Apparatus for detecting full seating of a buttress applicator in an end effector of a surgical stapler

Abstract

The present invention discloses an apparatus comprising: (a) at least one platform configured to be positioned between opposing first and second jaws of an end effector of a surgical stapler, wherein the at least one platform is configured to be transitionable between a first state and a second state; (b) at least one accessory element positioned on the at least one platform; (c) at least one detector configured to detect a predetermined portion of the end effector; and (d) a driver configured to selectively transition the at least one platform from the first state to the second state in a direction toward at least one of the first or second jaws when the at least one detector detects the predetermined portion of the end effector, for placing the at least one accessory element into contact with a corresponding surface of the at least one of the first or second jaws.

Description

Background Technology

[0001] In some surgical settings, endoscopic surgical instruments may be superior to traditional open surgical devices in creating smaller incisions within the patient, which can reduce postoperative recovery time and complications. Some endoscopic surgical instruments are adapted to place distal end-effectors at desired surgical sites via cannulation of a trocar. These distal end-effectors (e.g., internal cutters, grippers, scalpels, suture devices, clamps, entry devices, drug / gene therapy delivery devices, and energy delivery devices using ultrasound, RF, lasers, etc.) can engage tissue in various ways to achieve diagnostic or therapeutic effects. Endoscopic surgical instruments may include an axis located between the end-effector and a handle portion manipulated by the clinician. This axis allows insertion to the desired depth and rotation about the longitudinal axis of the axis, thereby facilitating the positioning of the end-effector within the patient. Positioning of the end-effector can be further facilitated by including one or more articulation joints or features that allow the end-effector to selectively articulate or otherwise deflect relative to the longitudinal axis of the axis.

[0002] Examples of endoscopic surgical instruments include surgical suture devices. Some of these suture devices are operable to clamp tissue layers, cut through the clamped tissue layers, and drive a staple through the tissue layers to substantially seal the cut tissue layers together near the cut ends. Exemplary surgical suture devices are disclosed only in U.S. Patent No. 7,380,696, published June 3, 2008, entitled “Articulating Surgical Stapling Instrument Incorporating a Two-Piece E-BeamFiring Mechanism”; U.S. Patent No. 8,408,439, published April 2, 2013, entitled “Surgical Stapling Instrument with An Articulatable End Effector”; and U.S. Patent No. 8,453,914, published June 4, 2013, entitled “Motor-Driven Surgical Cutting Instrument with Electric Actuator Directional Control Assembly”. The disclosure of each of the above-cited U.S. patents and U.S. patent publications is incorporated herein by reference.

[0003] Surgical staplers can also be used in open abdominal surgeries and / or other non-endoscopic procedures. By way of example only, in thoracic surgery, a surgical stapler can be inserted via a thoracotomy and thus positioned between the patient's ribs to reach one or more organs, in which a trocar is not used as the catheter for the stapler. For example, blood vessels leading to an organ can be severed and closed using a stapler before it is removed from the thoracic cavity. Of course, surgical staplers can be used in a variety of other situations and procedures.

[0004] Although various surgical suturing instruments and associated components have been manufactured and used, it is believed that no one had manufactured or used the invention described in the appended claims prior to the inventors. Attached Figure Description

[0005] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the general description of the invention given above and the detailed description of the embodiments given below, serve to explain the principles of the invention.

[0006] Figure 1 A perspective view of an exemplary surgical suturing instrument is shown;

[0007] Figure 2 It shows Figure 1 A side front view of the instrument;

[0008] Figure 3 It shows that it is in the open state. Figure 1 A perspective view of the end effector of the instrument;

[0009] Figure 4A It shows Figure 3 end effector along Figure 3 The side section view taken from line 4-4, with the firing beam in a near-side position;

[0010] Figure 4B It shows Figure 3 end effector along Figure 3 The side section view taken from line 4-4, with the firing beam in the far side position;

[0011] Figure 5 It shows Figure 3 end effector along Figure 3 The end cross-sectional view taken from line 5-5;

[0012] Figure 6 It shows Figure 3 Exploded perspective view of the end effector;

[0013] Figure 7 It shows Figure 3A perspective view of an end effector located at the tissue and already actuated once within the tissue;

[0014] Figure 8 A perspective view of an exemplary pair of support components is shown, wherein each support component can be applied to... Figure 3 The jaws of the end effector;

[0015] Figure 9A It shows Figure 3 A cross-sectional end view of a portion of the end effector, wherein Figure 8 The support assembly is applied to the upper and lower jaws of the end effector, showing the end effector jaws in the open state, with tissue positioned between the upper and lower jaws;

[0016] Figure 9B It shows Figure 9A A cross-sectional end view of the end effector and support assembly, showing the end effector jaws in a tissue-closed state;

[0017] Figure 9C The formed nail and the nail that has been passed are shown. Figure 3 The end effector is fixed to the tissue afterward. Figure 9A A cross-sectional view of the support assembly;

[0018] Figure 10 The formed nail and the nail that has been passed are shown. Figure 3 The end effector is fixed to the tissue afterward. Figure 9A A perspective view of the support components;

[0019] Figure 11 It shows that it can be used for carrying and application Figure 8 A perspective view of an exemplary support applicator compartment of the support assembly;

[0020] Figure 12 It shows Figure 11 A top plan view of the support application device compartment;

[0021] Figure 13A It shows Figure 3 end effector and Figure 11 A perspective view of the support applicator compartment, showing the end effector and the support applicator compartment aligned with each other;

[0022] Figure 13B It shows Figure 3 end effector and Figure 11 A perspective view of the support applicator compartment, in which the end effector jaws are closed on the platform of the support applicator compartment;

[0023] Figure 14 The bearing is shown Figure 8 A schematic side sectional view of another exemplary support object applicator for the support assembly;

[0024] Figure 15 It shows Figure 14 A schematic diagram of a support applicator, showing components configured to detect... Figure 3 Various electrical components of the electrical switch for the end effector's stop mechanism;

[0025] Figure 16A It shows the location at Figure 14 The support above the applicator Figure 3 A side sectional view of the end effector, showing the expandable platform of the support applicator in a collapsed state;

[0026] Figure 16B It shows the location at Figure 14 The support above the applicator Figure 3 A side sectional view of the end effector, showing an expandable platform of the end effector in a deployed state for applying a support assembly to the jaws of the end effector in response to an electrical switch of the end effector’s organization stop contacting the support applicator.

[0027] Figure 17A The bearing is shown Figure 8 One of the support components and positioned in Figure 3 A side sectional view of another exemplary support applicator above the lower jaw of the end effector, showing the movable platform of the support applicator in a retracted state; and

[0028] Figure 17B It shows the location at Figure 3 The end effector above the lower jaw Figure 17A A side sectional view of a support applicator, showing a movable platform for applying a support assembly to the lower jaw of an end effector in a deployed state in response to the distal tip of the lower jaw contacting a translational slider of the support applicator.

[0029] The accompanying drawings are not intended to be limiting in any way, and various embodiments of the invention can be conceived to be implemented in many other ways, including those not necessarily shown in the drawings. The drawings, which are incorporated in and constitute a part of this specification, illustrate several aspects of the invention and, together with the description, serve to explain the principles of the invention; however, it should be understood that the invention is not limited to the explicit arrangements shown. Detailed Implementation

[0030] The following description of certain examples of the present technology is not intended to limit the scope of the present technology. Other examples, features, aspects, embodiments, and advantages of the present technology will become apparent to those skilled in the art from the following description, which is given by way of example, representing one of the best ways contemplated for implementing the present technology. As will be appreciated, the technology described herein can have other different and obvious aspects, all of which are not departing from the present technology. Therefore, the accompanying drawings and descriptions should be considered substantially illustrative rather than restrictive.

[0031] Furthermore, it should be understood that any one or more of the teachings, expressions, embodiments, examples, etc., described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc., described herein. Therefore, the following teachings, expressions, embodiments, examples, etc., should not be considered in isolation from each other. Various suitable ways in which the teachings herein can be combined will be apparent to those skilled in the art. Such modifications and variations are intended to be included within the scope of the claims.

