produced can be with due to warehouse 5010 The distance that warehouse 5010 is compressed is linearly proportional or at least substantially linearly proportional.In certain embodiments, due to Warehouse 5010 and make the increase that drag is produced can be proportional to geometric distance that warehouse 5010 is compressed ground.

In various embodiments, to being described further above, foot can be applied to jaw 5040 and reservation matrix 5050 Enough percussion forces, to overcome above-mentioned drag and frictional force.In use, retaining matrix 5050 can be placed relative to staple 5020 To any suitable depth.In at least one embodiment, retaining matrix 5050 can be relative to the base portion 5022 of staple 5020 A depth is seated to, so that two-layer or more layer tissues are secured together and generation compression stress or pressure in tissue. In various scenarios, including retain the tolerable surgeon of system of matrix 5050 and staple 5020 and retain matrix by selecting 5050 depth being placed select to tissue apply compression stress or pressure size.For example, retaining matrix 5050 can be towards seam The staple basis 5022 of nail 5020 are pushed down, until retaining the bottom phase that matrix 5050 is seated to and supports slit 5032 Till certain depth 5011, wherein more shallow depth 5011 can produce the higher compression stress or pressure applied to tissue T, and Deeper depth 5011 can produce the lower compression stress or pressure applied to tissue T.In various embodiments, it is applied to tissue The compression stress or pressure of T can be to retain the depth 5011 that is placed of matrix 5050 linearly proportional or at least substantially linearly It is proportional.In various scenarios, the compression stress or pressure for being applied to tissue T may depend on positioned at reservation matrix 5050 and nail bin The thickness of the tissue T between 5020.More particularly, for given distance 5011, compared with thick tissue T presence than relatively thin group The presence for knitting T produces higher compression stress or pressure.

In various scenarios, to being described further above, surgeon can adjust and retain what matrix 5050 was placed Thicker and/or relatively thin tissue of the depth to cause to be located in end effector, and in the mode unrelated with tissue thickness to group Knit T and apply specific or predetermined pressure.For example, when relatively thin tissue T is fastened, surgeon can will retain matrix 5050 and pacify Put to shallower depth 5011, or deeper depth 5011 is seated to when the tissue T of fastening thicker, so as in tissue Reach identical or at least substantially identical compression stress.In certain embodiments, to being described further above, surgeon Optionally determine the size for being pointed to retain the compression stress that the tissue T between matrix 5050 and nail bin 5010 applies.Each In planting situation, surgeon can retain matrix 5050 and engage with staple 5020, and be positioned to matrix 5050 is retained and staple 5020 first distance of base portion 5022, to apply the first compression pressure to tissue.Alternatively, surgery doctor Life can will retain matrix 5050 and be positioned to and the second distance of base portion 5022, and the second distance is shorter than first distance, To be applied more than the second compression pressure of first pressure to tissue.Alternatively, surgeon can will retain square Battle array 5050 is positioned to base portion 5022 at a distance of the 3rd distance, and the 3rd distance is shorter than the second distance, to apply to tissue Plus more than the 3rd compression pressure of second pressure.In various embodiments, including the fastening of matrix 5050 and staple 5020 is retained System can allow that surgeon applies the compression pressure of wide scope to target tissue.

Referring now to Figure 161 D, in various embodiments, staple leg 5021 may pass through reservation matrix 5050 and be inserted into, and make Obtain staple leg top 5023 and extend to the top face for retaining matrix 5050.Figure 161 C are referred again to, at least one embodiment In, jaw 5040 may also include and be limited at mesopore therein 5042, and the mesopore can work as staple leg end 5023 and pass through Staple leg end 5023 is accommodated when retaining the retaining holes 5052 in matrix 5050.In at least one such embodiment, mesopore 5042 can align with retaining holes 5052 so that not contact jaw 5040 of leg 5021.In various embodiments, mesopore 5042 can With enough depth so that no matter why retaining the distance that is placed of matrix 5050, the not contact jaw of staple leg 5021 5040.Referring now to Figure 161 D, after retaining matrix 5050 and engaging with staple 5020 and be placed to desired location, nail bin is logical Road 5030 and jaw 5040 can be moved away from tissue T.More particularly, staple cartridge channel 5030 can be torn open from the nail bin 5000 being implanted into Unload, and anvil block 5040 can be dismantled from the reservation matrix 5050 being implanted into.When jaw 5040 is advanced away from matrix 5050 is retained And staple support member 5032 away from staple basis 5022 when advancing, although jaw 5040 and staple cartridge channel 5030 are no longer to retaining Matrix 5050 and base portion 5022 provide support, but still can keep retaining the distance between bottom of matrix 5050 and base portion 5022 5011.In various embodiments, although the warehouse 5010 for being compressed and/or the tissue T compressed apply to retaining matrix 5050 Bias force, but the stiction between staple leg 5021 and reservation matrix 5050 can be enough to keep reservation matrix 5050 just Position.In at least one such embodiment, warehouse 5010 can be made up of elastomeric material, and the elastomeric material when compressed can be right Retain matrix 5050 and staple 5020 and apply elastic bias force so that the elastic bias force be propulsive reservation matrix 5050 and Staple 5020 is so that it separates, but this motion is by the right of the frictional engagement between staple leg 5021 and reservation matrix 5050 It is anti-.

In various embodiments, as described above, retaining matrix may include multiple retaining holes, each of which retaining holes can be Wherein accommodate the leg of securing member.In at least one embodiment, referring now to Figure 162, there is shown with and retain matrix 5150 A part, the part may include the retaining holes 5152 limited by periphery 5156.In various embodiments, the periphery 5156 in hole 5152 May include circular or at least substantially circular profile and/or any other suitable profile.In certain embodiments, square is retained Battle array 5150 may include one or more holding members（Such as holding member 5153）, one or more of holding members extend to In hole 5152 and when can work as in fastener leg patchhole 5152, the hole 5152 engages the fastener leg.At least one In individual such embodiment, each holding member 5153 may include towards central axis 5159（That is, towards the center in hole 5152）Inwardly prolong The cantilever stretched.In various embodiments, each cantilever may include first end and the second end, and the first end is attached to guarantor Matrix body 5158, the second end is stayed to form the periphery 5156 of retaining holes 5152.In certain embodiments, retaining holes 5152 Periphery 5156 can be limited by the first diameter or width, and fastener leg can be limited by Second bobbin diameter or width, wherein institute Stating Second bobbin diameter can be more than first diameter.In at least one such embodiment, fastener leg can contact reservation structure In part 5153 one or more and bend it, so as to fastener leg insertion retaining holes 5152 in when make retaining holes 5152 Diameter increase.In certain embodiments, to being described further above, the periphery that fastener leg is limited can be more than guarantor Box out 5152 periphery 5156 so that when fastener leg insertion periphery 5156 in when, fastener leg expands can periphery 5156 Exhibition.

Figure 162 is referred again to, in various embodiments, hole 5152 can be limited by energy deformation element 5153, each of which energy Deformation element 5153 can relative to or independently of other can deformation elements 5153 bend.In at least one such embodiment, Adjacent energy deformation element 5153 can be separated by slit 5154, and the slit can allow each energy deformation element 5153 relative to it It can the flexing of deformation element 5153.In certain embodiments, each slit 5154 may include to be located at and retain in matrix body 5158 First end 5155, the second end that is open into retaining holes 5152 and between first end 5155 and the second end The constant or at least substantially constant width for extending.In various other embodiments, the width of each slit 5154 can not Unanimously, and width of each slit 5154 between its first end and the second end can increase and/or reduce.In some realities In applying example, the first end 5155 of slit 5154 may include enlarging section（Such as rounded portions）, the enlarging section can 1）To be attached to The base portion for retaining the energy deformation element 5153 of matrix body 5158 provides tension force release；And 2）There is provided can deform structure for increase The flexible device of part 5153.In various embodiments, the geometry of energy deformation element 5153 and/or slit 5154 can be selected It is selected to provide desired flexibility for energy deformation element 5153.In certain embodiments, for example slit 5154 can be lengthened out, to be formed Longer energy deformation element 5153, the longer energy deformation element is more scratched than the energy deformation element 5153 with short length Property.In at least one embodiment, the width of each energy deformation element 5153 can be selected to its and provide desired flexibility.More Specifically, the energy deformation element with relatively thin width is more flexible than the energy deformation element with thicker width.Join again See Figure 162, in certain embodiments, the first end for being attached to reservation matrix body 5158 of the cantilever of energy deformation element 5153 The second end of cantilever can be wider than.In at least one such embodiment, cantilever can be between its first end and the second end It is tapered in linear or at least substantially linear mode.

Figure 162 is referred again to, in various embodiments, retaining matrix body 5158 may include with tissue contacting surface 5151 and the flat or at least substantially flat material sheet of top surface 5157.In at least one such embodiment, contact tissue Surface 5151 can be parallel to each other with top surface 5157 or at least substantially be parallel to each other.In various embodiments, it is each to deform structure Part 5153 may include that Part I 5153a and Part II 5153b, wherein Part I 5153a can be extended in a first direction, and And Part II 5153b can extend along different directions or second direction.In at least one such embodiment, retain matrix body 5158 can limit plane, and the Part I 5153a of energy deformation element 5153 can be located in this plane.In various embodiments In, the Part II 5153b of energy deformation element 5153 can angularly extend relative to Part I 5153a.At least one In such embodiment, Part II 5153b can extend along the direction away from the top surface 5157 for retaining matrix body 5158, and In some embodiments, Part II 5153b can be assembled towards the central axis 5159 of retaining holes 5152.In any case, each In kind of embodiment, when Part II 5153b can work as fastener leg and be inserted into through Part II 5153b, Part II 5153b can bend away from central axis 5159.Enforcement in the insertion retaining holes 5152 of staple leg 5021 of staple 5020 wherein In example, energy deformation element 5153 can be along the Direction distortion of the base portion 5122 generally away from staple 5120.Therefore, in some embodiments In, can deformation element 5153 can be along identical with the direction that staple leg 5021 is inserted into or at least substantially identical general direction is scratched It is bent.

Figure BD is referred again to, in various embodiments, the Part II 5153b of energy deformation element 5153 for example can be wrapped each Include sharp top, when the sharp top can work as staple leg 5021 and be inserted, the top is against staple leg 5021 Enter line slip.If the sharp tips of Part II 5153b also can staple leg 5021 in opposite direction（That is, will be from retaining holes 5052 directions for removing staple leg 5021）It is pulled, then the sharp tips are engaged into staple leg 5021.In some situations In, Part II 5153b can be tilted more than 90 degree of angle relative to the side of staple leg 5021, therefore when staple leg 5021 is subject to When tending to from retaining holes 5052 withdrawing from the power of staple leg 5021, Part II 5153b can dig or be dug into staple leg 5021 Bian Zhong.In certain embodiments, staple leg 5021 can in its surface include impression and/or chamber（Such as micro-indentations）, the pressure Trace and/or chamber for example can wherein accommodate the end of energy deformation element 5053.In at least one such embodiment, work as opposite joint When nail leg 5021 applies to withdraw from power, the end of energy deformation element 5053 can be confined in or be dug in the impression of staple leg 5021. In various embodiments, the result in staple leg 5021 is dug into as Part II 5153b, is to remove staple from retaining holes 5022 Leg 5021 and power only Part II 5153b can be seated in staple leg 5021 the deeper inside that acts on and increase removes staple leg 5021 desired power.Further, since Part II 5153b is inclined upwardly, therefore at least one embodiment, Part II 5153b can be more allowed in the insertion retaining holes 5152 of staple leg 5021 and withdrawing from more resistant to staple leg 5021.Therefore, at least one In individual embodiment, staple leg 5021 is inserted into desired power in retaining holes 5022 and is smaller than from retaining holes 5022 removing staple leg 5021 desired power.In various embodiments, the desired power of staple leg 5021 is for example removed from retaining holes 5022 comparable by seam Desired power about 50% in the insertion retaining holes 5022 of nail leg 5021.In various other embodiments, for example, remove the phase of staple leg 5021 The power of prestige is than the desired power about 10% of insertion staple leg 5021 to about between 100%.In certain embodiments, staple is for example removed The desired power of leg 5021 can be about 100%, about 150%, about the 200% of the desired power of insertion staple leg 5021, and/or stitch than insertion The desired power about 200% of nail leg 5021.

