Surgical staple cartridge for supporting surgical buttress material

Abstract

To provide a surgical staple cartridge for supporting a surgical buttress material.SOLUTION: An end effector for use with a surgical stapler includes a staple cartridge assembly movable relative to an anvil assembly. The staple cartridge assembly defines a plurality of retention slots and a cavity. The staple cartridge assembly includes a plurality of staples, a plurality of pushers, an actuation sled, a surgical buttress material, a suture, and an anchoring button. The actuation sled is configured for movement along a length of the staple cartridge assembly to sequentially engage the plurality of pushers to eject the plurality of staples through the respective plurality of retention slots.SELECTED DRAWING: None

Description

[Technical field]

[0001] FIELD OF THE DISCLOSURE This application relates to surgical staplers and, more particularly, to a surgical staple cartridge configured to removably support a surgical buttress material. [Background technology]

[0002] Surgical staplers are used by surgeons to sequentially or simultaneously apply one or more rows of fasteners, e.g., staples or two-part fasteners, to body tissue for the purpose of en bloc joining of segments of body tissue and / or creating an anastomosis. Linear surgical staplers generally include a pair of jaws or finger-like structures between which the body tissue to be joined is placed. When the linear surgical stapler is actuated or "fired," a firing bar moves longitudinally to contact a staple drive member in one of the jaws. The staple drive member drives the surgical staples into an anvil in the opposing jaw forming staples through the body tissue. When removing or separating the body tissue, a knife blade can be provided in one of the jaws of the device to cut the body tissue between the lines of staples.

[0003] A surgical support, such as a mesh or buttress material, can be used in combination with a surgical stapler to bridge, repair, and / or reinforce tissue defects in a patient, such as those occurring in the abdominal wall, lumbar wall, diaphragm, or musculoaponeurotic regions of the body. The surgical buttress material reinforces the staple line as well as covers the tissue junctions to reduce pre-healing leakage. The surgical buttress material can help promote proper staple formation while reducing any malalignment of tissue and / or kinking / malformation caused by abnormal or uneven tissue. The surgical buttress material can also help provide support to weakened tissue or address differences in tissue thickness.

[0004] Therefore, new systems and methods that allow for easy and effective attachment of surgical buttress material to a surgical stapler, as well as easy and effective removal of surgical buttress material from a surgical stapler, would be desirable. Summary of the Invention [Means for solving the problem]

[0005] According to an embodiment of the present disclosure, an end effector for use with a surgical stapler includes an anvil assembly and a staple cartridge assembly movable between an approximated position and a spaced position relative to the anvil assembly. The staple cartridge assembly defines a plurality of retention slots and a cavity. The staple cartridge assembly includes a plurality of staples, a plurality of pushers, an actuation sled, a surgical buttress material, a tie string, and a locking button. The plurality of staples are disposed within respective plurality of retention slots. The plurality of pushers are configured to eject the plurality of staples through respective plurality of retention slots. The actuation sled is configured to move along a length of the staple cartridge assembly to sequentially engage the plurality of pushers to eject the plurality of staples through respective plurality of retention slots. The actuation sled includes a first knife blade. The surgical buttress material is configured to be supported on a tissue-facing surface of the staple cartridge assembly. The tie string includes opposite ends fixedly attached to opposing sides of the staple cartridge assembly. The fixation button is configured to be received within a cavity of the staple cartridge assembly such that a portion of the binding thread is retained within the cavity for being severed by a first knife blade of the actuating sled as the actuating sled advances distally.

[0006] In one embodiment, the staple cartridge assembly can further define opposed lateral grooves configured to securely receive opposite ends of each of the binding threads.

[0007] In another embodiment, the locking button can define opposed circumferential grooves that mate with respective opposed lateral grooves of the staple cartridge assembly.

[0008] In yet another embodiment, the locking button can define a notch configured to receive a first knife blade of the actuation sled therethrough.

[0009] In yet another embodiment, a portion of the binding threads can be disposed perpendicular to a central longitudinal axis defined by the staple cartridge assembly.

[0010] In yet another embodiment, the fixation button can include an engagement portion defining a transverse groove configured to support a portion of the binding thread within the cavity.

[0011] In one embodiment, a staple cartridge assembly can include opposing lateral guides configured to receive surgical buttress material between the opposing lateral guides.

[0012] In another embodiment, the staple cartridge assembly can further define a central longitudinal slot in communication with the cavity.

[0013] In one embodiment, a central longitudinal slot can extend through the cavity.

[0014] In another embodiment, the actuation sled can further include a second knife blade configured to extend through the central longitudinal slot to cut surgical buttress material and tissue in overlapping relationship with the tissue-facing surface of the staple cartridge assembly.

[0015] In yet another embodiment, the surgical buttress material can have a distal portion that includes a notch that coincides with a distal portion of the central longitudinal slot.

[0016] In yet another embodiment, the cavity of the staple cartridge assembly can be defined in a distal portion of the staple cartridge assembly.

[0017] According to another embodiment of the present disclosure, an end effector for use with a surgical stapler includes an anvil assembly and a staple cartridge assembly movable between an approximated position and a spaced position relative to the anvil assembly. The cartridge assembly defines a plurality of retention slots and a lateral slot. The cartridge assembly includes a plurality of staples, a plurality of pushers, an actuation sled, a surgical buttress material, a tie string, and a slider cam. The plurality of staples are disposed within respective retention slots. The plurality of pushers are configured to eject the plurality of staples through respective retention slots. The actuation sled is configured to move along a length of the staple cartridge assembly to engage the plurality of pushers to eject the plurality of staples through respective retention slots. The surgical buttress material is configured to be supported on a tissue-facing surface of the staple cartridge assembly. The tie string includes opposite ends fixedly attached to opposite sides of the staple cartridge assembly. The slider cam is configured to be slidably received within the lateral slot. The slider cam includes an engagement portion configured to engage the actuation sled such that axial displacement of the actuation sled causes lateral movement of the slider cam that in turn releases one of the opposing ends of the binding thread from a corresponding lateral groove of the staple cartridge assembly.

[0018] In one embodiment, the engagement portion can have an arcuate or tapered profile.

[0019] In another embodiment, the slider cam may further include a side portion having a flat surface configured to engage one of the opposing ends of the binding thread.

[0020] In yet another embodiment, the slider cam can include a body portion including side portions and fingers flexibly extending distally from the body portion.