[0032] For clarity of disclosure, the terms "proximal" and "distal" are defined herein with respect to a human or robotic operator of the surgical instrument. The term "proximal" refers to the element location of the surgical end effector that is closer to the human or robotic operator of the surgical instrument and further away from the surgical instrument. The term "distal" refers to the element location of the surgical end effector that is closer to the surgical instrument and further away from the human or robotic operator of the surgical instrument. Furthermore, the terms "upper," "lower," "lateral," "transverse," "bottom," and "top" are relative terms to provide additional clarity to the figures provided below. Therefore, the terms "upper," "lower," "lateral," "transverse," "bottom," and "top" are not intended to unnecessarily limit the invention described herein.

[0033] I. Exemplary Surgical Stapler

[0034] Figures 1 to 7 An exemplary surgical suturing and cutting instrument (10) is shown, sized to be inserted through a trocar cannula or incision (e.g., thoracotomy, etc.) into a patient's surgical site to perform surgery. The instrument (10) of this example includes a shank portion (20) connected to a shaft (22) that terminates distally in an articulation joint (11), which is further coupled to an end effector (12). Once the articulation joint (11) and the end effector (12) are inserted through the cannula's insertion channel, the articulation joint (11) can be remotely articulated via articulation controls (13), such as... Figure 1The end effector (12) is depicted as a virtual image, such that the end effector (12) can be deflected from the longitudinal axis (LA) of the shaft (22) at a desired angle (α). The end effector (12) of this example includes a lower jaw (16) and an upper jaw in the form of a pivotable anvil (18), the lower jaw including a staple cartridge (37).

[0035] The handle portion (20) includes a pistol grip (24) and a closing trigger (26). The closing trigger (26) is pivotable toward the pistol grip (24) so ​​that the anvil (18) clamps or closes toward the lower jaws (16) of the end effector (12). Such closure of the anvil (18) is provided by a closing tube (32) and a closing ring (33), both of which translate longitudinally relative to the handle portion (20) in response to the pivoting of the closing trigger (26) relative to the pistol grip (24). The closing tube (32) extends along the length of the shaft (22); and the closing ring (33) is positioned distal to the articulated joint (11). The articulated joint (11) is operable to transfer / transmit longitudinal motion from the closing tube (32) to the closing ring (33).

[0036] like Figure 2 As shown, the handle portion (20) also includes a firing trigger (28). An elongated member (not shown) extends longitudinally through the shaft (22) and, in response to actuation of the firing trigger (28), transmits longitudinal firing motion from the handle portion (20) to the firing beam (14). This distal translation of the firing beam (14) causes the tissue clamped in the end effector (12) to be sutured and cut, as will be described in more detail below.

[0037] like Figures 3 to 6 As shown, the end effector (12) employs a firing beam (14) comprising a laterally oriented upper pin (38), a firing beam top cap (44), a laterally oriented middle pin (46), and a distal cutting edge (48). The upper pin (38) is positioned within a longitudinal anvil slot (42) of the anvil (18) and is translatable within said longitudinal anvil slot. The firing beam top cap (44) extends the firing beam (14) through a lower jaw slot (45) (…). Figure 4B (As shown) The lower surface of the lower jaw (16) is slidably engaged, and the lower jaw groove (45) is formed through the lower jaw (16). The central pin (46) slidably engages the top surface of the lower jaw (16), thereby cooperating with the firing beam top cover (44).

[0038] Figure 3 This example illustrates the proximal-positioned firing beam (14) and the anvil (18) pivoting to an open configuration, allowing the unexploded cartridge (37) to be removably inserted into the channel of the lower jaws (16). Figures 5 to 6As best seen in this example, the staple cartridge (37) includes a cartridge body (70) that presents an upper deck (72) and is coupled to a lower cartridge tray (74). Figure 3 As best seen, a vertical slot (49) extends longitudinally through a portion of the staple cartridge body (70). Similarly... Figure 3 As best seen, three rows of nail holes (51) are formed through the upper deck (72) on each transverse side of the vertical slot (49). Figures 4A to 6 As shown, a wedge-shaped slider (41) and multiple nail actuators (43) are held between the cartridge (70) and the tray (74), wherein the wedge-shaped slider (41) is positioned close to the nail actuators (43). The wedge-shaped slider (41) is capable of longitudinal movement within the nail cartridge (37); while the nail actuators (43) are capable of vertical movement within the nail cartridge (37). The nails (47) are also positioned within the cartridge (70), above the corresponding nail actuators (43). Each nail (47) is vertically driven within the cartridge (70) by the nail actuator (43) to drive the nail (47) outward through the associated nail hole (51). Figures 4A to 4B and Figure 6 As is best seen, the wedge slider (41) has an inclined cam surface that pushes the nail driver (43) upward as the wedge slider (41) is driven toward the distal end through the nail cartridge (37).

[0039] By advancing the closed tube (32) and closed ring (33) to the distal end of the actuator (12) as... Figures 4A to 4B In the closed configuration shown, by engaging the upper pin (38) into the longitudinal anvil slot (42), the firing beam (14) is pushed distally until it engages with the anvil (18). Push block (80) Figure 5 Located at the distal end of the firing beam (14), when the firing trigger (28) is actuated, the wedge-shaped slider (41) is pushed distally as the firing beam (14) advances distally through the staple cartridge (37). During this firing, the cutting edge (48) of the firing beam (14) enters the vertical slot (49) of the staple cartridge (37), thereby severing the tissue clamped between the staple cartridge (37) and the anvil (18). Figures 4A to 4B As shown, the intermediate pin (46) and the pusher (80) actuate the nail cartridge (37) together by entering the slot (49) within the nail cartridge (37), thereby driving the wedge-shaped slider (41) into an upward-pushing contact with the nail actuator (43), which in turn drives the nail (47) outward through the nail hole (51) and causes the nail to contact the nail forming recess (53) on the inner surface of the anvil (18). Figure 3 (As shown in the diagram) to form a contact. Figure 4B The firing beam (14) is shown after the tissue has been cut and sutured, and then completely translated distally. From Figures 4A to 4BThe nail-shaped recess (53) is intentionally omitted in the view, but... Figure 3 As shown in [the image]. Figure 5 The anvil is intentionally omitted in the view (18).

[0040] Figure 7 An end effector (12) is shown, actuated through tissue (90) by a single firing stroke. Cutting blade (48) Figure 7 The tissue (90) has been cut through (the obscured area), and the staple driver (43) has driven three rows of alternating staples (47) through the tissue (90) on each side of the cut line created by the cutting edge (48). After the first firing stroke is completed, the end effector (12) is withdrawn from the patient and the empty staple cartridge (37) is replaced with a new staple cartridge (37). The end effector (12) is then reinserted into the patient to reach the suture site for further cutting and suturing. This process can be repeated until the desired number and pattern of firing strokes across the tissue (90) have been completed.

[0041] The device (10) may be further constructed and operated based on any of the teachings of the following references, the disclosures of which are incorporated herein by reference: U.S. Patent No. 8,210,411, entitled “Motor-Driven Surgical Instrument,” published July 3, 2012; U.S. Patent No. 9,186,142, entitled “Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks,” published November 17, 2015; U.S. Patent No. 9,517,065, entitled “Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler,” published December 13, 2016; U.S. Patent No. 9,622,746, entitled “Distal Tip Features for End Effector of Surgical Instrument,” published April 18, 2017; and U.S. Patent No. 9,622,746, entitled “Lockout Feature for Movable,” published August 1, 2017. U.S. Patent No. 9,717,497, entitled “Cutting Member of Surgical Instrument”; U.S. Patent No. 9,795,379, entitled “Surgical Instrument with Multi-Diameter Shaft”, published on October 24, 2017; U.S. Patent No. 9,808,248, entitled “Installation Features for Surgical Instrument End Effector Cartridge”, published on November 7, 2017; U.S. Patent No. 9,839,421, entitled “Jaw Closure Feature for End Effector of Surgical Instrument”, published on December 12, 2017; and / or U.S. Patent No. 10,092,292, entitled “StapleForming Features for Surgical Stapling Instrument”, published on October 9, 2018.

