Apparatus and methods for individually applying buttress to jaws of end effector of surgical stapler

Abstract

An apparatus is disclosed that is configured to apply adjunct material to a stapling surface of a jaw of a surgical stapler. The jaw includes an outer surface disposed opposite the stapling surface. The apparatus includes a housing and an arm. The housing includes a first contact feature configured to contact one of the adjunct material or the outer surface of the jaw. The arm is operatively coupled with the housing. The arm includes a second contact feature configured to move relative to the first contact feature to contact the other of the adjunct material or the outer surface of the jaw. The first and second contact features are configured to cooperate to apply a compressive force in a direction toward the first contact feature to constrict the adjunct material against the stapling surface to install the adjunct material to the stapling surface.

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 staplers. Some of these staplers are operable to clamp tissue layers, cut through the clamped tissue layers, and drive staples through the tissue layers to substantially seal the cut tissue layers together near the cut ends. Exemplary surgical staplers 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 disclosures of each of the above-cited U.S. patents and U.S. patent publications are 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 cross-sectional view taken by 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 Cross-sectional end 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 14A perspective view of a first exemplary alternative application device is shown;

[0024] Figure 15A Show Figure 14 Application device Figure 8 support components and Figure 3 A cross-sectional view of an end effector, wherein the application device secures the applied support assembly to the distal portion of the upper jaw of the end effector;

[0025] Figure 15B It shows Figure 15A A cross-sectional view of the application device, support assembly, and end effector, wherein the application device secures the applied support assembly to the proximal portion of the upper jaw;

[0026] Figure 15C It shows Figure 15B A cross-sectional view of the end effector, wherein the support assembly is fixed to the upper jaw of the end effector and Figure 8 The second support assembly is fixed to the lower jaw of the end effector;

[0027] Figure 16 A perspective view of a second exemplary alternative application device is shown, in which selected internal components are schematically shown in dashed lines;

[0028] Figure 17A It shows Figure 16 application device and Figure 3 A cross-sectional view of an end effector, wherein the application device applies and secures a continuous support assembly from the material dispenser to the proximal portion of the upper jaw of the end effector;

[0029] Figure 17B It shows Figure 17A A cross-sectional view of the application device and end effector, wherein the application device applies and secures the continuous support assembly from the material dispenser to the distal portion of the upper jaw;

[0030] Figure 18 A perspective view of a third exemplary alternative application device is shown;

[0031] Figure 19A It shows Figure 18 Application device Figure 8 support components and Figure 3 A cross-sectional view of the end effector, wherein the arm of the application device pivots toward the upper jaw;

[0032] Figure 19B It shows Figure 19A A cross-sectional view of the application device, support assembly, and end effector, wherein the lateral weak portion of the arm is disconnected to release the support assembly from the application device and to apply and secure the support assembly to the upper jaw.

[0033] Figure 19C It shows Figure 19A A cross-sectional view of the application device, support assembly, and end effector, wherein the support assembly is fixed to the upper jaw and the application device is removed from the upper jaw;

[0034] Figure 20 A fourth exemplary application device is shown. Figure 8 support components and Figure 3 A cross-sectional view of the end effector, wherein the arm of the application device pivots toward the lower jaw of the end effector;

[0035] Figure 21 A perspective view of a fifth exemplary alternative application device is shown;

[0036] Figure 22A It shows Figure 21 Application device Figure 8 support components and Figure 3 A cross-sectional view of an end effector, wherein the application device moves proximally along the upper jaw of the end effector;

[0037] Figure 22B It shows Figure 22A A cross-sectional view of the application device, support assembly, and end effector, wherein the application device rotates via a tab to apply and secure the support assembly to the upper jaw;

[0038] Figure 23 A perspective view of a sixth exemplary alternative application device is shown;

[0039] Figure 24A It shows Figure 23 Application device Figure 8 support components and Figure 3 A cross-sectional view of an end effector, wherein the application device and support assembly move proximally along the upper jaw of the end effector;

[0040] Figure 24B It shows Figure 24A A cross-sectional view of the application device, support assembly, and end effector, wherein the arm of the application device rotates to apply and secure the support assembly to the upper jaw; and

[0041] Figure 25 An exemplary method for applying the support assembly is shown.

[0042] 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

[0043] 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.

[0044] 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.

[0045] 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.

[0046] I. Exemplary Surgical Stapler

[0047] Figures 1 to 7An 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 1 The 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).

[0048] 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 movement from the closing tube (32) to the closing ring (33).

[0049] 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.

[0050] 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).

[0051] 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 6 As 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). The upper deck (72) is positioned opposite the outer surface (60). 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).

[0052] 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 4BAs shown, the intermediate pin (46) and the pusher (80) actuate the nail cartridge (37) together by entering the vertical slot (49) within the nail cartridge (37), thereby driving the wedge-shaped slider (41) into upward contact with the nail actuator (43), which in turn drives the nail (47) outward through the nail hole (51) and causes the nail forming recess (53) on the contact surface (52) of the nail with the anvil (18) to... Figure 3 (as shown) to form contact. The anvil (18) includes a proximal portion (54) and a distal portion (56) as well as an outer surface (58) disposed opposite to the contact surface 52. 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 4B The 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).

[0053] 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.

[0054] 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.

[0055] II. Exemplary support assembly and support applicator compartment

[0056] 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).

[0057] 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.

[0058] A. Exemplary components of the support assembly

[0059] 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).

[0060] 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.

[0061] 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.

[0062] B. Exemplary suturing of tissue and support components

[0063] 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).

[0064] 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 support assembly (110, 112) thus provides 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).

[0065] C. An exemplary support applicator compartment with a movable retainer arm

[0066] 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).

[0067] 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).

[0068] 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).

[0069] 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).

[0070] III. Exemplary alternative application devices and related methods for applying support to the end effector of a surgical suture device Law

[0071] In some cases, it may be desirable to provide an application device configured to apply the staple reinforcement accessory to one or both jaws of the surgical stapler end actuator (12) while the jaws remain open, or otherwise prevent the jaws from closing via actuation of the end actuator (12) closure system (such as actuation via the closure trigger (26) of the surgical stapler (10). Alternatively, it may be advantageous to apply the accessory material separately to one or both jaws of the end actuator (12) of the surgical stapler (10). The exemplary application devices (310, 410, 510, 610, 710, 810) described below provide such functionality, such that each application device (310, 410, 510, 610, 710, 810) is configured to be manipulated relative to the end actuator (12) to apply the accessory material individually to one or both jaws, without requiring, as described above... Figures 13A to 13B The jaws are actuated and closed. The application device (310, 410, 510, 610, 710, 810) can apply minimal pressure to properly place the auxiliary material onto the desired jaws (e.g., the lower jaw (16) or the anvil (18)).

[0072] It should be understood that any of the exemplary application devices described below may be configured to apply the auxiliary material in the form of a support (such as the support assembly (110, 112) described above) 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 jaws of the end effector (12) may 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 may be suitably configured for single or multiple use.