Figure 162 is referred again to, in certain embodiments, Part II 5153b can circumferentially be arranged around hole 5152 and can Pit is limited between Part II 5153b and hole 5152.More particularly, Part II 5153b can limit pit 5160, recessed When hole 5160 can work as fastener leg and be inserted in retaining holes 5152, pit 5160 accommodates the end of fastener leg.Each In planting embodiment, the Part II 5153b of energy deformation element 5153 may include annular or at least substantially annular profile, institute Stating profile for example can collaboratively limit the annular of pit 1560 or at least substantially annular profile.In at least one such reality In applying example, Part II 5153b can limit taper or truncated cone shape pit.In various embodiments, pit can be by fitness number Purpose energy deformation element（Such as four can deformation element 5153（Figure 162）, six can deformation element 5153（Figure 163）Or eight Can deformation element 5153（Figure 164））Limit.Referring now to Figure 165, in certain embodiments, retain matrix（For example retain matrix 5250）Energy deformation element for example can be formed cone shape or at least substantially for cone shape.In various embodiments, protect Matrix 5250 is stayed for example to may include multiple retaining holes（Such as retaining holes 5252）, the plurality of retaining holes can limit by periphery 5256 It is fixed.In various embodiments, periphery 5256 may include polygonal or at least substantially for polygonal profile and/or other are suitable Suitable profile.In certain embodiments, retaining matrix 5250 may include one or more holding members（Such as holding member 5253）, when one or more of holding members are extended in hole 5252 and can worked as in fastener leg patchhole 5252, institute State hole 5252 and engage the fastener leg.In at least one such embodiment, each holding member 5253 may include towards center Axis 5259（That is, towards the center in hole 5252）The cantilever for extending internally.In various embodiments, each cantilever may include first end Portion and the second end, the first end is attached to reservation matrix body 5258, and the second end forms retaining holes 5252 Periphery 5256.In certain embodiments, the periphery 5256 of retaining holes 5252 can be limited by the first diameter or width, and securing member Supporting leg can be limited by Second bobbin diameter or width, wherein the Second bobbin diameter can be more than first diameter.It is such at least one In embodiment, fastener leg can contact one or more in holding member 5253 and bend it, so as in securing member Increase the diameter of retaining holes 5252 when in supporting leg insertion retaining holes 5252.In certain embodiments, to carrying out above further Description, the periphery that fastener leg is limited can be more than the periphery 5256 of retaining holes 5252 so that when fastener leg insertion week When in side 5256, fastener leg extends can periphery 5256.

Figure 165 is referred again to, in various embodiments, hole 5252 can be limited by energy deformation element 5253, each of which energy Deformation element 5253 can relative to or independently of other can deformation elements 5253 bend.In at least one such embodiment, Adjacent energy deformation element 5253 can be separated by slit 5254, slit 5254 can allow it is each can deformation element 5253 relative to Other can the flexing of deformation element 5253.In various embodiments, retaining matrix body 5258 may include with tissue contacting surface 5251 and the flat or at least substantially flat material sheet of top surface 5257.In at least one such embodiment, contact tissue Surface 5251 can be parallel to each other with top surface 5257 or at least substantially be parallel to each other.In various embodiments, it is each to deform structure Part 5253 may include that Part I 5253a and Part II 5253b, wherein Part I 5253a can be extended in a first direction, and And Part II 5253b can extend along different directions or second direction.In at least one such embodiment, retain matrix body 5258 can limit plane, and the Part I 5253a of energy deformation element 5253 can be located in this plane.In various embodiments In, the Part II 5253b of energy deformation element 5253 can angularly extend relative to Part I 5253a.At least one In such embodiment, Part II 5253b can extend along the direction away from the top surface 5257 for retaining matrix body 5258, and In some embodiments, Part II 5253b can be assembled towards the central axis 5259 of retaining holes 5252.In any case, each In kind of embodiment, when Part II 5253b can work as fastener leg and be inserted into through Part II 5253b, Part II 5253b can bend away from central axis 5259.Figure 165 is referred again to, in certain embodiments, Part II 5253b can be surrounded Hole 5252 circumferentially arranges and can limit pit between Part II 5253b and hole 5252.More particularly, Part II 5253b can limit pit, and when the pit can work as fastener leg and be inserted in retaining holes 5252, the pit accommodates fastening The end of part supporting leg.In various embodiments, can the Part II 5253b of deformation element 5253 can for example limit polygon or extremely Polygonal pit is substantially less.In various embodiments, pit can be by the energy deformation element of suitable number（For example can limit Foursquare four can deformation element 5253（Figure 165）, can limit six of hexagon can deformation elements 5253（Figure 166）Or Octagonal eight can be limited can deformation element 5253（Figure 167））Limit.

Referring now to Figure 168, in various embodiments, retain matrix（For example, matrix 5350 is retained）Can be by flat or extremely Few substantially flat material（For example, titanium and/or stainless steel）Thin slice is formed.In at least one such embodiment, one can be passed through Individual or multiple punching courses form multiple holes 5352 in the body 5358 for retaining matrix 5350.Material sheet can be positioned in punching In compression mould, the mould can stamp out some parts of material when activating, to form such as slit 5354, slit 5354 hole 5355, and/or the periphery 5356 of retaining holes 5352.Stamping mold can also bend to energy deformation element 5353 suitable Suitable configuration.In at least one such embodiment, stamping mold can make Part II 5353b along broken line 5353c relative to A part of 5353a is upwardly-deformed.Referring now to Figure 169, in various embodiments, retain matrix（For example retain matrix 5450）Can Including multiple retaining holes 5452.With it is similar to the above, the periphery 5456 of each retaining holes 5452 can be by by between slit or slit 5454 The multiple energy deformation elements 5453 for separating are limited.In at least one such embodiment, the entirety of each energy deformation element 5453 Can be bent upwards, including the free end of the cantilever of energy deformation element 5453 periphery 5456 can be limited.In various enforcements In example, retaining matrix 5450 may include to surround or at least substantially about multiple holes 5455 of retaining holes 5452.At least one In such embodiment, hole 5455 can surround or surround by can deformation element 5453 cantilever the periphery that limits of fixing end and arranged Arrange circular array.In certain embodiments, each hole 5455 may include circular or at least substantially circle periphery and/or appoint What its suitable periphery.In use, hole 5455 can 1）To be attached to the energy deformation element 5453 for retaining matrix body 5458 Base portion provide tension force release；And 2）There is provided for the flexible device of increase energy deformation element 5453.In various embodiments In, it is more flexible that larger hole 5455 can enable deformation element 5453 compared with less hole 5455.Additionally, closer to can deform The hole 5455 of component 5453 can provide bigger flexibility compared with farther hole 5455.

Referring now to Figure 170, in various embodiments, retain matrix（For example, matrix 5550 is retained）May include multiple guarantors Box out 5552.Each retaining holes 5552 may each comprise elongated slot 5554, and the elongated slot has the circular of amplification or at least base Circular end 5555 in sheet.In at least one such embodiment, end 5555 can be limited by the diameter for being wider than slit 5554. In certain embodiments, elongated slot 5554 and end 5555 can position and/or between two parties along longitudinal axis 5559.In various enforcements In example, slit 5554 and end 5555 can limit two relative lugs 5553, and described two relative lugs 5553 can connect The leg of securing member is closed, and when fastener leg is inserted into through lug 5553, described two relative lugs 5553 Can bend.In at least one embodiment, the end 5555 with bigger girth or diameter can limit longer lug 5553, the lug 5553 is more flexible than the lug 5553 that the end 5555 with less girth or diameter is limited. In various embodiments, end 5555 can have identical girth and diameter, and at least one such embodiment, it is each convex Piece 5553 can be with regard to vertical with longitudinal axis 5559 or at least substantially vertical axisymmetrical.Alternatively, end End 5555 can have different girth and/or diameter, wherein at least one embodiment, each lug 5553 can be not in relation to it Axisymmetrical.In at least one this alternative embodiment, when fastener leg is inserted into through retaining holes 5552 When, lug 5553 can be around its axis distortion.Referring now to Figure 171, in various embodiments, retain matrix（For example retain matrix 5650）May include multiple retaining holes 5652.Each retaining holes 5652 may each comprise elongated slot 5654, and the elongated slot includes circle Shape or at least substantially circular end 5655.In at least one such embodiment, elongated slot 5654 and end 5655 can Position along longitudinal axis 5659 and/or between two parties.In various embodiments, each end 5655 can be by the width with slit 5654 Identical or at least substantially identical diameter restriction.

Referring now to Figure 172, in various embodiments, retain matrix（For example, matrix 5750 is retained）May include multiple guarantors Box out 5752.Each retaining holes 5752 may include the multiple slits with enlarged distal end 5755（Such as slit 5754）.At least In one such embodiment, slit 5754 and end 5755 can position and/or between two parties along longitudinal axis 5759.In various embodiments In, axis 5759 can along be mutually perpendicular to or across direction extend.In certain embodiments, slit 5754 and end 5755 can examples Such as limit four lugs 5753, four lugs 5753 can jointing fastener supporting leg, and when fastener leg is through protecting When boxing out 5752 and being inserted into, four lugs 5753 bend.In at least one embodiment, each lug 5753 can Including triangle or at least substantially for triangle configuration（Such as equilateral triangle）.Referring now to Figure 173, it is various its In its embodiment, retain matrix（For example retain matrix 5850）May include multiple retaining holes 5852.Each retaining holes 5852 can be wrapped Include the multiple slits with end 5855（Such as slit 5854）, wherein slit 5854 and end 5855 can be along longitudinal axis 5859 Position and/or placed in the middle.In various embodiments, axis 5859 can along be mutually perpendicular to or across direction extend.In some enforcements In example, slit 5854 and end 5855 can limit lug 5853, lug 5853 can jointing fastener supporting leg, and work as securing member When supporting leg is inserted into through retaining holes 5852, lug 5853 bends.In at least one embodiment, each lug 5853 May include the profile of arch.More particularly, different from the sharp end shown in Figure 170, each lug 5853 may include curved Bent end, the end being capable of contact securing member supporting leg.

Referring now to Figure 174, in various embodiments, retain matrix（For example, matrix 5950 is retained）May include multiple guarantors Box out 5952.Each retaining holes 5952 may include multiple slits（Such as slit 5954）, each of which slit 5954 can be along axis 5959 extend and/or placed in the middle.In various embodiments, axis 5959 can transversely to one another, and at least one such enforcement Example in, axis 5959 can be disposed so that all axis 5959 extend through the center of retaining holes 5952 and it is equally spaced from each other ground or At least substantially it is equally spaced.In at least one embodiment, each slit 5954 may include towards retaining holes 5952 The openend at center and positioned at slit 5954 opposed ends the second end or blind end 5955.With it is similar to the above, it is narrow Groove 5954 and end 5955 can for example limit three lugs 5953, three lugs 5953 can jointing fastener supporting leg, and And when fastener leg is inserted into through retaining holes 5952, three lugs 5953 bend.In various embodiments In, each lug 5953 may include the arch configuration extended between the adjacent end 5955 of slit 5954.Referring now to figure, 175, in various embodiments, retain matrix（For example retain matrix 6050）May include multiple retaining holes 6052.Each retaining holes 6052 may include lug 6053, lug 6053 can jointing fastener supporting leg, and when fastener leg is inserted into retaining holes When in 6052, lug 6053 bends.In at least one such embodiment, lug 6053 may include to be fixed to reservation matrix The base portion of body 6058 and including arch or the free end of curved profile 6056, the free end being capable of contact securing member Leg.In certain embodiments, fastener leg can be the staple leg being made up of circular wire rod, wherein the profile 6056 for bending can Match with the crooked outer surface of circular wire rod or at least substantially match.

Figure 175 is referred again to, in various embodiments, retaining matrix body 6058 may include multiple slits 6054 and hole 6055, the plurality of slit 6054 and hole 6055 can limit the various pieces of lug 6053 and retaining holes 6052.At least one In individual embodiment, lug 6053 may include rectangular configuration, and the rectangular configuration includes parallel or at least substantially parallel side. Referring now to Figure 176, in certain embodiments, retain matrix（For example retain matrix 6150）May include multiple retaining holes 6152. Each retaining holes 6152 may include lug 6153, the lug can jointing fastener supporting leg, and when fastener leg is inserted into When in retaining holes 6152, the lug bends.In at least one such embodiment, lug 6153 may include to be fixed to reservation The base portion of matrix body 6158 and including arch or the free end of curved profile 6156, the free end being capable of contact securing member Supporting leg.In various embodiments, retaining matrix body 6158 may include multiple slits 6154 and hole 6155, the plurality of slit 6154 and hole 6155 can limit the various pieces of lug 6153 and retaining holes 6152.In at least one embodiment, lug 6153 may include tapered configuration, and the tapered configuration includes the side of arch.In at least one such embodiment In, lug 6153 can geometrically be tapered, for example, cause base portion to be wider than free end.

In various embodiments, as described above, fastening system may include multiple staples, the plurality of staple is included through guarantor The staple leg for staying the multiple retaining holes in matrix and being inserted into.In certain embodiments, following article is more fully described, staple During the first jaw can be maintained at, and retain matrix and can be maintained in the second jaw, wherein the first jaw and the second jaw At least one of can move towards another one.In various scenarios, the staple in the first jaw can be fixed in wherein, make When proper reservation matrix is engaged with staple leg, staple leg aligns with retaining holes.Referring to Figure 177 and Figure 178, in some embodiments In, closure system may include the nail bin 6200 for example in the first jaw of surgical stapling device and for example stitch positioned at surgery Reservation matrix 6250 in second jaw of clutch.Referring now to Figure 184 and Figure 185, to being described further above, retain Matrix 6250 may include multiple retaining holes 6252, and each of which retaining holes 6252 may include by one or more deflection components 6253 peripheries 6256 for limiting.In at least one such embodiment, to being described further above, for limiting each hole 6252 deflection component 6253 can limit pit 6201.In various embodiments, each pit 6201 may include for example to bend And/or concave surface, the bending and/or concave surface for example can be unjustified with retaining holes 6252 in staple leg and be connect first The end of staple leg is guided into hole 6252 in the situation of tactile deflection component 6253 and/or tissue contacting surface 6251.