[0042] II. Exemplary support assembly and support applicator compartment

[0043] In some cases, it may be desirable to equip the end effector (12) of the surgical instrument (10) with an adjunct material (such as a support) to reinforce the tissue mechanical fastening provided by the staples (47). This support prevents the applied staples (47) from being pulled through the tissue and may otherwise reduce the risk of tissue tearing at or near the site of the applied staples (47). In addition to providing structural support and integrity for a row of staples (47) or as an alternative, the support may provide a variety of other effects, such as filling of gaps or spaces, administration of therapeutic agents, and / or other effects. In some cases, the support may be disposed on the upper deck (72) of the staple cartridge (37). As described above, the deck (72) houses the staples (47) driven by the staple actuator (43). In some other cases, the support may be disposed on the surface of the anvil (18) facing the staple cartridge (37). It should also be understood that a first support may be disposed on the deck (72) of the staple cartridge (37), while a second support may be disposed on the anvil (18) of the same end effector (12).

[0044] Various examples of the forms in which the support may take will be described in more detail below. Various ways in which the support may be attached to the staple cartridge (37) or the anvil (18) will also be described in more detail below. Exemplary support assemblies, exemplary materials and techniques for applying the support assembly, and exemplary support applicator cartridges may be constructed in accordance with at least some of the teachings of the following patents, the disclosures of which are incorporated herein by reference: U.S. Patent No. 10,166,023, entitled “Method of Applying a Buttress to a Surgical Stapler End Effector,” published January 1, 2019, and / or U.S. Patent No. 10,349,939, entitled “Method of Applying a Buttress to a Surgical Stapler,” published July 16, 2019.

[0045] A. Exemplary components of the support assembly

[0046] Figure 8An exemplary pair of support assemblies (110, 112) (each also individually referred to as a “support”) are shown. The support assembly (110) of this example includes a support body (114) and an upper adhesive layer (116). Similarly, the support assembly (112) includes a support body (118) and a lower adhesive layer (120). In this example, each support body (114, 118) includes a strong yet flexible material configured to structurally support a row of nails (47). By way of example only, each support body (114, 118) may include a mesh of polyglactin 910 material from Ethicon Ltd. (Somerville, New Jersey). Alternatively, in addition to polyglactin 910 material, or as an alternative, any other suitable material or combination of materials may be used to form each support body (114, 118).

[0047] Each support body (114, 118) may include materials including, for example, hemostatic agents such as fibrin to aid in blood clotting and reduce bleeding at surgical sites along tissue (T1, T2). As another illustrative example only, each support body (114, 118) may include other adjuvants or hemostatic agents such as thrombin, which may be used to enable each support body (114, 118) to aid in blood clotting and reduce bleeding at surgical sites. Other adjuvants or agents that may be incorporated into each support body (114, 118) may also include, but are not limited to, medical fluids or matrix components.

[0048] In this example, an adhesive layer (116) is applied to the support body (114) to adhere the support body (114) to the underside (124) of the anvil (18). Similarly, an adhesive layer (120) is applied to the support body (118) to adhere the support body (118) to the upper deck (72) of the staple cartridge (37). Such adhesive material provides proper positioning of the support bodies (114, 118) before and during actuation of the end effector (12); and then allows the support bodies (114, 118) to separate from the end effector (12) after the end effector (12) has been actuated without damaging the support bodies (114, 118) to a degree sufficient to impair their proper subsequent function.

[0049] B. Exemplary sutures for tissue and support components

[0050] Figures 9A to 9CAn exemplary sequence is shown in which a surgical suture end actuator (12), in which a support assembly (110, 112) is already loaded, is actuated to drive a staple (47) through two opposing tissue layers (T1, T2), wherein the support assembly (110, 112) is secured to the same tissue layer (T1, T2) by the staple (47). Specifically, Figure 9A Tissue layers (T1, T2) positioned between the anvil (18) and the cartridge (37) are shown, with the anvil (18) in the open position. A support assembly (110) is adhered to the underside (124) of the anvil (18) via an adhesive layer (116); while a support assembly (112) is adhered to the upper deck (72) of the cartridge (37) via an adhesive layer (120). Thus, tissue layers (T1, T2) are interposed between the support assemblies (110, 112). Next, a closing trigger (26) pivots toward the pistol grip (24) to drive the closing tube (32) and closing ring (33) distally. This drives the anvil (18) to... Figure 9B The closed position is shown. At this stage, the tissue layers (T1, T2) are compressed between the anvil (18) and the staple cartridge (37), where the support assemblies (110, 112) engage the opposing surfaces of the tissue layers (T1, T2). The end effector (12) is then actuated as described above, thereby driving the staple (47) through the support assemblies (110, 112) and the tissue (T1, T2). Figure 9C As shown, the crown (122) of the driven nail (47) abuts against the tissue layer (T2) to capture and retain the support assembly (112). The deformable leg (126) of the nail (47) abuts against the tissue layer (T1) to capture and retain the support assembly (110).

[0051] Similarly, a series of pins (47) abut against the tissue layers (T1, T2) to capture and retain the support assembly (110, 112), thereby securing the support assembly (110, 112) to the tissue (T1, T2), as... Figure 10 As shown. Because the end effector (12) is pulled away from the tissue (T1, T2) after the deployment of the pins (47) and the support assembly (110, 112), the support assembly (110, 112) disengages from the end effector, so that the support assembly (110, 112) is held fixed to the tissue (T1, T2) by the pins (47). The supports (110, 112) thus provide structural reinforcement for the rows of pins (47) formed in the tissue (T1, T2). Additionally, as... Figure 10It can be seen that the cutting edge (48) of the firing beam (14) on the far side also cuts through the centerline of the support tissue assembly (110, 112), thereby dividing each support assembly (110, 112) into a corresponding pair of segments, so that each segment remains fixed to the corresponding cut area of ​​the tissue (T1, T2).

[0052] C. An exemplary support applicator compartment with a movable retainer arm

[0053] Because the end effector (12) of the surgical instrument (10) can be actuated multiple times during a single surgical procedure, it may be desirable to enable the operator to repeatedly and easily load the support assembly (110, 112) onto the end effector jaws (16, 18) during that single surgical procedure. Figures 11 to 13B An exemplary support applicator compartment (210) (also referred to as a "support applicator") is shown, which can be used to support, protect, and apply auxiliary materials, such as support assemblies (110, 112), to an end effector (12). Figures 11 to 12 As best seen in the present example, the compartment (210) includes an open end (212) and a closed end (214). The open end (212) is configured to receive an end actuator (12), as will be described in more detail below. The compartment (210) also includes a first housing (216a) and a second housing (216b), which together generally define a “U” shape to present the open end (212). A platform (218) and a slider retainer (220) are interposed between the first housing (216a) and the second housing (216b).

[0054] The platform (218) of this example is configured to support a pair of support assemblies (110) on one side of the platform (218) and another pair of support assemblies (112) on the other side of the platform (218). The platform (218) is exposed in a recess formed between the forks of the “U” configuration of the first housing (216a) and the second housing (216b). Each support assembly (110, 112) is respectively disposed in a separate corresponding pair of portions to avoid crossing the slots (42, 49) of the anvil (18) and the staple cartridge (37), but the platform (218) can equally easily support a wide-type support assembly (110, 112) that crosses the slots (42, 49) of the anvil (18) and the staple cartridge (37) individually, respectively. More specifically, the outer edge of the platform (218) includes a ridge-shaped retaining feature (530) that further engages the first housing (216a) and the second housing (216b) to prevent the platform (218) from sliding relative to the first housing (216a) and the second housing (216b).

[0055] The first housing (216a) and the second housing (216b) include an integral gripping feature (222) and an indicator plate (224) positioned to correspond to a window (226) formed in the first housing (216a) and the second housing (216b), such that the indicator plate (224) is visible through the window (226) at different times. The arm (228) of this example is configured to selectively secure the support assemblies (110, 112) to the platform (218). The arm (228) of this example is resilient and is therefore configured to resiliently abut against the support assemblies (110, 112), thereby causing the support assemblies (110, 112) to retract against the platform (218). The support applicator compartment (210) includes a pair of cam surfaces (232) with gradually changing cross-sections and a corresponding pair of housing engagement features (234) positioned to engage corresponding surfaces of the first housing (216a) and the second housing (216b). The first housing (216a) and the second housing (216b) include a proximal guide feature (236) and a distal guide feature (238) configured to assist in providing proper alignment of the end effector (40) with the housing (210).

