In various embodiments, a tissue thickness compensator can comprise a compressible extracellular matrix and a bioabsorbable material dispersed within the extracellular matrix, wherein the bioapsorption of the bioabsorbable material is configured to leave behind channels in the extracellular matrix. The tissue thickness compensator can also comprise generation means for generating the ingrowth of tissue into the channels. In at least one embodiment, the tissue thickness compensator can comprise dissolvable wicking members which, when dissolved, can leave behind channels in the tissue thickness compensator. In certain embodiments, the tissue thickness compensator can comprise at least one rupturable capsule.

A surgical fastener assembly includes one or more arrays of fasteners, each of the fasteners including a head portion opposite to a sharp portion. Each of the head portions of the fasteners is held by a fastener head holding member. A receiver member is aligned with each of the one or more arrays of fasteners. A fluid actuator is provided for each of the one or more arrays of fasteners, and it is contractible and expandable. Each of the fluid actuators is configured to provide a force against its corresponding array of fasteners to propel the sharp portions of the fasteners towards the receiver member and also configured to provide a force to free the head portions from the fastener head holding member.

A surgical stapler, or fastening instrument, may generally comprise a layer, such as a tissue thickness compensator, for example, releasably attached to a fastener cartridge and/or anvil by a flowable attachment portion. The flowable attachment portion may be indefinitely flowable. The flowable attachment portion may be flowable from the time that layer is installed to the fastener cartridge to the time in which the layer is implanted to patient tissue. The flowable attachment portion may comprise a pressure sensitive adhesive. The flowable attachment portion may comprise an adhesive laminate comprising a base layer comprising the tissue thickness compensator and an adhesive layer on at least a portion of a surface of the base layer comprising the pressure sensitive adhesive. Articles of manufacture comprising flowable attachment portion and methods of making and using the flowable attachment portion are also described.

A surgical fastening instrument includes an elongate shaft extending from a handle. An end effector is coupled to one end of the elongate shaft. The end effector has a first jaw with retainer strips disposed thereon. Each retainer strip includes rows of receptacles and each receptacle has a passageway leading to a chamber formed in the first jaw. The end effector also includes a second jaw with fastener strips disposed thereon. The first jaw is pivotally coupled to the second jaw. Each fastener strip includes rows of fasteners and each fastener is slidably positioned on a lance extending from a surface of the second jaw. The lances are aligned with the receptacles and each fastener has barbs configured to be retained in one of the chambers.

The present disclosure relates to a fastener applicator including a handle, a first trigger coupled rotatably with respect to the handle, and a second trigger coupled rotatably with respect to the handle. An interlock is disposed with the second trigger and comprises a cam follower engaged in a cam channel that selectively prevents rotation of the second trigger relative to the first trigger depending on a location of the cam follower within the cam channel. The location of the cam follower in the cam channel is set by a position of the first trigger. Methods of operating the various embodiments disclosed are also provided.

A bio-compatible and bio-resorbable implantable device for repairing soft tissue which has a first plate and a second plate and a plurality of connecting elements for connecting the first and second plates is provided. The first plate has a first surface suitable for being placed on a first side of the soft tissue. The second plate has a second surface suitable for being placed on a second side of the soft tissue. Each connecting element has a first portion integral with the first plate and a second portion integral with the second plate. The connecting elements extend from at least one of the first surface of the first plate and the second surface of the second plate to reach the other one of the first surface of the first plate and second surface of the second plate for locking the first and second plates in a definable respective position.

A system for coupling a tendon to a bone may include a tendon coupling device engageable with a tendon, a fastener to secure the tendon coupling device to the tendon, a bone coupling device, and a flexible element. The flexible element may include a first portion and a second portion. The first portion of the flexible element may be couplable with the fastener to securably attach the flexible element to the tendon. The bone coupling device may include a bone-facing surface engageable with a surface of the bone proximate a bone tunnel formed through the bone, and a hole formed through the bone coupling device. The second portion of the flexible element may be receivable through the bone tunnel and the hole formed through the bone coupling device to engage an opposing surface of the bone coupling device and securably couple the tendon to the bone.

A fastener cartridge can comprise a support portion, a tissue thickness compensator positioned relative to the support portion, and a plurality of fasteners positioned within the support portion and/or the tissue thickness compensator which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein a second jaw, or anvil, can be positioned opposite the first jaw. To deploy the fasteners, a staple-deploying member is advanced through the fastener cartridge to move the fasteners toward the anvil. As the fasteners are deployed, the fasteners can capture at least a portion of the tissue thickness compensator therein along with at least a portion of the tissue being fastened.

A surgical implant for fixing a soft tissue to a bone comprising a staple and a plate. The staple and the plate are positionable on an instrument in such a way that the plate may be manipulated with the instrument to hold the soft tissue against the bone and in such a way that the staple is fixable to the bone with the plate positioned between a bridge of the staple and the soft tissue when legs of the staple are driven through the plate and into the bone.

A stapling assembly comprising a tissue thickness compensator is disclosed. The tissue thickness compensator comprises a body portion comprising a porous material and a plurality of cavities defined in the body portion, wherein the cavities are aligned with forming surfaces of an anvil such that fasteners of a fastener cartridge are configured to at least one of the cavities when the fasteners are ejected from the fastener cartridge or capture the cavities and compress the cavities within the tissue thickness compensator when the fasteners are ejected from the fastener cartridge and formed by forming surfaces of the anvil. The stapling assembly further comprises at least one medicament positioned within each cavity prior to firing the stapler, wherein the medicament is different than the porous material.