Surgical device and end effector

Abstract

A surgical device or a portion of a surgical device places a purse string suture in tissue within a body (e.g., an intraperitoneal space). The surgical device includes or a distal end effector for a surgical device includes a jaw assembly, a staple cartridge, and a suture.

Description

[0001] Cross-reference to related applications

[0002] This application claims the benefit and priority of U.S. Provisional Patent Application No. 62 / 978,435, filed February 19, 2020, the entire contents of which are incorporated herein by reference. Technical Field

[0003] This disclosure relates to surgical devices and methods of using the same. More specifically, this disclosure relates to endoscopic surgical devices for attaching purse-string sutures to tissues. Background Technology

[0004] Surgeons use surgical suturing devices to apply one or more rows of fasteners, such as nails or two-piece fasteners, sequentially or simultaneously to body tissue to join fragments of body tissue together and / or create anastomoses.

[0005] Circular surgical suture devices typically include: a staple cartridge assembly containing a circular staple row; an anvil assembly operatively associated with the staple cartridge assembly; and a circular blade housed within the circular staple row. In use, during end-to-end circular anastomosis, the two ends of a hollow tissue segment (e.g., intestine, small intestine, or other tubular organ) are positioned between the anvil assembly and the staple cartridge assembly and connected by clamping the ends together and driving the circular staple row through the clamped tissue segment. During staple firing, the circular blade is advanced to cut portions of the tissue segment extending within the staple suture, thereby establishing a pathway through the two stapled tissue segments.

[0006] Before approaching the anvil assembly relative to the staple cartridge assembly, the ends of the tissue segment can be secured to the anvil and staple cartridge assembly using a purse-string suture. A purse-string suture is used to close or narrow openings or passages in the tissue segment. The suture is typically passed through each tissue segment in a continuous suture manner, entering and exiting around the end of the tissue segment, manually or using an external device with needles or staples for attaching sutures to the tissue. After suturing the tissue segment, the ends of the suture are pulled together to close or narrow any openings in the tissue segment. The ends of the suture can then be tied together.

[0007] For example, in laparoscopic end-to-end gastrointestinal anastomosis, the surgeon may create an external incision to bring a tissue segment (e.g., intestine or colon) outside the body to attach a purse-string suture. The tissue segment is devascularized, and the purse-string suture is attached to the tissue segment by hand suturing or using an open purse-string device. However, such procedures can cause complications such as bleeding, injury, or increased surgical and / or recovery time, and revascularization of the tissue segment can lead to anastomotic leakage. Summary of the Invention

[0008] According to one aspect of this disclosure, a surgical apparatus includes an end effector comprising a jaw assembly, first and second staple cartridges, and a suture. The jaw assembly includes first and second jaws disposed opposite to each other and movable between an open position and a closed position. Each of the first and second staple cartridges has a tissue-facing surface defining a staple recess in which a staple is held. The first and second staple cartridges are respectively disposed within the first and second jaws and are movable within the first and second jaws during movement of the jaw assembly between the open and closed positions. The suture extends longitudinally along the tissue-facing surface of the staple cartridge and across each of the staple recesses.

[0009] The end effector may include a tool assembly, and first and second jaws may be releasably attached to the tool assembly. The tool assembly may include first and second jaw components, and each of the first and second jaws may include a proximal portion of a respective first and second jaw component configured to releasably engage the tool assembly.

[0010] Each of the first and second jaws can extend along a longitudinal axis, and the first and second staple cartridges can move along a transverse axis orthogonal to the longitudinal axis.

[0011] Each of the first and second jaws may include a body defining an elongated support channel and a longitudinally extending rib defining an outer surface of the body. The first and second staple cartridges may be disposed within the respective elongated support channels of the first and second jaws such that when the first and second jaws are in the open position, the first and second staple cartridges are spaced apart from the respective longitudinally extending ribs, and when the first and second jaws are in the closed position, the first and second staple cartridges are abutting the longitudinally extending ribs.

