US20140048580A1

US20140048580A1 - Buttress attachment features for surgical stapling apparatus

Info

Publication number: US20140048580A1
Application number: US13/942,822
Authority: US
Inventors: Rahim R. Merchant; Gerald N. Hodgkinson; Danny Berry; Sally L. Carter
Original assignee: Covidien LP
Current assignee: Covidien LP
Priority date: 2012-08-20
Filing date: 2013-07-16
Publication date: 2014-02-20
Also published as: AU2013211499B2; ES2669220T3; JP6290556B2; CA2823283C; EP2700367A1; EP2700367B1; US20180214147A1; US20210085312A1; US10881395B2; JP2014036860A; AU2013211499A1; CA2823283A1

Abstract

An end effector assembly for use with a surgical stapler, comprising a staple cartridge having a tissue contacting surface, an anvil plate having a tissue contacting surface, a buttress material releasably disposed on the tissue contacting surfaces of each of the staple cartridge and the anvil plate, and an epoxy positioned onto the tissue contacting surfaces of each of the staple cartridge and anvil plate defining an attachment zone configured to retain the respective buttress material atop the respective tissue contacting surfaces.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of and priority to U.S. Provisional Patent Application Ser. No. 61/684,846, filed Aug. 20, 2012, the entire disclosure of which is incorporated by reference herein.

BACKGROUND

1. Technical Field
The present disclosure relates to surgical stapling apparatuses and buttress materials for use with said surgical stapling apparatus and, more particularly, to structures and methods for attaching a buttress material to a surgical stapling apparatus.
2. Background of Related Art
Surgical stapling apparatus are employed by surgeons to sequentially or simultaneously apply one or more rows of fasteners, e.g., staples or two-part fasteners, to body tissue for the purpose of joining segments of body tissue together. Such apparatus generally include a pair of jaws or finger-like structures between which the body tissue to be joined is placed. When the stapling apparatus is actuated, or “fired”, longitudinally moving firing bars contact staple drive members in one of the jaws. The staple drive members push the surgical staples through the body tissue and into an anvil in the opposite jaw which forms the staples. If tissue is to be removed or separated, a knife blade can be provided in the jaws of the apparatus to cut the tissue between the lines of staples.
For most procedures, the use of bare staples, with the staples in direct contact with the patient's tissue, is generally acceptable. In certain procedures, the use of surgical supports, e.g., meshes or buttress materials, are employed by surgeons in combination with linear or annular stapling devices to bridge, repair and/or reinforce tissue defects within a patient, especially those occurring in the abdominal wall, chest wall, diaphragm, and other musculo-aponeurotic areas of the body. The buttress material tends to reinforce the staple or suture line as well as cover the juncture of the tissues to reduce leakage prior to healing. In certain minimally invasive surgical procedures the buttress material may be pre-attached to the surgical instrument being used. For example, the buttress material can be attached to a staple cartridge or anvil plate of a surgical stapling instrument by the manufacturer.
A surgical stapling apparatus having a surgical buttress releasably secured thereto by at least one anchor is disclosed in International Published Application No. WO 08/109,125 A1, the disclosure of which is hereby incorporated by reference herein in its entirety. The buttress is attached to the apparatus by at least one anchor and includes knife blades for severing the anchors.
U.S. Pat. No. 5,441,193 to Gravener, the disclosure of which is hereby incorporated by reference herein in its entirety, discloses a surgical device having a sheet of curved resilient material attached thereto. Elongated projections can be fixed within slots using adhesive bonding and perforations permit tearing of the film to separate the central portion of the film from the side portions.
It would be desirable to provide improved means of securely attaching a surgical buttress to the staple cartridge or anvil plate while allowing the buttress material to fully release from the surgical stapling apparatus after the staples have been fired.