[0056] Figure 13A A compartment (210) is shown in which the retainer arm (228) is positioned against the platform (218) to hold the support assembly (110, 112); while Figure 13B A compartment (210) is shown in which the retainer arm (228) is positioned to release the support assembly (110, 112) from the platform (218). Figures 13A to 13B Only the support assembly (110) on the platform (218) is shown; the support assembly (112) is held on and released from the platform (218) in the same manner. To use the bin (210) to load the end effector (12), the operator will first position the bin (210) and the end effector (12) such that the end effector is aligned with the open end (212) of the bin (210), as shown. Figure 13A As shown. The operator then advances the distal end effector (12) and / or the proximal end chamber (210) to position the platform (218) and support assemblies (110, 112) between the anvil (18) and the staple cartridge (37), as shown. Figure 13BAs shown. Then, the operator squeezes the closing trigger (26) of the instrument (10) to close the end effector jaws (16, 18) on the platform (218), thereby adhering the support assembly (110, 112) to the anvil (18) and the cartridge (37), and simultaneously pressing the cam surface (232). The pressing of the cam surface (232) laterally actuates the retainer arm (228), thereby releasing the support assembly (110, 112) from the platform (218), so that the end effector jaws (16, 18) can disengage from the platform (218), while the support assembly (110, 112) remains adhered to the anvil (18) and the cartridge (37).

[0057] III. Exemplary alternative application devices and related methods for applying the support to the surgical suture end actuator Law

[0058] In some cases, it may be desirable to provide an application device configured to apply a staple-reinforcing accessory to one or both jaws of the surgical stapler end effector while the jaws remain open, or otherwise prevent the jaws from closing via actuation of the end effector closure system of the stapler (such as via actuation of the closure trigger (26) of the surgical stapler (10). It may also be desirable to provide an application device configured to assist in providing proper alignment of the end effector 40 of the surgical stapler 10 with the application device (e.g., to ensure that an accessory of appropriate set size is applied to the desired jaws). The exemplary application devices described below provide such functionality, such that each application device is configured to be maneuverable relative to the end effector to apply the accessory to one or both jaws without requiring the aforementioned method. Figures 13A to 13B The jaws shown are actuated and closed. In addition, the exemplary application device described below is operable to apply minimal pressure to properly place the auxiliary material onto the desired jaws (e.g., the lower jaw (16) or the anvil (18)).

[0059] It should be understood that any of the exemplary application devices described below can be configured to apply the auxiliary element in the form of a support (such as the aforementioned supports (110, 112)) or a tissue thickness compensator (e.g., of the type disclosed in U.S. Patent Publication No. 2012 / 0080336 entitled “Staple Cartridge Comprising Staples Positioned Within A Compressible Portion Thereof,” published April 5, 2012 and now abandoned, the disclosure of which is incorporated herein by reference). Additionally, the application of the nail reinforcement element to the end effector jaws can be achieved using adhesive features as described above and / or mechanically connected features (e.g., of the type disclosed in U.S. Patent No. 7,665,646 entitled “Interlocking Buttress Material Retention System,” published February 23, 2010, the disclosure of which is incorporated herein by reference). Furthermore, any of the exemplary application devices described below can be suitably configured for single or multiple use.

[0060] A. An exemplary support with an organizational stop-engagement feature for detecting proper placement in an end effector. Supporting Applicator

[0061] Figures 14 to 16B An exemplary support applicator (310) is shown, which is configured to prevent improper loading of the support assembly (110, 112) onto the jaws of the end effector when the support applicator (310) is not longitudinally aligned with the jaws via a tissue stop-engagement feature. The support applicator (310) is similar to the support applicator (210) described above, except as further described below.

[0062] The support applicator (310) of this example includes a housing (312) extending between a proximal end (313) and a distal end (314). The housing (312) includes an integral gripping feature defining a handle (316) positioned at or near the distal end (314) of the housing (312). The support applicator (310) also includes an expandable compression pad or platform (318) configured to selectively transition between a collapsed or non-expanded state and a deployed or expanded state, in which the collapsed or non-expanded state the platform (318) presents a generally flat configuration. Figure 14 and Figure 16A In this deployment or expansion state, the platform (318) presents a roughly wedge-shaped configuration. Figure 16BIn this respect, the support applicator (310) also includes: a platform driver in the form of a screw (320) rotatably coupled to the housing (312) and extending between opposing folded halves of the platform (318); and a plurality of extendable arms or links (322) positioned between the screw (320) and the opposing folded halves of the platform (318) such that rotation of the screw (320) in a predetermined direction causes the links (322) to extend radially outward from the screw (320) for deploying the platform (318). In the example shown, the support applicator (310) also includes an energy storage device in the form of a motor (324) having a power source, such as a battery (326), selectively electrically connected thereto and configured to selectively supply torque to the screw (320) for deploying the platform (318). In this respect, the support applicator (310) also includes a detector in the form of an electrical probe or switch (328) that is electrically connected to the motor (324) and the battery (326) for controlled activation of the motor (324), as will be described in more detail below.

[0063] The platform (318) of this example is configured to support a support assembly (110) on one opposite folded side of the platform (318) and another support assembly (112) on the other opposite folded side of the platform (318). In the example shown, the platform (318) supports a wide-type support assembly (110, 112) that integrally spans the slots (42, 49) of the anvil (18) and the staple cartridge (37), respectively. However, the support assemblies (110, 112) may alternatively be arranged in separate corresponding pairs of portions to avoid spanning the slots (42, 49) of the anvil (18) and the staple cartridge (37), respectively.

[0064] An electrical switch (328) is positioned at or near the proximal end (313) of the housing (312) and is configured to detect a predetermined portion of the end actuator (12), such as a tissue stop (12a) defined by the side flange of the anvil (18), when the end actuator (12) is properly positioned relative to the support applicator (310) to load the support assembly (110, 112) onto the end actuator (12). For example, and referring to Figure 15The electrical switch (328) can be configured to move from an open state to a closed state in response to contact with the tissue stop (12a). The motor (324) can be configured to be activated in response to the movement of the electrical switch (328) to the closed state to deploy the platform (318). For example, the movement of the electrical switch (328) to the closed state can selectively place the motor (324) in electrical communication with the battery (326), such that power is selectively supplied from the battery (326) to the motor (324) via the electrical switch (328). Thus, the motor (324) can be configured to selectively supply torque to the screw (320) for deploying the platform (318) in response to detection of the tissue stop (12a) via the electrical switch (328). In this way, the electrical switch (328) can assist in providing proper longitudinal and lateral alignment of the end effector (12) with the support applicator (310) during the deployment of the platform (318). In one example, the support applicator (310) may include a pair of electrical switches (328) configured to detect corresponding tissue stops (12a) defined by the laterally opposite side flanges of the anvil (18), and a motor (324) may be configured to selectively supply torque to a screw (320) for deploying the platform (318) in response to the detection of both tissue stops (12a) by the corresponding electrical switches (328) (e.g., simultaneously). The pair of electrical switches (328) may assist in providing proper angular alignment (e.g., relative to the longitudinal axis of the end effector (12)) with the support applicator (310) during deployment of the platform (318). Alternatively, the support applicator (310) may include a pair of laterally opposed angled ramps or cam surfaces at or near the proximal end (313) of the housing (312) for capturing tissue stop (12a) and aligning the end actuator (12) at an angle with the support applicator (310) during distal advance of the end actuator (12) relative to the support applicator (310).

[0065] Figure 16A An end effector (12) is shown, which is in the open state and positioned relative to the support applicator (310) such that the electrical switch (328) is spaced apart from the tissue stop (12a), thereby preventing the platform (318) from changing into a collapsed state; while Figure 16BAn end effector (12) is shown positioned relative to the support applicator (310) such that an electric switch (328) contacts the tissue stop (12a), thereby activating the motor (324) and thus transforming the platform (318) from a collapsed state to a deployed state. To load the end effector (12) using the support applicator (310), the operator first positions the support applicator (310) and the end effector (12) such that the platform (318) and the support assembly (110, 112) are positioned between the anvil (18) and the staple cartridge (37), with the platform (318) in a collapsed state, as shown... Figure 16A As shown. The operator then advances the end effector (12) distally relative to the support applicator (310) to bring the electrical switch (328) into contact with the tissue stop (12a), as... Figure 16B As indicated by the first arrow (A1) in the diagram. The platform (318) can respond as follows: Figure 16B The contact indicated by the second arrow (A2) is achieved by the motor (324) deploying the end effector jaws (16, 18) towards them, thereby adhesively attaching the support assemblies (110, 112) to the respective jaws (16, 18). The support assemblies (110, 112) can be released from the platform (318), allowing the end effector jaws (16, 18) to disengage from the platform (318) while the support assemblies (110, 112) remain adhered to the respective jaws (16, 18).