[0012] Each of the first and second nail cartridges may include a nail pusher extending longitudinally therethrough, such that when the first and second jaws are in the closed position, the longitudinally extending ribs engage the nail pusher to eject the nail from the respective first and second nail cartridges.

[0013] Each of the first and second jaws may include a pair of openings defined on opposite sides of a longitudinally extending rib in the outer surface of the body. Each of the first and second staple cartridges may include a sidewall having a pair of projecting edges extending upward from the cartridge body on opposite sides of the staple pusher. The pair of projecting edges may extend through the pair of openings in the body of the respective first and second jaws.

[0014] Each of the first and second jaws may include an inner surface, and when the first and second jaws are in the open position, the tissue-facing surface of each of the first and second staple cartridges is offset from the inner surface, and when the first and second jaws are in the closed position, the tissue-facing surface is flush with the inner surface.

[0015] The suture may include a distal portion extending beyond the first and second staple cartridges and a central portion extending proximally to the first and second staple cartridges, the central portion being bent between the first and second jaws.

[0016] According to another aspect of this disclosure, an end effector includes a jaw assembly, first and second staple cartridges, and a suture. The jaw assembly includes first and second jaws disposed opposite to each other and movable between an open position and a closed position. Each of the first and second staple cartridges has a tissue-facing surface that defines a staple recess in which a staple is held. The first and second staple cartridges are respectively disposed within a first or second jaw and are movable within the first or second jaw during movement of the jaw assembly between the open and closed positions. The suture extends longitudinally along the tissue-facing surfaces of the first and second staple cartridges and crosses each of the staple recesses.

[0017] The end effector may include a tool assembly, and first and second jaws may be releasably attached to the tool assembly. The tool assembly may include first and second jaw components, and each of the first and second jaws may include a proximal portion of a respective first and second jaw component configured to releasably engage the tool assembly.

[0018] Each of the first and second jaws can extend along a longitudinal axis, and the first and second staple cartridges can move along a transverse axis orthogonal to the longitudinal axis.

[0019] Each of the first and second jaws may include a body defining an elongated support channel and a longitudinally extending rib defining an outer surface of the body. The first and second staple cartridges may be disposed within the respective elongated support channels of the first and second jaws such that when the first and second jaws are in the open position, the first and second staple cartridges are spaced apart from the respective longitudinally extending ribs, and when the first and second jaws are in the closed position, the first and second staple cartridges are abutting the longitudinally extending ribs.

[0020] Each of the first and second nail cartridges may include a nail pusher extending longitudinally therethrough, such that when the first and second jaws are in the closed position, the longitudinally extending ribs engage the nail pusher to eject the nail from the respective first and second nail cartridges.

[0021] Each of the first and second jaws may include a pair of openings defined on opposite sides of a longitudinally extending rib in the outer surface of the body. Each of the first and second staple cartridges may include a sidewall having a pair of projecting edges extending upward from the cartridge body on opposite sides of the staple pusher. The pair of projecting edges may extend through the pair of openings in the body of the respective first and second jaws.

[0022] Each of the first and second jaws may include an inner surface, and when the first and second jaws are in the open position, the tissue-facing surface of each of the first and second staple cartridges is offset from the inner surface, and when the first and second jaws are in the closed position, the tissue-facing surface is flush with the inner surface.

[0023] The suture may include a distal portion extending beyond the first and second staple cartridges and a central portion extending proximally to the first and second staple cartridges, the central portion being bent between the first and second jaws.

[0024] Other aspects, features, and advantages will be apparent from the description, drawings, and claims. Attached Figure Description

[0025] Various aspects of this disclosure are described below with reference to the accompanying drawings, which are incorporated in and constitute a part of this specification, wherein:

[0026] Figure 1 This is a side perspective view of a surgical device according to an embodiment of the present disclosure;

[0027] Figure 2 It is the end effector of a surgical device. Figure 1 A magnified perspective view of the detailed areas within the image;

[0028] Figure 3 yes Figure 2 The bottom perspective view of the end effector shows the first jaw of the jaw assembly being attached and the second jaw of the jaw assembly being removed, and the cartridge being separated from the first jaw.