[0073] A. First exemplary alternative application device

[0074] Figures 14 to 15C A first exemplary alternative application device (310) is shown, configured to apply adjunct materials (e.g., support assemblies (110, 112) or tissue thickness compensators) to the jaws (e.g., lower jaw (16) or anvil (18)) of the end effector (12) of a surgical stapler (10). The application device (310) adjusts the thickness of the anvil (18) or lower jaw (16) to allow the application device (310) to properly apply the adjunct materials to the anvil (18) or lower jaw (16), respectively. Figure 14As shown, the application device (310) includes a housing (312), an arm (314), an elastic feature (316), and a connecting feature (shown as a pin (318)). The housing (312) includes a main body member (320), a protrusion (322) extending from the main body member (320), and a first contact feature (324). The first contact feature (324) extends from the main body member (320) and is translatably fixed relative to the main body member (320). The arm (314) can be connected to the housing (312) using a pin (318) that extends through a cavity (not shown) provided in the main body member (320) of the housing (312). However, other suitable structures for connecting the housing (312) and the arm (314) are also conceivable. The arm (314) includes a proximal end (326) and a distal end (328), wherein a second contact feature (330) is provided at the distal end (328) of the arm (314).

[0075] like Figure 14 As shown, the resilient feature (316) can be coupled to the main body member (320) of the housing (312) and the proximal end (326) of the arm (314). The resilient feature (316) and the pin (318) can be used to rotatably bias the arm (314) toward the housing (312). The resilient feature (316) is configured to bias the arm (314), including the second contact feature (330), relative to the first contact feature (324), as... Figures 15A to 15B The application of compressive force secures the auxiliary material to the desired jaws. The resilient feature (316) may include at least one spring operatively coupled to the housing (312). Figure 14 As shown, the elastic feature (316) includes a tension spring (332). A first end (342) of the tension spring (332) can be connected to the main body member (320), and a second end (344) of the tension spring (332) can be connected to the proximal end (326) of the arm (314). The tension spring (332) can bias the arm (314) including the second contact feature (330) relative to the first contact feature (324) by applying a compressive force. Figure 14 The first contact feature (324) and the second contact feature (330) are shown separated from each other by a certain distance in a neutral configuration (i.e., a stationary configuration). Alternatively, it is envisioned that the second contact feature (330) can contact the first contact feature (324) in the neutral configuration so as to apply a predetermined contact force to the first contact feature (324) before the application device (310) secures the auxiliary material to the jaws of the end effector (12).

[0076] The first contact feature (324) and / or the second contact feature (330) may include a roller. For example... Figure 14As shown, the first contact feature (324) includes a roller (334) connected to the main body member (320) via a connecting feature (336). Similarly, the second contact feature (330) includes a roller (338) connected to the arm (314) via a connecting feature (340). The rollers (334, 338) are configured to apply a compressive force as they move along the jaws. Specifically, the roller (338) applies a compressive force to the jaws of the end effector (12), while the roller (334) applies a reaction force. Therefore, the roller (334) can be stationary and not deflected relative to the main body member (320). Although the rollers (334, 338) in Figure 14 The roller is shown as a single elongated roller, but other suitable rollers are also contemplated, including rollers with discontinuous contact surfaces. The connecting features (336, 340) may include, for example, a pin or another suitable coupling along a feature that allows the roller (334) to rotate relative to the body member (320) and allows the roller (338) to rotate relative to the arm (314). While the first contact feature (324) and the second contact feature (330) are shown as including rollers (334, 338), it is also contemplated that the first contact feature (324) and the second contact feature (330) may include low-friction elements that can slide along the outer surface of the auxiliary material or jaws.

[0077] Figures 15A to 15C The diagram shows the attachment of auxiliary material to the suture surface of the jaws of the end effector (12). As described above, the auxiliary material may include support assemblies (110, 112), tissue thickness compensation elements, or other suitable materials. The suture surface is intended to include the upper plate (72) of the staple cartridge (37) including staple holes (50) or the contact surface (52) of the anvil (18) including staple forming recesses (53), such as Figure 3 As shown. It is also envisioned that the anvil (18) may be disposed on the lower jaws and the staple cartridge (37) may be disposed on the upper jaws. The application device (310) is shown as securing the support assembly (110) to the anvil (18), wherein the support assembly (110) is already at least partially disposed on the anvil (18). In some forms, a user using a separate device (not shown) may first apply the support assembly (110) to the anvil (18), such that the application device (310) presses the support assembly (110) more firmly against the anvil (18) to secure the support assembly (110) in place with the desired pressure. In other forms, the application device (310) may include or be coupled to a material dispenser for supplying auxiliary materials, which is similar to the one referenced below. Figures 16 to 17B Detailed description of the material dispenser (430).

[0078] Figure 15A It shows Figure 14The application device (310) and Figure 3 A cross-sectional view of the end effector (12), wherein the application device (310) secures the support assembly (110) to the distal portion (54) of the anvil (18) of the end effector (12). As described above, the support assembly (110) includes an upper adhesive layer (116) configured to adhere the support assembly (110), including the support body (114), to the contact surface (52) of the anvil (18). Figure 15A As shown, the anvil (18) includes an outer surface (58) disposed at a 180-degree angle to the contact surface (52). The roller (338) of the second contact feature (330) is configured to apply a compressive force to compress the support assembly (110) against the distal portion (54) of the anvil (18), thereby fixing the upper adhesive layer (116) of the support assembly (110) to the contact surface (52), thus securing the upper adhesive layer (116) to the contact surface (52). Figures 15A to 15B As shown, rollers (334, 338) are arranged opposite to each other along the compression plane (CP). Roller (334) can rotate relative to roller (338) in the opposite direction. Roller (338) applies a compressive force when roller (338) moves along the outer surface (58) of anvil (18) and roller (334) moves along the contact surface (52) of anvil (18). In some types, roller (338) can apply a compressive force when roller (338) moves along the contact surface (52) of anvil (18) and roller (334) moves along the outer surface (58) of anvil (18).

[0079] Figure 15B It shows Figure 15A A cross-sectional view of the application device (310) and end actuator (12), wherein after the roller (334) rolls along the outer surface (58) of the anvil (18), the application device (310) applies the support assembly (110) to the proximal end (54) of the anvil (18), and the roller (338) rolls along the support body (114) to adhere the upper adhesive layer (116) to the contact surface (52). While the user may typically attach the support assembly (110) to the distal portion (54) of the anvil (18) and then to the proximal portion (56) of the anvil (18), it is also envisioned that the user may attach the support assembly (110) to the proximal portion (56) of the anvil (18) and then to the distal portion (54) of the anvil (18).

