JP2017012905A - Surgical stapling apparatus including buttress attachment via tabs - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a surgical buttress for use with an anastomosis stapling apparatus.SOLUTION: An apparatus for joining two hollow organ sections with an annular array of surgical staples comprises: a staple cartridge component including a plurality of surgical staples arranged in an annular array; an anvil component movable relative to the staple cartridge component between spaced and approximated positions; a buttress component configured and dimensioned to be positioned on a distal surface of the staple cartridge component, the buttress component including a buttress member and a plurality of circumferentially arranged tabs extending proximally from the buttress member; and a fastening member configured and dimensioned to engage the plurality of circumferentially arranged tabs.SELECTED DRAWING: Figure 1

Description

(Technical field)
The present disclosure relates to surgical instruments for applying surgical fasteners or staples to body tissue, and more particularly to a surgical buttress for use with an end-to-end anastomosis stapling apparatus.

(Background of related technology)
An anastomosis is a surgical joint of isolated hollow organ sections. Typically, the anastomosis procedure is followed by surgery where the affected or defective area of the hollow tissue is removed, and the remaining end areas are joined. Depending on the desired anastomosis procedure, the end sections can be joined either by annulus, end-to-end or side-to-side organ reconstruction methods.

  In a circular anastomosis procedure, the two ends of an organ area are joined by a stapling instrument that drives a circular array of staples through the end area of each organ area and simultaneously Core any tissue within the circular array and open the tubular passage. Typically, these instruments include an elongate shaft having a handle portion at the proximal end to actuate the instrument and a staple holding component disposed at the distal end. An anvil assembly including an anvil shaft with an anvil head attached is attached to the distal end adjacent to the staple holding component. Opposed end areas of the stapled organ are clamped between the anvil head and the staple holding component. The clamped tissue is stapled by driving a plurality of staples from the staple holding component so that the staple ends penetrate the tissue and are deformed by the anvil head.

  In use, one end area of the organ is secured around the anvil assembly and the other end area of the organ is held in place adjacent the staple holding component. The shaft of the anvil assembly is removably connected to the instrument. When the anvil shaft is secured to the instrument, the anvil is pulled closer to the staple holding component. The instrument is then fired, allowing the staples to penetrate tissue in both areas of the organ and deforming against the anvil. During the firing step, a circular knife is advanced to cut the tissue inside the staple line, thereby establishing a passageway between the two areas of the organ. After firing, the instrument is typically removed by withdrawing the anvil through the staple line, after which the surgeon carefully checks the surgical site to ensure that the correct anastomosis has been achieved.

  While circular staplers are useful in many surgical procedures, for example, anastomotic leaks, tissue tears during bleeding of the stapler, bleeding, and other complications can occur. In order to ameliorate such problems, buttresses or reinforcing materials have been utilized. However, due to the inherent difficulty of positioning and securing such materials to the instrument, there is a buttress material and buttress material and instrument that can be safely and effectively positioned within the staple cartridge and / or anvil. There is still a need for combinations.

  Embodiments of the present disclosure provide an apparatus for joining two hollow organ sections with an annular array of surgical staples. The apparatus includes a staple cartridge component, an anvil component, a buttress component, and a clamping member. The staple cartridge component includes a plurality of surgical staples arranged in an annular array. An anvil component is movable relative to the staple cartridge component between a remote position and an approximated position to adjustably clamp the organ area between the staple cartridge component and the anvil component. The buttress component is configured and dimensioned to be positioned on the distal surface of the staple cartridge component. The buttress component includes a buttress member and tabs arranged along a plurality of circumferences extending proximally from the buttress member. The clamping member is configured and dimensioned to engage tabs arranged along the plurality of circumferences in order to securely position the buttress component on the staple cartridge component.

  In an embodiment, the buttress member may have an annular configuration. In particular, the buttress member may be disposed concentrically in a juxtaposed relationship with the plurality of surgical staples. The clamping member may be an annular ring configured to exert an inward force against the tabs arranged along the plurality of circumferences with the outer wall of the staple cartridge component backed. And dimensions. Further, the clamping member may be a suture that is tied around tabs arranged along the plurality of circumferences with the outer wall of the staple cartridge component on the back.

  In another embodiment, the outer wall of the staple cartridge component may define a circumferential groove, the circumferential groove being configured to receive a portion of a tab arranged along the plurality of circumferences; And adapted. The fastening member may be aligned with the circumferential groove.

  The apparatus may further include a knife member arranged concentrically with the buttress member within the staple cartridge component. The knife member may be movable relative to the staple cartridge component. In particular, the buttress member may be configured to be disposed radially outward of the knife member.

  Each of the tabs arranged along the plurality of circumferences may define a line of weakness adjacent to the buttress member to allow separation of the buttress member from the plurality of tabs. The buttress component may be configured such that tabs arranged along the plurality of circumferences engage an inner wall of the staple cartridge component.

  According to another embodiment of the present disclosure, an apparatus for joining two hollow organ sections with an annular array of surgical staples is provided. The apparatus includes a staple cartridge component, an anvil component, a buttress component, and a clamping member. The staple cartridge component includes a plurality of surgical staples in an annular array. An anvil component is movable relative to the staple cartridge component between a remote position and an approximated position to adjustably clamp the organ area between the staple cartridge component and the anvil component. The buttress component is configured and dimensioned to be positioned on the distal surface of the staple cartridge component. In particular, the buttress component includes a buttress member and an outer rim extending proximally from the buttress member. The outer rim is configured and adapted to engage the outer wall of the staple cartridge component. A clamping member is tied around the outer rim of the buttress component to secure the outer rim against the outer wall of the staple cartridge component.