[0021] In yet another embodiment, the lateral slot can include a first stop configured to engage a portion of the finger to limit lateral displacement of the slider cam.

[0022] In yet another embodiment, the finger can include a hook portion configured to engage a first stop of the lateral slot.

[0023] In one embodiment, the staple cartridge assembly can define a central longitudinal slot extending along the length of the staple cartridge assembly.

[0024] In another embodiment, the side slot of the staple cartridge assembly can further include a second stop configured to limit lateral displacement of the slider cam toward the central longitudinal slot.

[0025] In one embodiment, the slider cams can be disposed laterally inwardly on either end of the binding thread.

[0026] In another embodiment, the surgical buttress material can define opposing notches configured to mate with respective opposing lateral grooves of the staple cartridge assembly.

[0027] In yet another embodiment, the staple cartridge assembly can include opposing lateral guides configured to receive surgical buttress material therebetween.

[0028] In yet another embodiment, the surgical buttress material may include stepped portions configured to engage respective opposing lateral guides.

[0029] In still yet another embodiment, the staple cartridge assembly can further include a hook member extending from the tissue-facing surface.

[0030] In one embodiment, the surgical buttress material may define a notch.

[0031] In another embodiment, the hook members can be configured to be received through notches in the surgical buttress material to secure the surgical buttress material to the staple cartridge assembly.

[0032] In yet another embodiment, the actuation sled can also include a knife blade configured to extend through the central longitudinal slot to cut surgical buttress material and tissue in overlapping relationship with the tissue-facing surface of the staple cartridge assembly.

[0033] In yet another embodiment, both ends of the binding thread can be frictionally secured within respective opposing lateral grooves of the staple cartridge assembly.

[0034] According to yet another embodiment of the present disclosure, an end effector for use with a surgical stapler includes an anvil assembly and a staple cartridge assembly movable between an approximated position and a spaced position relative to the anvil assembly. The cartridge assembly defines a plurality of retention slots and a lifting slot. The cartridge assembly includes a plurality of staples, a plurality of pushers, an actuation sled, a surgical buttress material, a tie string, and a lifting member. The plurality of staples are disposed within the respective plurality of retention slots. The plurality of pushers are configured to eject the plurality of staples through the respective plurality of retention slots. The actuation sled is configured to move along a length of the staple cartridge assembly to engage the plurality of pushers to eject the plurality of staples through the respective plurality of retention slots. The surgical buttress material is configured to be supported on a tissue-facing surface of the staple cartridge assembly. The tie string includes opposite ends fixedly attached to opposing sides of the staple cartridge assembly to releasably secure the surgical buttress material to the tissue-facing surface. The lifting member is configured to extend through the lifting slot to urge the binding threads away from the surgical buttress material to release the surgical buttress material from the staple cartridge assembly.

[0035] In one embodiment, the lifting member can be coupled to one of the pushers.

[0036] In another embodiment, the lifting member can be coupled to a distal-most pusher of the plurality of pushers.

[0037] In yet another embodiment, the staple cartridge assembly can define opposing lateral grooves configured to secure respective ends of the binding thread.

[0038] In yet another embodiment, one of the opposing side grooves can be adjacent to the lifting slot such that a portion of the binding thread extends across the lifting slot.

[0039] In one embodiment, the binding threads can be flexible.

[0040] In another embodiment, the staple cartridge assembly can include opposing lateral guides configured to receive surgical buttress material therebetween.

[0041] In yet another embodiment, the surgical buttress material may define a notch.