[0080] Figure 15C It shows Figure 15BA cross-sectional view of the end effector (12) is shown, wherein the support assembly (110) is fixed to the contact surface (52) of the anvil (18), and the support assembly (112) is fixed to the upper deck (72) of the lower jaw (16) of the end effector (12). As shown, the support assembly (112) includes a lower adhesive layer (120) configured to adhere the support assembly (112), including the support body (118), to the upper deck (72) of the lower jaw (16). The application of the support assembly (112) can be similar to the application of the support assembly (110) described above. For example, as the roller (334) moves along the outer surface (60) of the lower jaw (16), the roller (338) can apply a compressive force, and the roller (338) moves the support body (118) to adhere the lower adhesive layer (120) to the upper deck (72) of the lower jaw (16). However, it is also envisioned that as the roller (334) moves along the support body (114), the roller (338) can apply a compressive force to adhere the lower adhesive layer (120) to the upper deck (72) of the lower jaw (16), and the roller (338) moves along the outer surface (60) of the lower jaw (16). Since the lower jaw (16) is shown to be thicker than the anvil (18), the tension spring (332) can be further stretched to further separate the rollers (334, 338). Stretching the tension spring (332) can result in a greater spring force, causing the lower jaw (16) to be inserted between the rollers (334, 338).

[0081] B. Second exemplary alternative application device

[0082] Figures 16 to 17B A second exemplary alternative application device (410) is shown, configured to apply adjunct material to the jaws (e.g., lower jaw (16) or anvil (18)) of the end effector (12) of a surgical stapler (10). The application device (410) adjusts the thickness of the anvil (18) or lower jaw (16) to allow the application device (410) to properly apply adjunct material to the anvil (18) and lower jaw (16). Thus, applying a support assembly (112) to a lower jaw (16) including a staple cartridge (37) using the application device (410) is similar to the application of the support assembly (110) described above. Figure 16As shown, the application device (410) includes a housing (412), an arm (414), and an elastic feature (416). The housing (412) includes a base (418), a first post (420), a second post (422), and a first contact feature (424). The first post (420) and the second post (422) extend outward from the base (418). The first post (420) and the second post (422) are shown as parallel to each other. Optionally, the arm (414) can be translated along a slot (426) provided in the first post (420) and the second post (422). The arm (414) includes a second contact feature (428).

[0083] The housing (412) may include an accessory material dispenser (430) that dispenses accessory material from a reel (432) using a first contact feature (424). As shown, the accessory material is a continuous support assembly (433). The support assembly (433) may include an adhesive surface coupled to the stitching surface. It should be understood that the material dispenser (430) may also be constructed and operated in accordance with the teachings of U.S. Patent Publication No. 2015 / 0076212, entitled “Surgical End Effector Having Buttress Retention Features,” published March 19, 2015, the disclosure of which is incorporated herein by reference. The continuous support assembly (433) may be dispensed at the first contact feature (424). The first contact feature (424) applies the support assembly (433) to the contact surface (52). As shown, the first contact feature (424) includes a roller (434) fixed to the first column (420), the second column (422), and the material dispenser (430) using a connecting feature (436). Optionally, the reel (432) can be removed from the housing (412) by removing the connecting feature (436) that connects the first contact feature (424) to the material dispenser (430). The material dispenser (430) can deliver multiple support materials without reloading. Furthermore, the material dispenser (430) with a single product code can dispense supports of different lengths. This can reduce the number of different support sizes that the user already has in stock or on hand.

[0084] The application device (410) can control the force applied to the jaws from the material dispenser (430) using the elastic feature (416). The elastic feature (416) can be disposed between the base (418) of the housing (412) and the arm (414). The elastic feature (416) is configured to bias the arm (414), including the second contact feature (428), relative to the first contact feature (424) to apply a compressive force, such as... Figures 17A to 17BAs shown. The arm (414) is configured to translate relative to the base (418) using an elastic feature (416). For example, the elastic feature (416) may include at least one spring. Figure 16 As shown, the elastic feature (416) includes a pair of compression springs (438). However, more or fewer compression springs (438) are also envisioned, such as a single compression spring.

[0085] like Figures 17A to 17B As shown, a first end (440) of the compression spring (438) can be coupled to the base (418), and a second end (442) of the compression spring (438) can be coupled to the arm (414). The compression spring (438) is configured to bias the arm (414), including the second contact feature (428), relative to the first contact feature (424) by applying a compressive force. In other words, the compression spring (438) pushes the arm (414) upward against the outer surface (58) of the anvil (18). The compression spring (438) disposed between the arm (414) and the base (418) can provide the desired applied pressure to secure the auxiliary material to the stitching surface of the jaws. Figure 16 The first contact feature (424) and the second contact feature (428) are shown separated from each other by a certain distance in a neutral configuration (i.e., a stationary configuration). Alternatively, it is envisioned that the second contact feature (428) can contact the first contact feature (424) in the neutral configuration so as to apply a predetermined contact force to the first contact feature (424) before the application device (410) is used to secure the auxiliary material to the contact surface (52) of the upper deck (72) of the lower jaw (16) or the anvil (18).

[0086] The first contact feature (424) and / or the second contact feature (428) may include a roller. For example... Figure 16 As shown, the second contact feature (428) includes a pair of rollers (444) configured to apply a compressive force as the rollers (444) move along the outer surface of the jaws. While a pair of rollers (444) is shown, more or fewer rollers (444) are also envisioned. The rollers (444) of the arm (414) allow for the smooth application of adjunct material along the length of the jaws. The arm (414) including the rollers (444) is configured to translate relative to the base (418) to simultaneously contact the outer surface as the adjunct material is applied to the contact surface (52) of the upper deck (72) of the lower jaw (16) or the anvil (18) from the reel (432). The rollers (444) can be coupled to the arm (414) using a coupling feature (446). Specifically, the rollers (444) are configured to apply a compressive force to the jaws of the end effector (12), while the rollers (434) are configured to apply a reaction force. Therefore, the roller (434) can be stationary and not deflected relative to the base (418). Figure 14As shown, rollers (434, 444) are arranged opposite each other along the compression plane (CP). Although roller (434) is in Figure 16 The roller is shown as a single elongated roller, but other rollers are also envisioned, including rollers with discontinuous contact surfaces or multiple discrete rollers. The connecting features (436, 446) may include, for example, a pin or another suitable coupling along a feature that allows the roller (434) to rotate relative to the material dispenser (430) and allows the roller (444) to rotate relative to the arm (414). While the second contact feature (428) is shown as including the roller (444), it is also envisioned that the second contact feature (428) may include a low-friction element that can slide along the jaws.