SUMMARY

Disclosed herein is a surgical stapling apparatus including a buttress material and a method of attaching the buttress material to the surgical stapling apparatus.
In one embodiment of present application a system for securing surgical buttresses to the jaws of the stapler is disclosed. The system allows the surgical buttresses to be secured to the staple cartridge and/or anvil plate by utilizing ultraviolet light curable epoxy to adhere the surgical buttresses to a tissue contacting surface of the staple cartridge and/or anvil plate. Perforations may be provided around the location of the epoxy to allow the surgical buttress to release from the tissue contacting surfaces by the force applied by the grasp of staples in the surgical buttress.
In accordance with one embodiment of the present disclosure, the use of ultraviolet light curable epoxy allows the same attachment means to be utilized for both the metal based anvil plate and metal or non-metal staple cartridge. In addition, the use of ultraviolet light curable epoxy can be precisely controlled both in terms of spatial placement and volume of deposition as to not impact the anvil plate or staple cartridge. Most importantly, the ultraviolet light curable epoxy is essentially part of the stapling device as it does not detach with the surgical material and is not implanted into the body.
In another embodiment of the present disclosure, surgical buttresses are secured to the staple cartridge and/or anvil plate with the use of retaining members placed through at least one hole of the surgical buttress and through at least one opening of at least one of the staple cartridge and/or anvil plate.
In one aspect of the present disclosure, a staple cartridge for use with a surgical stapling apparatus is disclosed. The staple cartridge includes a cartridge body including a tissue contacting surface defining a plurality of staple retaining slots. The tissue contacting surface of the cartridge body is fabricated from a first material. The staple cartridge further includes a staple disposed within each staple retaining slot of the cartridge body. A buttress material is releasably disposed on the tissue contacting surface of the cartridge body and an epoxy is positioned on the tissue contacting surface of the cartridge body defining an attachment zone configured to retain the buttress material atop the tissue contacting surface.
In an aspect of the present disclosure, the epoxy is an ultraviolet light curable epoxy.
In an aspect of the present disclosure, the tissue contacting surface has a first and second outer edge.
In an aspect of the present disclosure, the tissue contacting surface has a distal end such that a distal attachment zone is positioned from the first outer edge to the second outer edge.
In an aspect of the present disclosure, the tissue contacting surface has a proximal end such that a first proximal attachment zone is positioned parallel to the first outer edge and second proximal attachment zone is positioned parallel to the second outer edge.
In an aspect of the present disclosure, the staple cartridge defines a central longitudinal slot configured to enable passage of a knife blade therethrough.
In an aspect of the present disclosure, the first and second proximal attachment zones are positioned distally from a proximal end of the central longitudinal slot.
In an aspect of the present disclosure, the distal attachment zone is positioned proximally for a distal end of the central longitudinal slot.
In an aspect of the present disclosure, the buttress material has perforations at the proximal end of the tissue contacting surface such that the perforations are positioned perpendicularly and distally from the first and second proximal attachment zone.
In an aspect of the present disclosure, the buttress material has perforations at the distal end of the tissue contacting surface such that the perforations are positioned parallel and proximal from the at least one distal attachment zone.
In an aspect of the present disclosure, a plurality of attachment zones are disposed intermittently along the first and second outer edges.
In an aspect of the present disclosure, the plurality of attachment zones are concentric.
In an aspect of the present disclosure, the buttress material has perforations such that the perforations surround the plurality of attachment zones.
In an aspect of the present disclosure, an end effector assembly for a surgical stapler is disclosed. The end effector including a staple cartridge having a tissue contacting surface, the tissue contacting surface of the cartridge body being fabricated from a first material. The end effector further including an anvil plate having a tissue contacting surface, the tissue contacting surface of the anvil plate being fabricated from a second material that is dissimilar from the first material. A buttress material is releasably disposed on the tissue contacting surfaces of each of the staple cartridge and the anvil plate and an epoxy positioned onto the tissue contacting surfaces of each of the staple cartridge and anvil plate defining an attachment zone configured to retain the respective buttress material atop the respective tissue contacting surfaces.
In an aspect of the present disclosure, a surgical stapling apparatus is disclosed. The apparatus includes a cartridge body including a tissue contacting surface defining a plurality of staple retaining slots and a staple disposed with each staple retaining slot of the cartridge body. The staple cartridge further includes a substantially circular buttress material releasably disposed on the tissue contacting surface of the cartridge body, the buttress material including an inner peripheral edge, an outer peripheral edge, and a middle portion extending between the inner and outer peripheral edges and an epoxy positioned on the tissue contacting surface of the cartridge body defining an attachment zone configured to retain the buttress material atop the tissue contacting surface. In certain preferred embodiments, the epoxy is a curable epoxy, and may be curable upon exposure to ultraviolet light.
The buttress material may further include perforations arranged to allow the buttress material to separate from the cartridge body. A retaining member may also be disposed in a hole in the surgical stapling apparatus.
In a further aspect of the present disclosure, a method of assembling a surgical stapling apparatus comprises: providing a surgical stapling apparatus having at least one tissue contacting surface, the tissue contacting surface having a stapling zone and at least one attachment zone; applying epoxy on the at least one attachment zone on the tissue contacting surface; applying a buttress to the tissue contacting surface so as to contact at least a portion of the buttress with the epoxy, the buttress having a portion for overlying the stapling zone and a portion overlying the attachment zone for being permanently attached to the tissue contacting surface; and curing the epoxy.
The epoxy may be curable with exposure to ultraviolet light. In certain embodiments, the surgical stapling apparatus has an anvil plate and a staple cartridge. The surgical stapling apparatus can be selected from the group consisting of a circular surgical stapler and a linear surgical stapler. The method can include disposing a retaining member in a hole in the surgical stapling apparatus.
Any of the above aspects of the present disclosure described may be combined with any other aspect of the present disclosure without departing from the scope of the present disclosure.
In another aspect of the present disclosure, a tool assembly for use in a surgical stapling apparatus for joining tissue portions is disclosed. The tool assembly includes a staple cartridge containing a plurality of surgical staples therein and an anvil plate configured to cooperate with the staple cartridge to grasp tissue disposed therebetween where at least one of the staple cartridge and the anvil plate includes at least one opening. The tool assembly further includes a buttress material supported on the at least one of the staple cartridge and the anvil plate and including at least one hole formed therein. The tool assembly further includes at least one retaining member extending through the at least one hole and the at least one opening. The retaining member is configured to releasably secure the buttress material to the at least one of the staple cartridge and the anvil plate and is configured to separate from the buttress material to release the buttress material from the at least one of the staple cartridge and the anvil plate after firing of the surgical stapling apparatus.
In an aspect of the present disclosure, the at least one retaining member includes a pair of buttons and a tether extending therebetween. The tether extends through the at least one hole and the at least one opening with one of the buttons disposed adjacent each of the at least one hole and the at least one opening to releasably secure the buttress material to the at least one of the staple cartridge and the anvil plate.
In an aspect of the present disclosure, the pair of buttons are sized such that a diameter of each button is larger than the respective hole or opening.
In an aspect of the present disclosure, the at least one of the staple cartridge and the anvil plate includes a tissue contacting surface and a side surface. The buttress material includes a flap extending beyond the tissue contacting surface and configured for placement adjacent the side surface. The flap includes the at least one hole extending therethrough and the at least one opening is disposed in the side surface such that the at least one retaining member releasably secures the flap to the side surface.
In an aspect of the present disclosure, the surgical stapling apparatus is a linear surgical stapling apparatus.
In an aspect of the present disclosure, the at least one hole includes a plurality of holes longitudinally spaced along the buttress material.
In an aspect of the present disclosure, the at least one hole includes a plurality of holes spaced along the buttress material transverse to a longitudinal axis of the tool assembly.
In an aspect of the present disclosure, the at least one hole is disposed adjacent to a corner of the buttress material and the at least one opening extends through a tissue contacting surface of the at least one of the staple cartridge and the anvil plate.
In an aspect of the present disclosure, the surgical stapling apparatus is a circular surgical stapling apparatus.
In an aspect of the present disclosure, the at least one hole includes a plurality of holes annularly spaced along the buttress material.
In an aspect of the present disclosure, the buttress material includes a first flap adjacent an inner side surface of the at least one of the staple cartridge and the anvil plate and a second flap adjacent an outer surface of the at least one of the staple cartridge and the anvil plate. Each of the first and second flaps includes the at least one hole and each of the inner and outer side surfaces includes the at least one opening.
In an aspect of the present disclosure, a tissue contacting surface of the at least one of the staple cartridge and the anvil plate includes a flange extending radially inward therefrom. The buttress material is supported on the flange and includes the at least one hole adjacent the flange. The flange includes the at least one opening therein.
In an aspect of the present disclosure, the retaining member is formed of a bioabsorbable polymer.
In an aspect of the present disclosure, the retaining member is configured to fracture after the plurality of surgical fasteners are fired.
In an aspect of the present disclosure, the retaining member is dissolvable in a body fluid.
In an aspect of the present disclosure, the retaining member dissolvable in saline.
In an aspect of the present disclosure, the retaining member has a melt temperature of about body temperature.
In an aspect of the present disclosure, retaining member has a melt temperature of about 37° C.
In an aspect of the present disclosure, the buttress material includes a plurality of perforations that are configured to allow the retaining member to separate from the buttress material.
In yet another aspect of the present disclosure, a method of attaching a buttress material to a surgical stapling apparatus during assembly is disclosed. The method includes the steps of: providing a staple cartridge containing a plurality of surgical staples therein, providing an anvil plate configured to cooperate with the staple cartridge to grasp tissue disposed therebetween, positioning a buttress material on at least one of the staple cartridge and the anvil plate, inserting a retaining member having a first end and a second end through at least one hole of the buttress material and at least one opening of the at least one of the staple cartridge and the anvil plate, and melting the retaining member to form a button on each of the first and second ends to releasably secure the buttress material to the at least one of the staple cartridge and the anvil plate.
In an aspect of the present disclosure, the buttons are formed such that a diameter of each button is larger than the respective hole or opening.
In an aspect of the present disclosure, a surgical stapling apparatus for joining tissue portions is disclosed. The apparatus includes a staple cartridge having a plurality of surgical staples disposed therein and at least one opening formed therein. The staple cartridge further includes a buttress material supported on the staple cartridge and including at least one hole formed therein and at least one retaining member extending through the at least one hole and the at least one opening. The retaining member is configured to releasably secure the buttress material to the staple cartridge and is configured to separate from the buttress material to release the buttress material from the staple cartridge after firing of the surgical stapling apparatus.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the presently disclosed interlocking buttress retention systems are disclosed herein with reference to the drawings, wherein:

FIG. 1 is a perspective view of a surgical stapling apparatus according to an embodiment of the present disclosure;

FIG. 2 is a perspective view, with parts separated, of a staple cartridge of the surgical stapling apparatus of FIG. 1, illustrating a surgical buttress associated therewith;