[0042] In yet another embodiment, the staple cartridge assembly can include a hook member extending from a tissue-facing surface of the staple cartridge assembly configured to be received through a notch in the surgical buttress material to secure the surgical buttress material to the staple cartridge assembly. For example, the present application provides the following: (Item 1) 1. An end effector for use with a surgical stapler, comprising: an anvil assembly; a staple cartridge assembly movable between an approximated position and a spaced position relative to the anvil assembly, the staple cartridge assembly defining a plurality of retention slots and cavities, the staple cartridge assembly comprising: a plurality of staples disposed within each of the plurality of retention slots; a plurality of pushers configured to eject the plurality of staples through respective ones of the plurality of retention slots; an actuation sled configured to move along a length of the staple cartridge assembly to sequentially engage the plurality of pushers to eject the plurality of staples through respective one of the plurality of retention slots, the actuation sled including a first knife blade; a surgical buttress material configured to be supported on a tissue-facing surface of the staple cartridge assembly; and a binding thread including opposite ends fixedly attached to opposite sides of the staple cartridge assembly; and a locking button configured to be received within the cavity of the staple cartridge assembly such that a portion of the coupling thread is retained within the cavity to be severed by the first knife blade of the actuation sled as the actuation sled advances distally. (Item 2) The end effector of the preceding item, wherein the staple cartridge assembly further defines opposed lateral grooves configured to fixedly receive the opposite ends of each of the binding threads. (Item 3) The end effector of any one of the preceding claims, wherein the locking button defines opposing circumferential grooves that mate with the opposing lateral grooves of each of the staple cartridge assemblies. (Item 4) 20. The end effector of claim 1, wherein the locking button defines a notch configured to receive the first knife blade of the actuation sled therethrough. (Item 5) The end effector of any one of the preceding items, wherein the portion of the binding thread is arranged perpendicular to a central longitudinal axis defined by the staple cartridge assembly. (Item 6) The end effector of any one of the preceding claims, wherein the fixation button includes an engagement portion defining a transverse groove configured to support the portion of the binding thread within the cavity. (Item 7) 20. The end effector of claim 19, wherein the staple cartridge assembly includes opposing lateral guides configured to receive the surgical buttress material therebetween. (Item 8) The end effector of any one of the preceding items, wherein the staple cartridge assembly further defines a central longitudinal slot in communication with the cavity. (Item 9) 2. The end effector of claim 1, wherein the central longitudinal slot extends through the cavity. (Item 10) 13. The end effector of claim 12, wherein the actuation sled further comprises a second knife blade configured to extend through the central longitudinal slot to cut the surgical buttress material and tissue in overlapping relationship with the tissue-facing surface of the staple cartridge assembly. (Item 11) 2. The end effector of claim 1, wherein the surgical buttress material has a distal portion including a notch that coincides with a distal portion of the central longitudinal slot. (Item 12) The end effector of any one of the preceding items, wherein the cavity of the staple cartridge assembly is defined in a distal portion of the staple cartridge assembly. (Item 13) 1. An end effector for use with a surgical stapler, comprising: an anvil assembly; a staple cartridge assembly movable between an approximated position and a spaced position relative to the anvil assembly, the cartridge assembly defining a plurality of retention slots and lateral slots, the cartridge assembly comprising: a plurality of staples disposed within each of the plurality of retention slots; a plurality of pushers configured to eject the plurality of staples through respective ones of the plurality of retention slots; an actuation sled configured to move along a length of the staple cartridge assembly to engage the plurality of pushers to eject the plurality of staples through respective one of the plurality of retention slots; a surgical buttress material configured to be supported on a tissue-facing surface of the staple cartridge assembly; and a binding thread including opposite ends fixedly attached to opposite sides of the staple cartridge assembly; and a slider cam configured to be slidably received within the side slot, the slider cam including an engagement portion configured to engage the actuation sled such that axial displacement of the actuation sled causes lateral movement of the slider cam which in turn releases one of the opposing ends of the coupling thread from the corresponding side groove of the staple cartridge assembly. (Item 14) The end effector of the preceding item, wherein the engagement portion has an arcuate or tapered profile. (Item 15) The end effector of any one of the preceding claims, wherein the slider cam further includes a side portion having a flat surface configured to engage with the one end of the coupling thread. (Item 16) 2. The end effector of claim 1, wherein the slider cam includes a body portion including the side portions and fingers flexibly extending distally from the body portion. (Item 17) 2. The end effector of claim 1, wherein the lateral slot includes a first stop configured to engage a portion of the finger to limit lateral displacement of the slider cam. (Item 18) 2. The end effector of claim 1, wherein the finger includes a hook portion configured to engage the first stop of the lateral slot. (Item 19) The end effector of any one of the preceding items, wherein the staple cartridge assembly defines a central longitudinal slot extending along the length of the staple cartridge assembly. (Item 20) The end effector of any one of the preceding items, wherein the lateral slot of the staple cartridge assembly further includes a second stop configured to limit lateral displacement of the slider cam toward the central longitudinal slot. (Item 21) The end effector according to any one of the preceding items, wherein the slider cam is arranged laterally inwardly of both ends of the connecting thread. (Item 22) 20. The end effector of claim 19, wherein the surgical buttress material defines opposing notches configured to mate with the opposing lateral grooves of each of the staple cartridge assemblies. (Item 23) 20. The end effector of claim 19, wherein the staple cartridge assembly includes opposing lateral guides configured to receive the surgical buttress material therebetween. (Item 24) 20. The end effector of claim 19, wherein the surgical buttress material includes a stepped portion configured to engage each of the opposing lateral guides. (Item 25) The end effector of any one of the preceding items, wherein the staple cartridge assembly further includes a hook member extending from the tissue-facing surface. (Item 26) 2. The end effector of claim 1, wherein the surgical buttress material defines a notch. (Item 27) 20. The end effector of claim 19, wherein the hook member is configured to be received through the notch in the surgical buttress material to secure the surgical buttress material to the staple cartridge assembly. (Item 28) 13. The end effector of claim 12, wherein the actuation sled includes a knife blade configured to extend through the central longitudinal slot to cut the surgical buttress material and tissue in overlapping relationship with the tissue-facing surface of the staple cartridge assembly. (Item 29) The end effector of any one of the preceding items, wherein the opposite ends of the binding thread are frictionally secured within the opposing lateral grooves of each of the staple cartridge assemblies. (Item 30) 1. An end effector for use with a surgical stapler, comprising: an anvil assembly; a staple cartridge assembly movable between an approximated position and a spaced position relative to the anvil assembly, the cartridge assembly defining a plurality of retention slots and lift slots, the cartridge assembly comprising: a plurality of staples disposed within each of the plurality of retention slots; a plurality of pushers configured to eject the plurality of staples through respective ones of the plurality of retention slots; an actuation sled configured to move along a length of the staple cartridge assembly to engage the plurality of pushers to eject the plurality of staples through respective one of the plurality of retention slots; a surgical buttress material configured to be supported on a tissue-facing surface of the staple cartridge assembly; and a tie thread including opposite ends fixedly attached to opposite sides of the staple cartridge assembly so as to releasably secure the surgical buttress material to the tissue-facing surface; and a lifting member configured to extend through the lifting slot to urge the tie threads away from the surgical buttress material to release the surgical buttress material from the staple cartridge assembly. (Item 31) The end effector described in the preceding item, wherein the lifting member is coupled to one of the plurality of pushers. (Item 32) 2. The end effector of claim 1, wherein the lifting member is coupled to a distal-most pusher of the plurality of pushers. (Item 33) The end effector of any one of the preceding items, wherein the staple cartridge assembly defines opposed lateral grooves configured to secure respective ends of the binding thread. (Item 34) 2. The end effector of claim 1, wherein one of the opposing side grooves is adjacent to the lifting slot such that a portion of the binding thread extends across the lifting slot. (Item 35) 2. The end effector of claim 1, wherein the binding thread is flexible. (Item 36) 20. The end effector of claim 19, wherein the staple cartridge assembly includes opposing lateral guides configured to receive the surgical buttress material therebetween. (Item 37) 2. The end effector of claim 1, wherein the surgical buttress material defines a notch. (Item 38) 13. The end effector of claim 12, wherein the staple cartridge assembly includes a hook member extending from the tissue-facing surface of the staple cartridge assembly, the hook member configured to be received through the notch in the surgical buttress material to secure the surgical buttress material to the staple cartridge assembly. (Summary) An end effector for use with a surgical stapler includes a staple cartridge assembly movable relative to an anvil assembly. The staple cartridge assembly defines a plurality of retention slots and a cavity. The staple cartridge assembly includes a plurality of staples, a plurality of pushers, an actuation sled, a surgical buttress material, a tie thread, and a locking button. The actuation sled is configured to move along a length of the staple cartridge assembly to sequentially engage the plurality of pushers to eject the plurality of staples through respective retention slots. The locking button is configured to be received within the cavity of the staple cartridge assembly such that a portion of the tie thread is retained within the cavity for severing by a knife blade of the actuation sled as the actuation sled advances distally. [Brief description of the drawings]

[0043] The above and other aspects, features, and advantages of the present disclosure will become apparent in light of the following detailed description taken in conjunction with the accompanying drawings, which are incorporated in and constitute a part of this specification.