[0087] Figures 17A to 17B The application and attachment of the auxiliary material to the jaws of the end effector (12) is shown. Specifically, Figure 17A It shows Figure 16 The application device (410) and Figure 3 A cross-sectional view of the end effector (12), wherein the application device (410) secures the support assembly (110) to the proximal portion (56) of the anvil (18). As shown, the support assembly (110) includes an upper adhesive layer (116) configured to adhere the support assembly (110), including the support body (114), to the contact surface (52) of the anvil (18). The outer surface (58) of the anvil (18) is positioned 180 degrees opposite to the contact surface (52). Figure 17A As shown, the roller (444) of the second contact feature (428) applies a compressive force to compress the support assembly (110) against the proximal portion (56) of the anvil (18), thereby securing the upper adhesive layer (116) of the support assembly (110) to the contact surface (52). The roller (434) can rotate in the opposite direction relative to the roller (444). As the roller (434) moves along the outer surface (58) of the anvil (18), the roller (444) applies a compressive force, and the roller (434) moves along the support body (114) to adhere the upper adhesive layer (116) to the contact surface (52) of the anvil (18). The application device (410) applies a clamping force on the anvil (18) between the proximal tip of the roller (434) and the center point of the roller (444) of the arm (414), which acts as a bottom force limiting and return device.

[0088] Figure 17B It shows Figure 17AA cross-sectional view of the application device (410) and end effector (12), wherein after the roller (434) rolls along the support body (114) to adhere the upper adhesive layer (116) to the contact surface (52), the application device (410) applies and secures the support assembly (110) to the distal portion (54) of the anvil (18), and the roller (444) rolls along the outer surface (58) of the anvil (18). While a user may typically secure the support assembly (110) to the proximal portion (56) of the anvil (18) and then to the distal portion (54) of the anvil (18), it is envisioned that a user may secure the support assembly (110) to the distal portion (54) of the anvil (18) and then to the proximal portion (56) of the anvil (18). Applying the support assembly (112) to the lower jaw (16) including the staple cartridge (37) can be similar to the application of the support assembly (110) described above.

[0089] C. Third exemplary alternative application device

[0090] Figures 18 to 19C A third exemplary alternative application device (510) is shown, configured to apply adjunct material to the jaws (e.g., anvil (18)) of the end effector (12) of a surgical suture device (10). Figure 18 As shown, the application device (510) includes a housing (512), an arm (514), and a hinge (516). The hinge (516) pivotally connects the arm (514) to the housing (512) at a hinge point HP, such that the arm (514) can pivot relative to the housing (512) to apply and secure the auxiliary material (shown as a support assembly (110)) to the anvil (18). The housing (512) includes a first contact feature (518) shown as a generally planar base. The first contact feature (518) includes an inner surface (520) and an outer surface (522), wherein the inner surface (520) faces the arm (514). The arm (514) includes a connecting portion (524) and a second contact feature (526) shown as a generally planar platform. The connecting portion (524) has a first thickness (D1) to accommodate the thickness of the anvil (18). The connecting portion (524) may include a hole (527) to allow the jaws to extend through it, such as Figures 19A to 19C As shown. The second contact feature (526) includes an inner surface (528) and an outer surface (530), wherein the inner surface (528) faces the inner surface (520) of the first contact feature (518). Figures 19A to 19B As shown, the cavity (532) is disposed between the inner surfaces (520, 528) of the first contact feature (518) and the second contact feature (526).

[0091] The second contact feature (526) is configured to be able to open relative to the first contact feature (518) in an open configuration (e.g., Figure 19A (as shown) and closed configurations (such as) Figure 19B Pivoting between (as shown), wherein the second contact feature (526) pushes the support assembly (110) into contact with the suture surface. Figure 18 As shown, the second contact feature (526) includes an inner portion (534), an outer portion (536), and a retaining portion (538). The inner and outer portions (534, 536) are connected together by transversely brittle portions (540, 542). The transversely brittle portions (540, 542) are configured to detach when a predetermined pressure is applied to release the auxiliary material from the application device (510). The retaining portion (538) is located at the end of the second contact feature (526) opposite to the hinge (516). The transversely brittle portions (540, 542) are configured to break to separate the inner and outer portions (534, 536), except for the retaining portion (538) that holds the inner and outer portions (534, 536) together.

[0092] Figures 19A to 19B An auxiliary material (shown as a support assembly (110)) is attached to the upper jaw (shown as an anvil (18)) of the end effector (12). As shown, the application device (510) can load and attach the support assembly (110) to the anvil (18). Specifically, Figure 19A It shows Figure 18 The application device (510) and Figure 3 A cross-sectional view of the end effector (12), wherein the arm (514) of the application device (510) pivots toward the upper jaw (shown as an anvil (18)). The outer surface (58) of the anvil (18) is disposed 180 degrees opposite to the contact surface (52). As shown, the support assembly (110) includes an upper adhesive layer (116) configured to adhere the support assembly (110), including the support body (114), to the contact surface (52) of the anvil (18). Figure 19A As shown, the second contact feature (526) of the arm (514) provides an elongated platform to which the first side of the support assembly (110) is releasably attached (e.g., via adhesion). In other words, the support body (114) can be temporarily attached to the inner surface (528) of the second contact feature (526) using an adhesive or mechanical connection feature. The inner portion (534) of the second contact feature (526) can be perforated along the side except for the retaining portion (538).

[0093] Figure 19B It shows Figure 19AA cross-sectional view of the application device (510) and end effector (12), wherein the transversely fragile portions (540, 542) break to release the application device (510) from the anvil (18). A second contact feature (526) applies compressive force to compress the support assembly (110) against the proximal portion (56) of the anvil (18), thereby applying and securing the support assembly (110) to the contact surface (52). The transversely fragile portions (540, 542) break off when the arm (514) rotates toward the jaws of the end effector (12) with sufficient force and compresses against the jaws of the end effector. This transforms the inner portion (534) into a flap (544) with a free end, which is hingedly attached to the retaining portion (538), such that the remaining portion of the arm (514), such as the flap (544), is not a completely loose piece that could fall onto the patient or the floor. Figure 19B As shown, the retaining portion (538) may include a flexible portion configured to bend but not break when the support assembly (110) is released from the application device (510). The support assembly (110) separates from the inner portion (534) of the second contact feature (526) in response to the closing of the jaw upper arm (514) of the end effector (12). Thus, the application device (510) may use the laterally fragile portions (540, 542) to control the force applied to the contact surface (52) of the anvil (18) of the support assembly (110).

[0094] The transversely vulnerable portions (540, 542) are shown as spaced perforations along the corresponding sides of the inner portion (534) but not at the distal end. For ease of application, the transversely vulnerable portions (540, 542) may be positioned around an area adjacent to the support assembly (110) such that when the support assembly (110) is applied, the transversely vulnerable portions (540, 542) tear and secure the support assembly (110) to the anvil (18). The transversely vulnerable portions (540, 542) may be varied to increase or decrease the force applied to the support assembly (110) to the anvil (18) before the transversely vulnerable portions (540, 542) are cut. For example, the spacing between adjacent perforations and / or the material-to-gap ratio may be varied. The transversely vulnerable portions (540, 542) on the application device (510) prevent reuse after the application of auxiliary materials. The application device (510) prevents the broken transverse vulnerable parts (540, 542) from being reused. In some models, once the arm (514) is opened, the arm (514) can destroy itself or lock into a non-closable state, so that the pawl is overcome but difficult to reset.

