A tissue thickness compensator may generally comprise a first layer comprising a first biocompatible material sealingly enclosed in a water impermeable material and a second layer comprising a second biocompatible material comprising at least one encapsulation, wherein the first biocompatible material expands when contacted with a fluid. The tissue thickness compensator may comprise a haemostatic agent, an anti-inflammatory agent, an antibiotic agent, anti-microbial agent, an anti-adhesion agent, an anti-coagulant agent, a medicament, and/or pharmaceutically active agent. The encapsulation may comprise a biodegradable material to degrade in vivo and/or in situ. The tissue thickness compensator may comprise a hydrogel. The reaction product may comprise a fluid-swellable composition. Articles of manufacture comprising the tissue thickness compensator and methods of making and using the tissue thickness compensator are also described.

An anastomotic coupler is provided. A ring forms an aperture operable to receive a tubular structure. The ring can include a plurality of receiving portions. A fixation device includes a housing and a cartridge. The cartridge includes a plurality of fasteners, and the housing is operable to receive the tubular structure such that the cartridge is inserted into a lumen of the tubular structure. The ring is aligned with the cartridge such that the receiving portions are aligned with the fasteners. Upon actuation of the fixation device, the fasteners puncture the tubular structure radially outward from the lumen and are received by the receiving portions such that the tubular structure is coupled with the ring.

An extraocular muscle clip (22) for correcting strabismus includes upper and lower plates (24, 26) which are couplable together to sandwich and grasp extraocular muscle (42). A delivery tool (50) delivers the clip (22) and includes a shaft (52) and a muscle hook (56) that is slidable underneath the extraocular muscle (42) to position the lower plate (26) of the clip (22) underneath the muscle (42). An integrated blade (60) of the tool (50) cuts the extraocular muscle (42) subsequently to grasping of the muscle (42) by the upper and lower plates (24, 26) of the clip (22). One or more sutures (30) are coupled to the upper plate (24) and/or the lower plate (26) of the clip (22) and facilitate recoupling of the extraocular muscle (42) to a globe of the eye (40) following cutting of the extraocular muscle (42). Other embodiments are also described.

A surgical stapler including an anvil, a staple cartridge, and a buttress material removably retained to the anvil and/or staple cartridge. In various embodiments, the staple cartridge can include at least one staple removably stored therein which can, when deployed, or fired, therefrom, contact the buttress material and remove the buttress material from the anvil and/or staple cartridge. In at least one embodiment, the anvil can include at least one lip and/or groove configured to removably retain the buttress material to the anvil until deformable members extending from the surgical staple are bent by the anvil and are directed toward and contact the buttress material.

Abdominal approximation devices and methods are described where one variation of the tissue securement assembly may generally include a fixation member having a length, a thickness control securement member which is adjustably securable along the length, and a frame which is adjustably securable to the thickness control securement member. The frame may have a relaxed configuration and a biasing configuration which imparts a biasing force against the thickness control securement member when in the biasing configuration such that the biasing force is applied at a distance from tissue to be approximated via the fixation member.

A piece of buttress material and an end-effector of a surgical instrument including features which can aid a surgeon in properly and quickly attaching the piece of buttress material to the end-effector. In various embodiments, a piece of buttress material can include retention features which can be engaged with portions of an end-effector to releasably retain the piece of buttress material to at least a portion of the end-effector. Similarly, an end-effector can include features configured to engage portions of a piece of buttress material to releasably retain the piece of buttress material to the end-effector. In at least one embodiment, more than one piece of buttress material can be releasably retained to an end-effector.

Disclosed are embodiments of a method for occluding a left atrial appendage (LAA) and other cavities or openings within a body. Some embodiments of the method can include an implant configured to be deployed within the LAA or other cavity, configured to be expanded or moved against a wall portion of the LAA or other cavity, and configured to twist at least a portion of the LAA or other cavity when the implant is rotated. Thereafter, one or more securing elements, staples, sutures, or other fasteners can be implanted in the gathered tissue to hold the tissue in the gathered state, thereby occluding the opening of the LAA or other cavity. In some embodiments, the opening of the LAA or other cavity can be occluded by elongating or otherwise reshaping the opening using an implant device, and securing the opening in the occluded state.

A tissue thickness compensator may generally comprise a first layer comprising a first biocompatible material sealingly enclosed in a water impermeable material and a second layer comprising a second biocompatible material comprising at least one encapsulation, wherein the first biocompatible material expands when contacted with a fluid. The tissue thickness compensator may comprise a haemostatic agent, an anti-inflammatory agent, an antibiotic agent, anti-microbial agent, an anti-adhesion agent, an anti-coagulant agent, a medicament, and/or pharmaceutically active agent. The encapsulation may comprise a biodegradable material to degrade in vivo and/or in situ. The tissue thickness compensator may comprise a hydrogel. The reaction product may comprise a fluid-swellable composition. Articles of manufacture comprising the tissue thickness compensator and methods of making and using the tissue thickness compensator are also described.

An end effector for use with a surgical instrument is disclosed. The end effector comprises a shaft defining a longitudinal axis, a first jaw, a second jaw movable relative to the first jaw, a closure member configured to move the second jaw relative to the first jaw, a slot, a first pin, and a second pin. The first jaw comprises a tissue-contacting surface. The first pin is engaged between the first jaw and the second jaw. The closure member is configured to move the first pin to apply a closing force to the second jaw. The second pin extends into the slot. The second jaw is rotatable relative to the first jaw about the second pin. The first pin and the second pin comprise a clamped configuration where the first pin and the second pin are aligned along the longitudinal axis.

Methods and devices for temporarily occluding blood vessels are provided for use in emergency conditions to control trauma-induced hemorrhaging.