[0044] [Figure 1] FIG. 1 is a perspective view of a surgical stapler having a surgical buttress material attached thereto in accordance with an embodiment of the present disclosure; [Diagram 2] 2 is a perspective view of an end effector of the surgical stapler of FIG. 1; FIG. [Diagram 3] FIG. 2 is an exploded perspective view, with parts separated, of a tool portion of the end effector of FIG. 1; [Figure 4]FIG. 2 is a perspective view of a staple cartridge assembly of the end effector of FIG. 1 illustrating a surgical buttress material removably secured thereto; [Diagram 5] FIG. 5 is an enlarged view of the indicated area of ​​detail of FIG. 4. [Figure 6] 5 is an enlarged view of the indicated area of ​​detail of FIG. 3 illustrating the actuation sled of the staple cartridge assembly of FIG. 4; [Figure 7] 5 is an enlarged view of the indicated area of ​​detail of FIG. 3 illustrating the locking button of the staple cartridge assembly of FIG. 4; [Figure 8] 8 is a cross-sectional view of the staple cartridge assembly of FIG. 4 taken along section line 8-8 of FIG. 4. [Figure 9] 9 is an enlarged view of the indicated area of ​​detail of FIG. 8 illustrating the placement of a locking button in conjunction with the staple cartridge assembly of FIG. 8; [Figure 10] 9 is an enlarged view of the indicated area of ​​detail of FIG. 8 illustrating the placement of a locking button in conjunction with the staple cartridge assembly of FIG. 8; [Figure 11] 11 is a cross-sectional view of the staple cartridge assembly of FIG. 5 taken along section line 11-11 of FIG. 5. [Figure 12] 12 is a cross-sectional view of the staple cartridge assembly of FIG. 11 taken along section line 12-12 of FIG. 11 illustrating severing of the binding threads; [Figure 13] FIG. 9 is a partial perspective view of the staple cartridge assembly of FIG. 8 illustrating severing of the binding thread; [Figure 14] 2 is a perspective view of tissue stapled and severed by the surgical stapler of FIG. 1; [Figure 15] 12 is a perspective view of a staple cartridge assembly for use with the surgical stapler of FIG. 1 in accordance with another embodiment of the present disclosure; FIG. [Figure 16] FIG. 16 is an enlarged view of the indicated area of ​​detail of FIG. 15. [Figure 17]FIG. 16 is a perspective view of the staple cartridge assembly of FIG. 15 with the surgical buttress material separated therefrom; [Figure 18] FIG. 18 is an enlarged view of the indicated area of ​​detail of FIG. 17 illustrating the slider cam of the staple cartridge assembly of FIG. 15; [Figure 19] 19 is a cross-sectional view of the staple cartridge assembly of FIG. 15 taken along section line 19-19 of FIG. 15; [Figure 20] FIG. 20 is an enlarged view of the indicated area of ​​detail of FIG. 19. [Figure 21] 21 is a cross-sectional view of the surgical cartridge assembly of FIG. 20 taken along section line 21-21 of FIG. 20. [Figure 22] FIG. 20 is a partial cross-sectional view of the surgical cartridge assembly of FIG. 19 illustrating the slider cam in a laterally displaced position. [Diagram 23] 23 is a cross-sectional view of the surgical cartridge assembly of FIG. 22 taken along section line 23-23 of FIG. 22. [Figure 24] FIG. 16 is a partial perspective view of the surgical cartridge assembly of FIG. 15 illustrating severing of the connecting thread. [Diagram 25] 12 is a perspective view of a staple cartridge assembly for use with the surgical stapler of FIG. 1 in accordance with yet another embodiment of the present disclosure; FIG. [Figure 26] FIG. 26 is an enlarged view of the indicated area of ​​detail of FIG. 25. [Figure 27] FIG. 26 is a perspective view of a staple pusher and staples of the staple cartridge assembly of FIG. 25; [Figure 28] FIG. 28 is a partial top view of the staple cartridge assembly of FIG. 25 illustrating the staple pusher of FIG. 27 shown in phantom lines. [Figure 29] 29 is a cross-sectional view of the staple cartridge assembly of FIG. 28 taken along section line 29-29 of FIG. 28; [Diagram 30] FIG. 30 is a cross-sectional view of the staple cartridge assembly of FIG. 29 illustrating actuation of the lifting member; [Diagram 31] FIG. 26 is a partial perspective view of the staple cartridge assembly of FIG. 25 illustrating actuation of the lifting member; DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0045] Embodiments of the present disclosure will now be described in detail with reference to the drawings in which like reference numerals identify similar or identical elements. Throughout this description, the term "proximal" refers to a portion of a structure or its component that is closer to a user, and the term "distal" refers to a portion of a structure or its component that is farther from a user. Directional reference terms such as "upper", "lower", "side", etc. are used to facilitate the description of the embodiments and are not intended to have a limiting effect on the final orientation of a structure or any portion thereof. In the following description, well-known functions or configurations have not been described in detail to avoid obscuring the present disclosure in unnecessary detail.

[0046] 1-3, an exemplary surgical stapler 1 in the form of a linear surgical stapler is shown for use in fastening tissue with staples and applying surgical buttress material 100 to tissue. The surgical stapler 1 generally includes a handle assembly 10, an elongated tubular body portion 20 extending distally from the handle assembly 10, and an end effector 30 extending distally from the elongated tubular body portion 20. The end effector 30 includes an anvil assembly 40 and a staple cartridge assembly 50. The end effector 30 may be permanently attached or removably coupled to the elongated tubular body portion 20 and thus may be replaceable with a new end effector 30. The anvil assembly 40 and / or the staple cartridge assembly 50 may be pivotable relative to one another such that the anvil 40 and / or the staple cartridge assembly 50 are movable between an open position in which the anvil 40 and the staple cartridge assembly 50 are spaced apart from one another and an approximated position in which the anvil 40 and the staple cartridge assembly 50 are substantially adjacent one another. The handle assembly 10 includes an actuation button 12 configured to actuate an electric motor (not shown) operably associated with the actuation sled 66, for example, to eject staples 58 out of the staple cartridge assembly 50, as well as an opening button 14 and an approximation button 16 configured to actuate electric motors (not shown) operably associated with the anvil 40 and / or the staple cartridge assembly 50, for example, to transition the anvil 40 and / or the staple cartridge assembly 50 between the open and approximated positions.