In various embodiments, to being described further above, fastening system may also include multiple staples 6220, described The staple leg 6221 that multiple staples 6220 are inserted into including the retaining holes 6252 that may pass through in reservation matrix 6250.At least one In individual such embodiment, each staple 6220 may include for example substantially U-shaped cross section configuration, and the configuration includes base portion 6222, The staple leg 6221 can be upwardly extended from base portion 6222.Referring now to Figure 180 and Figure 181, in various embodiments, retain square Retaining holes 6252 in battle array 6250 can be aligned to such as two parallel or at least substantially parallel stringers, and the stringer can Extend along the longitudinal axis for retaining matrix or parallel to the longitudinal axis.In certain embodiments, the retaining holes in the first row 6252 can offset or stagger arrangement relative to the retaining holes 6252 in the second row.In at least one such embodiment, each staple 6220 may include the first staple leg 6221 and the retaining holes 6252 positioned at the second row in the retaining holes 6252 of the first row In the second staple leg 6221, wherein as a result, base portion 6222 can along across retain matrix 6250 longitudinal axis direction Extend.In at least one such embodiment, staple 6220 can be parallel to each other or at least substantially be parallel to each other.More specifically Say, the base portion 6222a of such as staple 6220a can parallel to or at least substantially parallel to the base portion 6222b of staple 6220b, institute State staple 6220b base portion 6222b can parallel to or at least substantially parallel to the base portion 6222c of staple 6220c.At least one In individual embodiment, the plane that the staple leg 6221a of such as staple 6220a is limited can parallel to or at least substantially parallel to seam The plane that the staple leg 6221b of nail 6220b is limited, and the plane that the staple leg 6221b of staple 6220b is limited can be parallel In or at least substantially parallel to the plane that limited of staple leg 6221 of staple 6220c.

Referring now to Figure 177 and 179, in various embodiments, nail bin 6200 may include multiple staples 6220 and including Multiple alignment guides（For example, slit, groove, and/or hole）Alignment matrix 6260, the plurality of alignment guide can be right Neat staple 6220.In various scenarios, alignment matrix 6260 was enabled to before the joint close nail leg 6221 of matrix 6250 is retained, The staple leg 6221 of staple 6220 aligns with the retaining holes 6252 in matrix 6250 is retained.Referring now to Figure 182 and Figure 183, In various embodiments, alignment matrix 6260 may include multiple alignment holes 6262, and the plurality of alignment hole 6262 can closely hold Receive the staple leg 6221 of staple 6220.In at least one such embodiment, each staple 6220 may include base portion 6222 and From two staple legs 6221 that base portion 6222 extends, the wherein base portion 6222 of staple 6220 can surround the bottom for retaining matrix 6260 Surface 6264 extends, and staple leg 6221 may pass through alignment hole 6262 and upwardly extend.In certain embodiments, each alignment Hole 6262 can be circular or at least substantially circular, and limit the diameter in alignment hole 6262 can be equal to or slightly greater than through The diameter of the staple leg 6221 for wherein extending.In various embodiments, alignment matrix 6260 may also include the structure of multiple projections Part 6263, the plurality of raised component 6263 can upwardly extend from the top surface 6261 of alignment matrix 6260 and around or at least portion Divide ground around alignment hole 6262.In certain embodiments, raised component 6263 can provide longer alignment hole 6262, wherein In various situations, longer hole 6262 may compare the alignment that short hole 6262 better controls over staple leg 6221.

In use, in various embodiments, the first jaw for supporting nail bin 6200 can be located at the tissue that will be sewn On side, and the second jaw for retaining matrix 6250 is supported to be positioned on the opposite side of tissue.In certain embodiments, Once jaw is properly positioned relative to tissue, then the second jaw and reservation matrix 6250 can be moved towards nail bin 6200.Each In planting embodiment, when staple leg 6221 is inserted into through the retaining holes 6252 for retaining matrix 6250, retain matrix 6250 Tissue contacting surface or lower surface 6251 can contact tissue and will organize the tissue contacting surface for being pressed against alignment matrix 6260 Or on top surface 6261.In various other embodiments, as described in more detail below, nail bin 6200 can also for example include being located at The top of top surface 6261 of alignment matrix 6260 and the energy nail bin support member of accessible tissue.Figure 179 and Figure 183 is referred again to, at certain In a little embodiments, alignment matrix 6260 may also include and be limited at one or more of holes 6203；When alignment matrix 6260 When positioning against tissue, one or more of holes 6203 can wherein accommodate a part for tissue.Can compress wherein Warehouse is located at the top of alignment matrix 6260 and/or against in the embodiment of alignment matrix 6260, when warehouse is compressed, can compress A part for warehouse can be in access aperture 6203.Similarly, retaining matrix 6250 may include multiple holes 6202, the plurality of hole 6202 Reservation matrix 6250 can be worked as when positioning against tissue, the plurality of hole 6202 accommodates wherein at least a portion of tissue.

To being described further above, when the staple leg 6221 of staple 6220 is through the retaining holes for retaining matrix 6250 6252 and when being inserted into, the top of staple leg 6221 can be from the top surface 6257 for retaining matrix 6250 upwardly.In various situations In, as described above, the end of staple leg 6221 can keep not bending after being inserted into through retaining holes 6252.Referring now to Figure 186-189, in certain embodiments, including the fastening system of nail bin 6200 and reservation matrix 6250 may include multiple protectiveness Cap or covering（Such as cap 6270）, the plurality of protectiveness cap or covering can mount to be projected on the top of reservation matrix 6250 Staple leg 6221.In various embodiments, each cap 6270 can completely or at least partially cover the sharp of staple leg 6221 End so that the sharp tips will not contact the tissue being adjacent.Referring now to Figure 189, at least one embodiment, Each cap 6270 may include to be limited at hole therein 6271, and the hole can wherein be closely received the end of staple leg 6221 End.In various embodiments, cap 6270 can be by elastomeric material（Such as siloxanes, polyisoprene, Sanoprene, and/or day Right rubber）Constitute.In at least one embodiment, the girth or diameter in hole 6271 is smaller than the staple leg 6221 being inserted Girth or diameter.In at least one such embodiment, hole 6271 in protectiveness cap 6270 is expansible accommodating seam wherein Nail leg 6221.In various alternative embodiments, cap 6270 may not include hole, and the end of staple leg 6221 can work as During the insertion cap 6270 of leg 6221, the cutaway tip cap 6270.In any case, in various embodiments, each cap 6270 can be seated on staple leg 6221, until the base portion 6272 of cap 6270 is adjoined or the neighbouring top surface for retaining matrix 6250 6257 and position till.In various scenarios, cap 6270 enables to it and is closely seated on the end of staple leg 6221, So as not to being removed from the end easily.In certain embodiments, each cap 6270 can for example including taper Or be at least substantially the outer surface of taper.In various embodiments, cap 6270 may include any suitable shape, for example, include Shape that is parabola shaped or being at least substantially parabola shaped outer surface.

In various embodiments, for example can be disposed using the surgical stapling device shown in Figure 190-192 for example above-mentioned tight Fixer system.In various embodiments, end effector may include the first jaw or the jaw 6240 of staple cartridge channel 6230 and second, First jaw or staple cartridge channel 6230 can support nail bin 6200 wherein, and the second jaw 6240 can support reservation square Battle array 6250 and the plurality of protectiveness cap 6270.Referring primarily to Figure 190, it illustrates the second jaw 6240 in open configuration, Jaw 6230 and 6240 can be positioned such that tissue T is located at and retain between matrix 6250 and nail bin 6200 relative to tissue T. In various embodiments, as described above, nail bin 6200 may also include energy nail bin support member（Such as warehouse 6210）, the energy nail bin support member In can be positioned with staple 6220 and alignment matrix 6260.In at least one such embodiment, tissue T can be against warehouse 6210 Top surface and position.In certain embodiments, the second jaw 6240 may include multiple depressed parts or hole 6245 and one or more Retain structure or retainer, the plurality of depressed part or hole 6245 can accommodate multiple protectiveness caps 6270, and one Or multiple reservation structures or retainer can be held in place relative to cap 6270 by matrix 6250 is retained.In at least one such reality In applying example, retaining matrix 6250 can be maintained at cap 6270 in hole 6245.Referring now to Figure 20 2, in various embodiments, often One hole 6245 can accommodate part or all of cap 6270 wherein.In certain embodiments, the size quilt in hole 6245 Sufficiently being set to and can be for instance such that can be fixed on cap 6270 by least one of press-fitting and/or snap fit features In hole 6245.In certain embodiments, cap 6270 can be fixed in hole 6245 using at least one adhesive.At least In one such embodiment, this adhesive may be chosen such that in the joint close nail leg 6221 of cap 6270 and the second jaw 6240 After away from the fastener assembly motion being implanted into, cap 6270 can be dismantled from the second jaw 6240.Referring now to Figure 20 3, at certain In a little embodiments, the second jaw 6240 may also include at least one cover sheet 6246, at least one cover sheet 6246 Can be assembled to the second jaw 6240 and can extend in the top of cap 6270 and cap 6270 is maintained in hole 6245.At least one this In class embodiment, for example, at least a portion of cover sheet 6246 is fixed to into jaw 6240 using at least one adhesive. In use, at least one embodiment, before end effector is inserted into operative site, cover sheet 6246 can be at least Partly dismantle from jaw 6240.In certain embodiments, cover sheet 6246 can be by can be implanted into material（Such as PDS and/or PGA）Constitute, when staple leg 6221 exposes from reservation matrix 6250, the material that can be implanted into can be cut by staple leg 6221. In at least one such embodiment, cover sheet 6246 can be fixed in fastening between covering 6270 and reservation matrix 6250 In system.

Referring now to Figure 191, to being described further above, jaw 6240 can move to closure position from open position Put, in closing position, tissue T is positioned against reservation matrix 6250 and warehouse 6210.In this position, retain matrix 6250 can not engage staple 6220.In various embodiments, jaw 6240 can by actuator 6235 its open position with Move between its closing position.In at least one such embodiment, jaw 6240 may include the distal pin 6243 extended from it With proximal pin 6244, in the distally slit 6233 that wherein distal pin 6243 can be in warehouse channel 6230 be limited to vertically or at least Substantially perpendicularly slide, and the proximal slot 6234 that wherein proximal pin 6244 can be in staple cartridge channel 6230 be equally limited to Inside vertically or at least substantially vertically slide.In use, actuator 6235 can proximally retract, by the He of pin 6243 6244 drive into the upper end of its corresponding slit 6233 and 6234, as shown in Figure 191.In at least one such embodiment, Actuator 6235 may include distally driving slit 6236 and nearside driving slit 6237, wherein driving the side of slit 6236 and 6237 Wall energy enough contacts respectively distal pin 6243 and proximal pin 6244, and drives up pin 6243 when actuator 6235 is proximally moved With 6244.More particularly, when actuator 6235 is proximally moved, distal pin 6243 can make inclining for distally driving slit 6236 Oblique Part I 6236a upward slidings are into mid portion or Part II 6236b；Similarly, proximal pin 6244 can make far Side drives the inclined Part I 6237a upward slidings of slit 6237 into mid portion or Part II 6237b.Work as pin When 6243 and 6244 both of which are moved upwards, jaw 6240 can rotate down to closing position towards tissue T.

Referring now to Figure 192, to being described further above, actuator 6235 further can proximally be pulled, with The second jaw 6240, nail bin support member 6210 are pushed down on towards the first jaw 6230 and make reservation matrix 6250 and multiple protectiveness Cap 6270 is engaged with the staple leg of staple 6220.In at least one such embodiment, the additional nearside fortune of actuator 6235 It is dynamic to make the side wall difference contact plug 6243 and 6244 of driving slit 6236 and 6237 and respectively towards the bottom of slit 6233 and 6234 Hold downward drive pin 6243 and 6244.In this case, actuator 6235 can proximally be pulled so that distal pin 6243 from Open the Part II 6236b of driving slit 6236 and enter inclined Part III 6236c, and similarly, proximal pin 6244 Leave the Part II 6237b of driving slit 6237 and enter inclined Part III 6237c.When the both of which of pin 6243 and 6244 When moving downward, the second jaw 6240 can move downwardly to firing position towards the first jaw 6230.In at least one such enforcement In example, the second jaw 6240 can be moved downward so that retained matrix 6250 and remained parallel to or at least substantially parallel to warehouse 6210 top surface and/or parallel to or at least substantially parallel to alignment matrix 6260.In any case, once retaining matrix 6250 and protectiveness cap 6270 engage staple 6220 staple leg 6221, as shown in Figure 194, then the second jaw 6240 may return to Open or at least substantially open position.In at least one such embodiment, actuator 6235 can be promoted towards distally, Respectively to drive pin 6243 and 6244 to the end of slit 6233 and 6234, and subsequently once pin is narrow through driving accordingly The mid portion 6236b and 6237b of groove 6236 and 6237, then actuator 6235 driven downwards towards the bottom of slit 6233 and 6234 It is dynamic.Once the second jaw 6240 is opened, then the first jaw 6230 can be dismantled from the nail bin 6200 being implanted into, and the first jaw 6230 and second jaw 6240 can be removed away from the fastener assembly being implanted into, as shown in Figure 193.