FIG. 3 is a perspective view, with parts separated, of an anvil plate of the surgical stapling apparatus of FIG. 1, illustrating a surgical buttress associated therewith;

FIG. 4 is a perspective view of the staple cartridge, illustrating the surgical buttress affixed to the staple cartridge;

FIG. 5 is a perspective view of the anvil plate, illustrating the surgical buttress affixed to the anvil plate;

FIG. 6 is a perspective view of a distal end of the surgical stapling apparatus of FIG. 1, shown in use positioned about a tissue section;

FIG. 7 is a cross-sectional view taken along line 7-7 of FIG. 6;

FIG. 8 is a perspective view of the stapled and divided tissue section of FIG. 6;

FIG. 9A is a perspective view of an illustrative embodiment of a surgical stapling apparatus in accordance with another embodiment of the present disclosure;

FIG. 9B is a side elevational view partially, broken away, of the surgical stapling apparatus of FIG. 9A;

FIG. 10A is a perspective view of an illustrative embodiment of the staple cartridge of the surgical stapling apparatus of FIG. 9A including a surgical buttress in accordance with an embodiment of the present disclosure;

FIG. 10B is a top plan view of the staple cartridge and surgical buttress illustrated in FIG. 10A;

FIG. 11 is perspective view of an intestinal area of a patient, illustrating a method of positioning the anvil rod and staple cartridge of the surgical stapling apparatus of FIGS. 9A, 9B, and 10 within the intestinal area;

FIG. 12 is a schematic perspective view of the intestinal area of FIG. 11, illustrating the anvil rod mounted to the surgical stapling apparatus;

FIG. 13A is a perspective view of an alternate embodiment of a staple cartridge of the surgical stapling apparatus of FIG. 1, illustrating a buttress material supported thereon;

FIG. 13B is a top, plan view of the buttress material of FIG. 13A, illustrating the buttress material unfolded;

FIG. 14A is a top, cross-sectional view of the cartridge of FIG. 13A, taken along section line 14A-14A of FIG. 13A;

FIG. 14B is a front, cross-sectional view of the staple cartridge of FIG. 13A, taken along section line 14B-14B of FIG. 13A;

FIG. 15A is a perspective view of another embodiment of a staple cartridge of the annular surgical stapling apparatus of FIG. 1, illustrating a buttress material supported thereon;

FIG. 15B is a top, plan view the buttress material of FIG. 15A;

FIG. 16A is a side, cross-sectional view of the staple cartridge of FIG. 15A, taken along section line 16A-16A of FIG. 15A;

FIG. 16B is a front, cross-sectional view of the staple cartridge of FIG. 15A, taken along section line 16B-16B of FIG. 15A;

FIG. 17A is a perspective view of another embodiment of a staple cartridge of the annular surgical stapling apparatus of FIGS. 9A-9B, illustrating a buttress material supported thereon;

FIG. 17B is a top, plan view the buttress material of FIG. 17A, illustrating the buttress material unfolded;

FIG. 18A is a side, cross-sectional view of the staple cartridge of FIG. 17A, taken along section line 18A-18A of FIG. 17A;

FIG. 18B is a top, cross-sectional view of the staple cartridge of FIG. 17A, taken along section line 18B-18B of FIG. 17A;

FIG. 19A is a top, plan view of another embodiment of a staple cartridge of the annular surgical stapling apparatus of FIGS. 9A-9B, illustrating a buttress material supported on a flange of the staple cartridge;

FIG. 19B is a top, plan view the buttress material of FIG. 19A;

FIG. 20A is a side, cross-sectional view of the staple cartridge of FIG. 19A, taken along section line 20A-20A of FIG. 19A, illustrating the staple cartridge having a flange;

FIG. 20B is a side, cross-sectional view of another embodiment of a staple cartridge of FIG. 19A, illustrating the staple cartridge having a relatively wider inner surface;

FIG. 21 is a perspective view of a anvil plate of the surgical stapling apparatus of FIG. 1, illustrating a buttress material supported thereon in accordance with another embodiment of the present disclosure; and

FIG. 22 is a perspective view of a staple cartridge of the annular surgical stapling apparatus of FIGS. 9A-9B, illustrating a buttress material supported thereon in accordance with another embodiment of the present disclosure.