[0047] For a detailed description of the structure and function of an exemplary surgical stapler, reference may be made to U.S. Patent Nos. 8,256,656, 7,819,896, and 7,128,253, each of which is incorporated herein by reference in its entirety. It should be appreciated that the principles of the present disclosure are equally applicable to surgical staplers having other configurations, such as the types described in U.S. Patent Nos. 7,334,717, 5,964,394, and 5,915,616, each of which is incorporated herein by reference in its entirety. It should therefore be understood that a variety of surgical staplers may be utilized.

[0048] 2, anvil assembly 40 includes an anvil plate (not shown) having a central longitudinal slot formed therein, and a cover plate 44 secured over the anvil plate such that the cover plate 44 defines a top or outward facing surface 46 of the anvil assembly 40. The anvil plate can include a plurality of staples that form pockets / cavities (not shown) defined within the anvil plate's inward, or tissue-facing, surface (not shown).

[0049] 3, staple cartridge assembly 50 includes cartridge carrier 52 defining an elongated support channel 51 configured and dimensioned to selectively receive staple cartridge 54 therein. Cartridge carrier 52 also defines a lower or outwardly facing surface 53 of staple cartridge assembly 50. The staple cartridge 54 is removable and replaceable within cartridge carrier 52. Staple cartridge 54 includes a body portion 54a and a cover 54b. The body portion 54a defines a staple pocket or retention slot 55 for receiving a plurality of fasteners or staples 58 and a staple pusher 60 therein. Staples 58 are of a conventional type and include a backspan having a pair of legs extending therefrom. The legs terminate in tissue-piercing tips. Staple pusher 60 is disposed within each staple pocket 55 and positioned between the staples 58 and the path of an actuation sled 66. A central longitudinal slot 57 is defined along the length of staple cartridge 54 for passage therethrough of first knife blade 61 of actuation sled 66 .

[0050] 4 and 5, a cavity 65 (FIG. 3) is defined adjacent a distal portion of the central longitudinal slot 57. The cavity 65 is configured to receive a fixation button 70 for supporting a binding thread 17 that secures the surgical buttress material 100 on the staple cartridge 54, as discussed below. The proximal and distal portions 55a, 55b of the body portion 54a of the staple cartridge 54 are configured to secure respective binding threads 17 thereto, thereby releasably securing the surgical buttress material 100 to the tissue-facing surface 56 (FIG. 3) of the body portion 54. To this end, the proximal portion 55a of the body portion 54a defines a lateral groove 69 configured to securely receive respective end portions of the binding threads 17 therein. For example, the end portions of the binding threads 17 can be secured in the lateral grooves 69 by a friction fit or by the use of an adhesive. Alternatively, the binding threads 17 can be ultrasonically welded to the lateral grooves 69. Additionally, proximal portion 55a of body portion 54a includes a pair of lateral guides 59 extending from tissue-facing surface 56 (FIG. 3). Surgical buttress material 100 is received between lateral guides 59. In this manner, in conjunction with the pair of lateral guides 59, binding threads 17 secure surgical buttress material 100 to proximal portion 55a of body portion 54a.

[0051] 4 and 5, the surgical buttress material 100 is further secured to the staple cartridge 54 by another binding thread 17 within the distal portion 55b of the body portion 54b. While the present disclosure discloses two binding threads 17 for securing each of the proximal and distal portions 102a, 102b of the surgical buttress material 100 to the body portion 54b, it is contemplated that any number of binding threads 17 may be utilized to effectuate securing the surgical buttress material 100 to the staple cartridge 54. The distal portion 55b of the body portion 54b of the staple cartridge 54 defines opposed lateral grooves 69 (only one shown) configured to securely receive respective end portions of the binding threads 17. The binding threads 17 secured in the opposed lateral grooves 69 are used to secure the distal end 102b of the surgical buttress material 100 to the distal portion 55b of the staple cartridge 54.

[0052] 6-10, to enhance the fastening and detachment of the surgical buttress material 100 to and from the staple cartridge 54, a fixation button 70 is disposed in a cavity 65 of the body portion 54a of the staple cartridge 54. The cavity 65 is defined within the distal portion 55b of the staple cartridge 54. In particular, a central longitudinal slot 57 extends through the cavity 65. The fixation button 70 includes a first finger 72 and a second finger 74 configured to flex relative to one another. The fixation button 70 includes an engagement portion 75 disposed between the first finger 72 and the second finger 74 for supporting a portion of the binding thread 17 thereon. The fixation button 70 defines opposed circumferential grooves 76a, 76b configured to receive the binding thread 17 therein. Additionally, the lock button 70 defines a notch 73 extending through the first finger 72 and the second finger 74. The notch 73 is configured to receive the second knife blade 62 of the actuation sled 66 therethrough. Under such configuration, as the actuation sled 66 advances, the second knife blade 62 of the actuation sled 66 extends through the notch 73 and severs a portion of the tie thread 17 extending across the notch 73. The first finger 72 and at least one of the second fingers 74 of the lock button 70 further define a notch 77 configured to engage a stop 67 ( FIG. 9 ) extending inwardly into the cavity 65 of the staple cartridge 54. Under such configuration, when the locking button 70 is pushed into the cavity 65 in the direction of arrow "L" (FIG. 9), the stop 67 engages the notch 77 and the stop 67 prevents the locking button 70 from being pulled back in the opposite direction of the arrow "L" such that the locking button 70 remains within the cavity 65 disposed therein.

[0053] 11, both ends of the binding thread 17 are secured in respective lateral grooves 69 (FIG. 5) in the distal portion 55b of the staple cartridge 54, and a portion of the binding thread 17 is retained within the cavity 65 of the staple cartridge 54 by a locking button 70. Under such configuration, the portion of the binding thread 17 extends between the first finger 72 and the second finger 74 and across a notch 73 (FIG. 6) to be severed by the second knife blade 62 of the actuating sled 66 advancing through the notch 73.

[0054] 6, the actuation sled 66 includes a camming wedge 68 configured to sequentially engage the staple pusher 60 (FIG. 3), a first knife blade 61 configured to be received through a central longitudinal slot 57 to sever tissue and surgical buttress material 100, and a second knife blade 62 configured to be received through a notch 73 (FIG. 7) in the locking button 70. During operation of the surgical stapler 1, the actuation sled 66 translates through the staple cartridge 54, advancing the camming wedge 68 into sequential contact with the staple pusher 60, moving the staple pusher 60 vertically within the staple pockets 55 and ejecting the staples 58 out of the staple pockets 55 toward the tissue-facing surface of the anvil plate (not shown) of the anvil assembly 40. Additionally, the second knife blade 62 is configured to sever the binding threads 17 positioned against the locking button 70, as will be discussed below.