[0066] While the deployment of the platform (318) has been described as automated via a motor (324) and a battery (326), the support applicator (310) may be configured such that the deployment of the platform (318) is performed manually via user input, such as by allowing the user to apply torque to the screw (320). In such a case, the support applicator (310) may include a locking mechanism configured to transition between a locked state and an unlocked state, in which the locking mechanism inhibits rotation of the screw (320), thereby preventing the deployment of the platform (318), and in which the locking mechanism allows rotation of the screw (320), thereby allowing the deployment of the platform (318) (e.g., when the user applies torque to the screw (320)). In one example, the motor (324) may be configured to selectively transition the locking mechanism from the locked state to the unlocked state in response to detection of a tissue stop (12a) via an electrical switch (328). Alternatively, the motor (324), battery (326), and electrical switch (328) may be omitted, and the support applicator (310) may include a detector in the form of a mechanical switch, such as a cam-type feature configured to selectively change the locking mechanism from a locked state to an unlocked state in response to contact with one or more tissue stops (12a). For example, such a cam-type feature may be configured to rotate in response to contact with a tissue stop (12a), and such rotation of the cam-type feature may allow rotation of the screw (320), thereby allowing deployment of the platform (318) (e.g., when torque is applied to the screw (320) by a user).

[0067] Although the support applicator (310) has been described as including an expandable platform (318) and a platform driver in the form of a screw (320) and a link (322) for deploying the platform (318), it should be understood that the support applicator (310) may include any other suitable type of platform and / or platform driver for deploying such a platform to attach the support assembly (110, 112) to the end effector jaws (16, 18). Similarly, although the support applicator (310) has been described as including a detector in the form of an electrical switch (328), it should be understood that the support applicator (310) may include any other suitable type of electrical and / or mechanical detector for detecting a predetermined portion of the end effector (12) when the support applicator (310) is properly aligned with it, such that the platform driver may be configured to selectively deploy the platform only when the detector detects the predetermined portion of the end effector (12) (e.g., by automatically deploying the platform in response to such detection, or by switching the locking mechanism of the driver to an unlocked state in response to such detection to allow the deployment of the platform). For example, the detector may be a contactless mechanism, such as a proximity sensor (e.g., optical, magnetic, etc.), which is configured to detect the presence of the predetermined portion of the end effector (12) without actually contacting the predetermined portion of the end effector (12).

[0068] B. An exemplary support with a distal tip-engagement feature for detecting proper placement in an end effector Application device

[0069] Figures 17A to 17B An exemplary support applicator (410) is shown, which is configured to prevent improper loading of the support assembly (110, 112) onto the jaws of the end effector when the support applicator (410) is not longitudinally aligned with the jaws via a distal tip-engagement feature. The support applicator (410) is similar to the support applicators (210, 310) described above, except as further described below.

[0070] The support applicator (410) of this example includes a housing (412) extending between a proximal end (413) and a distal end (414). The housing (412) includes a viewing window (416) positioned at or near the distal end (414) of the housing (412) to allow visual observation of internal components positioned within the housing (412), as will be described in more detail below. The support applicator (410) also includes a generally flat floating compression pad or platform (418) having a pair of slots (420) and configured to selectively retract in a retracted state ( Figure 17A ) and deployment status ( Figure 17BThe support applicator (410) also includes a platform driver in the form of multiple energy storage devices, comprising an elastic member positioned between the platform (418) and the housing (412), and more specifically, a compression leaf spring (424). The leaf spring (424) is configured to selectively switch between a compressed state and a compressed state. Figure 17A ) transforms into an expansion state ( Figure 17B This pushes the platform (418) in the application direction, the surface of which is configured to support the support assembly (110, 112) facing the application direction (e.g., perpendicular to the longitudinal axis of the platform (418)) for deployment of the platform (418). The support applicator (410) also includes a detector in the form of a mechanical switch, and more specifically, includes a longitudinally translatable slider (428) positioned on the side of the platform (418) opposite the leaf spring (424) to limit the movement of the platform (418) in the application direction, as will be described in more detail below.

[0071] The platform (418) of this example is configured to support at least one support assembly (110, 112) on at least one side of the platform (418). In the example shown, the platform (418) supports a wide support assembly (110, 112) integrally spanning the slots (42, 49) of the anvil (18) or the staple cartridge (37), but the support assembly (110, 112) may alternatively be arranged in separate corresponding pairs of portions to avoid spanning the slots (42, 49) of the anvil (18) and the staple cartridge (37) respectively.

[0072] The translatable slider (428) includes an activation rod (430) positioned at or near the distal end (414) of the housing (412) and a generally elongated support (432) extending proximally from the activation rod (430) and parallel to the platform (418). The translatable slider (428) also includes a pair of tabs (434) that project from the support (432) toward the platform (418) and are configured to selectively abut the platform (418) to prevent expansion of the leaf spring (424), and are further configured to selectively be received by a corresponding slot (420) to allow expansion of the leaf spring (424) for deployment of the platform (418). The activation lever (430) is configured to detect a predetermined portion of the end effector (12), such as the distal tip (12b) defined by the pin cartridge (37) of the lower jaw (16), when the end effector (12) is properly positioned relative to the support applicator (410) to load the support assembly (110, 112) onto the end effector (12). For example, a translational slider (428) may be configured to move from a proximal unactuated state to a distal actuated state in response to the activation lever (430) being pushed distally from the distal tip (12b) or otherwise contacting the distal tip. A leaf spring (424) may be configured to expand to deploy the platform (418) in response to the movement of the translational slider (428) to the actuated state. For example, the movement of the translational slider (428) to the actuated state can selectively align the tab (434) of the support (432) longitudinally with the slot (420) of the platform (418), allowing the leaf spring (424) to selectively push the platform (418) in the application direction. Thus, the leaf spring (424) can be configured to selectively push the platform (418) in the application direction to deploy the platform (418) in response to detection of the distal tip (12b) by the activation lever (430) of the translational slider (428). In this way, the translational slider (428) can assist in providing proper longitudinal and lateral alignment of the end effector (12) with the support applicator (410) during the deployment of the platform (418). In one example, the movement of the translational slider (428) to the actuated state can be observed through a viewing window (416), thereby providing a visual indication of the deployment of the platform (418).

[0073] Figure 17A An end effector (12) in the open state is shown, wherein a support applicator (410) is positioned above the lower jaw (16) such that the activation rod (430) of the translational slider (428) is spaced apart from the distal tip (12b), thereby allowing the tab (434) to abut the platform (418) to prevent the platform (418) from changing out of the retracted state; while Figure 17BAn end effector (12) is shown positioned relative to the support applicator (410) such that the distal tip (12b) pushes distally or otherwise contacts the activation lever (430) to thereby translate the slider (428) distally, causing the tab (434) to longitudinally align with the slot (420) and thus stop the abutment platform (418) to allow the leaf spring (424) to transition the platform (418) from a retracted state to a deployed state. To load the end effector (12) using the support applicator (410), the operator first positions the support applicator (410) and the end effector (12) such that the lower jaw (16) is received within the housing (412), with the platform (418) and the support assembly (110, 112) positioned between the anvil (18) and the staple cartridge (37), and with the platform (418) in the retracted state, as... Figure 17A As shown. The operator then advances the end effector (12) distally relative to the support applicator (410) to push or otherwise contact the activation lever (430) of the translational slider (428) distally via the distal tip (12b), as shown. Figure 17B As indicated by the third arrow (A3) in the diagram. The platform (418) can respond as follows: Figure 17B The contact indicated by the fourth arrow (A4) is deployed by the leaf spring (424) toward the lower jaw (16), thereby adhesively attaching the support assembly (110, 112) to the lower jaw (16). The support assembly (110, 112) can be released from the platform (418) so that the lower jaw (16) can disengage from the platform (418) while the support assembly (110, 112) remains adhered to the lower jaw (16).