DETAILED DESCRIPTION OF THE EMBODIMENTS

Various exemplary embodiments of the present disclosure are discussed herein below in terms of buttresses for use with surgical stapling apparatus. The buttresses described herein may be used in sealing a wound by approximating the edges of wound tissue between a staple cartridge and an anvil plate of a surgical stapling apparatus which contains at least one buttress. The at least one buttress is joined to the surgical stapling apparatus by at least one attachment zone formed by an epoxy positioned between a tissue contacting surface of each of the staple cartridge and anvil plate and the least one buttress. Firing of the surgical stapling apparatus forces legs of at least one staple to pass through an opening on the staple cartridge, the tissue, and the openings on the anvil plate to secure the buttress to the tissue, to secure the adjoining tissue to one another, and to seal the tissue. Thus, the present disclosure describes surgical buttresses, surgical stapling apparatus supporting said surgical buttresses, and methods and mechanisms for using the same.
It should be understood that a variety of surgical stapling apparatus may be utilized with a surgical buttress of the present disclosure. For example, linear stapler configurations may be utilized, such as, for example those including Duet TRS™ reloads and staplers with Tri-Staple™ technology, available through Covidien, which maintain a principal place of business at 555 Long Wharf Drive, North Haven, Conn. 06511, and transverse anastomosis staplers, such as, for example, EEA™, CEEA™, GIA™, EndoGIA™, and TA™ surgical staplers, also available G through Covidien. It should also be appreciated that the principles of the present disclosure are equally applicable to surgical staplers having alternate configurations, such as, for example, end-to-end anastomosis staplers having a circular cartridge and anvil (see, e.g., commonly owned U.S. Pat. No. 5,915,616, entitled “Surgical Fastener Applying Apparatus,” the entire content of which is incorporated herein by this reference); laparoscopic staplers (see, e.g., commonly owned U.S. Pat. Nos. 6,330,965 and 6,241,139, each entitled “Surgical Stapling Apparatus,” the entire contents of each of which being incorporated herein by this reference); and transverse anastomosis staplers (see, e.g., commonly owned U.S. Pat. Nos. 5,964,394 and 7,334,717, each entitled “Surgical Fastener Applying Apparatus”, the entire contents of each of which being incorporated herein by this reference).
Embodiments of the presently disclosed surgical buttress and surgical stapling apparatus will now be described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. In the following discussion, the terms “proximal” and “trailing” may be employed interchangeably, and should be understood as referring to the portion of a structure that is closer to a clinician during proper use. The terms “distal” and “leading” may also be employed interchangeably, and should be understood as referring to the portion of a structure that is further from the clinician during proper use. As used herein, the term “patient” should be understood as referring to a human subject or other animal, and the term “clinician” should be understood as referring to a doctor, nurse, or other care provider and may include support personnel.
Referring now to FIG. 1, there is disclosed an exemplary surgical stapling apparatus or surgical stapler 10 for use in stapling tissue and applying a buttress material or surgical buttress to the tissue. An exemplary example of this type of surgical stapling instrument is disclosed in U.S. Pat. No. 7,128,253, the entire disclosure of which is incorporated by reference herein.
Surgical stapling apparatus 10 generally includes a handle 12 having an elongate tubular member 14 extending distally from handle 12. An end effector assembly 16 is mounted on a distal end 18 of elongate tubular member 14. End effector assembly 16 includes a staple cartridge 200 configured to receive a cartridge body 32 therein and an anvil plate 300. End effector assembly 16 may be permanently affixed to elongate tubular member 14 or may be detachable and thus replaceable with a new end effector assembly 16. Anvil plate 300 is movably mounted on distal end 18 of jaw assembly 16 and is movable between an open position spaced apart from staple cartridge 200 to a closed position substantially adjacent staple cartridge 200. Anvil plate 300 is fabricated from a metal material, including and not limited to stainless steel, titanium, titanium alloy, and the like. At least a tissue contacting surface of staple cartridge 200 is fabricated from a material other than metal, including and not limited to plastic, thermoplastic, resin, polycarbonate, and the like.
Surgical stapling apparatus 10 further includes a trigger 33, as seen in FIG. 1, movably mounted on handle 12. Actuation of trigger 33 initially operates to move anvil plate 300 from the open to the closed position relative to staple cartridge 200 and subsequently actuates surgical stapling apparatus 10 to apply lines of staples to tissue. In order to properly orient end effector assembly 16 relative to the tissue to be stapled, surgical stapling apparatus 10 is additionally provided with a rotation knob 34 mounted on handle 12. Rotation of rotation knob 34 relative to handle 12 rotates elongate tubular member 14 and end effector assembly 16 relative to handle 12 so as to properly orient end effector assembly 16 relative to the tissue to be stapled.
A driver 36, as seen in FIGS. 6 and 7A, is provided to move anvil plate 300 between the open and closed positions relative to staple cartridge 200. Driver 36 moves through a longitudinal slot 338 (FIG. 3) formed in anvil plate 300. A knife 30 with knife blade 31 is associated with driver 36 to cut tissue captured between staple cartridge 200 and anvil plate 300 as driver 36 passes through slot 338. The driver may be configured as a beam with an upper portion that engages the anvil plate 300 and a lower portion that engages the channel that supports the staple cartridge 200. For example, U.S. Pat. No. 7,565,993 to Milliman et al., the disclosure of which is hereby incorporated by reference herein in its entirety, discloses an axial drive assembly 212 including an elongated drive beam 266 for approximating the anvil and staple cartridge to clamp tissue and fire staples therein. The stapling apparatus 10 can include such a beam, or other known structure. The staple cartridge 200 has staple receiving slots for retaining staples therein, whereas the anvil plate includes staple forming recesses. The driver forces the staples from the staple receiving slots and drives them into the staple forming recesses so that they are formed into a closed shape around tissue.
Reference may be made to commonly owned U.S. Pat. Nos. 5,915,616, 6,330,965, and 6,241,139, referenced above, for a detailed discussion of the construction and operation of an exemplary surgical stapling apparatus 10.
Staple cartridge 200 and/or anvil plate 300 may be provided with a surgical buttress 500. Surgical buttress 500 is provided to reinforce and seal the lines of staples applied to tissue by surgical stapling apparatus 10. Surgical buttress 500 may be configured into any shape, size, or dimension suitable to fit any surgical stapling, fastening, or firing apparatus.
Staple cartridge 200 is provided with a cartridge buttress 500 a and anvil plate 300 is provided with an anvil buttress 500 b in the manners described in more detail hereinbelow. The buttresses 500 a, 500 b may be made from any biocompatible natural or synthetic material. The material from which the buttresses 500 a, 500 b are formed may be bioabsorbable or non-bioabsorbable. It should be understood that any combination of natural, synthetic, bioabsorbable and non-bioabsorbable materials may be used to form the buttress material. The buttresses 500 a, 500 b may be porous or non-porous, combination of porous and non-porous layers. The non-porous buttresses 500 a, 500 b may be utilized to retard or prevent tissue ingrowth from surrounding tissues thereby acting as an adhesion barrier and preventing the formation of unwanted scar tissue.
Additional exemplary materials for surgical buttresses 500 a, 500 b for use with the surgical stapling devices disclosed herein are set forth in commonly assigned U.S. Pat. Nos. 5,542,594; 5,908,427; 5,964,774; and 6,045,560, and commonly assigned U.S. Application Publication Nos. 2006/0085034, filed on Apr. 20, 2006; and 2006/0135992, filed on Jun. 22, 2006, the entire contents of each of being hereby incorporated herein by reference in their entirety.
As illustrated in the current embodiment and shown in FIGS. 2 and 3, surgical buttress 500 is releasably attached to staple cartridge 200 and/or anvil plate 300 at attachment zones 240, 340, respectively, defined by strategically positioned ultraviolet (UV) light curable epoxy that affixes surgical buttresses 500 a, 500 b to the inwardly facing or tissue contacting surfaces 220, 320 of the staple cartridge 200 and/or the anvil plate 300, as discussed in detail below. The use of UV curably epoxy enables fixing of surgical buttresses 500 a, 500 b to the respective tissue contacting surfaces 220, 320 of staple cartridge 200 and anvil plate 300 which are fabricated from dissimilar material.
With reference to FIG. 2, cartridge buttress 500 a of staple cartridge 200 is operatively secured or adhered to a tissue contacting surface 220 of staple cartridge 200, by epoxy 250 positioned onto both a proximal end 260 and a distal end 262 of the tissue contacting surface 220. Epoxy 250 is disposed between the cartridge buttress 500 a and the tissue contacting surface 220. Staple cartridge 200 further includes a first outer edge 248 a and second outer edge 248 b. A distal attachment zone 240 a (FIG. 4) is disposed distally of a distal end of a central longitudinal slot 238 and extends substantially from the first outer edge 248 a to the second outer edge 248 b of staple cartridge 200. At least one proximal attachment zone 240 b is disposed proximally of the distal end of the central longitudinal slot 238. The proximal and distal attachment zones on the staple cartridge are positioned outside the area in which the staple receiving slots are defined in the staple cartridge.