[0055] Referring to FIG. 11 , initially, the staple cartridge 54 is loaded into the cartridge carrier 52 (FIG. 3). The surgical buttress material 100 may be removably secured to the staple cartridge 54 at any time before or after loading the staple cartridge 54 into the cartridge carrier 52. The surgical buttress material 100 is fabricated from biocompatible materials that are bioabsorbable or non-absorbable, natural or synthetic. It is understood that any combination of natural, synthetic, bioabsorbable, and / or non-bioabsorbable materials may be used to form the surgical buttress material 100. The surgical buttress material 100 may be biodegradable (e.g., formed from bioabsorbable and bioresorbable materials) such that the surgical buttress material 100 degrades or breaks down (physically or chemically) under physiological conditions within the body, and the degradation products are excretable or absorbable by the body. The components or portions of the surgical buttress material 100 may be formed from the same or different materials. The entire surgical buttress material 100 may be formed (e.g., cut) from a single sheet of material, or may be formed from multiple sheets of material that are manufactured from the same or different materials and attached to one another, for example, by welding, the use of adhesives, tying binding threads, etc.

[0056] In some embodiments, at least a portion of the surgical buttress material 100 is made from a biodegradable material selected from the following groups: natural collagen-forming materials, catgut, and synthetic resins, including biodegradable materials derived from alkylene carbonates, trimethylene carbonate, cyclobutane carbonate, caprolactone, valerolactone, dioxanone, polyanhydrides, polyesters, polyacrylates, polymethylmethacrylate, polyurethanes, glycolic acid, lactic acid, glycolide, lactide, polyhydric butyrates, polyorthoesters, polyhydric alkanoates, homopolymers thereof, and copolymers thereof. In some embodiments, at least a portion of the surgical buttress material 100 is made from a non-biodegradable material selected from the following group: polyolefins, polyethylene, polydimethylsiloxane, polypropylene, copolymers of polyethylene and polypropylene, blends of polyethylene and polypropylene, ultra-high molecular weight polyethylene, polyamide, polyesters, polyethylene terephthalate, polytetrafluoroethylene, polyether-esters, polybutaesters, polytetramethylene ether glycol, 1,4-butanediol, and polyurethane.

[0057] The surgical buttress material 100 may be porous, non-porous, or a combination thereof. Suitable porous structures include, for example, fibrous structures (e.g., knitted, woven, and non-woven structures) and / or foams (e.g., open or closed cell foams). Suitable non-porous structures include, for example, films. The surgical buttress material 100, or portions thereof, may be a meltblown or meltspun nonwoven structure, a mesh material, a braided material, and / or a molded or extruded sheet. The surgical buttress material 100, or portions thereof, may be a single porous or non-porous layer, or may include multiple layers, including any combination of porous and / or non-porous layers.

[0058] In use, the loaded surgical stapler 1 is introduced into a surgical site, for example, via a trocar or other access device. Tissue may be grasped between the anvil assembly 40 and the staple cartridge assembly 50 by pressing the closure button 16 of the handle assembly 10. Once the anvil 40 and staple cartridge assembly 50 are clamped onto the tissue, the clinician may press the actuation button 12 to initiate the stapling process, thereby advancing the actuation sled 66. As the actuation sled 66 advances distally, urging the staple pushers 60 upward against the backspan of the staples 58, the staples 58 are expelled out of the staple pockets 55 and penetrate the surgical buttress material 100 as well as the captured tissue, thereby stapling the surgical buttress material 100 to the tissue. The tissue-penetrating tips of the staples 58 are bent within staple-tip bending pockets in the anvil assembly 40, thereby securing the surgical buttress material 100 mounted on the tissue-facing surface 56 against the tissue.

[0059] As the surgical stapler 1 is actuated, a first knife blade 61 associated with the surgical stapler 1 and carried by the actuation sled 66 enters the notches 104 in the surgical buttress material 100 and severs the tissue between the rows of bent-tip staples, as well as the surgical buttress material 100 on the tissue. The resulting tissue is divided and stapled with staples 58.

[0060] 12-14 , as the actuation sled 66 advances further, the first knife blade 61 severs through the tie threads 17 securing the surgical buttress material 100 to the proximal portion 55a of the staple cartridge 54. As the actuation sled 66 reaches the distal portion 55b of the staple cartridge 54, the second knife blade 62 of the actuation sled 66 extends through the notch 73 of the fixation button 70 and severs the portion of the tie threads 17 extending therein, thereby severing the tie threads 17 securing the surgical buttress material 100 to the distal portion 55b of the staple cartridge 54. In this manner, the surgical buttress material 100 is detachable from the staple cartridge 54 and is divided into a first portion 132 and a second portion 134. At this time, the clinician can move the end effector 30 and / or the actuation sled 66 proximally to remove the surgical buttress material 100 that has been stapled to the tissue from the end effector 30. In this manner, the surgical buttress material 100 can be stapled to the tissue, thereby sealing and reinforcing the staple line created by the staples.

[0061] The spent staple cartridge 54 may then be removed and a new staple cartridge 54 and new surgical buttress material 100 may be loaded onto the staple carrier 52. Reloading of removable and replaceable staple cartridges is disclosed in U.S. Patent No. 9,016,539, the disclosure of which is incorporated herein by reference.

[0062] 15-17, another embodiment of a staple cartridge for use with a surgical stapler (FIG. 1) is shown as staple cartridge 154. Parts of staple cartridge 154 that are substantially similar to parts of staple cartridge 54 (FIG. 3) are not described herein to avoid obscuring the present disclosure in unnecessary detail. Staple cartridge 154 may be removably secured to cartridge carrier 52 (FIG. 1) by, for example, a snap fit or an interference fit. Staple cartridge 154 is configured to removably secure surgical buttress material 200 thereto. In particular, proximal portion 154a of staple cartridge 154 includes opposed lateral guides 159 configured to receive surgical buttress material 200 therebetween and a hook portion 190 configured to secure proximal portion 202 of surgical buttress material 200 thereto, as discussed below. Additionally, distal portion 154b of staple cartridge 154 defines opposed lateral grooves 169 for securing respective end portions of binding threads 17 therein, and a slot 163 configured to receive a slider cam 170 therein, as described hereinafter, to thereby detach surgical buttress material 200 from staple cartridge 154.