[0095] Figure 19C It shows Figure 19BA cross-sectional view of the application device (510) and end effector (12), wherein the support assembly (110) is applied to the anvil (18) and the application device (510) is actively removed. For example, the application device (510) can slide distally relative to the end effector (12) using a hole provided in the arm (514).

[0096] D. Fourth exemplary alternative application device

[0097] Figure 20 A fourth exemplary alternative application device (610) configured to apply adjunct material to the jaws (e.g., lower jaws (16)) of the end effector (12) of a surgical suture device (10) is shown. As shown, the application device (610) includes a housing (612), an arm (614), and a hinge (616). The hinge (616) pivotally connects the arm (614) to the housing (612) at a hinge point, such that the arm (614) can pivot relative to the housing (612) to apply and secure adjunct material (shown as a support assembly (112)) to the lower jaws (16). The housing (612) includes a first contact feature (618) shown as a generally planar base. The first contact feature (618) includes an inner surface (620) and an outer surface (622), wherein the inner surface (620) faces the arm (614).

[0098] The arm (614) includes a connecting portion (624) and a second contact feature (626) shown as a generally planar platform. The connecting portion (624) has a second thickness (D2) to accommodate the thickness of the lower jaw (16). Therefore, the connecting portion (624) may be longer than the connecting portion (524) to account for the increased thickness (i.e., height) of the lower jaw (16) compared to the anvil (18). The connecting portion (624) may include a hole (627) to allow the jaw to extend through it, such as Figures 19A to 19C As shown. The second contact feature (626) includes an inner surface (628) and an outer surface (630), wherein the inner surface (628) faces the inner surface (620) of the first contact feature (618). As shown, a cavity (632) is disposed between the inner surfaces (620, 628) of the first contact feature (618) and the second contact feature (626). The second contact feature (626) is configured to be able to open relative to the first contact feature (618) in an open configuration (similar to... Figure 19A Regarding the application device (510) shown) and the closed configuration (as shown) Figure 20The support assembly (110) pivots between the two portions (shown), wherein a second contact feature (626) is provided to push the support assembly (110) into contact with the suture surface. The second contact feature (626) includes an inner portion (634) and an outer portion (not shown), the outer portion being similar to the outer portion (536), and a retaining portion (638). The inner portion (634) is connected to the outer portion via a transversely fragile portion (not shown), the transversely fragile portion being similar to the transversely fragile portions (540, 542) described above.

[0099] Figure 20 An auxiliary material (shown as a support assembly (112)) is shown attached to the lower jaw (16) of the end effector (12). As shown, the application device (610) can load and secure the support assembly (110) to the lower jaw (16). Specifically, Figure 20 It shows Figure 3 A cross-sectional view of the application device (610) and end effector (12), wherein the arm (614) of the application device pivots toward the lower jaw (16) of the staple cartridge (37) including the end effector (12). The outer surface (60) of the lower jaw (16) is positioned 180 degrees opposite to the upper deck (72). As shown, the support assembly (110) includes a lower adhesive layer (120) configured to adhere the support assembly (112) including the support body (118) to the upper deck (72) of the staple cartridge (37) of the lower jaw (16). As shown, when the arm (614) rotates toward the jaw of the end effector (12) with sufficient force and compresses against the jaw of the end effector, the laterally fragile portion breaks off. This transforms the inner portion (634) into a flap (not shown) with a free end, which is hingedly attached to the retaining portion (638).

[0100] Applying the support assembly (112) to the lower jaw (16) including the staple cartridge (37) can be similar to applying the support assembly (110) to the anvil (18) as described above. It may be desirable to package the application devices (510, 610) together or to package the application devices (510, 610) and the support assemblies (110, 112) together. For example, a kit may include one application device (610) and an accompanying support assembly (110), and one application device (610) and an accompanying support assembly (112). As shown, the application devices (510, 610) are configured to apply the support assemblies (110, 112) to the desired jaws of the end effector. The application devices (510, 610) may include the support assemblies (110, 112) to be applied, and the application devices are individually fitted onto each jaw and closed, then removed to create force limitation. The application devices (510, 610) can be closed to different thicknesses to accommodate the different thicknesses of the jaws of each end effector. Optionally, markings (not shown) may be provided on the application devices (510, 610) to indicate the jaws to be used.

[0101] E. Fifth exemplary alternative application device

[0102] Figures 21 to 22B A fifth exemplary alternative application device (710) is shown, configured to apply adjunct material to the jaws (e.g., anvil (18)) of the end effector (12) of a surgical suture device (10). Figure 21 As shown, the application device (710) includes a housing (712) and an arm (714). The arm (714) includes a connecting portion (716) that engages with the housing (712). The housing (712) includes a first contact feature (718), shown as a U-shaped channel. The first contact feature (718) includes an inner surface (720) and opposing upward-facing walls (722, 724). The upward-facing walls (722, 724) include corresponding cutouts (726). The connecting portion (716) allows the arm (714) to function as a pivot element to apply and secure the auxiliary material (shown as a support assembly (110)) to the anvil (18). The arm (714) includes a second contact feature (728). The second contact feature (728) includes an inner surface (730) and an outer surface (732), wherein the inner surface (730) faces the inner surface (720) of the first contact feature (718). Figure 21 As shown, a channel (734) is disposed between the inner surfaces (720, 730) of the first contact feature (718) and the second contact feature (728). The housing (712) includes a downward-facing tab (736) for securing the support assembly (110) to the anvil (18).

[0103] Figures 22A to 22B The support assembly (110) is shown being applied to and secured to the upper jaw (shown as an anvil (18)) of the end effector (12). However, it is also envisioned that the application device (710) could be modified to apply the support assembly (112) to the upper deck (72) of the lower jaw (16). As shown, the application device (710) can load and secure the support assembly (110) to the anvil (18). Specifically, Figure 22A It shows Figure 21 The application device (710) and Figure 3 A cross-sectional view of the end effector (12), wherein the application device (710) moves proximally along the anvil (18). Figure 22A As shown, the second contact feature (728) of the arm (714) provides an elongated platform to which the first side of the support assembly (110) is releasably attached (e.g., via adhesion). The outer surface (78) of the anvil (18) is disposed 180 degrees opposite to the contact surface (52). When the second contact feature (728) pushes the support assembly (110) into contact with the stitching surface, the second contact feature (728) is configured to function as a lever against the first contact feature (718).

[0104] Figure 22B It shows Figure 22A A cross-sectional view of the application device (710) and the end effector (12), wherein the distal end (738) of the application device (710) is rotated to the contact anvil (18) to apply the support assembly (110) to the anvil (18). Figure 22B The end effector (12) is shown rotating downwards such that the anvil (18) is fully received within the channel (734) to compressively contact the support assembly (110), and adhesion is caused by the leverage provided by the contact between the outer surface (58) of the anvil (18) and the inner surface (730) of the second contact feature (728). Applying the support assembly (112) to the lower jaw (16) including the staple cartridge (37) can be similar to the application of the support assembly (110) described above, except that the modified application device (710) takes into account the additional thickness of the lower jaw (16).