Cartridge buttress 500 a includes perforations 246 that allow cartridge buttress 500 a to be released from the tissue contacting surface 220. Perforations 246 extend linearly in a direction perpendicular to the central longitudinal slot 238 near the proximal and distal attachment zones 240 a, 240 b. In particular, at the distal end 262 of staple cartridge 200, perforations 246 a of the cartridge buttress 500 a are disposed between the distal attachment zone 240 a and the distal end of the central longitudinal slot 238. Further, at the proximal end 260 of staple cartridge 200, the perforations 246 b of the cartridge buttress 500 a are disposed distally of each proximal attachment zone 240 b.
With reference to FIG. 3, and similar to cartridge buttress 500 a, anvil buttress 500 b is operatively secured or adhered to a tissue contacting surface 320 of anvil plate 300, by epoxy 350 positioned at a proximal 360 and distal end 362 of the anvil plate 300 and between the anvil buttress 500 b and the tissue contacting surface 320 of anvil plate 300. A distal attachment zone 340 a (FIG. 5) is disposed distally of a distal end of a central longitudinal slot 338 and extends substantially between the outer edges 348 a, 348 b of anvil plate 300. At least one proximal attachment zone 342 b is disposed proximally of the distal end of the central longitudinal slot 338. The proximal and distal attachment zones on the anvil plate 300 are positioned outside the area in which the staple receiving recesses are defined in the anvil plate.
Anvil buttress 500 b includes perforations 346 similar to cartridge buttress 500 a. Perforations 346 of anvil buttress 500 b extend linearly in a direction perpendicular to the central longitudinal slot 338 near the proximal and distal attachment zones 340 a, 340 b from the first and second outer edges 348 a, 348 b. In particular, at the distal end 362 of anvil plate 300, the perforations 346 a of the anvil buttress 500 b are disposed between the distal attachment zone 340 a and the distal end of the central longitudinal slot 338. Further, at the proximal end 360 of anvil plate 300, the perforations 346 b of the anvil buttress 500 b are disposed distally of each proximal attachment zone 340 b. the perforations enable the buttresses 500 a, 500 b to be permanently attached to the anvil plate and staple cartridge while allowing the release of the buttresses after stapling has been performed.
FIGS. 4 and 5 illustrate the buttresses 500 a, 500 b disposed on the staple cartridge 200 and anvil plate 300, respectively. As shown, additional attachment zones 240 c, 340 c, for respective staple cartridge 200 and anvil plate 300, are disposed along outer edges 248 a, 248 b, 348 a, 348 b of each of staple cartridge 200 and anvil plate 300. Perforations 246 c, 346 c surround the attachments zones 240 c, 340 c to allow buttresses 500 a, 500 b to be released from the tissue contacting surfaces 220, 320. The attachment zones 240 c, 340 c are shown as concentric but additional shapes and sizes may be contemplated. The attachment zones in any of the embodiments disclosed herein may have shapes that are circular, rectangular, oblong, etc., or any appropriate shape. Likewise, the epoxy material in any of the embodiments disclosed herein may have shapes that are circular, rectangular, oblong, etc., or any appropriate shape.
During assembly, epoxy 250, 350 is disposed at predetermined locations on tissue contacting surfaces 220, 320 of each of staple cartridge 200 and anvil plate 300 by known methods, such as spraying, dipping, blotting, dabbing, or similar known methods in the art. Once the buttresses 500 a, 500 b are placed onto each of the tissue contacting surfaces 220, 320 of staple cartridge 200 and anvil plate 300, respectively, an ultraviolet light is used to cure epoxy 250, 350 and bond buttresses 500 a, 500 b to the epoxy 250, 350 and thus to the tissue contacting surfaces 220, 320. In any of the embodiments disclosed herein, it is contemplated that the epoxy could be partially cured and then the buttress is adhered to the partially cured epoxy.
In any of the embodiments disclosed herein, the epoxy can be an epoxy that is cured using any electromagnetic radiation, including but not limited to ultraviolet light.
As illustrated in FIG. 6, during use of surgical stapling apparatus 10, the staple cartridge 200 and anvil plate 300, having surgical buttresses 500 a, 500 b loaded thereon (as described above) are positioned on either side of the surgical site. Tissue contacting surfaces 220, 320 of staple cartridge 200 and anvil plate 300 are positioned adjacent layers of tissue “T” to be fastened to one another.
As shown in FIG. 7, staple cartridge 22 includes surgical staples 50 positioned within the individual staple retaining slots 52. Staples 50 are of a conventional type and include a backspan 54 having a pair of legs 56 and 58 extending from backspan 54. Legs 56 and 58 terminate in tissue penetrating tips 60 and 62, respectively. Pushers 64 are located within staple retaining slots 52 and are positioned between staples 50 and the path of a drive bar 66.
Surgical stapling apparatus 10 is initially actuated by movement of trigger 33 relative to handle 12 (FIG. 1) causing driver 36 to move in the direction of arrow “A” (FIG. 6), and against sloped edge 21 of anvil plate 300 thereby causing anvil plate 300 to be moved to the closed position relative to staple cartridge 200. As drive bar 66 advances distally within staple cartridge 32, drive bar 66 urges pushers 64 upwardly against backspan 54 of staples 50 driving legs 56 and 58 of staples 50 through the cartridge buttresses 500 a, tissue “T”, and anvil buttress 500 b, towards staple forming pockets 68 in anvil plate 300. Tissue penetrating tips 60 and 62 of staple legs 56 and 58 are bent within staple forming pockets 68 in anvil plate 20 with backspan 54 securing surgical buttress 24 against tissue “T”. The buttresses 500 a, 500 b tear along the perforations 246, 346 thereby breaking the bonds formed by the epoxy 250, 350 and releasing the buttresses 500 a, 500 b from the tissue contacting surfaces 220, 320 of each of the staple cartridge 200 and anvil plate 300. In this manner, epoxy 250, 350 remains on the tissue contacting surfaces 220, 320 as the buttresses 500 a, 500 b detach. The epoxy is not implanted into the body but is removed with the stapling apparatus.
Upon full actuation of surgical stapling apparatus 10, a knife 30 associated with surgical stapling apparatus 10 and carried by driver 36 may be utilized to cut tissue “T”, as well as surgical buttresses 500 a, 500 b between the rows of now formed staples 50. Upon movement of anvil plate 300 to the open position spaced apart from staple cartridge 200, surgical buttresses 500 a, 500 b finish pulling away from tissue contacting surfaces 220, 320 from staple cartridge 200 and anvil plate 300 along the perforations 246, 346.
The resulting tissue “T”, divided and stapled closed with staples 50, is illustrated in FIG. 8. Specifically, surgical buttresses 500 a, 500 b are secured against tissue “T” by legs 56, 58 and backspans 54 of staples 50. Thus, surgical buttresses 500 a, 500 b are stapled to tissue “T” thereby sealing and reinforcing the staple lines created by staples 50.
Referring now to FIGS. 9A and 9B, an annular surgical stapling apparatus 110, for use with surgical buttresses 124 of the present disclosure, is shown. Surgical stapling apparatus 110 includes a handle assembly 112 having at least one pivotable actuating handle member 133, and an advancing member 135. Extending from handle member 112, there is provided a tubular body portion 114 which may be constructed so as to have a curved shape along its length. Body portion 114 terminates in a staple cartridge 122 which includes a pair of annular arrays of staple retaining slots 152 having a staple 150 disposed in each one of staple retaining slots 152. Positioned distally of staple cartridge 122 there is provided an anvil assembly 120 including an anvil member 121 and a shaft 123 operatively associated therewith for removably connecting anvil assembly 120 to a distal end portion of stapling apparatus 110.
Staple cartridge 122 may be fixedly connected to the distal end of tubular body portion 114 or may be configured to concentrically fit within the distal end of tubular body portion 114. Staple cartridge 122 includes a staple pusher 164 including a proximal portion having a generally frusto-conical shape and a distal portion defining two concentric rings of peripherally spaced fingers (not shown), each one of which is received within a respective staple retaining slot 152.
A knife 130, substantially in the form of an open cup with the rim thereof defining a knife blade 131, is disposed within staple cartridge 122 and mounted to a distal surface of a staple pusher 164. The knife 130 is disposed radially inward of the pair of annular arrays of staples 150. Accordingly, in use, as the staple pusher 164 is advanced, the knife 130 is also advanced axially outward.
As seen in FIG. 10A, a surgical buttress 124 is releasably attached to the staple cartridge 122 at attachment zones 140 defined by deposits of epoxy 150 disposed between the surgical buttress 124 and the tissue contacting surface 134 of the staple cartridge 122. As described herein above, epoxy 150 bonds the surgical buttress 124 to the tissue contacting surface 134. Perforations 146 surround each deposit of epoxy 150 to allow surgical buttress 124 to release from tissue contacting surface 134. Surgical buttress 124 is provided in an annular configuration and includes a central aperture 125 to receive shaft 123 of anvil assembly 120 therethrough. As illustrated, the attachment zones 140 are concentric in an annular configuration about an outer peripheral edge 162 and inner peripheral edge 160 of staple cartridge 122.
It is envisioned that the surgical buttress 124 may be additionally or alternatively attached or adhered to tissue contacting surface of anvil plate 121 in a manner similar to the surgical buttress 124 attached to staple cartridge 122.