[0063] The surgical buttress material 200 includes a proximal portion 202 including a stepped portion 206 configured to engage the lateral guides 159 of the staple cartridge 154 and defines a cavity 209 configured to engage and receive the hook portion 190 of the staple cartridge 154. The hook portion 190 may include a tapered portion 192 configured to enhance fixation of the surgical buttress material 200 with the staple cartridge 154. The distal portion 204 of the surgical buttress material 200 defines opposed lateral notches 205 configured to facilitate engagement with the binding threads 17. The distal portion 154b of the staple cartridge 154 defines lateral grooves 169 configured to secure respective end portions of the binding threads 17. In addition, the distal portion 154b of the staple cartridge 154 further defines a slot 163 dimensioned to receive a slider cam 170 slidably received therein.

[0064] 19 and 20, the slider cam 170 is laterally slidable within the slot 163. With particular reference to FIG. 18, the slider cam 170 includes a body 171 having an engagement surface 172 configured to engage a portion of the coupling thread 17 secured in a corresponding lateral groove 169 to disengage the coupling thread 17 from the corresponding lateral groove 169. The slider cam 170 further includes an inner portion 177 extending inwardly from the body 171 and a finger 174 extending distally from the body 171. The inner portion 177 has an arcuate or tapered surface 178 configured to engage a portion of the actuation sled 166. The finger 174 is spaced from the body 171 such that the finger 174 is configured to move toward and away from the body 171. In one embodiment, the fingers 174 are biased away from the body 171 such that the slider cam 170 moves laterally outward and the hook portions 174a of the fingers 174 engage the outer stops 157a of the support members 151 (FIG. 20) of the staple cartridge 154 to limit the lateral displacement of the slider cam 170. In this manner, the slider cam 170 can move laterally outward a predetermined amount. For example, the slider cam 170 can be displaced laterally outward a predetermined amount to displace the binding threads 17 out of the corresponding lateral grooves 169 of the staple cartridge 154.

[0065] 20-22, the slider cam 170 is disposed toward the inside of the end portions of the binding threads 17 secured within respective lateral grooves 169 (FIG. 16) of the staple cartridge 154. Initially, the inner portion 177 (FIG. 18) of the slider cam 170 is disposed to substantially coincide with the central longitudinal slot 157 (FIG. 20). The finger 174 extends upwardly from the plane defined by the body 171 and the inner portion 177 such that the finger 174 engages the inner stop 157b to limit displacement toward the central longitudinal slot 157. Under such configuration, the slider cam 170 is slidable between a first position in which the inner portion 177 is substantially aligned with the central longitudinal slot 157 (FIG. 20) and a second position in which the engagement surface 172 (FIG. 18) of the body 171 is substantially flush with the lateral surface of the staple cartridge 154 (FIG. 22).

[0066] 20-24, initially, slider cam 170 is disposed inwardly of the end portions of tie threads 17 securing distal portion 204 (FIG. 17) of surgical buttress material 200 to staple cartridge 154, such that the end portions of tie threads 17 are fixedly disposed within respective lateral grooves 169 (FIG. 16) of staple cartridge 154. As actuation sled 166 advances distally, elongated engagement portion 179 of actuation sled 166 engages arcuate or tapered surface 178 of inner portion 177 (FIG. 16) of slider cam 170, which in turn move slider cam 170 laterally outwardly in the direction of arrow "O" until hook portions 174a of fingers 174 engage outer stops 157a. Lateral outward displacement of slider cam 170 urges a corresponding end portion of binding thread 17 out of corresponding lateral groove 169. In this manner, one end of binding thread 17 is released from staple cartridge 154, thereby enabling removal of surgical buttress material 200 from staple cartridge 154. The method and use of staple cartridge 154 is substantially similar to the method and use of staple cartridge 54 described above, and therefore will not be described herein.

[0067] 25-31, yet another embodiment of a staple cartridge for use with a surgical stapler (FIG. 1) is shown as staple cartridge 254. Parts of staple cartridge 254 that are substantially similar to parts of staple cartridges 54 (FIG. 3), 154 (FIG. 15) will not be described herein to avoid obscuring the present disclosure in unnecessary detail. Staple cartridge 254 may be removably secured to cartridge carrier 52 (FIG. 1) by, for example, a snap or interference fit. Staple cartridge 254 defines a staple retention slot 255 (FIG. 31) for receiving therein a plurality of fasteners or staples 58 (FIG. 3), and a staple pusher 60 (FIG. 3). A central longitudinal slot 257 (FIG. 3) is defined along a substantial length of staple cartridge 254 to facilitate passage therethrough of first knife blade 61 (FIG. 6) of actuation sled 66. In particular, proximal portion 255a and distal portion 255b of staple cartridge 254 are configured to releasably secure surgical buttress material 300 to staple cartridge 254. Proximal portion 255a of staple cartridge 254 includes a pair of lateral guides 259 extending from tissue-facing surface 256. Surgical buttress material 300 is received between lateral guides 259. Additionally, proximal portion 255a of staple cartridge 254 includes a hook portion 290 that includes a tapered surface 292 configured to engage a cavity 304 defined in proximal portion 300a of surgical buttress material 300.

[0068] Distal portion 255b of staple cartridge 254 defines opposed lateral grooves 269 configured to receive respective end portions of binding threads 17 for securing surgical buttress material 300 to staple cartridge 254. In addition, distal portion 255b further defines a pair of opposed slots 271 configured to receive respective lifting members 263 ( FIG. 27 ). Under such configuration, a portion of surgical buttress material 300 is interposed between the opposed slots 271. Lifting members 263 may be disposed on respective distal-most pushers 260. In one embodiment, lifting members 263 and distal-most pushers 260 may be formed as a unitary structure.

[0069] A portion of surgical buttress material 300 is interposed between slots 271 such that when respective end portions of binding threads 17 are secured in lateral grooves 269, binding threads 17 extend over opposing slots 271. Under such configuration, binding threads 17 secure surgical buttress material 300 to distal portion 255b of staple cartridge 254.