  In an embodiment, the outer rim may include a loop arranged along a plurality of circumferences, the loop configured and adapted to receive the clamping member through the loop. Alternatively, the outer rim may define apertures arranged along a plurality of circumferences, the aperture being dimensioned to receive the clamping member through the aperture. Further, each aperture may include an adhesive for securing a clamping member to the aperture. The outer rim may define a circumferential line of weakness adjacent to the buttress member to allow separation of the buttress member from the outer rim.

  According to yet another embodiment of the present disclosure, an apparatus for joining two hollow organ sections with an annular array of surgical staples is provided. The apparatus includes a staple cartridge component, an anvil component, a knife member, and a buttress component. The staple cartridge component includes a plurality of surgical staples in an annular array. The anvil component defines a plurality of staple pockets for forming the surgical staple. An anvil component is movable relative to the staple cartridge component between a remote position and an approximated position to adjustably clamp the organ area between the staple cartridge component and the anvil component. Knife members are arranged concentrically within the staple cartridge component. The knife member is movable relative to the staple cartridge component. The buttress component includes a buttress member concentrically aligned with the plurality of surgical staples, and a plurality of circumferentially arranged tabs extending proximally from the buttress member. The plurality of tabs and the staple cartridge component have corresponding mounting members for securing the plurality of tabs to the staple cartridge component.

  In embodiments, the attachment member may be a hook and loop clamp. In particular, the staple cartridge component may have the hook and loop clamp on the outer wall of the staple cartridge component, and the plurality of tabs may have a hook and loop clamp corresponding to the inner surface of the plurality of tabs. . Alternatively, the staple cartridge component can have the hook and loop clamp on the inner wall of the staple cartridge component, and the plurality of tabs can have hook and loop clamps corresponding to the outer surface of the plurality of tabs. .

  According to yet another embodiment of the present disclosure, an apparatus for joining two hollow organ sections with an annular array of surgical staples is provided. The apparatus includes a staple cartridge component, an anvil component, a knife member, and a first buttress component. The staple cartridge component includes a plurality of surgical staples in an annular array. The anvil component includes an anvil member defining a plurality of staple pockets for forming the surgical staple and a shaft extending proximally from the anvil member. An anvil component is movable relative to the staple cartridge component between a remote position and an approximated position to adjustably clamp the organ area between the staple cartridge component and the anvil component. Knife members are arranged concentrically within the staple cartridge component. The knife member is movable relative to the staple cartridge component. The first buttress component includes a buttress member concentrically aligned with the anvil component and a rim extending distally from the buttress member. A first buttress component encases the plurality of staple pockets defined in the anvil member.

  The apparatus may further include a clamping member that secures the first buttress component to the shaft of the anvil component. In particular, the clamping member may include a plurality of barbs. The rim of the first buttress component may be an outer rim that engages an outer surface of the anvil member. Further, the first buttress component may further include an inner rim extending distally from the buttress member. The inner rim may be configured and dimensioned to engage the shaft of the anvil component.

  In an embodiment, the apparatus may further include a second buttress component that is concentrically aligned with the staple cartridge component. The second buttress component may include a buttress member and tabs arranged along a plurality of circumferences extending proximally from the buttress member. The plurality of tabs may engage an outer wall of the staple cartridge component. In particular, the plurality of tabs and the outer wall of the staple cartridge component may include corresponding hook and loop fasteners for securing the second buttress component to the staple cartridge component.

  Each tab may include a line of weakness adjacent to the buttress member for separation of the buttress member from the plurality of tabs. The buttress component may be configured such that the plurality of tabs engage an inner wall of the staple cartridge component. The plurality of tabs and the inner wall of the staple cartridge component may include corresponding hook and loop fasteners for securing the second buttress component to the staple cartridge component.

  An apparatus includes a clamping member configured and dimensioned to engage tabs arranged along the plurality of circumferences to securely position the second buttress component on the staple cartridge component. Further may be included. The clamping member may be an annular ring configured to exert an inward force on the tabs arranged along the plurality of circumferences with the outer wall of the staple cartridge component backed; Dimension. Alternatively, the clamping member may be a suture that is tied around tabs arranged along the plurality of circumferences with the outer wall of the staple cartridge component on the back.