As shown in FIG. 10B, surgical buttress 124 may be secured or adhered to the staple cartridge 122 along an inner portion or peripheral edge 160 and outer portion or peripheral edge 162 of surgical buttress 124. It is envisioned that other configurations may be utilized to retain the surgical buttress 124 to the staple cartridge 122, such as providing the attachment zones 140 along either the inner or outer annular row of staple retaining slots 152, or alternating the attachment zones 140 between the staple retaining slots 152, or among other arrangements within the purview of those skilled in the art.
Surgical stapling apparatus 110 and detachable anvil assembly 120 are used in an anastomosis procedure to effect joining of intestinal sections 50 and 52. The anastomosis procedure is typically performed using minimally invasive surgical techniques including laparoscopic means and instrumentation. At the point in the procedure shown in FIG. 11, a diseased intestinal section has been previously removed, anvil assembly 120 (optionally including a surgical buttress 124 thereon) has been applied to the operative site either through a surgical incision or transanally and positioned within intestinal section 52, and tubular body portion 114 of surgical stapling apparatus 110 (optionally including a surgical buttress 124 thereon) has been inserted transanally into intestinal section 50. Intestinal sections 50 and 52 are also shown temporarily secured about their respective components (e.g., shaft 123 of anvil assembly 120, and the distal end of tubular body portion 114) by conventional means such as a purse string suture “P”, as illustrated in FIG. 12.
Thereafter, the clinician maneuvers anvil assembly 120 until the proximal end of shaft 123 is inserted into the distal end of tubular body portion 114 of surgical stapling apparatus 110, wherein the mounting structure (not shown) within the distal end of tubular body portion 114 engages shaft 123 to effect the mounting. Anvil assembly 120 and tubular body portion 114 are then approximated to approximate intestinal sections 50, 52. Surgical stapling apparatus 110 is then fired. A knife (not shown) cuts the portion of tissue and surgical buttress 124 disposed radially inward of the knife, to complete the anastomosis. The anvil assembly 120 and staple cartridge 122 are opened, with surgical buttress 124 stapled to intestinal sections 50 and 52. Surgical buttress 124 tears away from the deposits of epoxy 150, along perforations 146.
With reference now to FIGS. 13A, 13B, 14A and 14B an alternate embodiment is shown wherein buttress material 1000 is disposed on the tissue contacting surface 2200 of staple cartridge 2000 by a pair of flaps 1020, or margins of material that are positioned adjacent side surfaces 2320 of staple cartridge 2000. Staple cartridge 2000 is similar to staple cartridge 200 discussed hereinabove having tissue contacting surface 2200 and a plurality of retention slots 2380 formed therein for retaining a plurality of staples or fasteners 2400 therein. Any of the embodiments disclosed herein can include the flaps or margins for attaching buttress material.
Buttress material 1000 is disposed on the tissue contacting surface 2200 of staple cartridge 2000 over the openings 2380 a of retention slots 2380. Buttress material 1000 includes a pair of flaps 1020 positioned adjacent side surfaces 2320 of staple cartridge 2000 and includes at least one hole 1040 extending through each of flaps 1020. Each hole 1040 is longitudinally spaced apart from the next along the length of a respective flap 1020. Staple cartridge 2000 further includes at least one opening 2480 in each of side surfaces 2320 where each opening 2480 corresponds to a respective one of the holes 1040 of buttress material 1000. In one embodiment, when buttress material 1000 is disposed on tissue contacting surface 2200, holes 1040 of buttress material 1000 substantially align or are in registration with the corresponding openings 2480 of staple cartridge 2000.
With reference now to FIGS. 14A and 14B, a retaining member 1060 extends through each hole 1040 of buttress material 1000 and corresponding opening 2480 of staple cartridge 2000 to secure buttress material 1000 to staple cartridge 2000. Retaining member 1060 includes a pair of buttons 1080 linked together by a shaft or tether 1100. Tether 1100 extends through one of openings 2480 and the corresponding hole 1040 such that a first button 1080 a is disposed adjacent an inner surface 2320 a of staple cartridge 2000 and a second button 1080 b is disposed adjacent an outer surface 1120 of buttress material 1000. Each button 1080 is sized to be larger than a respective opening 2480 or hole 1040 to inhibit removal of the retaining member 1060 from the opening 2480 and hole 1040 during use. The retaining member may have other shapes, including hooks, loops, or tabs. In certain embodiments, the retaining member has bulbous ends that facilitate snapping the retaining member through the holes 2480 and 1040.
Retaining members 1060 may be formed of a bio-compatible or bio absorbable material. In one embodiment, retaining members 1060 may be configured to be brittle and absorbable such that, upon firing of surgical stapling apparatus 10, retaining members 1060 are fractured to release buttress material 1000 from staple cartridge 2000. In another embodiment, retaining members 1060 may be dissolvable upon application of a subsequent fluid by the surgeon or by a surgical instrument, e.g. a saline fluid, during use in order to release buttress material 1000 from staple cartridge 2000. Retaining members 1060 may also or alternatively be dissolvable by body fluids in order to release buttress material 1000. In another embodiment, retaining members 1060 may be formed of an absorbable polymer or other similar low melt temperature material that is configured to melt or soften at body temperature, e.g., about 37° C., to release buttress material 1000 from staple cartridge 2000. In any of the embodiments disclosed herein, retaining members that are integrally formed with the buttress material may be used to attach the buttress to the anvil or staple cartridge of a stapling apparatus.
With reference now to FIGS. 15A, 15B, 16A and 16B, in another embodiment buttress material 2100 is disposed on the tissue contacting surface 2200 of staple cartridge 2000 over the openings 2380 a of retention slots 2380. Buttress material 2100 includes a proximal end 2600 and a distal end 2620. Each of proximal and distal ends 2600, 2620 includes at least one hole 2060 and preferably two holes 2060 extending therethrough. For example, in one embodiment, buttress material 2100 may be substantially rectangular with each hole 2060 disposed proximate to a corner 2080 of buttress material 2100. Staple cartridge 2000 further includes at least one opening 2050 through tissue contacting surface 2200 where each opening 2050 corresponds to a respective one of the holes 2060 of buttress material 2100. In one embodiment, when buttress material 2100 is disposed on tissue contacting surface 2200, holes 2060 of buttress material 2100 substantially align or are in registration with the corresponding openings 2050 of staple cartridge 2000.
With reference now to FIGS. 16A and 16B, one of retaining members 1060 extends through each hole 2060 of buttress material 2100 and corresponding opening 2050 of staple cartridge 2000 to secure buttress material 2100 to staple cartridge 2000, as described above. For example, tether 1100 of retaining member 1060 extends through one of openings 2050 and the corresponding hole 2060 such that the first button 1080 a is disposed adjacent an inner surface 2200 a of tissue contacting surface 2200 and the second button 1080 b is disposed adjacent an outer surface 2010 of buttress material 2100. Each button 1080 is sized to be larger than a respective opening 2050 or hole 2060 to inhibit removal of the retaining member 1060 from the opening 2050 or hole 2060 during use.
It is contemplated that a buttress material 1000 or 2100 may also or alternatively be disposed on anvil assembly in the same manner as described above with regard to the attachment of buttress materials 1000 and 2100 to staple cartridge 2000.
With reference now to FIGS. 17A-20B buttress material is shown as generally annular in shape for securing to an annular surgical stapling apparatus 110 as discussed in FIGS. 9A and 9B. Referring now to FIGS. 17A, 17B, 18A and 18B, a buttress material 4000 is generally annular in shape and includes an inner portion 4020, a middle portion 4040, and an outer portion 4060. A substantially centrally located aperture 4080, defined by the inner circumference of inner portion 4020 is formed through buttress material 4000. Buttress material 4000 may be any shape sufficient to provide support for anastomosis of tissue after surgical stapling apparatus 110 has been fired including, for example, a square, a circle, an oval, a triangle or any other polygonal or other shape.
Buttress material 4000 is sized such that when buttress material 4000 is positioned over tissue contacting surface 3360 of staple cartridge 3200, buttress material 4000 extends radially beyond inner surface 3200 a and outer surface 3200 b of staple cartridge 3200 such that inner portion 4020 and outer portion 4060 of buttress material 4000 may be folded over to abut or engage inner and outer surfaces 3200 a, 3200 b, respectively.
Each of inner portion 4020 and outer portion 4060 includes an annular array of holes 4412, 4416, respectively, and inner and outer surfaces 3200 a and 3200 b include corresponding openings 3240, 3260, respectively for the reception of retaining members 1060 therethrough. For example, when buttress 4000 is positioned on tissue contacting surface 3360 with inner and outer portions 4020, 4060 folded over to abut inner and outer surfaces 3200 a, 3200 b, respectively, the holes 4120, 4160 and the corresponding openings 3240, 3260 may be substantially radially aligned or in registration.