[0070] 30 and 31 , as lifting members 263 extend out of their respective slots 271, lifting members 263 urge binding threads 17 away from surgical buttress material 300, for example, toward anvil assembly 40, such that surgical buttress material 300 can be released from staple cartridge 254. In one embodiment, binding threads 17 may be flexible.

[0071] During operation of the surgical stapler 1, the actuation sled 66 translates through the staple cartridge 254, advancing the cam wedges 68 of the actuation sled 66 into sequential contact with the staple pushers 260, which causes the staple pushers 60 to move vertically within the staple pockets 255 and urge the staples 58 from the staple pockets 255 towards the anvil assembly 40. In addition, the lifting members 263 extend outwardly from their respective slots 271 (FIG. 26) to release the surgical buttress material 300 from the staple cartridge 254. The method and use of the staple cartridge 254 is substantially similar to the method and use of the staple cartridges 54, 154 described above and therefore will not be described herein.

[0072] Although several embodiments of the present disclosure are shown in the drawings, the present disclosure is not intended to be limited to these embodiments, since the present disclosure should be as broad as the art will permit, and it is intended that the specification be read in the same manner. Therefore, it should be understood that the present disclosure is not limited to the exact embodiments described, and various other changes and modifications can be made by those skilled in the art without departing from the scope or spirit of the present disclosure. Also, the components and features shown and described in connection with a specific embodiment can be combined with the components and features of certain other embodiments without departing from the scope of the present disclosure, and such modifications and variations are also included within the scope of the present disclosure. Therefore, the above description should not be construed as limiting, but merely as an illustration of preferred embodiments. Therefore, the scope of the embodiments should be determined by the appended claims and their legal equivalents, rather than by the examples given.

Claims

1. An end effector for use with a surgical stapler, said end effector comprising: a staple cartridge assembly including an actuation sled configured for axial displacement, said staple cartridge assembly defining a lateral slot, said staple cartridge assembly including a first stop; a binding thread including a first end and a second end removably secured to respective sides of the staple cartridge assembly; Buttress Assembly and Equipped with The buttress assembly includes: a surgical buttress material configured to be supported on a tissue-facing surface of the staple cartridge assembly; and a slider cam slidably received within the side slot of the staple cartridge assembly; Including, the slider cam is configured to engage the actuation sled such that when the actuation sled is advanced while engaged with the slider cam, the slider cam is displaced laterally and, in turn, releases the first end of the binding thread from a corresponding side of the staple cartridge assembly; The slider cam includes: a side portion having a planar surface configured to engage the first end of the binder thread; a body portion including the side portions; a finger flexibly extending distally from said body portion; Including, The first stop of the staple cartridge assembly engages a portion of the finger to limit lateral displacement of the slider cam, an end effector.

2. An end effector as described in claim 1, wherein the slider cam includes an arcuate surface configured to engage the actuation sled.

3. An end effector as described in claim 1, wherein the finger includes a hook portion configured to engage the first stop portion.

4. An end effector as described in claim 1, wherein the slider cam is positioned laterally inward of the first end and the second end of the connecting thread.

5. An end effector as described in claim 1, wherein the surgical buttress material defines a plurality of opposing notches for receiving the connecting threads, thereby enhancing fixation of the surgical buttress material to the staple cartridge assembly.

6. An end effector for use with a surgical stapler, comprising: a staple cartridge assembly including an actuation sled configured for axial displacement, said staple cartridge assembly defining lateral slots, said staple cartridge assembly defining a central longitudinal slot extending along a length of said staple cartridge assembly; a binding thread including a first end and a second end removably secured to respective sides of the staple cartridge assembly; Buttress Assembly and Equipped with The buttress assembly includes: a surgical buttress material configured to be supported on a tissue-facing surface of the staple cartridge assembly; and a slider cam slidably received within the side slot of the staple cartridge assembly; Including, the slider cam is configured to engage the actuation sled such that when the actuation sled is advanced while engaged with the slider cam, the slider cam is displaced laterally and, in turn, releases the first end of the binding thread from a corresponding side of the staple cartridge assembly; the lateral slots of the staple cartridge assembly further include stops configured to limit lateral displacement of the slider cam toward the central longitudinal slot.

7. An end effector for use with a surgical stapler, comprising: an anvil assembly; a staple cartridge assembly movable between an approximated position and a spaced position relative to the anvil assembly, the staple cartridge assembly defining a plurality of retention slots and lateral slots, the staple cartridge assembly defining a tissue-facing surface, the staple cartridge assembly including hook members extending from the tissue-facing surface; Equipped with The staple cartridge assembly includes: a plurality of staples disposed in each of the plurality of retention slots; a plurality of pushers configured to eject the plurality of staples through the plurality of respective retention slots; an actuation sled movable along a length of the staple cartridge assembly to engage the plurality of pushers to eject the plurality of staples through the plurality of respective retention slots; a binding thread including opposite ends releasably secured to respective sides of the staple cartridge assembly; Buttress Assembly and Including, The buttress assembly includes: a surgical buttress material configured to be supported on the tissue-facing surface of the staple cartridge assembly; and a slider cam slidably received within said lateral slot; Including, The slider cam is configured to engage the actuation sled, such that as the actuation sled is advanced, the actuation sled displaces the slider cam laterally outwardly and then pushes one of the ends of the binding thread through a corresponding side of the staple cartridge assembly, an end effector.

8. An end effector as described in claim 7, wherein the slider cam includes an engagement portion having a tapered contour.

9. An end effector as described in claim 7, wherein the slider cam is positioned laterally inward on both ends of the connecting thread.

10. An end effector as described in claim 7, wherein the surgical buttress material defines a plurality of opposing notches for receiving the bonding threads.

11. An end effector as described in claim 10, wherein the staple cartridge assembly defines a plurality of opposing lateral grooves that coincide with the respective opposing notches in the surgical buttress material.

12. An end effector as described in claim 11, wherein both ends of the connecting thread are frictionally secured in each of the plurality of lateral grooves of the staple cartridge assembly.

13. An end effector as described in claim 7, wherein the staple cartridge assembly includes a plurality of opposing lateral guides configured to receive the surgical buttress material between the plurality of opposing lateral guides.

14. The end effector of claim 13, wherein the surgical buttress material includes a stepped portion configured to engage with each of the plurality of opposing lateral guides.

15. An end effector as described in claim 7, wherein a proximal portion of the surgical buttress material defines a cavity for receiving the hook member of the staple cartridge assembly to secure the surgical buttress material to the staple cartridge assembly.

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