Figure 192 is referred again to, be reader will note that, although retaining matrix 6250 and cap 6270 joint close nail leg 6221, so And be not shown as pin 6243 and 6244 in figure being placed in the bottommost of its respective slots 6233 and 6234.When thick group Knitting T and be located at when retaining between matrix 6250 and warehouse 6210 can occur this situation.Referring now to Figure 195, thin group wherein Knit T to be located in the situation retained between matrix 6250 and warehouse 6210, pin 6243 and 6244 can be further driven downwards to it In corresponding slit 6233 and 6234, as shown in Figure 197.In general, at least one such embodiment, actuator 6235 Can proximally be pulled, will pass through the process shown in above-mentioned and Figure 195-197 upwardly or downwardly drive pin 6243 and 6244 are come, And because tissue T is relatively thin, retaining matrix 6250 and protectiveness cap 6270 can further be driven to the staple leg of staple 6220 On 6221, as shown in Figure 198 and Figure 199.In various embodiments, as the knot for retaining the adjustable that matrix 6250 is provided Really, it is thick or thin no matter to capture the tissue in end effector, can obtain identical in the tissue for being fastened Or at least substantially identical compression pressure.In certain embodiments, the adjustable that reservation matrix 6250 is provided may be allowed to Surgeon select to apply tissue by selecting to retain the depth that is placed of matrix 6250 larger compression pressure still compared with Little compression pressure.In at least one such embodiment, retain the scope that matrix 6250 can be seated on staple leg 6221 The length or scope that slit 6233 and 6234 can for example be passed through determines.

In various embodiments, as described above, protectiveness cap 6270 can be by the end that can for example firmly grasp staple leg 6221 Soft or flexibility material constitute.In certain embodiments, protectiveness cap 6270 can be by the plastics of energy bio-absorbable（For example With the polyglycolic acid that trade name Vicryl is sold（PGA）, PLA（PLA or PLLA）, PPDO（PDS）, poly- hydroxyl Phenylalkanoic acid ester（PHA）, with trade name Monocryl sell Poliglecaprone 25（PGCL）, polycaprolactone（PCL）, and/or The compound of PGA, PLA, PDS, PHA, PGCL, and/or PCL）And/or biocompatibility metal（Such as titanium and/or stainless steel） Constitute.As shown in Figure 189, at least one embodiment, each cap 6270 can be not attached to other caps 6270.Some other In embodiment, one or more caps 6270 can be mounted to reservation matrix 6250.In at least one such embodiment, cap 6270 For example reservation matrix 6250 can be connected to by least one adhesive, the wherein hole 6271 in cap 6270 can be with reservation matrix Retaining holes 6252 in 6270 is alignd or is at least substantially alignd.Referring now to Figure 200, in various embodiments, protectiveness cap, （Such as cap 6370）Inner chamber or fornix 6374 can be limited, inner chamber or fornix 6374 for example can hold the end of staple leg 6221 It is contained in wherein.In at least one such embodiment, cap 6370 may include bottom 6372 and extend through the hole of bottom 6372 6371.In various embodiments, hole 6371 can be limited by the component 6373 of one or more deflections, it is one or more of can When the component 6373 of flexure can work as staple leg 6221 and pass through and be inserted into, the component of one or more of deflections 6373 can bend.In certain embodiments, for example two or more caps 6370 can be connected together to form cap 6370 Array.Referring now to Figure 20 1, at least one such embodiment, multiple caps 6370 can be connected by material sheet 6375 It is connected together.In certain embodiments, thin slice 6375 can have enough rigidity so as to the desired arrangement of retention cap 6370 and/ Or alignment thereof.In at least one embodiment, cap 6370 can be by biocompatibility metal（Such as titanium and/or stainless steel）Structure Into, and thin slice 6375 can be by the plastics of energy bio-absorbable（The polyglycolic acid for example sold with trade name Vicryl（PGA）, it is poly- Lactic acid（PLA or PLLA）, PPDO（PDS）, polyhydroxyalkanoatefrom（PHA）, with trade name Monocryl sale Poliglecaprone 25（PGCL）, polycaprolactone（PCL）, and/or the compound of PGA, PLA, PDS, PHA, PGCL, and/or PCL） Constitute.In various embodiments, thin slice 6375 can be by wherein storing and/or be dispersed with antiseptic（Such as collargol and/or trichlorine It is raw）Energy bio-absorbable material constitute, such as when thin slice 6375 is by bio-absorbable, the antiseptic can be released.

In various embodiments, to being described further above, such as using injection molding method by the injection molding of thin slice 6375 Around cap 6370 so that cap 6370 is embedded in thin slice 6375.In some other embodiments, such as using injection molding method Carry out molded sheet 6375, wherein for example during injection molding method and/or after injection molding method, using process for stamping in thin slice Hole 6376 is formed in 6375.In any one situation in both cases, can be by the patchhole 6376 of cap 6370 and using press-fitting And/or snap-fitted interconnecting method and/or at least one adhesive are fixed in hole 6376.In certain embodiments, often One cap 6370 may include the ring-shaped groove for surrounding or at least partly surrounding the periphery of cap 6370, and the ring-shaped groove can be by hole 6376 periphery is accommodated wherein.In certain embodiments, thin slice 6375 can be by can allow to be carried out between cap 6370 relative fortune Dynamic flexible and/or pliable material is constituted.In at least one such embodiment, flexible thin sheet 6375 can be by such as rubber, modeling Material, and/or silicone compositions are constituted, and cap 6370 can be by rigid material（Such as metal）Constitute.In at least one such reality It is and similar to the above in applying example, flexible material can be overmolded to around cap 6370.In certain embodiments, for example can be by cap 6370 In being pressed into the thin slice 6375 of advance molding.In various embodiments, the hardness of flexible material can be chosen to provide thin slice 6375 desired rigidity.In certain embodiments, thin slice 6375 can make it include the band of flexibility.In any case, thin slice 6375 can be conducive to that cap 6370 is assembled in end effector, this is because multiple caps 6370 can be positioned and/or right simultaneously Together in end effector.Additionally, the thin slice 6375 for attachment cap 6370 is once implanted, then for example can come strong along staple line Change or support staple.In addition to the thin slice for attachment cap 6370 or as the replacement of the thin slice, cap 6370 can pass through multiple Chain link links together.In at least one such embodiment, this chain link can be to enter between flexible and tolerable cap 6370 Row relative motion.

Referring now to Figure 20 4 and 205, in various embodiments, protectiveness cap,（For example, cap 6470）May include shaping table Face, the profiled surface deforms can the top of staple leg.In at least one such embodiment, cap 6470 may include base portion 6472, the base portion may include to extend through hole therein 6471.In various embodiments, hole 6471 can be by staple leg（For example Staple leg 6221）It is closely received wherein.In at least one such embodiment, limiting the diameter or girth in hole 6471 can wait In or more than the diameter or girth of staple leg 6221.In various embodiments, cap 6470 may also include chamber or fornix 6474, the chamber Or fornix can work as the end that staple leg 6221 is accommodated when staple leg 6221 is inserted in cap 6470.Referring primarily to Figure 20 5, cap 6470 may also include anvil block or profiled surface 6473, and the anvil block or profiled surface can make staple leg 6221 bend and deform. In some situations, profiled surface 6473 for example can be bending and/or spill, and can work as staple leg 6221 and be inserted into cap Crimp staple leg 6221 when 6470.In certain embodiments, staple leg 6221 can be deformed sufficiently so that it cannot be passed through Hole 6471 and be withdrawn by, therefore cap 6470 can be locked to staple leg 6221.In at least one such embodiment, cap 6470 Base portion 6472 can limit the antelabium extended around hole 6471, and the antelabium can prevent strained staple leg 6221 from chamber 6474 In be removed.In various scenarios, as consequence of the above, one or more caps 6470 can prevent or suppress to retain matrix（Example Such as retain matrix 6250）Fall back or depart from from staple 6220.In various embodiments, although not shown, but cap 6470 can be right Claim ground or be at least substantially asymmetrically formed, and hole 6471 can position along the central axis 6479 extended through cap 6470.Again It is secondary referring to Figure 20 4, in various alternative embodiments, hole 6471 can offset relative to central axis 6479.At least one In individual such embodiment, the hole 6471 of skew may be allowed to the side of the contact profiled surface 6473 of staple leg 6221 and be crimped onto shaping The opposite side on surface 6473, rather than contact the center of profiled surface 6473, such as above-mentioned including the hole 6471 being centrally located As may occurring in embodiment.

In various embodiments, as described above, retaining matrix（For example, matrix 6250 is retained）By material sheet and can pass through The material sheet and multiple retaining holes 6252 for extending are constituted.In at least certain embodiments, constitute and retain matrix 6250 Material sheet can be rigid or substantially not bending.In some other embodiments, retaining matrix can be by reservation matrix The array of element and multiple flexible connectors or chain link for connecting the reservation matrix element are constituted.Referring now to figure, 206, in various embodiments, the part for retaining matrix or retaining matrix 6550 may include multiple element body 6505, described Multiple element body 6505 can be linked together by one or more connection chain links 6507.In at least one embodiment, it is each Component body 6505 may each comprise multiple energy deformation elements 6553, and the plurality of energy deformation element 6553 can wherein limit reservation Hole 6552.In certain embodiments, the component body 6505 and connection chain link 6507 for retaining matrix 6550 is formed as one simultaneously May include integral type material block.In various embodiments, retaining matrix 6550 can for example by metal material（Such as titanium and/or not Rust steel）Punching press or casting are formed.In at least one embodiment, retaining matrix 6550 can be by plastics（For example, polyethers ether copper （PEEK）, with trade name suture（Prolene）The polypropylene of sale, with trade name Ethibond and Mersilene sell it is poly- Ethylene glycol terephthalate, polyvinylidene fluoride, polyvinylidene fluoride -co- hexafluoropropene, with trade name Pronova sale Polyhexafluoropropylene-VDF, and/or with trade name Ethilon＆Nurolon sell long chain aliphatic polymer nylon 6 and Buddhist nun Dragon 6,6）Constitute, and for example can be formed by injection molding method.In certain embodiments, component body 6505 can not be with connection chain link 6507 form one.In various embodiments, multiple single component bodies 6505, the plurality of single element sheet can be produced Body 6505 is then connected to together and is embedded in reservation matrix.In at least one such embodiment, component body 6505 Can be by metal material（Such as titanium and/or stainless steel）It is stamped to form and is placed in plastic injection mould, wherein can be by plasticity Surrounded with formation in material injection mould or at least partly surround the edge 6506 of component body 6505 and from edge 6506 The connection chain link 6507 of extension.In some other embodiments, one or more connector dot matrix can be formed to include limiting Hole in multiple edges 6506, this hole of each of which can accommodate component body 6505 wherein.At least one In embodiment, each component body 6505 may include neighboring that is circular or being at least substantially circle；Similarly, per one side Can define in edge 6506 circle or be at least substantially circular hole, wherein the diameter in the hole can be equal to or less than element The diameter of body 6505.In at least one such embodiment, component body 6505 can be press-fitted or built-in edge 6505 in hole In.In certain embodiments, component body 6505 is fixed in hole using at least one adhesive.