For example, the present invention provides the following items.
(Item 1)
An apparatus for joining two hollow organ sections with an annular array of surgical staples, the apparatus comprising:
A staple cartridge component including a plurality of surgical staples arranged in an annular array;
An anvil component movable relative to the staple cartridge component between a remote position and an approximate position to adjustably clamp the organ area between the staple cartridge component and the anvil component The anvil component,
A buttress component configured and dimensioned to be positioned on a distal surface of the staple cartridge component, the buttress member and tabs arranged along a plurality of circumferences extending proximally from the buttress member A buttress component including
A clamping member configured and dimensioned to engage tabs arranged along the plurality of circumferences to securely position the buttress component on the staple cartridge component. .
(Item 2)
The apparatus of any one of the preceding items, wherein the buttress member has an annular configuration and is disposed concentrically in a juxtaposed relationship with the plurality of surgical staples.
(Item 3)
The clamping member is an annular ring, and the annular ring is configured and dimensioned to exert an inward force against the tabs arranged along the plurality of circumferences with the outer wall of the staple cartridge component as a back. The apparatus according to any one of the above items.
(Item 4)
Any of the preceding items, wherein the clamping member is a suture, the suture being tied around tabs arranged along the plurality of circumferences with the outer wall of the staple cartridge component on the back. The device according to item.
(Item 5)
The outer wall of the staple cartridge component defines a circumferential groove, the circumferential groove being configured and adapted to receive a portion of a tab arranged along the plurality of circumferences. The apparatus as described in any one of.
(Item 6)
The device according to any one of the preceding items, wherein the clamping member is aligned with the circumferential groove.
(Item 7)
The staple cartridge component of claim 1, further comprising a knife member concentrically arranged with the buttress member, wherein the knife member is movable relative to the staple cartridge component. apparatus.
(Item 8)
The apparatus of any one of the preceding items, wherein the buttress member is configured to be disposed radially outward of the knife member.
(Item 9)
Any of the preceding items, wherein the tabs arranged along the plurality of circumferences each define a line of weakness adjacent to the buttress member to allow separation of the buttress member from the plurality of tabs. The apparatus according to one item.
(Item 10)
The apparatus of any one of the preceding items, wherein the buttress component is configured such that tabs arranged along the plurality of circumferences engage inner walls of the staple cartridge component.
(Item 11)
An apparatus for joining two hollow organ sections with an annular array of surgical staples, the apparatus comprising:
A staple cartridge component comprising a plurality of surgical staples in an annular array;
An anvil component movable relative to the staple cartridge component between a remote position and an approximate position to adjustably clamp the organ area between the staple cartridge component and the anvil component The anvil component,
A buttress component configured and dimensioned to be positioned on a distal surface of the staple cartridge component, the buttress component including a buttress member and an outer rim extending proximally from the buttress member. The buttress component configured and adapted to engage the outer wall of the staple cartridge component;
A clamping member tied around the outer rim of the buttress component to secure the outer rim against the outer wall of the staple cartridge component.
(Item 12)
The outer rim includes a loop arranged along a plurality of circumferences, the loop configured and adapted to receive the clamping member through the loop. Equipment.
(Item 13)
The apparatus of any one of the preceding items, wherein the outer rim defines apertures arranged along a plurality of circumferences, the aperture being dimensioned to receive the clamping member through the aperture. .
(Item 14)
The apparatus of any one of the preceding items, wherein each aperture includes an adhesive for securing a clamping member to the aperture.
(Item 15)
The apparatus of any one of the preceding items, wherein the buttress member has an annular configuration and is disposed in a juxtaposed relationship with the plurality of surgical staples.
(Item 16)
Any of the preceding items, wherein the outer wall of the staple cartridge component has a circumferential groove, the circumferential groove being configured and adapted to receive a portion of the outer rim in the circumferential groove. A device according to claim 1.
(Item 17)
The device according to any one of the preceding items, wherein the clamping member is aligned with the circumferential groove.
(Item 18)
The staple cartridge component of claim 1, further comprising a knife member concentrically arranged with the buttress member, wherein the knife member is movable relative to the staple cartridge component. apparatus.
(Item 19)
The apparatus of any one of the preceding items, wherein the buttress member is configured to be disposed radially outward of the knife member.
(Item 20)
The apparatus of any one of the preceding items, wherein the outer rim defines a circumferential line of weakness adjacent to the buttress member to allow separation of the buttress member from the outer rim.
(Item 21)
An apparatus for joining two hollow organ sections with an annular array of surgical staples, the apparatus comprising:
A staple cartridge component comprising a plurality of surgical staples in an annular array;
An anvil component defining a plurality of staple pockets for forming the surgical staple, wherein the anvil component is spaced apart and approached to adjustably clamp the organ area between the staple cartridge component and the anvil component. An anvil component movable relative to the staple cartridge component between
A knife member arranged concentrically within the staple cartridge component and movable relative to the staple cartridge component;
A buttress component, the buttress component being concentrically aligned with the plurality of surgical staples, and a plurality of tabs arranged along a plurality of circumferences extending proximally from the buttress member; And wherein the plurality of tabs and the staple cartridge component comprise a buttress component having a corresponding attachment member for securing the plurality of tabs to the staple cartridge component.
(Item 22)
The apparatus according to any one of the preceding items, wherein the attachment member is a hook and loop clamp.
(Item 23)
Any of the preceding items, wherein the staple cartridge component has the hook and loop fasteners on an outer wall of the staple cartridge component, and the plurality of tabs have hook and loop fasteners corresponding to the inner surface of the plurality of tabs. A device according to claim 1.
(Item 24)
Any of the preceding items, wherein the staple cartridge component has the hook and loop clamp on the inner wall of the staple cartridge component, and the plurality of tabs have hook and loop clamps corresponding to the outer surface of the plurality of tabs. A device according to claim 1.
(Item 25)
An apparatus for joining two hollow organ sections with an annular array of surgical staples, the apparatus comprising:
A staple cartridge component comprising a plurality of surgical staples in an annular array;
An anvil component comprising an anvil member defining a plurality of staple pockets for forming the surgical staple, and a shaft extending distally from the anvil member, the staple cartridge component and the anvil component An anvil component movable relative to the staple cartridge component between a remote location and an approximate location to adjustably clamp the organ area between;
A knife member arranged concentrically within the staple cartridge component and movable relative to the staple cartridge component;
A plurality of staple pockets defined in the anvil member, the first buttress component including a buttress member concentrically aligned with the anvil component and a rim extending distally from the buttress member; And a first buttress component.
(Item 26)
The apparatus of any one of the preceding items, further comprising a clamping member that secures the first buttress component to the shaft of the anvil component.
(Item 27)
The apparatus of any one of the preceding items, wherein the rim of the first buttress component is an outer rim that engages an outer surface of the anvil member.
(Item 28)
The first buttress component further includes an inner rim extending distally from the buttress member, the inner rim configured and dimensioned to engage the shaft of the anvil component. The device according to any one of the above.
(Item 29)
The apparatus according to any one of the preceding items, wherein the clamping member includes a plurality of hooks.
(Item 30)
The apparatus further comprises a second buttress component concentrically aligned with the staple cartridge component, the second buttress component being arranged along a buttress member and a plurality of circumferences extending proximally from the buttress member. A device according to any one of the preceding items, comprising:
(Item 31)
The apparatus of any one of the preceding items, wherein the plurality of tabs engage an outer wall of the staple cartridge component.
(Item 32)
The plurality of tabs and the outer wall of the staple cartridge component include corresponding hook and loop clamps for securing the second buttress component to the staple cartridge component. Equipment.
(Item 33)
The apparatus of any one of the preceding items, wherein each tab includes a line of weakness adjacent to the buttress member for separation of the buttress member from the plurality of tabs.
(Item 34)
The apparatus of any one of the preceding items, wherein the second buttress component is configured such that the plurality of tabs engage an inner wall of the staple cartridge component.
(Item 35)
The plurality of tabs and the inner wall of the staple cartridge component include corresponding hook and loop clamps for securing the second buttress component to the staple cartridge component. Equipment.
(Item 36)
The apparatus of any one of the preceding items, wherein each tab includes a line of weakness adjacent to the buttress member for separation of the buttress member from the plurality of tabs.
(Item 37)
A clamping member further configured and dimensioned to engage the tabs arranged along the plurality of circumferences to securely position the second buttress component on the staple cartridge component. The apparatus according to any one of the preceding items.
(Item 38)
The clamping member is an annular ring, and the annular ring is configured and dimensioned to exert an inward force against the tabs arranged along the plurality of circumferences with the outer wall of the staple cartridge component as a back. The apparatus according to any one of the above items.
(Item 39)
Any of the preceding items, wherein the clamping member is a suture, the suture being tied around tabs arranged along the plurality of circumferences with the outer wall of the staple cartridge component on the back. The device according to item.