[0029] Figure 4 yes Figure 3 Top perspective view of the first jaws and the staple cartridge;

[0030] Figure 5 yes Figure 2 A side view of the end effector's staple cartridge and suture, shown as the first and second jaws of the jaw assembly being removed;

[0031] Figure 6 The one shown is in the open position according to an embodiment of this disclosure. Figure 2 A side perspective view of the jaw assembly, wherein tissue is located between the first and second jaws of the jaw assembly during surgical suturing;

[0032] Figure 7 It is shown as being in a closed position. Figure 6 A side perspective view of the jaw assembly, wherein tissue is held between the first and second jaws;

[0033] Figure 8 It is along Figure 6 Section line 8-8 is taken Figure 6 A cross-sectional view of the jaw assembly, shown as tissue being removed;

[0034] Figure 9 It is along Figure 7 Section line 9-9 is taken Figure 7 A cross-sectional view of the jaw assembly, shown as tissue being removed;

[0035] Figure 10 It occurred after surgical suturing. Figure 6 and Figure 7 A top-down perspective view of the organization; and

[0036] Figure 11 This occurs after the sutures are tightened and attached to the tissue. Figure 10 A top-down perspective view of the organization. Detailed Implementation

[0037] This disclosure relates to a surgical device for placing purse-string sutures within tissues in the body (e.g., the intraperitoneal space) without creating an external incision and for removing tissues from the abdomen as needed using an open purse-string suture device or technique. This reduces the likelihood of vascular damage to healthy tissues. Furthermore, external placement of tissues during laparoscopic surgery requires the removal of pneumoperitoneum, and therefore does not fully realize the advantages of laparoscopic surgery. Therefore, the formation of intraperitoneal purse-string sutures allows both patients and surgeons to benefit from laparoscopic surgery.

[0038] The surgical device of this disclosure can reach low or ultra-low distal stumps and form purse-string sutures therein, thus reducing the possibility of fistulas at the distal stump associated with dog ear sutures that may form during straight anastomosis purse-string suture operations. The surgical device of this disclosure minimizes or avoids accidental tissue incisions that may occur during manual suturing techniques and provides standard and / or controlled suture thicknesses through tissue.

[0039] Embodiments of this disclosure are discussed below with reference to a surgical device for securing sutures to tissue. The surgical device described herein can be used to apply sutures to hollow or tubular tissue segments (also commonly referred to herein as tissue) by grasping the distal portion of the tissue between the first and second jaws of the surgical device and securing the suture thereto with a staple.

[0040] Embodiments of the surgical device will now be described in detail with reference to the accompanying drawings, wherein like reference numerals denote similar or identical elements. Throughout this specification, the term "proximal" refers to a portion or component of the device closer to the user, and the term "distal" refers to a portion or component of the device farther from the user. The terms "generally" and "substantially" should be understood as synonyms with relatively little or no variation in the modified terminology. Directional reference terms, such as "upper," "lower," "top," "bottom," "side," etc., are intended to simplify the description of the embodiments and are not intended to have any limiting effect on the final orientation of the device or any part thereof.

[0041] Figure 1 and Figure 2 A laparoscopic purse-string suture device or surgical apparatus 1 for applying purse-string sutures to tissue is shown. Surgical apparatus 1 typically includes a housing 10, an elongated body portion or shaft 20 extending distally from the housing 10, and an end effector 30 extending distally from the shaft 20. The end effector 30 includes a tool assembly 32 having opposing jaw members 32a, 32b, and a jaw assembly 34 extending distally from the tool assembly 32. The jaw assembly 34 includes an upper or first jaw 40a and a lower or second jaw 40b disposed opposite the first jaw 40a. The first and second jaws 40a, 40b of the jaw assembly 34 are individually and releasably attached to the jaw members 32a, 32b of the tool assembly 32 (e.g., releasably secured to an existing integral end effector, such as...). Figure 1 and Figure 2 (As shown). Alternatively, the first and second jaws 40a, 40b may be integral with the end effector 30, which may be permanently or releasably fixed to the shaft 20 of the surgical device 1.