[0074] IV. Exemplary Combinations

[0075] The following examples illustrate various non-exhaustive ways in which the teachings herein can be combined or applied. It should be understood that the following examples are not intended to limit the scope of any claims that may be provided at any time in this patent application or a subsequent filing thereof. No disclaimer is intended. The following examples are provided merely for illustrative purposes. It is contemplated that the various teachings herein may be arranged and applied in a variety of other ways. It is also contemplated that some variations may omit certain features mentioned in the following examples. Therefore, none of the aspects or features mentioned below should be considered definitive unless otherwise expressly indicated, for example, by the inventor or a successor of the inventor of interest, at a later date. If any claim set forth in this patent application or a subsequent filing related to this patent application includes additional features beyond those mentioned below, such additional features should not be presumed to have been added for any reason related to patentability.

[0076] Example 1

[0077] An apparatus comprising: (a) at least one platform configured to be positioned between opposing first and second jaws of an end effector of a surgical suture device, wherein the at least one platform is configured to be transitionable between the first and second states; (b) at least one accessory element positioned on the at least one platform; (c) at least one detector configured to detect a predetermined portion of the end effector; and (d) an actuator configured to selectively transition the at least one platform from the first state to the second state in a direction toward at least one of the first or second jaws when the at least one detector detects the predetermined portion of the end effector, for placing the at least one accessory element into contact with a corresponding surface of the at least one of the first or second jaws.

[0078] Example 2

[0079] According to the device of embodiment 1, wherein the driver is configured to selectively transition the at least one platform from the first state to the second state in response to the at least one detector detecting the predetermined portion of the end effector.

[0080] Example 3

[0081] According to the device of embodiment 2, wherein the driver includes an energy storage device configured to selectively transition the at least one platform from the first state to the second state in response to the at least one detector detecting the predetermined portion of the end effector.

[0082] Example 4

[0083] According to the device of embodiment 3, the energy storage device includes a motor configured to be activated in response to the at least one detector detecting the predetermined portion of the end effector.

[0084] Example 5

[0085] According to the device of embodiment 4, the at least one detector includes at least one electrical switch electrically connected to the motor, wherein the at least one electrical switch is configured to switch between an open state and a closed state in response to contacting the predetermined portion of the end effector to activate the motor.

[0086] Example 6

[0087] According to the device of embodiment 5, the predetermined portion of the end effector includes at least one tissue stop of the end effector, wherein the at least one electrical switch is configured to switch between the open state and the closed state in response to contact with the at least one tissue stop.

[0088] Example 7

[0089] According to the device of embodiment 6, wherein the at least one detector includes a pair of electrical switches, wherein the at least one tissue stop includes a pair of tissue stops, and wherein the driver is configured to selectively transition the at least one platform from the first state to the second state when each of the pair of electrical switches contacts a corresponding tissue stop in the pair of tissue stops.

[0090] Example 8

[0091] According to the device of embodiment 3, the energy storage device includes an elastic member configured to transition between a compressed state and an expanded state in response to the at least one detector detecting the predetermined portion of the end effector.

[0092] Example 9

[0093] According to the device of embodiment 8, wherein the at least one detector includes a translational slider configured to translate relative to the at least one platform between an unactuated state and an actuated state, wherein in the unactuated state the slider prevents the elastic member from transitioning between a compressed state and an expanded state, and in the actuated state the slider allows the elastic member to transition between the compressed state and the expanded state in response to contacting the predetermined portion of the end effector.

[0094] Example 10

[0095] According to the device of embodiment 9, the translatable slider includes at least one tab and the at least one platform includes at least one slot, wherein the at least one tab is configured to abut the platform when the translatable slider is in the unactuated state, thereby preventing the elastic member from transitioning between the compressed state and the expanded state, wherein the at least one tab is configured to be received by the at least one slot when the translatable slider is in the actuated state, thereby allowing the elastic member to transition between the compressed state and the expanded state.

[0096] Example 11

[0097] According to any one or more of Embodiments 9 to 10, the predetermined portion of the end effector includes a distal tip of one of the first jaws or the second jaws of the end effector, and the translatable slider includes an activation rod configured to contact the distal tip for translating the slider between the unactuated state and the actuated state.

[0098] Example 12

[0099] The device according to any one or more of embodiments 9 to 11, wherein the elastic member includes a compression spring.

[0100] Example 13

[0101] According to the device of embodiment 12, the at least one platform is positioned between the compression spring and the translational slider.

[0102] Example 14

[0103] According to the device of embodiment 1, wherein the driver includes a locking mechanism configured to switch between a locked state and an unlocked state, wherein in the locked state the locking mechanism prevents the platform from switching, and in the unlocked state the locking mechanism allows the platform to switch in response to the at least one detector detecting the predetermined portion of the end effector.

[0104] Example 15

[0105] According to the device of embodiment 14, wherein the at least one detector includes at least one electrical switch electrically connected to the locking mechanism, wherein the at least one electrical switch is configured to switch between an open state and a closed state in response to contacting the predetermined portion of the end effector for switching the locking mechanism between the locked state and the unlocked state.

[0106] Example 16

[0107] A system comprising: (a) an end effector of a surgical suture device, wherein the end effector includes opposing first jaws and second jaws; and (b) a device according to any one or more of embodiments 1 to 15.

[0108] Example 17

[0109] According to the system of embodiment 16, the platform of the device is positioned between the first jaw and the second jaw of the end effector.

[0110] Example 18

[0111] An apparatus comprising: (a) an expandable platform configured to be positioned between opposing first and second jaws of an end effector of a surgical stapler, wherein the expandable platform is configured to selectively transition between a non-expanded state and an expanded state; (b) at least one accessory element positioned on the expandable platform; (c) at least one detector configured to detect a predetermined portion of the end effector; and (d) an actuator configured to selectively transition the expandable platform from the non-expanded state to the expanded state in a direction toward at least one of the first or second jaws when the at least one detector detects the predetermined portion of the end effector, for placing the at least one accessory element into contact with a corresponding surface of the at least one of the first or second jaws.

[0112] Example 19

[0113] According to the device of embodiment 18, wherein the driver is configured to selectively transition the expandable platform from the non-expandable state to the expanded state in response to the at least one detector detecting the predetermined portion of the end effector.

[0114] Example 20

[0115] According to the device of embodiment 18, wherein the driver includes a locking mechanism configured to switch between a locked state and an unlocked state, wherein in the locked state the locking mechanism prevents the expansion platform from switching, and in the unlocked state the locking mechanism allows the expansion platform to switch in response to the at least one detector detecting the predetermined portion of the end effector.

[0116] Example 21

[0117] A system comprising: (a) an end effector of a surgical suture device, wherein the end effector includes opposing first jaws and second jaws; and (b) a device according to any one or more of embodiments 18 to 20.

[0118] Example 22

[0119] According to the system of embodiment 21, the expandable platform of the device is positioned between the first jaw and the second jaw of the end effector.

[0120] Example 23

[0121] An apparatus comprising: (a) a housing defining an inner cavity configured to receive a portion of an end effector of a surgical suture device; (b) a platform positioned within the inner cavity of the housing; (c) an accessory element positioned on the platform; and (d) a translational slider wherein the platform is biased toward the translational slider in an application direction, wherein the translational slider is configured to translate relative to the housing between an unactuated state and an actuated state, wherein in the unactuated state the translational slider restricts movement of the platform in the application direction, and in the actuated state the translational slider allows movement of the platform in the application direction in response to contact of the translational slider with a predetermined portion of the end effector for positioning the accessory element in contact with a corresponding surface of the jaws.

[0122] Example 24

[0123] The device according to embodiment 23 further includes an elastic member positioned between the housing and the platform, wherein the platform is biased by the elastic member in the application direction.

[0124] Example 25

[0125] A system comprising: (a) an end effector of a surgical suture device, wherein the end effector includes opposing first jaws and second jaws; and (b) a device according to any one or more of embodiments 23 to 24.

[0126] Example 26

[0127] According to the system of embodiment 25, the jaws of the end effector are received in the cavity of the housing of the device.

[0128] Example 27

[0129] A method for applying an accessory element to at least one of opposing first and second jaws of an end effector of a surgical suture via a device comprising (a) at least one platform, (b) at least one accessory element positioned on said at least one platform, (c) at least one detector, and (d) a driver, the method comprising: (a) positioning said at least one platform between the first and second jaws of the end effector; (b) detecting a predetermined portion of the end effector via said at least one detector; and (c) when said at least one detector detects said predetermined portion of the end effector, changing said at least one platform from a first state to a second state via said driver in a direction toward said at least one of the first or second jaws, thereby placing said at least one accessory element in contact with a corresponding surface of said at least one of the first or second jaws.