(Summary)
An apparatus for joining two hollow organ sections with an annular array of surgical staples includes a staple cartridge component, an anvil component, a buttress component, and a clamping member. The staple cartridge component includes a plurality of surgical staples arranged in an annular array. The anvil component is moveable relative to the staple cartridge component between a remote position and an approximate position to adjustably clamp the organ area between the staple cartridge component and the anvil component. The buttress component is configured and dimensioned to be positioned on the distal surface of the staple cartridge component and the proximal surface of the anvil component. In particular, the buttress component includes a buttress member and tabs arranged along a plurality of circumferences extending proximally from the buttress member. The clamping member is configured and dimensioned to engage a plurality of circumferentially arranged tabs to securely position the buttress component on the staple cartridge component.

Various embodiments of the present disclosure are described hereinbelow with reference to the drawings.
FIG. 1 is a perspective view of an annular surgical stapling apparatus configured for use with a surgical buttress assembly, according to an embodiment of the present disclosure. FIG. 2 is a perspective view of the head portion of the surgical stapling apparatus of FIG. 1, showing the surgical buttress assembly attached to the distal portion of the staple cartridge assembly. FIG. 3 is an exploded perspective view of the head portion of FIG. 2, with parts separated. FIG. 4 is an enlarged cross-sectional view of the detailed area shown in FIG. FIG. 5 is a perspective view of a head portion of a surgical stapling apparatus including a surgical buttress assembly according to another embodiment of the present disclosure. FIG. 6 is an exploded perspective view of the head portion of FIG. 5, with parts separated. FIG. 7 is an enlarged cross-sectional view of the detailed area shown in FIG. FIG. 8 is a perspective view of the annular surgical device of FIG. 1 showing the insertion of the device through two hollow organ sections. FIG. 9 is an enlarged, partially longitudinal cross-sectional view of the head portion of the apparatus of FIG. FIG. 10 is an enlarged, partially longitudinal cross-sectional view of the head portion of the apparatus of FIG. 8, showing stapling and cutting of two hollow organ sections. FIG. 11 is a perspective view of a head portion of a surgical stapling apparatus including a surgical buttress assembly according to yet another embodiment of the present disclosure. FIG. 12 is an exploded perspective view of the head portion of FIG. 11, with parts separated. FIG. 13 is an enlarged cross-sectional view of the detailed area shown in FIG. FIG. 14 is a perspective view of a head portion of a surgical stapling apparatus including a surgical buttress assembly, according to yet another embodiment of the present disclosure. FIG. 15 is an exploded perspective view of the head portion of FIG. 14, with parts separated. FIG. 16 is an enlarged cross-sectional view of the detailed area shown in FIG. FIG. 17 is a perspective view of a head portion of a surgical stapling apparatus including a surgical buttress assembly, according to still yet another embodiment of the present disclosure. FIG. 18 is an exploded perspective view of the head portion of FIG. 17, with parts separated. FIG. 19 is an enlarged cross-sectional view of the detailed area shown in FIG. FIG. 20 is a perspective view of a head portion of a surgical stapling apparatus including a surgical buttress assembly, according to still another embodiment of the present disclosure. FIG. 21 is an exploded perspective view of the head portion of FIG. 20, with parts separated. FIG. 22 is an enlarged sectional view of the detailed area shown in FIG. FIG. 23 is a perspective view of a head portion of a surgical stapling apparatus including a surgical buttress assembly according to yet another embodiment of the present disclosure, separated from the surgical stapling apparatus and the surgical buttress assembly. Is shown. FIG. 24 is a perspective view of the anvil assembly and surgical buttress assembly of FIG. 23, with the surgical buttress assembly positioned securely on the anvil assembly. FIG. 25 is an exploded, perspective view of a head assembly of a surgical stapling apparatus including a surgical buttress assembly, with parts separated, according to yet another embodiment of the present disclosure. FIG. 26 is a perspective view of the anvil assembly and surgical buttress assembly of FIG. 25, with the surgical buttress assembly positioned securely on the anvil assembly.