In certain embodiments, to being described further above, retain matrix may include multiple element body 6505 with And multiple connection chain links 6507, the plurality of connection chain link 6507 can be with any suitable array（For example, shown in Figure 20 7-210 Person）Carry out connecting element body 6505.No matter why is the pattern of array, in various embodiments, connection chain link 6507 can allow Component body 6505 is relative to each other moved with retaining holes 6552.In at least one such embodiment, constitute and retain square The component body 6505 of battle array 6550 and the dot matrix of connection chain link 6507 are once engaged with tissue just can be stretched, distort, collapsing, And/or in other words flexing, so as to allow at least some motion in tissue and while resisted organize carries out larger motion. In various embodiments, each connection chain link 6507 may include flexure member, and the flexure member can stretch, distorts, and/or collapse Contracting, for example to allow that retaining matrix 6550 is retaining flexing between matrix element 6505.Figure 20 6 is referred again to, is limited from side The width of each chain link 6507 that edge 6506 extends can be narrower than the width at component body 6505 and/or edge 6506.Referring to figure 207-210, in certain embodiments, one or more chain links 6507 may include straight part, and the straight part is for example along phase Line between adjacent component body 6506 extends.In at least one such embodiment, each chain link 6507 may include to be attached to The first end of first edge 6506 and the second end for being attached to second edge 6506.Figure 20 6 is referred again to, in some enforcements In example, two or more chain links 6507 can be connected with each other.In at least one such embodiment, such as two or more chains Section 6507 can be connected at middle hinge 6509.In various embodiments, the tranverse sectional thickness and chain link of such as hinge 6509 6507 tranverse sectional thickness is compared can be reduced along one or more directions, and this may be allowed to connected chain link 6507 and relative to each other transports It is dynamic.In certain embodiments, retain matrix 6550 and may also include hinge 6508, chain link 6507 can be connected to edge by hinge 6508 6506 and allow relative motion between chain link 6507 and edge 6506.It is similar to hinge 6509, such as cross section of hinge 6508 Thickness can reduce compared with the tranverse sectional thickness of chain link 6507 along one or more directions.

In various embodiments, to being described further above, connected chain link 6507 can extend in different directions. In at least one such embodiment, the first chain link 6507 can be extended in a first direction, and the second chain link 6507 can be along second Direction extends, wherein the first direction may differ from the second direction.In certain embodiments, the first chain link 6507 can edge First Line extends, and the second chain link 6507 can extend along the second line, wherein the First Line can be at an angle of with second line （E.g., from about 30 degree, about 45 degree, about 60 degree, and/or about 90 degree）Intersect on ground.In various embodiments, hinge 6508 and/or hinge 6509 may include hinges, and the tolerable chain link 6507 of the hinges is relative to each other repeatedly moved without rupturing. In some embodiments, hinge 6508 and/or hinge 6509 may include frangible or easy fracture part, described frangible or easy fracture Part can rupture in hyperflexion and/or excessive number of times ground flexing.In at least one such embodiment, this frangible portion can Allow that one or more parts for retaining matrix 6550 disconnect with the another part for retaining matrix 6550.In various embodiments, Hinge 6508 and/or hinge 6509 for example may include that the ratio for retaining matrix 6550 retains the other parts of matrix 6550 and is easier to cut The section cut.More specifically, the tissue for retaining matrix and being fastened by the reservation matrix being implanted into being implanted into can often for various Reason is cut component and cuts, and this crosscutting in order to be conducive to carrying out, and hinge 6508 and/or hinge 6509 for example can be provided Approach or thin section, cutting element may pass through the approach or thin section more readily passes through reservation matrix 6550.In various realities In applying example, to being described further above, connection chain link 6507 may include for example to be limited to one or more of castings Structure or material upsetting, one or more of cast structures or material upsetting can be conducive to the bending of connection chain link 6507, break Split, and/or cut.

In various embodiments, retaining matrix may include multiple reservation matrix elements（For example, matrix element body 6505）, The plurality of reservation matrix element can be embedded in flexible material thin slice or material strips.In at least one embodiment, flexible material Thin slice can be by the elastomeric material of energy bio-absorbable（Such as siloxanes）Formed, wherein the flexible thin sheet can have been produced being limited to Multiple holes therein.In at least one such embodiment, solid flexible thin sheet is may be molded out and in the flexible thin sheet Perforation forms multiple holes.In various alternative embodiments, may be molded flexible thin sheet and restriction is formed in molding process Hole wherein.In any one situation in both cases, reservation matrix element 6505 can for example be inserted into and be maintained at scratches In property thin slice.And similar to the above in some other embodiments, flexible thin sheet can be formed at around matrix element 6505.Extremely In few one embodiment, flexible thin sheet for example can be made up of woven net and/or any other suitable material.To entering to advance above One step is described, and this woven net can be easy to crosscutting.

Referring now to Figure 21 1 and 212, in various embodiments, including retain matrix（For example, matrix 6250 is retained）It is tight Fixer system may also include covering（For example, covering 6670）, when the top of staple leg 6221 extends to reservation matrix 6250 6257 top of top surface when, the covering can cover the top.In various embodiments, covering 6670 could attach to protect Stay matrix 6250.In certain embodiments, covering 6670 and/or reservation matrix 6250 may include to retain structure, the reservation Covering 6670 can be remained to reservation matrix 6250 by structure.In at least one embodiment, using at least one bonding Covering 6670 is adhered to reservation matrix 6250 by agent.In at least one embodiment, covering 6670 can be made up of single layer, But covering 6670 is shown as including two layers that following article is more fully described.Referring primarily to Figure 21 2, in various realities In applying example, the top of staple leg 6221 can extend across the lower surface 6673 of covering 6670；However, covering 6670 can be wrapped Enough thickness is included, so that staple top does not extend through the top surface 6675 of covering 6670.Therefore, it is such at least one In embodiment, the end of staple leg 6221 can not be from the projection of covering 6670.In various embodiments, covering 6670 may include Multiple layers.In at least one such embodiment, covering 6670 may include ground floor 6671 and the second layer 6672.At least one In individual embodiment, ground floor 6671 and the second layer 6672 can be attached to each other, wherein at least one embodiment, the second layer 6672 May include the lower surface 6676 for being attached to ground floor 6671.In various embodiments, ground floor 6671 and the second layer 6672 can Including different thickness, and in certain embodiments, it may include identical thickness.In at least one embodiment, ground floor 6671 and the second layer 6672 may include substantially the same width and/or length.In alternative embodiment, the He of layer 6671 6672 may include different width and/or length.

In various embodiments, to being described further above, ground floor 6671 can be by can be cut by staple leg 6211 Energy compression foam, Web materials, and/or the hydrogel opened is constituted.In at least one embodiment, the second layer 6672 can be by harder Tough material or skin（Such as PGA and/or PDS）And/or any suitable backing material is constituted.In at least one such enforcement In example, staple leg 6221 can penetrate ground floor 6671；However, in various embodiments, staple leg 6221 can penetrate Two layer 6672.In certain embodiments, the second layer 6672 can be by constituting with sufficiently resilient and/or toughness material, the material The tolerable second layer 6672 of material is contacted and shifted by staple leg 6221, but not by the staple end of staple leg 6221 cut or only by Marginally cut.Although not shown in, but covering may include many more than two layer, wherein one or more in these layers It can be resistance to infiltration.In at least one such embodiment, in use, retaining matrix 6250 can position and quilt against tissue Fasten and promote towards distally so that the staple leg 6221 of staple 6220 is through the retaining holes in tissue T and reservation matrix 6250 6252 and promoted, and in the ground floor 6271 of covering 6270.In various embodiments, the end of staple leg 6221 can In not entering or at least substantially not entering the second layer 6272 of covering 6270.It is properly positioned matrix 6250 is retained Afterwards, jaw 6240 can be opened, and covering 6670 and reservation matrix 6250 can be dismantled from jaw 6240, as shown in Figure 21 1. As shown in Figure 21 1, jaw 6640 can keep more than one to retain matrix 6250 and covering 6670.In at least one such reality In applying example, jaw 6640 may include two passages 6679, and described two passages 6679 can be able to accommodate covering wherein 6670 and relative to covering 6670 position reservation matrix 6250 so that it is each retain matrix 6250 contact tissue table Face 6251 from the bottom of jaw 6240 downwardly against.In at least one such embodiment, retain matrix 6250 and covering 6270 Can be contained in jaw 6640 on every side of cutter slit 6678.In use, 6670 liang of matrix 6250 and covering are retained Person can be deployed and/or relative to the relative nail bin positioned through it simultaneously（Such as storehouse 6200）It is deployed in identical depth At degree.Subsequently, in various embodiments, the group for being fastened can be cut along line of cut by the cutting element for traversing cutter slit 6678 Knit, wherein jaw 6640 can subsequently be opened again.In certain embodiments, covering 6670 can be not attached to retain matrix 6250.In at least one such embodiment, covering 6670 can be positioned in passage 6679 and can be by being fixed It is maintained in passage 6679 to the reservation matrix 6250 of jaw 6640.In various embodiments, each reservation matrix 6250 Can be wider than and/or be longer than its corresponding covering 6670 so that retaining matrix 6250 can keep the entirety of its covering 6670 It is in place.In certain embodiments, it is each reservation matrix 6250 can for example its corresponding covering 6670 include identical width And/or length.

In various embodiments, as described above, closure system may include that reservation matrix can be attached to（For example, retain Matrix 6250）Material layer.Referring now to Figure 21 5, at least one embodiment, material layer 6870 could attach to retain matrix 6250 lower surface 6251.In certain embodiments, layer 6870 and/or reservation matrix 6250 may include to retain structure, described Retaining structure can remain to reservation matrix 6250 by layer 6870.In at least one embodiment, using at least one bonding Layer 6870 is adhered to reservation matrix 6250 by agent.In any case, layer 6870 may include lower surface or tissue contacting surface 6873, lower surface or tissue contacting surface 6873 can work as reservation matrix 6250 and move downward towards staple 6220 so that retaining holes 6252 with staple leg 6221 when engaging, lower surface or the contact tissue T of tissue contacting surface 6873.In at least one such reality In applying example, layer 6870 can be by energy compression material（For example can bio-absorbable foam）Constitute, the energy compression material can be compressed Between the lower surface 6251 and tissue T for retaining matrix 6250.In various embodiments, layer 6870 may also include storage and/ Or at least one medicine therein is absorbed in, at least one medicine can discharge when layer 6870 is compressed from layer 6870. In at least one embodiment, the medicine may include at least one tissue seal, styptic, and/or anti-biotic material（For example The silver of ionization and/or triclosan）.In various embodiments, the compression of layer 6870 can extrude medicine from layer 6870 so that tissue The whole on the surface of T is at least greatly coated with medicine.Additionally, when layer 6870 is compressed and staple leg 6221 penetrates group When knitting T and layer 6870, medicine for example can flow down and treat the tissue that cut by staple leg 6221 along staple leg 6221.Various In embodiment, retaining the body of matrix 6250 may include by biocompatible materials（Such as titanium and/or stainless steel）The for constituting One layer, and bottom 6870 may include by can bioabsorbable material（Such as oxidized regenerated cellulose（ORC）, such as（Liquid or quilt It is cryodesiccated）The bioactivator such as fibrin and/or fibrin ferment, glycerine, in fluffy or foam configuration absorbable pig The antibacterial such as the silver of gelatin, and/or such as ionization and/or triclosan）The second layer of composition.Other energy bioabsorbable material can Including such as Surgicel Nu-Knit, Surgicel Fibrillar, the collagen/ORC sold with trade name Promogran （It is the mixture with collagen matrix form construction）, with trade name Vicryl sell polyglycolic acid（PGA）, PLA （PLA or PLLA）, PPDO（PDS）, polyhydroxyalkanoatefrom（PHA）, with trade name Monocryl sell it is poly- Caprone 25（PGCL）, polycaprolactone（PCL）, and/or the compound of PGA, PLA, PDS, PHA, PGCL, and/or PCL.Although One layer 6870 is only shown in Figure 21 5, but any fitness number target zone can be used.In at least one embodiment, including The ground floor of one medicine could attach to retain matrix 6250, and the second layer including the second medicine or different pharmaceutical could attach to Ground floor.In at least one such embodiment, multiple layers, each of which layer can be used to may include to be contained in different medicines therein Thing and/or different drug regimens.

Referring now to Figure 21 3, in various embodiments, closure system may include to be attached to the bottom for retaining matrix 6250 The material layer 6770 on surface 6251.In certain embodiments, layer 6770 and/or reservation matrix 6250 may include to retain structure, institute Stating reservation structure can remain to reservation matrix 6250 by layer 6770.In at least one embodiment, using at least one viscous Layer 6770 is adhered to reservation matrix 6250 by mixture.In any case, layer 6770 may include lower surface or contact tissue table Face 6773, lower surface or tissue contacting surface 6773 can work as reservation matrix 6250 and move downward towards staple 6220 so as to retain When hole 6252 engages with staple leg 6221, lower surface or the contact tissue T of tissue contacting surface 6773.It is such at least one In embodiment, layer 6770 can be by energy compression material（For example can bio-absorbable foam）Constitute, the energy compression material can be pressed Shrink between the surface 6251 and tissue T for retaining matrix 6250.In various embodiments, layer 6770 may also include one or more Capsule or born of the same parents 6774, one or more of capsules or born of the same parents 6774 can wherein store at least one medicine.Referring to Figure 21 4, at certain In a little embodiments, capsule 6774 can align with retaining holes 6252 or at least substantially align so that when staple leg 6221 passes through tissue T And layer 6770 and when being promoted, staple leg 6221 can pierce capsule 6774 and/or in other words rupture capsule 6774.It is broken in capsule 6774 After splitting, at least one medicine M being stored in capsule 6774 can be flowed out in tissue T.In at least one such embodiment, medicine Thing M may include fluid, and the fluid can stay along staple leg 6221 or flow down by capillarity and treat and be cut by staple leg Tissue T.Used as consequence of the above, the medicine being stored in capsule 6774 can provide local treatment to tissue.In some embodiments In, can be stored with different medicines in the capsule 6774 in thin slice 6770.For example, can be stored with the first medicine in first group of capsule 6774 Or first drug regimen, and the medicine that can be stored with different in second group of capsule or different drug regimens.In various embodiments In, layer 6770 can be made up of flexible siloxanes thin slice, and capsule 6774 can represent the space in siloxanes thin slice.At least one In individual such embodiment, siloxanes thin slice may include two layers that can be attached to each other, and wherein capsule 6774 can be limited at described Between two layers.In various embodiments, layer 6770 may include one or more thin sections or weakening part（For example locally wear Hole）, one or more of thin sections or weakening part can be conducive to leg 6221 to cut layer 6770 and rupture capsule 6774. In some embodiments, at least a portion of capsule 6774 can be positioned in fornix 6777, and wherein fornix 6777 can be from thin slice 6770 Upwardly extend.In at least one such embodiment, at least a portion of fornix 6777 and/or capsule 6774 can be positioned in reservation In pit 6201 formed in matrix 6250.In certain embodiments, capsule 6774 may include the independent born of the same parents not being connected with each other. In some other embodiments, one or more in capsule 6774 can via extend through layer 6770 one or more paths, Conduit, and/or passage and be in fluid communication with each other.It is published in August 24 days and entitled " ADHESIVE AND in 2010 The disclosure of United States Patent (USP) No.7,780,685 of MECHANICAL FASTENER " is incorporated by reference in its entirety accordingly this Text.