[0042] The housing 10 of the surgical device 1 includes a handle assembly 12 having a stationary or fixed handle portion 12a and a movable handle portion or trigger 12b, the movable handle portion or trigger being movable relative to the fixed handle portion 12a to allow the first and second jaws 40a, 40b to be spaced apart from each other (e.g., see...). Figure 6The open or closed position of the clamping jaws and in which the first and second jaws 40a, 40b are substantially adjacent to each other and cooperate to grasp tissue therebetween (e.g., see [reference]). Figure 7 The closed or clamped position of the jaws 12b actuates the end effector 30. Actuation of the trigger 12b applies the suture 60 to the tissue captured between the first and second jaws 40a, 40b of the jaw assembly 34, as described in further detail below. The rotating assembly 14 is disposed within the housing 10 to facilitate rotation of the shaft 20 and thus rotation of the end effector 30, so as to properly orient the jaw assembly 34 relative to the tissue to be sutured.

[0043] like Figures 2 to 4 As shown, each of the first and second jaws 40a, 40b includes a body 42 and a staple cartridge 50 disposed within the body 42. Although Figure 3 and Figure 4 Only the first jaw 40a is shown, but it should be understood that the second jaw 40b is identical to it. The body 42 of each of the first and second jaws 40a, 40b has a proximal portion 42a configured to releasably engage the corresponding jaw components 32a, 32b of the tool assembly 32. The proximal portion 42a of the body 42 includes a slot 43, the size and shape of which are configured to receive the jaw components 32a, 32b in an interference (e.g., friction) fit arrangement. However, it should be understood that the proximal portion 42a of the body 42 can be coupled to the jaw components 32a, 32b by other mechanical or non-mechanical connections, such as coupling sheaths and / or temporary adhesives. Furthermore, although the tool assembly 32 is shown as opposing jaw components 32a, 32b, which have conductive tissue contact surfaces to perform other functions when the jaw assembly 34 is not attached to the tool assembly 32, it should be understood that the tool assembly 32 may have other configurations as understood by those skilled in the art, and the proximal portion 42a of the body 42 of the first and / or second jaws 40a, 40b may be configured for attachment thereto.

[0044] Each of the first and second jaws 40a, 40b has a body 42 with a distal portion 42b defining an elongated support channel 45 configured and sized to selectively receive a staple cartridge 50 within the body 42. The staple cartridge 50 may be removable and replaceable within the body 42. The elongated support channel 45 opens at an inner surface 44a of the body 42 and is defined between two longitudinally extending arms 46a, 46b and a longitudinally extending rib 46c, the two longitudinally extending arms defining opposite side surfaces 44b of the body 42, and the longitudinally extending rib defining a top surface 44c of the body 42. A pair of openings 47 are arranged substantially parallel in the top surface 44c of the body 42, defined on opposite sides of the longitudinally extending rib 46c. The longitudinally extending rib 46c and the pair of openings 47 extend the same length as the longitudinally extending arms 46a, 46b.

[0045] The staple cartridge 50 includes a cartridge body 52 having a tissue-facing surface or tissue-contacting surface 54, wherein the tissue-facing surface or tissue-contacting surface defines a staple recess or retaining slot 55 for receiving a plurality of fasteners or staples 56 therein. The staple recess 55 extends laterally across the tissue-facing surface 54 such that the staples 56 are arranged in a generally parallel configuration relative to each other along the length of the cartridge body 52. ​​The staples 56 are formed of a biocompatible material (e.g., a metal or a polymer), which may be bioabsorbable or non-absorbable, natural or synthetic, or a combination thereof. The size of the staples 56 is configured to engage tissue layers disposed adjacent to the tissue-facing surface 54 of the staple cartridge 50. When the staples 56 are placed in the staple recess 55, the staples have an initial configuration that is substantially U-shaped or C-shaped, and upon impact with the tissue, the staples may deform into a D-shaped or B-shaped configuration.