(Detailed description of embodiment)
DETAILED DESCRIPTION Embodiments of the present disclosure will now be described in detail with reference to the drawings, wherein like reference numerals indicate the same or corresponding elements in each of the several drawings. As used herein, the term “distal” conventionally refers to an instrument, apparatus, device or part of a component thereof that is further from the user, and the term “proximal” refers to an instrument, apparatus that is closer to the user. , Refers to the part of the device or its components. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail.

  Referring to FIG. 1, a surgical stapling apparatus 10 for performing an annular anastomosis of a hollow organ is shown. Surgical stapling apparatus 10 drives a circular array of staples 7 (FIG. 9) to penetrate the end area of each organ and simultaneously fires a cylindrical knife 76 (FIG. 9). Center any tissue radially inward of the 7 circular array and open a tubular passage, thereby joining the two ends of the organ. In accordance with an embodiment of the present disclosure, surgical stapling apparatus 10 includes a handle assembly 20 having a pair of pivotable actuation handle members 22 and advancement means 24 including a rotatable grip member 26 and distally from handle assembly 20. An elongated body portion 30 that extends, and a head portion 50 that includes an anvil assembly 60, a staple cartridge assembly 70, and a surgical buttress assembly 100.

  The components of surgical device 10 are generally formed from a thermoplastic material including polycarbonate and a metal including stainless steel and aluminum. The particular material selected to form a particular component depends on the strength requirements of that particular component. Staple 7 is a conventional type and includes a backspan, which has a pair of legs extending from the backspan. The leg ends at the tissue penetrating tip.

  The handle assembly 20 can be actuated to bring the anvil assembly 60 closer to the staple cartridge assembly 70 and to pass an annular array of a pair of staples 7 through the tissue. In order to properly position the tissue in the head portion 50, the rotatable grip member 26 is in a distant position and an approximate position in which the anvil assembly 60 is positioned adjacent to the staple cartridge assembly 70 to clamp the tissue therebetween. In between, the anvil assembly 60 may be rotated to move axially relative to the staple cartridge assembly 70. As will be described in detail below, the handle member 22 may be squeezed to fire the staples 7 through the tissue and join the two segments “T1” “T2” (FIG. 9) of the tubular tissue together. .

  The elongated body portion 30 is configured to have a slightly curved / curved shape along its length. However, the elongate body portion 30 can also be straight and flexible to bend in any configuration. The length, shape and / or diameter of the elongate body portion 30 can be varied to suit a particular surgical procedure.

  With reference to FIGS. 2-4, the head portion 50 includes an anvil assembly 60, a staple cartridge assembly 70, and a surgical buttress assembly 100 removably attached to the staple cartridge assembly 70. Staple cartridge assembly 70 may be fixedly connected to the distal end of elongate body portion 30 or may be configured to fit concentrically within the distal end of elongate body portion 30. In particular, the staple cartridge assembly 70 is an annular array of a pair of staple receiving slots 72, a pair of staple receiving slots 72 having a staple 7 disposed in each of the staple receiving slots 72, and an outer wall 79 thereof. And grooves 71 (FIG. 4) arranged along the circumference, such as countersinks.

  In addition, the staple cartridge assembly 70 includes a cylindrical knife 76 concentrically arranged with an annular array of a pair of staples 7 and a plurality of staple pushers 9 (FIG. 9), each staple pusher having a respective staple pusher. And a plurality of staple pushers disposed in the receiving slot 72 and ejecting each staple 7 through the slot 72. In use, the staple 7 moves through the slot 72 and tissue toward the anvil assembly 60 for its formation.

  Referring briefly to FIG. 9, the cylindrical knife 76 includes a distal rim 79 that defines a knife blade adapted to cut tissue. When the handle member 22 is actuated, the cylindrical knife 76 is moved distally to cut tissue and the plurality of pushers 9 are moved distally toward the anvil assembly 60 to receive staples. The staple 7 disposed in the slot 72 is discharged through the staple receiving slot.

  Returning to FIG. 3, and with particular reference to this view, anvil assembly 60 is positioned distal to staple cartridge assembly 70, and anvil assembly 60 includes an anvil member 62 and a shaft 64 extending proximally from anvil member 62. including. The anvil member 62 includes a plurality of pockets (not shown) for receiving the staples 7 and forming them. The shaft 64 is configured to be removably received on an access shaft 75 disposed on the elongate body portion 30. The approach shaft 75 is operably coupled to the rotatable grip member 26 of the handle assembly 20, and rotation of the rotatable grip member 26 moves the approach shaft 75 axially. Such axial movement of the access shaft 75 is transmitted to the anvil assembly 60 detachably coupled to the access shaft 75. In this manner, the anvil assembly 60 is positioned at a remote location and adjacent the staple cartridge assembly 70 such that the anvil assembly 60 adjustably clamps tissue between the anvil assembly 60 and the staple cartridge assembly 70. It is axially movable relative to the staple cartridge assembly 70 between the close positions.

  Examples of instruments for performing annular anastomoses of hollow organs are US Pat. No. 6,053,390, US Pat. No. 5,588,579, US Pat. No. 5,119,983, US Pat. 005,749, US Pat. No. 4,646,745, US Pat. No. 4,576,167, and US Pat. No. 4,473,077, each of which is hereby incorporated by reference in its entirety. Which is incorporated herein by reference.

  With continued reference to FIGS. 3 and 4, the surgical buttress assembly 100 includes a buttress component 110 and a clamping member in the form of an annular ring 130 that secures the buttress component 110 onto the staple cartridge assembly 70. It is set as a structure and a size to do. Buttress component 110 is provided to reinforce and seal the staple lines applied to tissue by surgical stapling apparatus 10.