In various embodiments, to being described further above, including warehouse, staple, and/or alignment matrix Nail bin can be loaded in the first jaw of end effector, and similarly, retain matrix and/or one or more coverings During the second jaw of end effector can be loaded on.Referring now to Figure 21 6, in certain embodiments, apparatus can be used（For example Warehouse loader 6990）Two or more fastener cartridges are inserted in end effector simultaneously.In at least one embodiment, example As warehouse loader 6990 may include shank 6991 and warehouse carrier 6992, wherein warehouse carrier 6992 may include the first reserve part and second The warehouse 6210 of nail bin 6200 can be remained to warehouse carrier 6992 by reserve part, first reserve part, and described second protects Portion is stayed to keep warehouse 6980, the warehouse 6980 supports wherein multiple protectiveness caps 6270 and along the bottom table of warehouse 6980 Face supports and retains matrix 6250.In various embodiments, the first reserve part and the second reserve part can each include one or more Holding member, one or more of holding members can be releasably engaged warehouse 6210 and 6980.Referring now to the Hes of Figure 21 7, Figure 21 8, in use, end effector may include the first jaw or the jaw of bottom jaw 6230 and second or top jaw 6940, wherein nail bin 6200 can be loaded in the first jaw 6230, and warehouse 6980 can be loaded on the second jaw 6940 In.In various scenarios, top jaw 6940 can be by actuator 6235 from open position（Figure 21 7）Rotate to closing position （Figure 21 8）, wherein the operation of actuator 6235 is as described above, for simplicity's sake here is omitted.Referring now to Figure 21 8, one Denier top jaw 6940 is in its closing position, then the distal end 6993 of warehouse carrier 6992 can be inserted in end effector so that Nail bin 6200 slides into the first attachment or passage in the first jaw 6230 through the distal end 6938 of the first jaw 6930 In 6939.Similarly, the distal end 6993 of warehouse carrier 6992 can be inserted in end effector so that warehouse 6980 is through the second pincers Mouthfuls 6940 distal end 6948 and slide in the second attachment or passage 6949 in the second jaw 6940.Hand-held warehouse loader The surgeon or other clinicians of 6990 shank 6991 can be each passed through passage 6939 and 6949 and promote nail bin 6200 And warehouse 6980, until nail bin 6200 and warehouse 6980 are placed in completely in passage 6939 and 6949.

When nail bin 6200 and warehouse 6980 are placed, nail bin 6200 and warehouse 6980 can respectively engage its corresponding jaw One or more reserve parts in 6230 and 6940, following article is more fully described.Referring now to Figure 21 9, in any situation In, once nail bin 6200 and warehouse 6980 are placed, then warehouse loader 6990 can be dismantled simultaneously from nail bin 6200 and warehouse 6980 Remove from end effector.In at least one such embodiment, for nail bin 6200 to be maintained in the first jaw 6230 Retention can be more than for nail bin 6200 to be remained to the retention of warehouse carrier 6992 so that when warehouse carrier 6992 is towards distally quilt When releasing end effector, nail bin 6200 is positively retained at the rear of the first jaw 6230.Similarly, for warehouse 6980 to be maintained at Retention in second jaw 6940 can be more than the retention for warehouse 6940 to be remained to warehouse carrier 6992 so that when storehouse carries Body 6992 towards distally be pushed out end effector when, warehouse 6940 is positively retained at the rear of the second jaw 6940.Once warehouse loader 6990 are removed from end effector, then the first jaw 6230 for being loaded and the second jaw 6940 for being loaded can be relative to generals The tissue T being sewn is positioned.Referring now to Figure 22 0, the second jaw 6940 can be from open position（Figure 21 9）Move to percussion Position（Figure 22 0）, so as to the reservation matrix 6250 that carried warehouse 6980 and the plurality of protectiveness cap 6270 be located at nail Staple 6220 in storehouse 6200 is engaged.

Referring now to Figure 22 1 and Figure 22 2, the second jaw 6940 can be opened again, and the plurality of protectiveness cap 6270 and retain matrix 6250 can dismantle from warehouse 6980 so that cap 6270 and reservation matrix 6250 can keep with tissue T and Nail bin 6200 is engaged.In at least one embodiment, warehouse 6980 may include multiple pits and one or more reservation slits, institute Stating multiple caps 6270 can be removably positioned in the plurality of pit, and one or more of reservation slits can be by Retain matrix 6250 and removably remain to warehouse 6980.In various embodiments, after the opening of the second jaw 6940, second The holding member engaged with warehouse 6980 of jaw 6940 can be maintained at warehouse 6980 in second jaw 6940.In some realities In applying example, warehouse 6980 can work as tear when the second jaw 6940 is opened so that a part for warehouse 6980 and cap 6270 and guarantor Stay matrix 6250 implanted together, and a part for warehouse 6980 is retained in the second jaw 6940.Similarly, refer again to Figure 22 1 and Figure 22 2, after the second jaw 6940 is opened, the holding member engaged with warehouse 6210 of the first jaw 6230 Warehouse 6210 can be maintained in the first jaw 6230.In certain embodiments, can to work as the first jaw 6230 remote for warehouse 6210 Tear when being pulled from the storehouse 6200 being implanted into so that a part for warehouse 6210 is together with staple 6220 and alignment matrix 6260 It is implanted, and a part for warehouse 6210 remained in the first jaw 6230.Referring now to Figure 22 3-225, in various enforcements In example, nail bin（Such as nail bin 6900）May include longitudinally to retain slit along one or more that the length of warehouse 6910 extends 6913, such as when nail bin 6900 is inserted in jaw 6930, one or more of longitudinal directions retain slit 6913 can be at it Middle one or more extended from jaw 6930 that accommodate longitudinally retain guide rail 6916.In use, at least one embodiment, For example before nail bin 6900 slides through the distal end 6938 for keeping passage 6939, the end for retaining slit 6913 can be with reservation The distal end alignment of guide rail 6916.

Figure 22 5 is referred again to, in various embodiments, jaw 6940 may include two holding passages 6949, each of which Passage 6949 is kept wherein to accommodate including multiple caps 6270 and retain the warehouse 6980 of matrix 6250.In some embodiments In, each warehouse 6980 may include that one or more longitudinally keep shoulder 6917, one or more of longitudinal directions to keep shoulder 6917 can work as that warehouse 6980 is inserted in jaw 6940 it is corresponding when keeping in passage 6949, it is one or more of vertical Slide to keeping one or more of shoulder 6917 along the second jaw 6940 longitudinally to retain guide rail 6918.In various embodiments, When warehouse 6980 is dismantled from the cap 6270 and reservation matrix 6250 being stored therein, retain guide rail 6918 and keep shoulder 6917 collaboratively can be maintained at warehouse 6980 in second jaw 6940.Referring now to Figure 22 4, in various embodiments, second, Jaw 6940 may also include one or more distally projections or holding member 6915 extended from it, one or more of distally Projection or holding member 6915 can removably be locked in warehouse 6980 in its corresponding holding passage.At least one this In class embodiment, the second jaw 6940 may include distally projection 6915, and distally projection 6915 is relative to each holding passage 6949 Can and be located so that when warehouse 6980 is inserted in passage 6949, each warehouse 6980 can surround the flexing of projection 6915, Wherein, just when warehouse 6915 is placed in completely in passage 6949, the cleanable projection 6915 in distal end and snap-fastener of warehouse 6980 In the top of projection 6915.It is to remove it after warehouse 6980 is previously used, as described above, warehouse 6980 can be withdrawn into into projection 6915 tops simultaneously remove it from holding passage 6949.With it is similar to the above, the first jaw 6930 may include from its extend one Individual or multiple distally retain projection 6914, and one or more of distally reservation projections 6914 can work as nail bin 6900 is pacified completely When putting, one or more of distally retain one or more reservation grooves or narrow that projection 6914 is accommodated in warehouse 6910 Groove 6912（Figure 22 3）In.

In various embodiments, to being described further above, wherein be positioned with multiple first securing members first is tight Firmware storehouse can be positioned in the first jaw of surgical fastening device, and is wherein positioned with the second tight of multiple second securing members Firmware storehouse can be positioned in the second jaw of surgical fastening device.In use, the first jaw and/or the second jaw can be towards another One is moved, to make the first securing member engage with the second securing member and to fix tissue therebetween.In certain embodiments, when When first securing member is engaged with the second securing member, the first fastener cartridge can be engaged with the second fastener cartridge.Implement at least one In example, the body of the first fastener cartridge can be made up of the first energy compression material, and the body of the second fastener cartridge can be by second Energy compression material is constituted, and wherein the first noumenon and/or the second body can be compressed against the tissue for being fastened.It is tight organizing Gu after, the first jaw can be away from the first fastener cartridge motion being implanted into, and the second jaw can be away from second for being implanted into Fastener cartridge is moved.Subsequently, the first jaw can be again loaded with another first fastener cartridge or similar component, and the second jaw Another second fastener cartridge or similar component can be again loaded, and reuse surgical fasteners tool can be reused.Although can be in some realities Staple used in example is applied, but it can also be envisaged that is gone out including other types of securing member（For example lock together when being bonded with each other Be divided into two-part securing member）Other embodiments.In at least one such embodiment, the first fastener cartridge may include to use In the first storage part for storing the first fastener portion, and the second fastener cartridge may include for store the second fastener portion the Two storage parts.In various embodiments, fastening system as herein described is using the material and/or shape including any proper types The securing member of formula.In certain embodiments, securing member may include penetrating component.This penetrating component can for example by polymer, multiple Compound, and/or multiple field substrate are constituted.The example of multiple field substrate can be the wire rod or thin with elastomer or polymer coating Plate base.It can be thin thin slice, and be formed so that penetrating component be oriented to perpendicular to or it is at least substantially vertical In connecting elements.Penetrating component may include profile, semicircular profile, and/or any crossbeam profile of rectangle.In various enforcements In example, using any suitable method（Such as wire rod extrusion method）To manufacture securing member as herein described.It is alternatively possible Property is that hollow penetrating component is formed using precision machining method.These penetrating components can by different from wire rod extrusion method and Processed using the method for combination of materials.

As described above, the top through reservation matrix projection of staple leg can be covered by one or more caps and/or covering Lid.In certain embodiments, the end of staple leg can deform after reservation matrix is inserted through.In at least one embodiment, use May also include positioned at retaining holes top and/or the anvil block pit alignd with retaining holes, the anvil in the jaw for retaining matrix is kept Seat pit can deform staple leg when staple leg is projected on above reservation matrix.In various embodiments, each staple Staple leg can be for example towards each other and/or towards the center inward curl of staple.In some other embodiments, in the staple leg of staple One or more can outwards crimp away from other staple legs and/or away from the center of staple.In various embodiments, no matter Staple leg is crimped along which direction, and the end of staple leg can contact and retain the body of matrix and can not be again introduced into by staple In the tissue of fastening.In at least one embodiment, deformation of the staple leg after reservation matrix is passed through can retain matrix lock In being scheduled on positioning.