With reference now to FIGS. 18A and 18B, one of retaining members 1060 extends through each hole 4120, 4160 of each of inner and outer portions 4020, 4060, respectively and through the corresponding openings 3240, 3260 of staple cartridge 3200 to secure buttress material 4000 to staple cartridge 3200. For example, the tether 1100 of a respective retaining member 1060 extends through one of openings 3240 of inner surface 3200 a and through the corresponding hole 4120 of inner portion 4020 of buttress material 4000 such that the first button 1080 a is disposed adjacent an inside portion 3250 of inner surface 3200 a and the second button 1080 b is disposed adjacent an outer surface 4020 a of inner portion 4020 of buttress material 4000. Likewise, the tether 1100 of another retaining member 1060 extends through one of openings 3260 of outer surface 3200 b and through the corresponding hole 4120 of outer portion 4060 such that the first button 1080 a is disposed adjacent an inside portion 3270 of outer surface 3200 b and the second button 1080 b is disposed adjacent an outer surface 4060 a of outer portion 4060. Each button 1080 is sized to be larger than a respective opening 3240, 3260 or hole 4120, 4160 to inhibit removal of the retaining member 1060 from the opening 3240, 3260 or hole 4120, 4160 during use.
With reference now to FIGS. 19A, 19B, 20A and 20B, in one embodiment, a buttress material 5000, formed of similar materials to buttress material 4000, described above, is generally annular in shape and includes an inner portion 5020, a middle portion 5040, and an outer portion 5060. A substantially centrally located aperture 5080, defined by the inner circumference of inner portion 5020 is formed through buttress material 5000. Buttress material 5000 may be any shape sufficient to provide support for anastomosis of tissue after surgical stapling apparatus 110 has been fired including, for example, a square, a circle, an oval, a triangle or any other polygonal or other shape.
With reference now to FIGS. 19A, 19B, and 20A, in one embodiment, buttress material 5000 is sized such that when buttress material 5000 is positioned over tissue contacting surface 3360 of staple cartridge 3200, the outer edge 5060 a of outer portion 5060 of buttress material 5000 is substantially aligned with outer surface 3200 b of staple cartridge 3200 and inner edge 5020 a of inner portion 5020 extends radially inward of the inner surface 3200 a of staple cartridge 3200. Staple cartridge 3200 includes a flange 3480 extending radially inward from tissue contacting surface 3360. Inner portion 5020 of buttress material 5000 includes an annular array of holes 5100, and flange 3480 includes a corresponding annular array of openings 3500 for the reception of retaining members 1060 therethrough. For example, when buttress 5000 is positioned on tissue contacting surface 3360 with inner portion 5020 extending radially inward of inner surface 3200 a, inner portion 5020 is positioned on flange 3480 and the holes 5100 and the corresponding openings 3500 in flange 3480 may be substantially aligned or in registration, e.g., longitudinally aligned.
One of retaining members 1060 extends through each hole 5100 of inner portion 5020 and through the corresponding openings 3500 of flange 3480 to secure buttress material 5000 to staple cartridge 3200. For example, the tether 1100 of a respective retaining member 1060 extends through one of openings 3500 of flange 3480 and through the corresponding hole 5100 of inner portion 5020 of buttress material 5000 such that the first button 1080 a is disposed adjacent a proximal surface 3480 a of flange 3480 and the second button 1080 b is disposed adjacent a distal surface 5020 a of inner portion 5020 of buttress material 5000. Each button 1080 is sized to be larger than a respective opening 3500 or hole 5100 to inhibit removal of the retaining member 106 from the opening 3500 or hole 5100 during use.
With reference now to FIG. 20B, in another embodiment, staple cartridge 3200 may include an inner surface 3520 having a greater radial thickness than inner surface 3200 a of staple cartridge 3200 illustrated in FIG. 20A such that a distal portion 3520 a of inner surface 3520 of staple cartridge 3200 extends radially inward from tissue contacting surface 3360. Similar to flange 3480 above, distal portion 3520 a of inner surface 3520 of staple cartridge 3200 includes an annular array of openings 3540 corresponding to the holes 5100 of buttress material 5000. For example, when buttress 5000 is positioned on tissue contacting surface 3360, inner portion 5020 is positioned on the distal portion 3520 a of inner surface 3520 such that the holes 5100 and the corresponding openings 3540 may be substantially aligned, e.g., longitudinally aligned or in registration.
One of retaining members 1060 extends through each hole 5100 of inner portion 5020 of buttress material 5000 and through the corresponding openings 3540 of the distal portion 3520 a of the inner surface 3520 of staple cartridge 3200 to secure buttress material 5000 to staple cartridge 3200. For example, the tether 1100 of a respective retaining member 1060 extends through one of openings 3540 of the distal portion 3520 a of inner surface 3520 of staple cartridge 3200 and through the corresponding hole 5100 of inner portion 5020 of buttress material 5000 such that the first button 1080 a is disposed proximal of the opening 3540 in distal portion 3520 a and the second button 1080 b is disposed adjacent a distal surface 5020 a of inner portion 5020 of buttress material 5000. Each button 1080 is sized to be larger than a respective opening 3540 or hole 5100 to inhibit removal of the retaining member 1060 from the opening 3540 or hole 5080 during use.
Referring now to FIGS. 13A, 15A, 17A and 19A, in any of the above embodiments, buttress materials 1000, 2100, 4000 and 5000 may include perforations or breakaway sections 1140, 2140, 4140, 5140 that are configured to release the buttress material 1000, 2100, 4000, 5000 from the cartridge assemblies 2000, 3200. For example, buttress material 1000 may include perforations extending longitudinally along the fold line of flaps 1020, buttress material 2100 may include perforations extending transverse to the longitudinal axis adjacent the holes 2060 of the proximal and distal portions 2600, 26200, buttress material 4000 may include perforations extending radially along the fold lines of one or both of inner portion 4020 and outer portion 4060, and buttress material 5000 may include an annular array of perforations disposed radially outward of holes 5100 relative to a longitudinal axis of the staple cartridge 3200. Alternatively, or in addition, each of holes 1040, 2060, 4120, 4160 and 5100 may include perforations or break away sections such that buttons 1080 a, 1080 b of a retaining member 1060 may break through or snap through holes 1040, 2060, 4120, 4160 and 5100 as buttress material 1000, 2100, 4000, 5000 is released from cartridge assemblies 2000, 3200.
Referring now to FIGS. 21 and 22, in one embodiment, it is contemplated that a buttress material 1000, 2100, 4000 and 5000 may alternatively or additionally be removably secured to one of anvil assemblies 2202, and 3220 in a similar manner as described in the above embodiments for removable securement of buttress materials 1000, 2100, 4000 and 5000 to cartridge assemblies 2000 and 3200.
In one embodiment, retaining members 1060 may be formed during assembly of the surgical stapling apparatus or placement of buttress material to the surgical stapling apparatus 10, 110 during the manufacture or assembly thereof. In a method of attaching the buttress material to a surgical stapling apparatus, the polymer is deposited onto the buttress material, the polymer material having a melting temperature lower than the melting temperature of the buttress material. The polymer can be deposited by injection molding, spraying, dipping, or other methods. In this way, the polymer material can be melted without disrupting the physical properties of the buttress material. In an embodiment of the present disclosure, the degradable polymer material for the attachment features is the polymer used in making Caprosyn™ sutures, also known as L25, which has a melt temperature of about 125 to about 145 degrees celcius, while the buttress material is L41 or L21, which have melting temperatures of about 210 to about 220 degrees celcius and about 185 to about 200 degrees celcius respectively. The L21 polymer is used to make Maxon™ sutures. The polymer L41 is similar to L21, but has a different chemical structure, and has a greater degree of crystallinity and a higher glass transition temperature and melting temperature. Both L21 and L41 are a copolymer of glycolide and trimethylene carbonate.
In certain embodiments, the top of the driver 36 mechanically disrupts the interlocking features of the bonding polymer and may shear off a portion of the polymer material. In certain embodiments, the knife severs off a portion of the polymer material that attaches the buttress material to the apparatus. In certain embodiments, small pushers are provided in the staple cartridge, which are actuated along with the staple firing pushers, to release the buttress material from the apparatus. In further embodiments, additional cutting assemblies can be provided in the anvil, staple cartridge, or both.
In any of the embodiments disclosed herein, the buttress material or the polymer of the attachment zone or attachment feature can be made from glycolic acid, glycolide, lactic acid, lactide, dioxanone, epsilon-caprolactone, trimethylene carbonate, etc., as is known in the art.
Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying figures are non-limiting exemplary embodiments, and that the description, disclosure, and figures should be construed merely exemplary of particular embodiments. It is to be understood, therefore, that the present disclosure is not limited to the precise embodiments described, and that various other changes and modifications may be effected by one skilled in the art without departing from the scope or spirit of the disclosure. Additionally, it is envisioned that the elements and features illustrated or described in connection with one exemplary embodiment may be combined with the elements and features of another exemplary embodiment without departing from the scope of the present disclosure, and that such modifications and variations are also intended to be included within the scope of the present disclosure. Accordingly, the subject matter of the present disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.