  The buttress component 110 includes a buttress member 112 having an annular profile configured to be concentrically aligned with the staple cartridge assembly 70 and tabs arranged along a plurality of circumferences extending proximally from the buttress member 112. 120. In use, buttress member 112 is mounted on distal surface 74 of staple cartridge assembly 70. The annular profile of buttress member 112 is configured and dimensioned to be flush with the outer peripheral edge of staple cartridge assembly 70 when attached to staple cartridge assembly 70. Further, the buttress member 112 is overlaid with an annular array of a pair of staple receiving slots 72. In this way, as the staples 7 are ejected through the annular array of a pair of staple receiving slots 72, the legs of each staple 7 pass through the buttress member 112 and the backspan of the staples 7 is the buttress member. Fixed or abutting against the proximal surface of 112.

  In addition, the cylindrical knife 76 is disposed radially inward of the annular array of staple receiving slots 72 and does not extend across the knife path of the cylindrical knife 76 and the annular array of staple receiving slots 72. The buttress member 112 in an overlapping relationship is disposed on the radially inner side. In this manner, when the handle member 22 is actuated, the entire buttress member 112 is stapled to the tissue to reinforce the tissue and the buttress member 112 is not cut by the cylindrical knife 76.

  The clamping member is configured and dimensioned to engage a plurality of circumferentially arranged tabs to securely position the buttress component on the staple cartridge component of the stapling apparatus. For example, tabs 120 arranged along a plurality of circumferences extending proximally from buttress member 112 can be positioned on distal surface 74 of cartridge assembly 70. Please refer to FIG. More particularly, the proximal end of each tab 120 extends proximally of a groove 71 circumferentially defined in the outer wall 79 of the cartridge assembly 70. Please refer to FIG.

  The clamping member may be provided in the form of an annular ring 130 that is secured around the tabs 120 arranged along the circumference so that the annular ring 130 is disposed across the groove 71. An inward radial force is exerted on the formed tab 120. In this manner, the annular ring 130 is over the groove 71 and substantially with the tab 120 disposed on or against a portion of the buttress member 112 and / or the outer wall 79 of the staple cartridge assembly 70. Are coplanar. Such a configuration allows buttress member 112 to be reliably positioned in place relative to staple cartridge assembly 70.

  The annular ring 130 may include a resilient band, but is not limited thereto. For example, a single spring metal that can be circular in shape, or a length of suture material, or similar straps, bands, cables, or other members can be used.

  Buttress component 110 is monolithically formed as a single structure. However, each tab 120 may include a break, perforation, or line of weakness adjacent to the buttress member 112 so that the buttress member 112 stapled to tissue can be cut or separated from the plurality of tabs 120. In this way, the tab 120 can be at least partially retained in the groove 71 by the annular ring 130 and later removed from the surgical site along with the surgical stapling apparatus 10.

  The buttress member 112 is made from a biocompatible material that is bioabsorbable or non-absorbable and is a natural or synthetic material. It should be understood that any combination of natural, synthetic, bioabsorbable, and non-absorbable materials can be used to form buttress member 112.

  Further, the buttress 112 can be porous, non-porous, or a combination thereof. It is also envisioned that the buttress member 112 described herein may include multiple layers in which non-porous and porous layers can be arbitrarily combined. For example, buttress member 112 may be formed to include a plurality of non-porous and porous layers stacked in an alternating manner. In another example, buttress member 112 may be formed in a “sandwich” manner, with the outer layer of buttress member 112 including a porous layer and the inner layer being a non-porous layer. An example of a multi-layer buttress member is US Patent Application Publication No. 2009/0001122 filed on June 27, 2007 entitled “Buttress and Surgical Stapling Apparatus”, the entire disclosure of which is incorporated herein by reference. Is disclosed.

  In particular, the use of a non-porous layer in buttress member 112 may increase the ability of buttress member 112 to resist tearing and perforation during manufacturing, shipping, handling, and stapling processes. In addition, the use of a non-porous layer in a surgical buttress also delays or inhibits tissue ingrowth from surrounding tissue, thereby acting as an adhesion barrier and unwanted scar tissue. Suppresses formation.

  Further, at least one bioactive agent can be combined with buttress member 112. The agent can be placed on or penetrated into the surface of the surgical buttress. In these embodiments, buttress member 112 can also serve as a vehicle for delivery of the bioactive agent. As used herein, the term “bioactive agent” is used in its broadest sense and includes any substance or mixture of substances that have clinical use.

  5-7, it is further contemplated that the surgical buttress assembly 200 may include a buttress component 110 and a clamping member in the form of a suture 230. In contrast to surgical buttress assembly 100, suture 230 may be utilized to securely position buttress component 110 on distal surface 274 of staple cartridge assembly 270. As described hereinabove, the proximal end of each tab 120 is a groove 271 defined in the outer wall 279 of the cartridge assembly 270 when the buttress member 112 is positioned on the distal surface 274 of the staple cartridge assembly 270. Extending across (FIG. 7).

  In use, the suture 230 is wrapped around the circumferentially arranged tabs 120, whereby the suture 230 is placed on the portion of the tab 120 disposed at least partially across the groove 271. On the other hand, it exerts an inward radial force. In particular, as shown in FIG. 7, the staple cartridge assembly 270 defines a groove 271 that has an arcuate, cross-sectional profile to better accommodate the suture 230 overlying the groove 271. . Such a configuration allows buttress component 110 to be securely positioned in place relative to staple cartridge assembly 270.