[0130] Example 28

[0131] According to the method of embodiment 27, in response to the at least one detector detecting the predetermined portion of the end effector, the at least one platform is transitioned from the first state to the second state via the driver.

[0132] Example 29

[0133] According to the method of embodiment 28, wherein the driver includes an energy storage device, wherein the at least one platform is transitioned from the first state to the second state via the energy storage device in response to the at least one detector detecting the predetermined portion of the end effector.

[0134] Example 30

[0135] According to the method of embodiment 29, wherein the energy storage device includes a motor, wherein transitioning the at least one platform from the first state to the second state includes activating the motor in response to the at least one detector detecting the predetermined portion of the end effector.

[0136] Example 31

[0137] According to the method of embodiment 30, wherein the at least one detector includes at least one electrical switch electrically connected to the motor, wherein changing the at least one platform from the first state to the second state includes changing the at least one electrical switch between an open state and a closed state in response to contacting the predetermined portion of the end effector to activate the motor.

[0138] Example 32

[0139] According to the method of embodiment 31, the predetermined portion of the end effector includes at least one tissue stop of the end effector, wherein changing the at least one platform from the first state to the second state includes changing the at least one electrical switch between the open state and the closed state in response to contacting the at least one tissue stop.

[0140] Example 33

[0141] According to the method of embodiment 32, wherein the at least one detector includes a pair of electrical switches, wherein the at least one tissue stop includes a pair of tissue stops, wherein when each of the pair of electrical switches contacts a corresponding tissue stop in the pair of tissue stops, the at least one platform is transitioned from the first state to the second state via the driver.

[0142] Example 34

[0143] According to the method of embodiment 29, wherein the energy storage device includes an elastic member, wherein changing the at least one platform from the first state to the second state includes changing the energy storage device between a compressed state and an expanded state in response to the at least one detector detecting the predetermined portion of the end effector.

[0144] Example 35

[0145] According to the method of embodiment 34, wherein the at least one detector includes a translational slider, wherein transitioning the at least one platform from the first state to the second state includes translating the translational slider relative to the at least one platform between an unactuated state and an actuated state, wherein in the unactuated state the slider prevents the elastic member from transitioning between a compressed state and an expanded state, and in the actuated state the slider allows the elastic member to transition between the compressed state and the expanded state in response to contacting the predetermined portion of the end effector.

[0146] Example 36

[0147] According to the method of embodiment 35, the translatable slider includes at least one tab and the at least one platform includes at least one slot, wherein the at least one tab abuts the platform when the translatable slider is in the unactuated state, thereby preventing the elastic member from changing between the compressed state and the expanded state, wherein changing the at least one platform from the first state to the second state includes the at least one tab being received by the at least one slot when the translatable slider is in the actuated state, thereby allowing the elastic member to change between the compressed state and the expanded state.

[0148] Example 37

[0149] According to any one or more of the methods in Embodiments 35 to 36, wherein the predetermined portion of the end effector includes a distal tip of one of the first jaws or the second jaws of the end effector, wherein the translatable slider includes an activation rod, wherein changing the at least one platform from the first state to the second state includes contacting the distal tip with the activation rod to thereby translating the slider between the unactuated state and the actuated state.

[0150] Example 38

[0151] According to one or more of the methods described in Examples 35 to 37, the elastic member includes a compression spring.

[0152] Example 39

[0153] According to the method of embodiment 38, the at least one platform is positioned between the compression spring and the translational slider.

[0154] Example 40

[0155] According to the method of embodiment 27, wherein the driver includes a locking mechanism, the method further includes switching the locking mechanism between a locked state and an unlocked state, wherein in the locked state the locking mechanism prevents the platform from switching, and in the unlocked state the locking mechanism allows the platform to switch in response to the at least one detector detecting the predetermined portion of the end effector.

[0156] Example 41

[0157] According to the method of embodiment 40, wherein the at least one detector includes at least one electrical switch electrically connected to the locking mechanism, wherein causing the locking mechanism to change between the locked state and the unlocked state includes causing the at least one electrical switch to change between an open state and a closed state in response to contacting the predetermined portion of the end effector.

[0158] Example 42

[0159] A method for applying an accessory element to at least one of opposing first and second jaws of an end effector of a surgical suture via a device comprising (a) an expandable platform, (b) at least one accessory element positioned on the expandable platform, (c) at least one detector, and (d) a driver, the method comprising: (a) positioning the expandable platform between the first and second jaws of the end effector; (b) detecting a predetermined portion of the end effector via the at least one detector; and (c) when the at least one detector detects the predetermined portion of the end effector, changing the expandable platform from a non-expanded state to an expanded state via the driver in a direction toward at least one of the first or second jaws, thereby positioning the at least one accessory element in contact with a corresponding surface of the at least one of the first or second jaws.

[0160] Example 43

[0161] According to the method of embodiment 42, in response to the at least one detector detecting the predetermined portion of the end effector, the expandable platform is transitioned from the non-expandable state to the expanded state via the driver.

[0162] Example 44

[0163] According to the method of embodiment 42, wherein the driver includes a locking mechanism, the method further includes switching the locking mechanism between a locked state and an unlocked state, wherein in the locked state the locking mechanism prevents the switching of the expandable platform, and in the unlocked state the locking mechanism allows the switching of the expandable platform in response to the at least one detector detecting the predetermined portion of the end effector.

[0164] Example 45

[0165] A method for applying an accessory element to the jaws of an end effector of a surgical suture device, the device comprising: (a) a housing defining an inner cavity; (b) a platform positioned within the inner cavity of the housing; (c) an accessory element positioned on the platform; and (d) a translational slider, wherein the platform is biased in an application direction toward the translational slider, the method comprising: (a) positioning the jaws of the end effector within the inner cavity of the housing; and (b) translating the translational slider relative to the housing between an unactuated state and an actuated state, wherein in the unactuated state the translational slider restricts movement of the platform in the application direction, and in the actuated state the translational slider allows movement of the platform in the application direction in response to contacting a predetermined portion of the end effector to thereby position the accessory element in contact with a corresponding surface of the jaws.

[0166] Example 46

[0167] The method according to embodiment 45 further includes an elastic member positioned between the housing and the platform, wherein the platform is biased by the elastic member in the application direction.

[0168] V. Miscellaneous

[0169] It should be understood that any one or more of the teachings, expressions, embodiments, examples, etc., described herein can be combined with any one or more of the other teachings, expressions, embodiments, examples, etc., described herein. Therefore, the foregoing teachings, expressions, embodiments, examples, etc., should not be considered in isolation from each other. Various suitable ways in which the teachings herein can be combined will be apparent to those skilled in the art. Such modifications and variations are intended to be included within the scope of the claims.

[0170] Furthermore, any one or more of the teachings herein may be combined with any one or more of the teachings disclosed in the following patent applications: U.S. Patent Application No. END9286USNP1, filed on the same date as this application, entitled “Apparatus and Method to Apply Buttress to End Effector of Surgical Stapler via FixedBase”; U.S. Patent Application No. END9286USNP2, filed on the same date as this application, entitled “Apparatus and Method to Apply Buttresses Separately to Jaws of End Effector of Surgical Stapler”; U.S. Patent Application No. END9286USNP3, filed on the same date as this application, entitled “Apparatus and Method to Close End Effector of Surgical Stapler onto”; and U.S. Patent Application No. END9286USNP3, filed on the same date as this application, entitled “Apparatus and Method to Close End Effector of Surgical Stapler onto”. The following U.S. patent applications were filed on the same date as this application: “Buttress” (Attorney File No. END9286USNP4); “Apparatus and Method to Apply Buttress to End Effector of Surgical Stapler with Authentication” (Attorney File No. END9286USNP6); and / or “Method of Applying Buttress to End Effector of Surgical Stapler” (Attorney File No. END9286USNP7). The disclosure of each of these U.S. patent applications is incorporated herein by reference.