[0046] The nail pusher 58 extends across the nail magazine 50 and connects with the rear span 56a of the nail 56. Figure 10Alignment. The cartridge 50 further includes a sidewall 52a having a protrusion 52b extending laterally therefrom, and a pair of projecting edges 52c extending upward from the cartridge body 52 on the opposite side of the staple pusher 58. The cartridge 50 is positioned within an elongated support channel 45 of the body 42 by aligning the protrusion 52b with a groove 49 defined in a longitudinally extending arm 46a, 46b of the body 42 and inserting the cartridge 50 therein, such that the pair of projecting edges 52b extend through a pair of openings 47 defined in the body 42, the staple pusher 58 is positioned adjacent to a longitudinally extending rib 46c of the body 42, and the tissue-facing surface 54 is positioned adjacent to an inner surface 44a of the body 42. The cartridge 50 is positioned within the body 42 such that during compression or firing of the surgical device 1, the cartridge can be moved in an upward direction or is permitted to move in an upward direction (e.g., outward and away from tissue positioned adjacent to the tissue-facing surface 54 of the cartridge 50). In the unclamped position, the protrusion 52b of the staple cartridge 50 is positioned within the recess 49 of the body 42 (see, for example, see...). Figure 8 In the clamped position, the protrusion 52b of the staple cartridge 50 extends out of the groove 49 and extends above the body 42 (see, for example, see...). Figure 9 ).

[0047] As in Figure 2 and Figure 5 As seen, a monofilament suture 60 extends longitudinally along the tissue-facing surface 54 of each of the staple cartridges 50 of the first and second jaws 40a, 40b and across each of the staple recesses 55, such that the suture 60 extends between the legs 56b of each of the staples 56 in the staple cartridge 50. The suture 60 may be a monofilament or polyfilament formed of a biocompatible material, which may be bioabsorbable or nonabsorbable, natural or synthetic, or a combination thereof. The distal portions 60a of the suture 60 extend distally beyond the staple cartridge 50 and the first and second jaws 40a, 40b, and the central portion 60b of the suture 60 extends proximally to the staple cartridge 50 and forms a bend in the suture 60 between the first and second jaws 40a, 40b. The suture 60 may further include a swab (not shown) at one or both distal portions 60a of the suture 60 to facilitate gripping and / or knotting of the suture 60.

[0048] In order to use the surgical device 1 during surgical suturing (e.g., applying a purse-string suture to the tissue), it is fixed to the distal end of the shaft 20 and loaded with, as Figure 1 and Figure 2 The end effector 30 of the first and second jaws 40a, 40b, staple cartridge 50, and suture 60 shown is inserted through an access device (not shown) that passes through, for example, a cannula, catheter, or inlet, and positioned at the desired surgical site. Figure 6As shown, a tissue “T” (e.g., a hollow tissue segment) is positioned between the first and second jaws 40a, 40b of the end effector 30, wherein an opening “P” defined through the tissue “T” is positioned substantially perpendicular to the central longitudinal axis “X” of the end effector 30, and the opening end “E” of the tissue “T” extends laterally adjacent to the end effector 30. Once properly oriented and positioned, the trigger 12b of the actuation handle assembly 12 is activated. Figure 1 ) to fire the surgical device 1, causing the jaw assembly 34 to... Figure 6 The opening position shown is moved to, as Figure 7 The closed position is shown. As the first and second jaws 40a and 40b move from the open position to the closed position, the tissue contact surface 54 of the staple cartridge 50 of the first and second jaws 40a and 40b clamps the tissue "T" and compresses the opening "P" in the closed tissue "T".