With reference to FIGS. 8-10, a surgical stapling apparatus 10 is shown used in an anastomosis procedure, for example, to provide a junction of two opposing bowel segments. Anastomosis procedures are typically performed using minimally invasive surgical techniques including laparoscopic means and instrumentation. Initially, the affected intestinal tract is removed. Thereafter, the anvil assembly 60 is inserted into the surgical site through either a surgical incision or anus and positioned within the intestinal tract section “T ₁ ”. The elongate body portion 30 of the surgical stapling apparatus 10, including the staple cartridge assembly 70, is inserted through the anus into the other intestinal tract “T ₂ ”. The intestinal sections “T ₁ ” and “T ₂ ” are then separated by their conventional means such as purse string suture “P” (see FIG. 9), for example their respective components (eg, shaft 64 and Around the distal end of the elongated body portion 30).

Thereafter, the clinician inserts and attaches / connects the proximal end of the shaft 64 into the distal end of the access shaft 75 disposed in the elongated body portion 30 of the surgical stapling apparatus 10. The anvil assembly 60 is operated until done. The shaft 64 engages the access shaft 75 so that it can operate as a single structure. Anvil assembly 60 and elongate body portion 30 are then approximated to approximate intestinal sections “T ₁ ” and “T ₂ ”. Surgical stapling apparatus 10 is then fired, causing a plurality of staple pushers 9, each disposed in a respective staple receiving slot 72, to eject each staple 7 through slot 72. Staple 7 moves through intestinal sections “T ₁ ” and “T ₂ ” and buttress member 112 toward anvil assembly 60 so that intestinal sections “T ₁ ” and “T ₂ ” staple with each other. Try to meet each other. On the other hand, the cylindrical knife 76 cuts a portion of the tissue disposed radially inward of the cylindrical knife 76 to complete the anastomosis. At this time, the tab 120 remains attached to the buttress member 112 stapled to the intestinal sections “T ₁ ” and “T ₂ ” and is secured to the staple cartridge assembly 70 by the annular ring 130. When surgical stapling apparatus 10 is removed from the surgical site, a rupture or line of weakness adjacent to buttress member 112 is tab 120 from buttress member 112 stapled to intestinal sections "T ₁ " and "T ₂ ". Facilitates separation.

  11-13, a buttress assembly 300 according to another embodiment of the present disclosure is shown. The clamping member is in the form of a suture 330. In particular, the buttress component 310 includes a buttress member 312 configured and dimensioned to be positioned on the distal surface 374 of the staple cartridge assembly 370 and a rim 320 that extends proximally from the outer radial edge of the buttress member 312. Including. The rim 320 engages the outer wall 379 of the staple cartridge assembly 370 so that the buttress component 310 wraps around the distal surface 374 of the staple cartridge assembly 370. The cylindrical knife 376 is disposed radially inward of the buttress member 312 so that the buttress member 312 is not cut by the cylindrical knife 376 under such a configuration.

  The rim 320 includes loops 315 arranged along a plurality of circumferences. Each loop 315 is configured and dimensioned to receive a suture 330 therethrough. The suture 330 is wrapped around the rim 320 with the outer wall 379 of the staple cartridge assembly 370 on the back through a plurality of loops 315 and tied to secure the buttress component 310 on the staple cartridge assembly 370. Further, the rim 320 includes a perforation, a plurality of perforations, or a line of weakness 316 defined in a circumference adjacent to the buttress member 312 such that the buttress member 312 stapled to tissue separates from the rim 320. Can be done. In this manner, the rim 320 separated from the buttress member 312 remains secured to the outer wall 379 of the staple cartridge assembly 370 by the suture 330 and is removed along with the staple cartridge assembly 370 from the surgical site. Alternatively, each loop 315 can be created by defining a pair of substantially adjacent slits in the rim 320.

  14-16, a buttress assembly 400 according to another embodiment of the present disclosure is shown. Buttress assembly 400 includes a buttress component 410 and a clamping member in the form of a suture 430. In particular, buttress component 410 includes buttress member 412 that is configured and dimensioned to be positioned on distal surface 474 of staple cartridge assembly 470 and rim 420 that extends proximally from a radial edge outside buttress member 412. Including. The rim 420 engages the outer wall 479 of the staple cartridge assembly 470 so that the buttress component 410 wraps the distal surface 474 of the staple cartridge assembly 470.

  In contrast to the rim 320, the rim 420 includes apertures, holes, or bores 415 arranged along a plurality of circumferences. Each bore 415 is configured and dimensioned to receive a suture 430 therethrough. The suture 430 is looped around the rim 420 through the plurality of bores 415 and tied to secure the buttress component 410 on the staple cartridge assembly 470. Further, the rim 420 includes a break 416 defined in a circumference adjacent to the buttress member 412 so that the buttress member 412 stapled to the tissue can be separated from the rim 420. In this manner, the rim 420 separated from the buttress member 412 is secured to the outer wall 479 of the staple cartridge assembly 470 and removed with the staple cartridge assembly 470 from the surgical site.

Each bore 415 may include an adhesive or a gel, such as a hydrogel, further contemplated to improve the fixation of the suture 430 in the bore 415. Further, the suture 430 may include a plurality of, for example, unidirectional barbs, which are envisioned to improve the fixation of the suture 430 in the bore 415. An example of a barbed suture is disclosed in US patent application Ser. No. 12 / 361,962, filed Jan. 29, 2009, the entire contents of which are incorporated herein by reference. Composite barbed sutures are commercially available as V-LOC ^™ from Tyco Healthcare Group, LLP (dba Covidien AG, Mansfield, Mass.).

  With reference to FIGS. 17-19, a buttress assembly 600 according to another embodiment of the present disclosure is shown. Buttress assembly 600 includes a buttress member 610 and tabs 620 arranged along a plurality of peripheries extending proximally from an outer radial edge of buttress member 610. Each tab 620 includes an attachment member 630a on the inner wall or surface 625 thereof.