[0171] It should be understood that any patent, patent publication, or other public material allegedly incorporated herein by reference, whether in whole or in part, is incorporated only to the extent that the incorporated material does not conflict with any existing definitions, statements, or other public material set forth in this disclosure. Therefore, and to the extent necessary, the disclosures expressly listed herein replace any conflicting material incorporated herein by reference. Any material, or part thereof, allegedly incorporated herein by reference that conflicts with any existing definitions, statements, or other public material set forth herein will be incorporated only to the extent that the incorporated material does not conflict with any existing public material.

[0172] The aforementioned devices can be applied to both traditional medical treatments and surgeries performed by medical professionals and robot-assisted medical treatments and surgeries. By way of example only, the various teachings herein can be readily incorporated into robotic surgical systems, such as the DAVINCI system from Intuitive Surgical, Inc. (Sunnyvale, California). ™ system.

[0173] Devices of the types described above may be designed for single-use and disposal, or they may be designed for multiple uses. In either or both cases, these types may be repaired for reuse after at least one use. Repair may include any combination of the following steps: disassembling the device, then cleaning or replacing specific parts, and subsequently reassembling. Specifically, some types of devices may be disassembled, and any combination may be used to selectively replace or remove any number of specific parts or portions of the device. While cleaning and / or replacing specific components, some types of devices may be reassembled at a repair facility or by the user prior to surgery for subsequent use. Those skilled in the art will appreciate that device repair can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques and the resulting repaired devices are within the scope of this application.

[0174] By way of example only, the types described herein can be sterilized before and / or after surgery. In one sterilization technique, the device is placed in a closed and sealed container such as a plastic bag or a TYVEK bag. The container and device can then be placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays, or high-energy electrons. The radiation kills bacteria on the device and in the container. The sterilized device can then be stored in a sterile container for later use. Any other techniques known in the art can also be used to sterilize the device, including but not limited to beta or gamma radiation, ethylene oxide, or vapor.

[0175] Various embodiments of the invention have been shown and described, and further improvements to the methods and systems described herein can be achieved by suitable modifications made by those skilled in the art without departing from the scope of the invention. Several such possible modifications have been mentioned, and other modifications will be apparent to those skilled in the art. For example, the embodiments, implementations, geometries, materials, dimensions, ratios, steps, etc., discussed above are illustrative and not essential. Therefore, the scope of the invention should be considered in accordance with the following claims and should be understood as not being limited to the details of the structures and operations shown and described in the specification and drawings.

Claims

1. An apparatus for detecting complete placement of a support applicator in the end effector of a surgical suture device, comprising: (a) At least one platform configured to be positioned between opposing first and second jaws of the end effector of a surgical stapler, wherein the at least one platform is configured to be transitionable between a first state and a second state; (b) At least one auxiliary element, said at least one auxiliary element being positioned on said at least one platform; (c) At least one detector, said at least one detector being configured to detect a predetermined portion of the end effector; and (d) A driver configured to selectively transition the at least one platform from a first state to a second state in a direction toward at least one of the first jaws or the second jaws when the at least one detector detects the predetermined portion of the end effector, for placing the at least one accessory element into contact with the corresponding surface of the at least one of the first jaws or the second jaws.

2. The device according to claim 1, wherein, The driver is configured to selectively transition the at least one platform from the first state to the second state in response to the at least one detector detecting the predetermined portion of the end effector.

3. The device according to claim 2, wherein, The driver includes an energy storage device configured to selectively transition the at least one platform from the first state to the second state in response to the at least one detector detecting the predetermined portion of the end effector.

4. The device according to claim 3, wherein, The energy storage device includes a motor configured to be activated in response to the at least one detector detecting the predetermined portion of the end effector.

5. The device according to claim 4, wherein, The at least one detector includes at least one electrical switch electrically connected to the motor, wherein the at least one electrical switch is configured to switch between an open state and a closed state in response to contact with the predetermined portion of the end effector to activate the motor.

6. The device according to claim 5, wherein, The predetermined portion of the end effector includes at least one tissue stop of the end effector, wherein the at least one electrical switch is configured to switch between the open state and the closed state in response to contact with the at least one tissue stop.

7. The device according to claim 6, wherein, The at least one detector includes a pair of electrical switches, wherein the at least one tissue stop includes a pair of tissue stops, and wherein the driver is configured to selectively transition the at least one platform from the first state to the second state when each of the pair of electrical switches contacts a corresponding tissue stop in the pair of tissue stops.

8. The device according to claim 3, wherein, The energy storage device includes an elastic member configured to transition between a compressed state and an expanded state in response to the at least one detector detecting the predetermined portion of the end effector.

9. The device according to claim 8, wherein, The at least one detector includes a translational slider configured to translate relative to the at least one platform between an unactuated state and an actuated state, wherein in the unactuated state the slider prevents the elastic member from transitioning between a compressed state and an expanded state; In the actuated state, the slider allows the elastic member to transition between the compressed state and the expanded state in response to contacting the predetermined portion of the end effector.

10. The device according to claim 9, wherein, The translatable slider includes at least one tab and the at least one platform includes at least one slot, wherein the at least one tab is configured to abut the platform when the translatable slider is in the unactuated state, thereby preventing the elastic member from transitioning between the compressed state and the expanded state, wherein the at least one tab is configured to be received by the at least one slot when the translatable slider is in the actuated state, thereby allowing the elastic member to transition between the compressed state and the expanded state.

11. The device according to claim 9, wherein, The predetermined portion of the end effector includes a distal tip of one of the first jaws or the second jaws of the end effector, wherein the translatable slider includes an activation rod configured to contact the distal tip for translating the slider between the inactive state and the activated state.

12. The device according to claim 9, wherein, The elastic component includes a compression spring.

13. The device according to claim 12, wherein, The at least one platform is positioned between the compression spring and the translational slider.

14. The device according to claim 1, wherein, The driver includes a locking mechanism configured to switch between a locked state and an unlocked state, in which the locking mechanism prevents the platform from switching; and in the unlocked state, the locking mechanism allows the platform to switch in response to the at least one detector detecting the predetermined portion of the end effector.

15. The device according to claim 14, wherein, The at least one detector includes at least one electrical switch electrically connected to the locking mechanism, wherein the at least one electrical switch is configured to switch between an open state and a closed state in response to contact with the predetermined portion of the end effector, for the purpose of switching the locking mechanism between the locked state and the unlocked state.

16. An apparatus for detecting complete placement of a support applicator in the end effector of a surgical suture, comprising: (a) An expandable platform configured to be positioned between opposing first and second jaws of the end effector of a surgical stapler, wherein the expandable platform is configured to selectively switch between a non-expanded state and an expanded state. (b) At least one auxiliary element, said at least one auxiliary element being positioned on the expandable platform; (c) At least one detector, said at least one detector being configured to detect a predetermined portion of said end effector; and (d) A driver configured to selectively transition the expandable platform from the non-expanded state to the expanded state in a direction toward at least one of the first jaws or the second jaws when the at least one detector detects the predetermined portion of the end effector, for placing the at least one accessory element into contact with the corresponding surface of the at least one of the first jaws or the second jaws.

17. The device according to claim 16, wherein, The driver is configured to selectively transition the scalable platform from the non-scalable state to the scalable state in response to the at least one detector detecting the predetermined portion of the end effector.

18. The device according to claim 16, wherein, The driver includes a locking mechanism configured to switch between a locked state and an unlocked state, in which the locking mechanism prevents the expansion platform from changing its position. In the unlocked state, the locking mechanism allows the expansion platform to transform in response to the at least one detector detecting the predetermined portion of the end effector.

19. An apparatus for detecting complete placement of a support applicator in the end effector of a surgical suture, comprising: (a) A housing defining an inner cavity configured to receive the jaws of an end effector of a surgical suture device; (b) A platform, said platform being positioned within the inner cavity of the housing; (c) An auxiliary element, said auxiliary element being positioned on the platform; and (d) A translational slider, wherein the platform is biased toward the translational slider in an application direction, wherein the translational slider is configured to translate relative to the housing between an unactuated state and an actuated state, wherein in the unactuated state the translational slider restricts the movement of the platform in the application direction; and in the actuated state the translational slider allows the platform to move in the application direction in response to contacting a predetermined portion of the end effector for positioning the auxiliary element into contact with a corresponding surface of the jaws.

20. The device of claim 19, further comprising a resilient member positioned between the housing and the platform, wherein, The platform is biased in the application direction by the elastic member.

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