[0049] like Figure 8 As shown, in the open position, the staple pusher 58 of the staple cartridge 50 is positioned spaced apart from the longitudinally extending ribs 46c of the corresponding first and second jaws 40a, 40b, and the tissue-facing surface 54 of the staple cartridge 50 is offset relative to the inner surface 44a of the corresponding first and second jaws 40a, 40b. Alternatively, the staple pusher 58 may contact the longitudinally extending ribs 46c before clamping and / or firing. Figure 9 Move the opening position shown to the left as indicated. Figure 8 During the closed position shown, the staple cartridge 50 moves outward away from the tissue "T" in the direction of the transverse axis "A" during compression. Figure 7 The transverse axis is substantially orthogonal to the longitudinal axis "B" extending through each of the first and second jaws 40a, 40b. As the staple cartridge 50 moves outward, the staple pusher 58 abuts against the longitudinally extending ribs 46c, and the tissue-facing surface 54 is substantially flush with the inner surfaces 44a of the first and second jaws 40a, 40b. The longitudinally extending ribs 46c of each of the first and second jaws 40a, 40b act as stops to halt upward movement of the staple cartridge 50 within the respective first and second jaws 40a, 40b, and push the staple pusher 58 downward toward the tissue "T" and fire the staple 56 into the tissue "T".

[0050] Subsequently, when the first and second jaws 40a, 40b are opened to release the tissue “T”, the suture 60 is pinned to the tissue “T”, thereby attaching the suture 60 to the tissue “T” between each of the formed staples 56 around the periphery of the tissue “T” (e.g., in the form of a continuous suture), as... Figure 10As shown in Figure 11, the end portion 60a of the suture 60 can then be pulled to tighten the suture 60 and narrow the opening "P" defined in the tissue "T", for example, around the anvil or compartment assembly of the circular stapler (not shown).

[0051] The end effector 30 can be a disposable or reusable end effector. The end effector 30 may be pre-loaded with the jaw assembly 34, regardless of whether the staple cartridge 60 and / or suture 66 are loaded into the jaw assembly 34. The staple cartridge 60 may be manufactured to contain the suture 66 loaded therethrough (e.g., see...). Figure 5 The jaw assembly 34 may be a fixed, permanent component of the end effector 30, or an interchangeable, releasable engagement portion thereof (e.g., that may be attached to an existing end effector or surgical device), and / or the cartridge 50 and suture 60 may be replaceable components of the end effector 30.

[0052] The end effector 30 and / or jaw assembly 34 described herein can also be configured for use with other surgical devices, such as robotic, electric or manual surgical devices / instruments.

[0053] Those skilled in the art will understand that the apparatuses and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments, and that the descriptions, disclosures, and drawings should be interpreted merely as examples of specific embodiments. Therefore, it should be understood that this disclosure is not limited to the precise embodiments described, and that those skilled in the art can make various other changes and modifications without departing from the scope or spirit of this disclosure. Furthermore, it is contemplated that elements and features illustrated or described in conjunction with one exemplary embodiment may be combined with elements and features of another exemplary embodiment without departing from the scope of this disclosure, and such modifications and variations are also intended to be included within the scope of this disclosure. Therefore, the subject matter of this disclosure is not limited to what has been specifically shown and described.

Claims

1. A surgical device comprising: An end effector comprising: A jaw assembly comprising first and second jaws disposed opposite each other and movable between an open position and a closed position; First and second staple cartridges, each having a tissue-facing surface defining a staple recess therein, the first and second staple cartridges being respectively disposed within the first and second jaws and movable within the jaws during movement of the jaw assembly between the open and closed positions; and The suture extends longitudinally along the tissue-facing surfaces of the first and second staple cartridges and crosses each of the staple recesses; The suture includes distal portions extending beyond the first and second staple cartridges and the first and second jaws, and a central portion extending proximally to the first and second staple cartridges, the central portion bending between the first and second jaws, and the suture also includes a swab at one or both distal portions of the suture.

2. The surgical apparatus of claim 1, wherein the end effector comprises a tool assembly, and the first and second jaws are releasably attached to the tool assembly.

3. The surgical apparatus of claim 2, wherein the tool assembly includes first and second jaw components, and each of the first and second jaws includes a proximal portion configured to releasably engage a respective one of the first and second jaw components of the tool assembly.

4. The surgical apparatus of claim 1, wherein each of the first and second jaws extends along a longitudinal axis, and the first and second staple cartridges are movable along a transverse axis orthogonal to the longitudinal axis.