[0105] F. Sixth exemplary alternative application device

[0106] Figures 23 to 24B A sixth exemplary alternative application device (810) is shown, configured to apply adjunct material to the jaws (e.g., anvil (18)) of the end effector (12) of a surgical suture device (10). Figure 23As shown, the application device (810) includes a housing (812), an arm (814), and a connecting feature (816) that pivotally connects the arm (814) to the housing (812). The housing (812) includes a first contact feature (818), shown as a U-shaped channel. The first contact feature (818) includes an inner surface (820) and opposing upward-facing walls (822, 824). The upward-facing walls (822, 824) include a hole (826) configured to receive the connecting feature (816). The connecting feature (816) allows the arm (814) to pivot to apply and secure the auxiliary material (shown as a support assembly (110)) to the anvil (18). The arm (814) includes a body portion (828). The body portion (828) includes a handle portion (830) disposed opposite to a second contact feature (832), shown as a cam feature. The second contact feature (832) includes a first cam surface (834) and a second cam surface portion (836). For example... Figure 24A As shown, the first cam surface (834) is separable from the connecting feature (816) by a first distance (D1). A channel (838) is provided between the inner surface (820) of the first contact feature (818) and the first cam surface (834) and the second cam surface (836) of the second contact feature (832). When the application device (810) is loaded onto the anvil (18), the first cam surface (834) of the second contact feature (832) is provided across the channel (838) from the inner surface (820) of the first contact feature (818).

[0107] Figures 24A to 24B The support assembly (110) is shown attached to the upper jaw of the end effector (12). As shown, the application device (810) can load and secure the support assembly (110) to the contact surface (52) of the anvil (18). However, it is also contemplated that the application device (810) can be modified to apply the support assembly (112) to the upper deck (72) of the lower jaw (16). Specifically, Figure 24A It shows Figure 23 The application device (810) and Figure 3 A cross-sectional view of the end effector (12), wherein the application device (810) moves proximally along the anvil (18). Figure 24A As shown, the second contact feature (832) of the arm (814) provides an elongated platform to which the first side of the support assembly (110) is releasably attached (e.g., via adhesion). When the second contact feature (832) pushes the support assembly (110) into contact with the contact surface (52) of the anvil (18), the second contact feature (832) is configured to function as a lever against the first contact feature (818).

[0108] Figure 24BIt shows Figure 24A A cross-sectional view of the application device (810) and the end effector (12), wherein the handle portion (830) of the arm (814) of the application device (810) rotates to the distal portion (54) of the contact anvil (18) to apply the support assembly (110) to the anvil (18). Figure 24B The end effector (12) is shown rotating downwards, causing the anvil (18) to be fully received within the channel (838) to compressively contact the support assembly (110), and adhesion is caused by the leverage provided by the contact between the outer surface (58) of the anvil (18) and the second cam surface (836) of the second contact feature (832). Figure 24B As shown, the second cam surface (836) can be separated from the connecting feature (816) by a second distance (D2). Applying the support assembly (112) to the lower jaw (16) including the staple cartridge (37) can be similar to the application of the support assembly (110) described above, except that the modified application device (810) takes into account the additional thickness of the lower jaw (16).

[0109] G. An exemplary method for applying auxiliary material to the end effector jaws

[0110] A method (910) is also described for applying an adjunct material (e.g., a support assembly (110, 112) or a tissue thickness compensator) to the suture surface (upper plate (72) or contact surface (52)) of the first or second jaw (e.g., the lower jaw (16) or anvil (18)) of the end effector (12) of a surgical suturer (10) using an application device (310, 410, 510, 610, 710, 810). At step (912), the method (910) may include opening the jaws of the end effector (12) such that the lower jaw (16) and the anvil (18) are spaced apart. At step (914), the method (910) may include compressing the auxiliary material between the first contact feature (324, 424, 518, 618, 718, 818) and the second contact feature (330, 428, 526, 626, 728, 832) with the lower jaw (16) or anvil (18) in an open configuration to attach the auxiliary material to the stitching surface (e.g., upper deck (72) or contact surface (52)) of one of the lower jaws (16) or anvil (18) of the end effector (12). The auxiliary material may be attached to the stitching surface of one of the first jaws or the second jaw by compressing the support assembly (110, 112) with a local compressive force applied between the rollers (334, 338, 434, 444) using the application device (310, 410).

[0111] IV.Exemplary combinations

[0112] 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.

[0113] Example 1

[0114] An apparatus configured to apply an adjunct material to a suture surface of a surgical suture jaw, wherein the jaw includes an outer surface disposed opposite to the suture surface, wherein the suture surface includes a plurality of staple holes or a plurality of staple-forming recesses, the apparatus comprising: (a) a housing including a first contact feature configured to contact one of the adjunct material or the outer surface of the jaw; and (b) an arm operatively coupled to the housing, wherein the arm includes a second contact feature configured to move relative to the first contact feature to contact the other of the adjunct material or the outer surface of the jaw, wherein the first contact feature and the second contact feature are configured to cooperate to apply a compressive force in a direction toward the first contact feature, causing the adjunct material to be compressed against the suture surface to attach the adjunct material to the suture surface.

[0115] Example 2

[0116] The device according to Embodiment 1 further includes an elastic feature operatively coupled to the housing and the arm, wherein the elastic feature is configured to bias the arm, including the second contact feature, relative to the first contact feature to apply the compressive force.

[0117] Example 3

[0118] According to the device of embodiment 2, the elastic feature includes a spring operatively coupled to the housing and the arm, wherein the spring is configured to bias the arm, including the second contact feature, relative to the first contact feature to apply the compressive force.

[0119] Example 4

[0120] According to any one or more of embodiments 2 to 3, the elastic feature includes a tension spring, wherein the tension spring is configured to bias the arm including the second contact feature relative to the first contact feature to apply the compressive force.

[0121] Example 5

[0122] According to one or more of embodiments 2 to 3, the arm includes a platform, the elastic feature includes a compression spring, and the compression spring is configured to translate the platform to bias the second contact feature to apply the compressive force.

[0123] Example 6

[0124] According to the device of any one or more of embodiments 1 to 5, at least one of the first contact feature or the second contact feature includes a roller configured to apply the compressive force and roll along the stitching surface or along the outer surface of the jaws.

[0125] Example 7

[0126] According to any one or more of the devices described in Embodiments 1 to 5, wherein the first contact feature includes a first roller, wherein the second contact feature includes a second roller, wherein the second roller is configured to apply the compressive force when the second roller rolls along the jaws.

[0127] Example 8

[0128] According to any one or more of the devices described in Embodiments 1 to 5, one of the first contact feature portion or the second contact feature portion includes a first roller and a second roller, the first roller and the second roller being configured to apply the compressive force as the first roller and the second roller move along the outer surface of the stitching surface or the jaws.