Referring now to Figure 22 6 and Figure 22 7, in various embodiments, surgery suturing appliance,（For example, surgical stapling device 7000） May include the first jaw 7030 and the second jaw 7040, wherein the second jaw 7040 can by the motion of actuator 6235 direction And move away from the first jaw 7030.The operation of actuator 6235 is as described above, for simplicity's sake here is omitted.Various In embodiment, the first jaw 7030 may include distal end 7031 and near-end 7032, wherein the first jaw 7030 can be limited to distal end The passage extended between 7031 and near-end 7032, the passage can accommodate nail bin.For ease of diagram, do not show in Figure 22 6 The warehouse of this nail bin, but this nail bin may include warehouse, the staple 6220 in warehouse and under staple 6220 The staple driver 7012 of side.In certain embodiments, although not illustrating in Figure 22 6 for simplicity's sake, but the second jaw 7040 can will retain matrix（For example retain matrix 6250）Being maintained on staple 6220 and/or move as mentioned above will retain square Battle array is moved to and engaged with the leg of staple 6220.In at least one embodiment, surgical stapling device 7000 may also include such as position Sledge 7010 in the first jaw 7030, sledge 7010 can slide and towards from the distal end 7031 of the first jaw 7030 towards near-end 7032 The matrix that retains of two jaws 7040 lifts staple driver 7012 and the staple 6220 being supported on staple driver 7012.Each In planting other embodiments, for example sledge 7010 proximally 7032 can be moved towards distal end 7031, to dispose staple 6020.At least one In individual embodiment, sledge 7010 may include one or more inclined slopes or cam 7011, one or more of inclined oblique Slope or cam 7011 in the slid underneath of staple driver 7012 and can be lifted up staple driver 7012.In various embodiments In, surgical stapling device 7000 may also include the pull bar or push rod that can be for example operably coupled to sledge 7010, the pull bar or push rod Can be by the actuator on the shank and/or axle of surgical stapling device 7000 proximally and/or towards distally motion.

Figure 22 6 is referred again to, in various embodiments, the second jaw 7040 of surgical stapling device 7000 may include framework 7041st, distal end 7048 and the near-end 7049 with the relative positioning of distal end 7048.In certain embodiments, the second jaw 7040 may be used also Including guidance system, the guidance system includes one or more guide rails extended along the longitudinal axis of framework 7041（For example lead Rail 7045 and 7046）, following article is more fully described, and one or more of guide rails can be guided can be in staple 6220 Staple leg 6221 engages the staple leg of staple 6220 and makes one or more anvil blocks or convex of its deformation through after reservation matrix Wheel.In at least one such embodiment, guide rail 7045 and 7046 may include along guide line material or cable, the guide line material or Cable is for example along the top of framework 7041 or top surface, around distally post 7047 and return along the top of framework 7041 or top surface Extend.As described above, and referring now primarily to Figure 22 8 and Figure 23 0, in various embodiments, the second jaw 7040 can also be wrapped Include one or more anvil blocks or cam（Such as the first anvil block 7050 and the second anvil block 7060）, one or more of anvil blocks or convex Wheel can longitudinally be moved along the second jaw 7040, to become the leg through after reservation matrix in the leg of staple 6220 Shape.In at least one embodiment, surgical stapling device 7000 may also include and be connected to and/or can be operably coupled to the first anvil block 7050 the first anvil block driver or actuator 7051, the first anvil block driver or actuator can proximally pull the first anvil Seat 7050 and/or towards distally promote the first anvil block 7050.Similarly, at least one embodiment, surgical stapling device 7000 is gone back May include the second anvil block driver or the actuator that be connected to and/or can be operably coupled to the second anvil block 7060, described second Anvil block driver or actuator can promote the second anvil block 7060 and/or proximally pull the second anvil block 7060 towards distally.Each In planting embodiment, the first anvil block 7050 may include guide groove 7052, and the second anvil block 7060 may include guide groove 7062, the guide groove 7052 and guide groove 7062 can be able to that guide rail 7045 or guide rail 7046 can be slidingly received wherein.It is such at least one In embodiment, guide rail 7045 and 7046 can be closely received in guide groove 7052 and 7062 so that can be prevented or at least be limited There is relative lateral movement or side-to-side movement between guide rail 7045 and 7046 and guide groove 7052 and 7062.

In certain embodiments, to being described further above, the first anvil block 7050 and can be towards remote can proximally be pulled Layback moves the second anvil block 7060.Referring to Figure 22 6, at least one embodiment, guide rail 7045 and 7046 and distally post 7047 can Including pulley system, the pulley system can pull the second anvil block 7060 and/or proximally pull the second anvil block towards distally 7060.In at least one such embodiment, guide rail 7045 and guide rail 7046 may include to surround the company of distally post 7047 and extension Continuous wire rod or cable, wherein a part for the continuous wire can be pulled so that wire rod is rotated around distally post 7047. In various embodiments, guide rail 7046 can for example be mounted to the second anvil block 7060 so that when continuous cable is rotated in the first direction When, the second anvil block 7060 can be pulled to distally towards the distal end 7048 of jaw 7040, and when continuous cable in a second direction or When rightabout is rotated, the second anvil block 7060 can be pulled to nearside towards near-end 7049.Referring now to Figure 22 8, at least one In embodiment, guide rail 7046 can be fixed in guide groove 7062 so that can therebetween transmit pulling force.In at least one such enforcement In example, guide rail 7045 can slide in another guide groove 7062.In various embodiments, the first anvil block 7050 can be with the second anvil 7060 unrelated modes of seat work, and pulley system and the guide groove 7052 that is limited in the first anvil block 7050 can be slidably Accommodate guide rail 7045 and 7046 so that allow to carry out relative fortune between pulley system and guide groove 7052 and guide rail 7045 and 7046 It is dynamic.In various embodiments, constituting the continuous cable of guide rail 7045 and 7046 can have enough flexibility, to adapt to top pincers Mouthfuls 7040 open and close.Continuous cable can also have enough flexibility to adapt to the second jaw 7060 bottom of toward and away from The vertical movement of portion's jaw 7030, is described in more detail.

Figure 22 8 and Figure 23 0 is referred again to, in various embodiments, the first anvil block 7050 may include the cam extended from it Driven member 7055, cam follower 7055 can be ridden in one or more being limited in the framework 7041 of the second jaw 7040 Cam slot or guide groove（Such as cam slot 7070（Figure 23 1））In.More particularly, at least one embodiment, framework 7041 the first cam slots 7070 that may include the first side Longitudinal extending along framework 7041 and the second side along framework 7041 Or the second cam 7070 of opposite side Longitudinal extending, wherein the cam follower 7055 extended from the first side of the first anvil block 7050 Can ride in the first cam slot 7070, and the cam follower 7055 extended from the second side of the first anvil block 7050 can ride Across in the second cam slot 7070.In at least one such embodiment, the profile of each cam slot 7070 can be identical Or at least substantially identical, and can be mutually aligned or at least substantially align.Similarly, in various embodiments, second Anvil block 7060 may include the cam follower 7065 extended from it, and cam follower 7065 can be ridden in being limited to the second jaw Cam slot 7070 in 7040 framework 7041（Figure 23 1）In.More particularly, at least one embodiment, from second The cam follower 7065 that first side of anvil block 7060 extends can be ridden in the first cam slot 7070, and from the second anvil block The cam follower 7065 that 7060 the second side extends can be ridden in the second cam slot 7070.In use, the first anvil block The cam follower 7065 of 7050 anvil block 7060 of cam follower 7055 and second can slide in cam slot 7070 so that When the first anvil block 7050 and the second anvil block 7060 are pulled to nearside and/or are pushed to distally, the first anvil block 7050 and the second anvil Seat 7060 is advanced along the profile of cam slot 7070.In various embodiments, each cam slot 7070 may include multiple resting Part or top 7071 and multiple driver portions or bottom 7072, the plurality of portion or the top 7071 and the plurality of of resting Driver portion or bottom 7072 can be in anvil blocks 7050 and 7060 along longitudinal direction（That is, in the distal end 7048 of framework 7041 and near-end Between 7049）While motion vertically（That is, toward and away from bottom jaw 7030）Motion anvil block 7050 and 7060, following article It is more fully described.

When surgical stapling device 7000 is in non-cock, referring to Figure 23 1, the first anvil block 7050 can be positioned in framework At 7041 distal end 7048, and the second anvil block 7060 can be positioned at the near-end 7049 of framework 7041；Additionally, referring now to Figure 23 2, when surgical stapling device 7000 is in non-cock, the staple 6220 in the first jaw 7030 can be inserted not yet In entering tissue T and/or the reservation matrix above tissue T.Referring now to Figure 23 3, in use, staple driver 7012 can Staple 6220 is driven up in the staple cavity 7033 of nail bin；In addition, the first anvil block 7050 can be from the distal end 7048 of framework 7041 Towards the proximal motion of distal end 7049, to engage the staple leg 6221 of staple 6220.In at least one embodiment, in the first anvil Seat 7050 can drive up staple 6220 before engaging with the staple leg 6221 of staple 6220.In various embodiments, first Anvil block 7050 is advanced into before contact staple leg 6221, and sledge 7010 can upwards dispose all of staple 6220, or as other one Plant and select, sledge 7010 can proximally be moved while the first anvil block 7050 is proximally moved, but sledge 7010 can fully draw Lead the first anvil block 7050 staple 6220 is deployed in into the front of the first anvil block 7050.In various embodiments, as shown in Figure 23 3, Cam slot 7070 can or be arranged such that for example when the first cam 7050 through rest portion or top when, the first cam 7050 profiled surface（Such as profiled surface or cam face 7053 and 7054）At least some in accessible staple leg 6221 Staple leg 6221.In various scenarios, the cam follower 7055 of the first anvil block 7050 can be respectively positioned at cam slot 7070 rest in portion 7071 so that the position of profiled surface 7053 and 7054 in raising, and cause when anvil block 7050 thus During through in the portion of resting, staple leg 6221 only partially deforms.When the first cam 7050 is further moved along cam slot 7070 When, as shown in Figure 23 4, the cam follower 7055 of the first anvil block 7050 can be driven to the drive division of cam slot 7070 or under In portion 7072 so that profiled surface 7053 and 7054 is moved downward vertically towards staple leg 6021, so that staple leg 6021 is driven Into the configuration that it is fully formed.Subsequently, when the first anvil block 7050 is further advanced along cam slot 7070, the first anvil block 7050 can be rested in portion 7071 by another group of vertical drive upwards to cam slot 7070.As shown in Figure 23 3 and Figure 23 4, read Person should be noted that the first anvil block 7050 can only engage some staple legs and not engage other staple legs.In at least one such enforcement In example, the first anvil block 7050 for example can only make the one group of staple leg deformation for including the distal staple leg 6221 of staple 6220. In at least one such embodiment, the first anvil block 7050 can make distal staple leg 6221 towards the center deformation of staple 6220. In various embodiments, each proximal staple leg 6221 can twice by the first anvil block 7050（That is, by the first profiled surface 7053 and The second profiled surface 7054 alignd with the first profiled surface 7053）Contact.In at least one such embodiment, when the first anvil In when resting in portion or top, the first profiled surface 7053 can make distal staple leg 6221 be deformed into part deformation structure to seat 7050 Type, and when during the first anvil block 7050 moves to drive division or bottom, the second profiled surface 7054 can make distal staple leg 6221 are deformed into and are fully formed configuration.Referring now to Figure 22 8 and Figure 22 9, in various embodiments, the first anvil block 7050 may include Multiple first profiled surfaces 7053 and multiple second profiled surfaces 7054, so as to staple leg 6221 be aligned to more than a line or The distal staple leg 6221 that staple 6220 is made during one line deforms.In various embodiments, following article is more fully described, example As the second anvil block 7060 deforms can the proximal staple leg 6221 of staple 6020.

In various embodiments, to being described further above, the first anvil block 7050 can be from the distal end of framework 7041 7048 march to near-end 7049, so that all distal staple legs 6221 for making staple 6220 deform.Reader will note that, the first anvil block 7050 can upwardly or downwardly move relative to undeformed proximal staple leg 6221, and to adapt to this relative motion, each In planting embodiment, the first anvil block 7050 may include one or more clearance slots 7057（Figure 23 0）, one or more of gaps Slit 7057 can work as the first anvil block 7050 makes distal staple leg 6221 accommodate unbent proximal staple leg 6221 when bending.Phase As, Figure 22 8 is referred again to, the second anvil block 7060 may include clearance slot 7067, and the clearance slot can work as the first anvil block 7050 the first cam actuators 7051 for adapting to move up and down as mentioned above when it rests motion between portion and drive division are hung down Straight motion.After all distal staple legs 6221 are bent, at least one embodiment, anvil actuator 7061 can make Two anvil blocks 7060 move to distal end 7048 from the near-end 7049 of framework 7041.With it is similar to the above, referring now to Figure 23 5, such as The cam follower 7065 of two anvil blocks 7060 can slide in the cam slot 7070 so that the second anvil block 7060 the portion of resting or on Move between portion and drive division or bottom, to make proximal staple leg 6221 be deformed inward towards the center of staple 6220.With above Similar, the second anvil block 7060 may include multiple first shapings or cam face 7063 and multiple second shapings or cam face 7064, it is the plurality of first shaping or cam face 7063 and it is the plurality of second shaping or cam face 7064 can distinguish energy One or more for enough making in proximal staple leg 6021 deform at least in part and/or are badly deformed.Figure 22 9 is referred again to, the Two anvil blocks 7060 may include multiple first profiled surfaces 7063 and multiple second profiled surfaces 7064, the plurality of first shaping table Face 7063 and the plurality of second profiled surface 7064 stitch can the nearside of the staple 6220 for being arranged in multiple rows or a plurality of line Nail leg 6221 deforms.Equally as shown in Figure 22 9, first profiled surface 7063 and the second profiled surface 7064 of the second anvil block 7060 Can not align with the first profiled surface 7053 of the first anvil block 7050 and the second profiled surface 7054, wherein as a result, staple 6220 proximal leg 6221 can be located in different row or line from the distally leg 6221 of staple 6220.Reader shall yet further be noted that When the second anvil block 7060 is moved towards distally, the second anvil block 7060 can promote the first anvil block 7050.In at least one such enforcement In example, the second anvil block 7060 can push back to the first anvil block 7050 in the distal end 7048 of framework 7041 so that the first anvil block 7050 May return to its initial position or non-firing position.After all proximal staple legs 6221 of staple 6220 deform, second Anvil block 7060 can proximally retract and be back to its initial position or non-firing position.Consequently, it is possible to surgical stapling device 7000 can It is reset to so that new nail bin can be positioned in the first jaw 7030, and new reservation square can be positioned in the second jaw 7040 Battle array, to reuse surgical stapling device 7000.