  Further, the outer wall 679 of the staple cartridge assembly 670 includes attachment members 630b arranged along a plurality of circumferences corresponding to the attachment members 630a on the tabs 620. Attachment members 630a and 630b may include, for example, refastenable tape or hook and loop fasteners. Alternatively, the tab 620 can include a double-sided adhesive tape for releasably positioning the buttress assembly 600 to the staple cartridge assembly 670.

  It is further envisioned that each tab 620 may include a break, perforation, or line of weakness 616 such that buttress member 610 stapled to tissue can be cut or separated from tab 620. In this manner, tab 620 can be attached to staple cartridge assembly 670 by attachment members 630a and 630b and removed from the surgical site along with staple cartridge assembly 670.

  Referring now to FIGS. 20-22, buttress assembly 700 includes a plurality of proximally extending radial inner edges of buttress member 710 that engage buttress member 710 and inner wall 777 of staple cartridge assembly 770. It is also contemplated that it may include tabs 720 arranged along a circumference. In particular, each tab 720 includes a mounting member 730a on its outer wall. Further, the inner wall 777 of the staple cartridge assembly 770 includes attachment members 730b arranged along a plurality of circumferences corresponding to the attachment members 730a on the tabs 720. Attachment members 730a and 730b may include, for example, a refastenable tape or hook and loop clamp.

  Under such a configuration, a cylindrical knife 776 is positioned radially inward of mounting members 730b arranged circumferentially on the inner wall 777 of the staple cartridge assembly 770, and each tab 720 is The outer wall of the mounting member 730a is positioned radially outward. Under such a configuration, the cylindrical knife 776 moves between the attachment members 730 a and 730 b to cut the tab 720 from the buttress member 710. Further, tab 720 may include a break, perforation, or line of weakness 716 to facilitate cutting tab 720 from buttress member 710. In this way, the buttress member 710 stapled to the tissue can be separated from the tab 720.

  23 and 24, a buttress assembly 800 according to another embodiment of the present disclosure is shown. In contrast to buttress assembly 100, 200, 300, 400, 600, 700 described herein above, buttress assembly 800 is configured and adapted to be securely positioned on anvil assembly 60. Buttress assembly 800 includes a buttress component 810. A suture 830 is used to attach the buttress component to the stapling device. Buttress component 810 extends distally from buttress member 812 having an annular profile configured and dimensioned to be flush with the outer peripheral edge of anvil member 62 when attached to anvil member 62. A rim 820. Further, the rim 820 engages the outer wall 61 of the anvil member 62 so that the buttress component 810 encloses the proximal surface of the anvil member 62 that defines a plurality of pockets for receiving and forming the staples 7. . In addition, buttress member 812 defines an aperture, hole, or bore 816 that is configured and dimensioned to receive shaft 64 of anvil assembly 60 therethrough. Bore 816 is sized to provide friction and an interference fit around shaft 64. Additionally or alternatively, a suture 830 can be further utilized to securely clamp the buttress member 812 to the shaft 64.

  Referring to FIGS. 25 and 26, in an alternative embodiment, buttress assembly 900 includes a buttress member 912 that extends radially between an outer rim 920 and an inner rim 940. In particular, the outer rim 920 is configured and dimensioned to engage the outer wall 61 of the anvil member 62, and the inner rim 940 is configured to provide an interference or friction fit to the shaft 64 of the anvil assembly 60. And dimensions. In this way, radial and longitudinal movement of buttress assembly 900 relative to anvil assembly 60 is minimized. Further, a clamping member in the form of a suture 930 is wound or tied to the shaft 64 of the anvil assembly 60 around the inner rim 940 of the buttress member 912 to further place the buttress assembly 900 onto the anvil assembly 60. Securely fix.

  With continued reference to FIG. 25, buttress assembly 900 includes buttress assembly 100 that is positionable on distal surface 74 of staple cartridge assembly 70, and buttress assemblies 200, 300, 400, 600, 700 described above herein. Can be used with any of these. Buttress assembly 100 is positioned radially outward of cylindrical knife 76. Thus, when the handle member 22 is actuated, the entire buttress member 112 is stapled to the tissue to reinforce the tissue and the buttress member 112 is not cut by the cylindrical knife 76. However, the cylindrical knife 76, along with the inner rim 940 and the suture 930 wound and tied around the inner rim 940, cores a portion of the buttress member 912 into the tissue. Release from a portion of buttress member 912 that is also stapled. The use and operation of assembly 200, 300, 400, 600, 700, 800, 900 is substantially similar to the use and operation of buttress assembly 100 described herein above. It is therefore not further described here.

  While exemplary embodiments of the present disclosure have been described herein with reference to the accompanying drawings, the above description, disclosure, and drawings should not be construed as limiting, but as specific implementations. It should be construed as merely illustrative of the form. For example, a buttress assembly 900 that includes a buttress member 912 that extends radially between the inner rim 940 and the outer rim 920 can be tailored for use on the distal surface 74 of the staple cartridge assembly 70. Further, the buttress assembly 900 can further utilize an annular ring 130 or suture 330 to secure the outer rim 920 of the buttress assembly 900 to the outer wall 61 of the anvil assembly 60. Accordingly, the present disclosure is not limited to these specific embodiments, and various other changes and modifications can be made in those specific embodiments by those skilled in the art without departing from the scope or spirit of the present disclosure. Should be understood.

10 surgical stapling apparatus 20 handle assembly 22 handle member 24 advancement means 26 rotatable grip member 30 elongate body portion 50 head portion 60 anvil assembly 62 anvil member 64 shaft 70 staple cartridge assembly 72 staple receiving slot 76 cylindrical knife 100 surgical Buttress assembly 110 Surgical buttress assembly 112 Buttress member 120 Tabs 130 arranged along the circumference Annular ring

Claims (1)

Invention described in the specification.

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