5. The surgical apparatus of claim 1, wherein each of the first and second jaws comprises a body defining an elongated support channel and a longitudinally extending rib defining an outer surface of the body, the first and second staple cartridges being disposed within the respective elongated support channels of the first and second jaws such that, when the first and second jaws are in the open position, the first and second staple cartridges are spaced apart relative to the respective longitudinally extending ribs, and when the first and second jaws are in the closed position, the first and second staple cartridges are adjacent to the longitudinally extending ribs.

6. The surgical apparatus of claim 5, wherein each of the first and second staple cartridges includes a staple pusher extending longitudinally therethrough, and when the first and second jaws are in the closed position, the longitudinally extending ribs engage the staple pusher to expel the staple from the respective first and second staple cartridges.

7. The surgical apparatus of claim 6, wherein each of the first and second jaws includes a pair of openings defined in the outer surface of the body on opposite sides of the longitudinally extending rib.

8. The surgical apparatus of claim 7, wherein each of the first and second staple cartridges includes a sidewall having a pair of projecting edges extending upward from the cartridge body on opposite sides of the staple pusher, the pair of projecting edges extending through the pair of openings in the body of the respective first and second jaws.

9. The surgical apparatus of claim 1, wherein each of the first and second jaws includes an inner surface, and when the first and second jaws are in the open position, the tissue-facing surface of each of the first and second staple cartridges is offset from the inner surface, and when the first and second jaws are in the closed position, the tissue-facing surface is flush with the inner surface.

10. An end effector comprising: A jaw assembly comprising first and second jaws disposed opposite each other and movable between an open position and a closed position; First and second staple cartridges, each having a tissue-facing surface defining a staple recess therein, the first and second staple cartridges being respectively disposed within the first and second jaws and movable within the jaws during movement of the jaw assembly between the open and closed positions; and The suture extends longitudinally along the tissue-facing surfaces of the first and second staple cartridges and crosses each of the staple recesses; The suture includes distal portions extending beyond the first and second staple cartridges and the first and second jaws, and a central portion extending proximally to the first and second staple cartridges, the central portion bending between the first and second jaws, and the suture also includes a swab at one or both distal portions of the suture.

11. The end effector of claim 10, further comprising a tool assembly, wherein the first and second jaws are releasably attached to the tool assembly.

12. The end effector of claim 11, wherein the tool assembly includes first and second jaw components, and each of the first and second jaws includes a proximal portion configured to releasably engage a respective one of the first and second jaw components of the tool assembly.

13. The end effector of claim 10, wherein each of the first and second jaws extends along a longitudinal axis, and the first and second staple cartridges are movable along a transverse axis orthogonal to the longitudinal axis.

14. The end effector of claim 10, wherein each of the first and second jaws comprises a body defining an elongated support channel and a longitudinally extending rib defining an outer surface of the body, the first and second staple cartridges being disposed within the respective elongated support channels of the first and second jaws such that, when the first and second jaws are in the open position, the first and second staple cartridges are spaced apart relative to the respective longitudinally extending ribs, and when the first and second jaws are in the closed position, the first and second staple cartridges are adjacent to the longitudinally extending ribs.

15. The end effector of claim 14, wherein each of the first and second staple cartridges includes a staple pusher extending longitudinally therethrough, and when the first and second jaws are in the closed position, the longitudinally extending ribs engage the staple pusher to eject the staple from the respective first and second staple cartridges.

16. The end effector of claim 15, wherein each of the first and second jaws includes a pair of openings defined in the outer surface of the body on opposite sides of the longitudinally extending rib.

17. The end effector of claim 16, wherein each of the first and second staple cartridges includes a sidewall having a pair of protruding edges extending upward from the cartridge body on opposite sides of the staple pusher, the pair of protruding edges extending through the pair of openings in the body of the respective first and second jaws.

18. The end effector of claim 10, wherein each of the first and second jaws includes an inner surface, and when the first and second jaws are in the open position, the tissue-facing surface of each of the first and second staple cartridges is offset from the inner surface, and when the first and second jaws are in the closed position, the tissue-facing surface is flush with the inner surface.

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