In various embodiments, it is described two or more as described above, surgical stapling device may include two or more anvil blocks Multiple anvil blocks can be along being longitudinally travelled to engage the leg of multiple staples along transverse direction.In certain embodiments, surgical stapling Device may include the anvil block for proximally moving, such as so that first group of staple leg deforms and for example make second group of staple leg deformation. In at least one such embodiment, this anvil block may include the profiled surface for example towards nearside and the shaping table towards distally Face.

Referring now to Figure 23 6, in various embodiments, anvil block,（For example, anvil block 7140）May include lower surface or tissue Contact surface 7141 and the multiple forming pits 7142 in being limited to lower surface or tissue contacting surface 7141.At least one In individual embodiment, anvil block 7140 may include the more than one plate that can be welded in framework 7144（Such as crater plate 7143）. In at least one such embodiment, in the board channel 7145 that each crater plate 7143 can be positioned in framework 7144 and pass through Extend through the welding slit 7146 of framework 7144 and be soldered to framework 7144 to form longitudinal welding pieces 7147.Various In embodiment, longitudinal welding pieces 7147 for example may include continuous weldment or the edge extended along the whole length of welding slit 7146 A series of pads spatially spaced apart that the length of welding slit 7146 extends.In various embodiments, each pit Plate 7143 may each comprise two or more plate parts being soldered together.It is each at least one such embodiment Crater plate 7143 may each comprise can be along first plate part 7143a welded together of seam 7148 and the second plate part 7143b. In various embodiments, before in the board channel 7145 that plate 7143 is soldered in framework 7144, the first of each plate 7143 Plate part 7143a and the second plate part 7143b can be soldered together.In at least one such embodiment, the first plate part 7143a and the second plate part 7143b may include to fit together to form the profile of the cooperation of impervious seam 7148（For example Zigzag appearance shown in Figure 23 6）.In at least one embodiment, each plate 7143 may include e.g., from about .02 " height, The height can be higher than the depth of board channel 7145 so that framework of the tissue contacting surface 7141 of plate 7143 from anvil block 7040 7044 extend.Referring now to Figure 23 7, in certain embodiments, plate 7143 can be for example by the far-end positioned at plate 7143 extremely Lack a weldment 7149 and connect together.

As shown in Figure 23 6 and Figure 23 7, each crater plate 7143 may each comprise and be limited at multiple forming pits therein 7142.In various embodiments, can be by any suitable manufacture method（Such as Ginding process and/or electrode combustion method） Forming pit 7142 is formed in plate 7143.Referring now to Figure 23 8 and Figure 23 9, at least one such embodiment, for example, can lead to Cross following methods to manufacture each forming pit 7142：Deep-well 7150 is initially formed, then around deep-well 7150 arch is formed Or curved surface 7151, staple leg guiding groove 7152 is then formed in curved surface 7151.In various other enforcements In example, these steps can be performed with any suitable order.Referring now to Figure 24 0, in various embodiments, staple formation is recessed Hole 7142 can be formed to make the inner edge 7153 of forming pit to be spaced apart by consistent or at least substantially consistent gap 7154. In at least one such embodiment, gap 7154 may be, for example, about .008 ".Additionally, at least one such embodiment, Forming pit 7142 can be positioned along two or more rows or line, and the center line of forming pit 7142 can be by consistent or at least base Spacing 7155 consistent in sheet is spaced apart.In at least one such embodiment, the spacing 7155 between center line may be, for example, About .035 ".Refer again to Figure 24 0, in various embodiments, each forming pit 7142 can narrow width 7156 with it is wide It is tapered between width 7157.In at least one such embodiment, such as narrow width 7156 may be about .045 ", and And wide width 7157 may be about .075 ".In various embodiments, plate 7143 can by with the identical material structure of framework 7144 Into.In at least one such embodiment, plate 7143 and the both of which of framework 7144 can for example by stainless steel（Such as 300 series or The stainless steel of 400 series）And/or titanium is constituted.In various other embodiments, plate 7143 and framework 7144 can be by different materials Constitute.In at least one such embodiment, plate 7143 for example can be made up of ceramic material, and framework 7144 can for example by not Rust steel and/or titanium are constituted.In various scenarios, according to the material for being used, such as in addition to above-mentioned welding method or as upper The replacement of welding method is stated, at least one method for welding is it is also possible to use and plate 7143 is fixed in framework 7144.

Referring now to Figure 24 1-243, in various embodiments, anvil block 7240 may include framework 7244 and can be inserted into frame Multiple crater plates 7243 in frame 7244.With it is similar to the above, each crater plate 7243 may include to be limited at it is therein it is multiple into Shape pit 7242.In at least one embodiment, anvil block framework 7244 may include to be limited at reservation slit 7246 therein, should Retaining slit can accommodate the reservation guide rail 7247 extended from crater plate 7243.It is that crater plate 7243 is assembled into into anvil block framework 7244, the side wall 7245 of the anvil block framework 7244 can outwards flexing or expansion（As shown in Figure 24 2）, so as to retain slit 7246 become Width, so that each slit 7246 that retains can wherein accommodate the reservation guide rail 7247 of crater plate 7243.Once retain guide rail 7247 are positioned in reservation slit 7246, and side wall 7245 can be released（As shown in Figure 24 3）, so as to allow framework 7244 with Elastic type is retracted and/or is back to its non-flexion.In this case, retain the regracting of slit 7246 and therefore will protect Guide rail 7247 is stayed to capture wherein.In certain embodiments, retain guide rail 7247 and/or retain slit 7246 may include one or The conical surface of multiple cooperations；After the reservation slit 7246 of flexing is released, the taper table of one or more of cooperations Face can be formed can retain the taper lock engagement that guide rail 7247 is maintained in reservation slit 7246.With similar to the above, crater plate 7243 can be made up of the material identical or different with framework 7244.In at least one such embodiment, plate 7243 can for example by Ceramic material is constituted, and framework 7244 for example can be made up of stainless steel and/or titanium.In various scenarios, according to being used Material, for example, can be fixed on plate 7243 in framework 7244 using at least one method for welding and/or at least one welding method.

Processed after being designed as being intended for single use by device disclosed in this invention, or can be designed as them can It is used for multiple times.However, in either case, described device can be repaired, to reuse after use at least one times. Again any combination that may include following steps is recovered：Dismantle the device and then cleaning or replace some parts and subsequent group Dress.Particularly, described device can be dismantled, and can optionally be replaced in any combination or to remove the device any number of Specific component or part.After cleaning and/or displacement specific part, the device can be re-assemblied so as to subsequent at restoration facilities Use, or re-assemblied by surgical team before it will carry out surgical operation.Those skilled in the art will be appreciated that, fill The reparation put can utilize various technologies for dismantling, cleaning/replace and re-assembly.The use of these technologies and gained Prosthetic device is within the scope of the present invention.

Preferably, device as herein described is processed before surgery.First, new or used device is obtained, and must Device is cleaned when wanting.Then device is carried out disinfection.In a kind of disinfection technology, the device is placed on and is closed and close In the container of envelope, such as in plastics or TYVEK bag.Then container and device are placed on the radiation area that can penetrate the container, Such as γ radiation, x- rays or high energy electron.Radiate and kill the bacterium on device and in container.Then by the device after sterilizing In being stored in disinfecting container.The sealing container holding meanss are aseptic until opening the container in medical facilities.

Any patent, announcement or other open materials being expressly incorporated herein in full or partly by reference only simultaneously The material for entering not be expressly incorporated herein in existing definition of the present invention, statement or the afoul scope of other open materials.By This, under necessary degree, the disclosure for herein explicitly illustrating will replace any phase punching being herein incorporated by reference Prominent material.If according to state be herein incorporated by reference but with existing definition as herein described, statement or other open material phases Any material of conflict or part thereof, under the degree of conflict is not produced only between the material being incorporated to and existing open material It is expressly incorporated herein.

Although by the present invention, as an example property design is described, it is also possible in the spirit and scope of the disclosure It is interior that the present invention is modified.Therefore present patent application be intended to any modification using its general principles, purposes or Remodeling.Additionally, present patent application is intended to belong in art of the present invention known or used having in practical framework with this public affairs Open different patterns.

Claims (18)

1. a kind of nail bin, including：

Multiple staples, staple described in each of which includes base portion and can deform leg from the base portion is upwardly extending；

The ground floor being made up of the material that can collapse, wherein the leg that can deform is positioned in the ground floor；

Adhere to the second layer of the ground floor；And

The third layer of the second layer is removedly adhered to, wherein the third layer includes multiple staple slits, and wherein The staple basis are positioned in the staple slit and are supported from below by the staple slit,

Wherein described ground floor is made up of the first foamed material with the first density, and wherein described third layer is by another bubble Foam material is constituted, and the density that another foamed material has is more than first density.

2. nail bin according to claim 1, wherein the third layer includes at least one perforation, at least one perforation Can allow for the third layer to remove from the second layer with two or more parts.

3. nail bin according to claim 2, wherein the plurality of staple is arranged to the first staple line and the second staple line, And wherein described at least one perforation extends between first staple line and second staple line.

4. nail bin according to claim 1, wherein the staple slit can be in the staple basis and the third layer Between gap is provided.

5. nail bin according to claim 1, wherein the third layer is made up of hemostatic material.

6. nail bin according to claim 1, wherein the leg extension that can deform is through the second layer.

7. a kind of fastener cartridge, including：

Multiple securing members, securing member described in each of which includes base portion and from the upwardly extending tissue capture portion of the base portion；

The first laminates being made up of energy conquassation material, wherein the tissue capture portion is positioned in first laminates；

It is attached to the second laminates of first laminates；And

The third layer compound of second laminates is removably attached to, wherein the third layer compound includes that multiple receivings are narrow Groove, and wherein described fastener base be positioned in it is described receiving slit in and by it is described receiving slit support from below,

Wherein described ground floor compound is made up of the first foamed material with the first density, and wherein described third layer compound It is made up of another foamed material, the density that another foamed material has is more than first density.

8. fastener cartridge according to claim 7, wherein the third layer compound includes at least one perforation, it is described at least One perforation can allow for the third layer compound and be removed from second laminates with two or more parts.

9. fastener cartridge according to claim 8, wherein the plurality of securing member is arranged to the first securing member row and the Two securing members are arranged, and wherein described at least one perforation is prolonged between first securing member row and second securing member row Stretch.

10. fastener cartridge according to claim 7, wherein the receiving slit can the fastener base with it is described Gap is provided between third layer compound.

11. fastener cartridges according to claim 7, wherein the third layer compound is made up of hemostatic material.

12. fastener cartridges according to claim 7, wherein the tissue capture portion extends through second laminates.

A kind of 13. methods for loading staple to nail bin, comprise the following steps：

Multiple staples are positioned in transfer blade, the transfer blade includes multiple chambers that can accommodate the staple；

The staple cartridge body that will be compressed is positioned relative to the transfer blade；

By gripper shoe against the staple cartridge body positioning that can be compressed；

Compression step, i.e. compress the staple cartridge body that can be compressed between the gripper shoe and the transfer blade；And

Inserting step, i.e. by the staple insertion staple cartridge body that can be compressed.

14. methods according to claim 13, wherein the inserting step occurs during the compression step.

15. methods according to claim 13, are also included the step in the staple cartridge body plug-in-sleeve that can be compressed.

16. methods according to claim 15, also including sealing described sleeve pipe the step of.

17. methods according to claim 13, wherein the inserting step includes projecting the staple from the transfer blade.

18. methods according to claim 17, wherein the injection staple is included the staple at least in part In inserting the gripper shoe.