[0129] Example 9

[0130] The device according to any one or more of Embodiments 1 to 5 further includes a reel including a supply source of the auxiliary material, wherein the reel is coupled to the housing, and wherein the first contact feature includes a roller configured to apply the auxiliary material to the stitching surface.

[0131] Example 10

[0132] According to the device of embodiment 9, the housing further includes a base, and the arm includes a second contact feature configured to translate relative to the base to simultaneously contact the outer surface as the reel applies the auxiliary material to the stitching surface.

[0133] Example 11

[0134] The device according to any one or more of embodiments 1 to 10 further includes a hinge that pivotally connects the arm relative to the housing between an open configuration and a closed configuration at a hinge point, wherein in the open configuration, the jaws are configured to be inserted between the first contact feature and the second contact feature, wherein in the closed configuration, the second contact feature is configured to contact the stitched surface.

[0135] Example 12

[0136] According to the device of embodiment 11, the second contact feature includes: (i) an inner portion and an outer portion connected together by a first transversely fragile portion and a second transversely fragile portion, and (ii) a retaining portion disposed at an end of the second contact feature opposite to the hinge, wherein the first transversely fragile portion and the second transversely fragile portion are configured to break to separate the inner portion and the outer portion, but are held together by the retaining portion.

[0137] Example 13

[0138] The device according to any one or more of Embodiments 1 to 10 further includes a hinge that pivotally connects the arm relative to the housing at a hinge point, wherein the second contact feature includes a first lateral vulnerable portion and a second lateral vulnerable portion, the first lateral vulnerable portion and the second lateral vulnerable portion being configured to disengage when a predetermined pressure is applied to release the accessory material from the device.

[0139] Example 14

[0140] According to any one or more of the devices described in Embodiments 1 to 13, the auxiliary material includes at least one of a support assembly or a tissue thickness compensation member, the support assembly or tissue thickness compensation member being releasably fixed to the second contact feature.

[0141] Example 15

[0142] The device according to any one or more of Embodiments 1 to 13, wherein the accessory material includes a support assembly, wherein the support assembly includes an adhesive surface configured to adhere the support assembly to the stitching surface.

[0143] Example 16

[0144] A device for loading the jaws of a surgical suture device, wherein the jaws include a suture surface and an outer surface disposed opposite the suture surface, wherein the suture surface includes a plurality of staple holes or a plurality of staple forming recesses, the device comprising: (a) an accessory material including a coupling feature; (b) a housing including a first contact feature, wherein the first contact feature is configured to contact one of the accessory material or the outer surface of the jaws; (c) an arm operatively coupled to the housing, wherein the arm includes a second contact feature configured to be movable relative to the first contact feature to contact the other of the accessory material or the outer surface of the jaws; and (d) an elastic feature operatively coupled to the housing and the arm, wherein the elastic feature is configured to bias the arm including the second contact feature relative to the first contact feature to apply a compressive force in a direction toward the first contact feature, causing the accessory material to be compressed against the suture surface to mount the accessory material to the suture surface.

[0145] Example 17

[0146] According to the device of embodiment 16, the auxiliary material includes at least one of a support assembly or a tissue thickness compensation component.

[0147] Example 18

[0148] According to the device of embodiment 16, the accessory material includes a support assembly, and the connecting feature includes an adhesive surface configured to adhere to the stitched surface.

[0149] Example 19

[0150] A method for attaching an accessory material to a suture surface of a first or second jaw of an end effector of a surgical suture device using an apparatus, wherein the suture surface includes a plurality of pin holes or a plurality of pin-forming recesses, wherein the apparatus includes a housing and an arm operatively coupled to the housing, wherein the housing includes a first contact feature, and wherein the arm includes a second contact feature movable relative to the first contact feature, the method comprising: (a) separating the first and second jaws into an open configuration; and (b) with the first and second jaws in the open configuration, applying a compressive force using the second contact feature to compress the accessory material between the first and second contact features to attach the accessory material to the suture surface.

[0151] Example 20

[0152] According to the method of embodiment 19, wherein the second contact feature includes a first roller, wherein the first contact feature includes a second roller, and wherein applying the compressive force further includes applying the compressive force to compress the accessory material between the first roller and the second roller to attach the accessory material to the stitching surface.

[0153] Example 21

[0154] According to any one or more of the methods in Embodiments 19 to 20, applying the compressive force further includes applying the compressive force in a direction toward the first contact feature to compress the accessory material against the suture surface to attach the accessory material to the suture surface.

[0155] Example 22

[0156] According to any one or more of the methods in Embodiments 19 to 21, wherein the device includes an elastic feature operatively coupled to the housing and the arm, wherein the method further includes using the elastic feature to bias the arm, which includes a second contact feature, relative to the first contact feature to apply the compressive force.

[0157] Example 23

[0158] According to the method of embodiment 22, wherein the elastic feature includes a tension spring operatively coupled to the housing and the arm, and wherein the method further includes using the tension spring to bias the arm including the second contact feature relative to the first contact feature.

[0159] Example 24

[0160] According to any one or more of the methods in Embodiments 19 to 21, wherein the arm includes a platform, wherein the elastic feature includes a compression spring, and wherein the method further includes using the compression spring to bias the arm including the second contact feature relative to the first contact feature to translate the platform.

[0161] Example 25

[0162] According to any one or more of the methods in embodiments 19, 21, 22 and 23, at least one of the first contact feature or the second contact feature includes a roller, wherein applying the compressive force further includes rolling the roller along the stitching surface or along the outer surface of the jaws.

[0163] Example 26

[0164] According to any one or more of the methods in embodiments 19, 21, 22 and 23, wherein the first contact feature includes a first roller, wherein the second contact feature includes a second roller, and wherein applying the compressive force further includes rolling the second roller along the jaws.

[0165] Example 27

[0166] According to any one or more of the methods in embodiments 19, 21, 22 and 23, one of the first contact feature portion or the second contact feature portion includes a first roller and a second roller, wherein applying the compressive force further includes rolling the first roller and the second roller along the outer surface of the stitching surface or the jaws to apply the compressive force.

[0167] Example 28

[0168] According to any one or more of the methods in embodiments 19, 21, 22 and 23, wherein the device further includes a reel including a supply source of the auxiliary material, wherein the first contact feature includes a roller, and wherein applying the compressive force further includes rolling the roller along the suture surface to provide the compressive force when the auxiliary material is applied to the suture surface.

[0169] Example 29

[0170] According to the method of embodiment 28, wherein the housing further includes a base, and applying the compressive force further includes, when the spool applies the auxiliary material to the stitched surface, causing the arm including the second contact feature to translate relative to the base to simultaneously contact the outer surface.