Claims

What is claimed is:

1. A staple cartridge for use with a surgical stapling apparatus, the staple cartridge comprising:

a cartridge body including a tissue contacting surface defining a plurality of staple retaining slots, the tissue contacting surface of the cartridge body being fabricated from a first material;

a staple disposed within each staple retaining slot of the cartridge body;

a buttress material releasably disposed on the tissue contacting surface of the cartridge body; and

an epoxy positioned on the tissue contacting surface of the cartridge body defining an attachment zone configured to retain the buttress material atop the tissue contacting surface.

2. The staple cartridge of claim 1, wherein the epoxy is an ultraviolet light curable epoxy.

3. The staple cartridge of claim 2, wherein the tissue contacting surface has a first and second outer edge.

4. The staple cartridge of claim 3, wherein the tissue contacting surface has a distal end such that a distal attachment zone is positioned from the first outer edge to the second outer edge.

5. The staple cartridge of claim 4, wherein the tissue contacting surface has a proximal end such that a first proximal attachment zone is positioned parallel to the first outer edge and second proximal attachment zone is positioned parallel to the second outer edge.

6. The staple cartridge of claim 5, wherein the staple cartridge defines a central longitudinal slot configured to enable passage of a knife blade therethrough.

7. The end effector of claim 6, wherein the first and second proximal attachment zones are positioned distally from a proximal end of the central longitudinal slot.

8. The end effector of claim 6, wherein the distal attachment zone is positioned proximally for a distal end of the central longitudinal slot.

9. The staple cartridge of claim 7, wherein the buttress material has perforations at the proximal end of the tissue contacting surface such that the perforations are positioned perpendicularly and distally from the first and second proximal attachment zone.

10. The staple cartridge of claim 8, wherein the buttress material has perforations at the distal end of the tissue contacting surface such that the perforations are positioned parallel and proximal from the at least one distal attachment zone.

11. The staple cartridge of claim 3, wherein a plurality of attachment zones are disposed intermittently along the first and second outer edges.

12. The staple cartridge of claim 11, wherein the plurality of attachment zones are concentric.

13. The staple cartridge of claim 12, wherein the buttress material has perforations such that the perforations surround the plurality of attachment zones.

14. An end effector assembly for a surgical stapler, the end effector comprising:

the staple cartridge according to claim 1, the tissue contacting surface of the cartridge body being fabricated from a first material;

an anvil plate having a tissue contacting surface, the tissue contacting surface of the anvil plate being fabricated from a second material that is dissimilar from the first material;

a buttress material releasably disposed on the tissue contacting surfaces of each of the staple cartridge and the anvil plate; and

an epoxy positioned onto the tissue contacting surfaces of each of the staple cartridge and anvil plate defining an attachment zone configured to retain the respective buttress material atop the respective tissue contacting surfaces.

15. The end effector of claim 14, wherein the staple cartridge and the anvil plate have a central longitudinal slot configured to enable passage of a knife blade therethrough.

16. The end effector of claim 14, wherein the buttress material on each of the tissue contacting surfaces of each of the staple cartridge and the anvil plate has perforations positioned perpendicular to the central longitudinal slot.

17. A surgical stapling apparatus, comprising:

a cartridge body including a tissue contacting surface defining a plurality of staple retaining slots;

a staple disposed with each staple retaining slot of the cartridge body;

a substantially circular buttress material releasably disposed on the tissue contacting surface of the cartridge body, the buttress material including an inner peripheral edge, an outer peripheral edge, and a middle portion extending between the inner and outer peripheral edges; and

18. The surgical stapling apparatus of claim 18, wherein the epoxy is an ultraviolet light curable epoxy.

19. The surgical stapling apparatus of claim 18, wherein the buttress material includes perforations arranged to allow the buttress material to separate from the cartridge body.