[0171] Example 30

[0172] According to the method of embodiment 19, the device further includes a hinge, and the method further includes: (a) opening the device into an open configuration, wherein the jaws are inserted between the first contact feature and the second contact feature; and (b) pivoting the arm at the hinge point relative to the housing into a closed configuration, wherein the second contact feature contacts the stitched surface.

[0173] Example 31

[0174] According to the method of embodiment 19, wherein the device includes a hinge, wherein the second contact feature includes: an inner portion and an outer portion connected together by a first lateral brittle portion and a second lateral brittle portion; and a retaining portion disposed at an end of the second contact feature opposite to the hinge, wherein applying the compressive force further includes rotating the arm including the inner portion and the outer portion toward the first contact feature to disengage the first lateral brittle portion and the second lateral brittle portion, thereby separating the inner portion and the outer portion, wherein the inner portion and the outer portion remain held together by the retaining portion.

[0175] Example 32

[0176] According to the method of embodiment 31, disconnecting the first transversely fragile portion and the second transversely fragile portion further includes disconnecting the first transversely fragile portion and the second transversely fragile portion when a predetermined pressure is applied to release the auxiliary material from the device.

[0177] Example 33

[0178] According to any one or more of the methods in Examples 19 to 32, wherein the auxiliary material includes at least one of the support assembly or the tissue thickness compensation member, wherein applying the compressive force further includes applying the compressive force using the second contact feature to compress at least one of the support assembly or the tissue thickness compensation member between the first contact feature and the second contact feature to mount at least one of the support assembly or the tissue thickness compensation member to the suture surface.

[0179] Example 34

[0180] According to any one or more of the methods in Examples 19 to 32, wherein the auxiliary material includes a support assembly, wherein the support assembly includes an adhesive surface, wherein applying the compressive force further includes applying the compressive force using the second contact feature to compress the support assembly between the first contact feature and the second contact feature to mount the adhesive surface when the support assembly is mounted to the stitching surface.

[0181] V. Miscellaneous

[0182] 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.

[0183] 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 Close End Effector of Surgical Stapler via Driven Member”; U.S. Patent Application No. END9286USNP4, filed on the same date as this application, entitled “Apparatus and Method to Detect Full Seating of Buttress Applicator in End Effector of Surgical Stapler”; and U.S. Patent Application No. END9286USNP4, filed on the same date as this application, entitled “Apparatus and Method to Detect Full Seating of Buttress Applicator in End Effector of Surgical Stapler”. The following U.S. patent applications were filed on the same date as this application: “Stapler” (Attorney File No. END9286USNP5); “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.

[0184] 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.

[0185] 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.

[0186] 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.

[0187] 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.

[0188] 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. A surgical device configured to apply adjunct material to a suture surface of the jaws of a surgical stapler, wherein the jaws include an outer surface disposed opposite to the suture surface, wherein the suture surface includes a plurality of staple holes or a plurality of staple forming recesses, the surgical device comprising: (a) A housing including a first contact feature, wherein the first contact feature is configured to contact one of the outer surfaces of the accessory material or the jaws; (b) An arm operatively coupled to the housing, wherein the arm includes a second contact feature configured to be movable relative to a first contact feature to contact the other of the accessory material or the outer surface of the jaws, wherein the first and second contact features are configured to cooperate to apply a compressive force in a direction toward the first contact feature, causing the accessory material to be compressed against the suture surface to mount the accessory material to the suture surface; and (c) An elastic feature operatively coupled to the housing and the arm, wherein the elastic feature is configured to bias the arm, including the second contact feature, relative to the first contact feature to apply the compressive force.

2. The surgical device according to claim 1, wherein, The elastic feature includes a spring operatively coupled to the housing and the arm, wherein the spring is configured to bias the arm, including the second contact feature, relative to the first contact feature to apply the compressive force.

3. The surgical device according to claim 1, wherein, The elastic feature includes a tension spring, wherein the tension spring is configured to bias the arm including the second contact feature relative to the first contact feature to apply the compressive force.

4. The surgical device according to claim 1, wherein, The arm includes a platform, wherein the elastic feature includes a compression spring, wherein the compression spring is configured to translate the platform to bias the second contact feature to apply the compressive force.

5. The surgical device according to claim 1, wherein, At least one of the first contact feature or the second contact feature includes a roller configured to apply the compressive force and roll along the stitching surface or along the outer surface of the jaws.

6. The surgical device according to claim 1, wherein, The first contact feature includes a first roller, wherein the second contact feature includes a second roller, wherein the second roller is configured to apply the compressive force when the second roller rolls along the jaws.

7. The surgical device according to claim 1, wherein, One of the first contact feature portion or the second contact feature portion includes a first roller and a second roller, the first roller and the second roller being configured to apply the compressive force as the first roller and the second roller move along the outer surface of the stitching surface or the jaws.

8. The surgical device of claim 1, further comprising a reel including a supply source for the accessory material, wherein the reel is coupled to the housing, and wherein the first contact feature includes a roller configured to apply the accessory material to the suture surface.

9. The surgical device according to claim 8, wherein, The housing also includes a base, wherein the arm includes a second contact feature configured to translate relative to the base to simultaneously contact the outer surface as the reel applies the auxiliary material to the stitched surface.

10. The surgical device according to claim 1, wherein, The accessory material includes at least one of a support assembly or a tissue thickness compensation element, which is releasably fixed to the second contact feature.

11. The surgical device according to claim 1, wherein, The accessory material includes a support assembly, wherein the support assembly includes an adhesive surface configured to adhere the support assembly to the suture surface.

12. The surgical device according to claim 1, further comprising: The associated material including the connecting feature portion, The elastic feature is configured to bias the arm, including the second contact feature, relative to the first contact feature to apply a compressive force in the direction toward the first contact feature, causing the accessory material to be compressed against the suture surface to attach the accessory material to the suture surface.

13. The surgical device according to claim 12, wherein, The accessory materials include at least one of a support assembly or a tissue thickness compensation component.

14. The surgical device according to claim 12, wherein, The auxiliary material includes a support assembly, wherein the connecting feature includes an adhesive surface configured to adhere to the stitched surface.

15. A method for securing an accessory material to a suture surface of a first or second jaw of an end effector of a surgical stapler using a surgical device, wherein the suture surface includes a plurality of staple holes or a plurality of staple-forming recesses, wherein the surgical device includes a housing and an arm operatively coupled to the housing, wherein the housing includes a first contact feature, wherein the arm includes a second contact feature movable relative to the first contact feature, wherein the second contact feature includes a first roller, wherein the first contact feature includes a second roller, wherein the surgical device includes an elastic feature operatively coupled to the housing and the arm, wherein... The elastic feature is configured to bias the arm, including the second contact feature, relative to the first contact feature to apply a compressive force, the method comprising: (a) Separating the first jaws and the second jaws into an open configuration; and (b) With the first jaw and the second jaw in the open configuration, a compressive force is applied using the second contact feature to compress the accessory material between the first contact feature and the second contact feature, so as to attach the accessory material to the suture surface.

Images