A surgical stapling apparatus includes a loading unit, a surgical buttress, and a buttress retention band. The loading unit includes an anvil assembly and a staple cartridge assembly. The staple cartridge assembly includes a staple cartridge having a tissue facing surface including staple pockets and a central longitudinal slot defined therethrough, and a protrusion extending outwardly therefrom. The surgical buttress includes a proximal end portion and a distal end portion. The proximal end portion is positioned over the protrusion of the staple cartridge. The buttress retention band is disposed around the proximal end portion of the surgical buttress and the protrusion of the staple cartridge to releasably secure the proximal end portion of the surgical buttress to the staple cartridge assembly.

In general, adaptive responses from smart packaging of drug delivery absorbable adjuncts and methods of using smart packaging of drug delivery absorbable adjuncts are provided.

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.

Various exemplary devices and methods are provided for performing surgical procedures. In general, one or more adjuncts can be used in conjunction with surgical instruments. The adjunct(s) can have medicant(s) thereon and/or therein. The medicant(s) can vary depending on the desired effect of the medicant(s) on surrounding tissue. As a non-limiting example, medicant(s) can be provided to influence hemostasis, inflammation, macrophages, and/or fibroblasts. When used in conjunction with a surgical stapler, the adjunct(s) can be disposed between and/or on jaws of the stapler, incorporated into a staple cartridge disposed in the jaws, or otherwise placed in proximity to the staples. When staples are deployed, the adjunct(s) can remain at the treatment site with the staples.

An anvil buttress loading system includes an anvil assembly, an anvil buttress loading tool, and an anvil buttress. The anvil buttress is releasably retained on the anvil buttress loading tool with a body of the anvil buttress is positioned on a base of the anvil buttress loading tool, a proximal tab of the anvil buttress positioned over a loading ramp of the anvil buttress loading tool, and a distal tab of the anvil buttress positioned within a flange of the anvil buttress loading tool. The anvil buttress is transferrable from the anvil buttress loading tool to the anvil assembly such that the anvil buttress is releasably secured to the anvil assembly with the body positioned on a tissue facing surface of the anvil assembly, the proximal tab engaged with a pin assembly of the anvil assembly, and the distal tab engaged with an anvil tip of the anvil assembly.

Surgical stapling apparatuses have a buttress attached thereto. The buttress includes an elongate rectangular body having a proximal portion, a distal portion, and opposing lateral sides running along the elongate rectangular body from the proximal portion to the distal portion. The buttress possesses a layer of a therapeutic agent on at least the proximal portion. In embodiments the buttress possesses the therapeutic agent at both the proximal portion and the distal portion.

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 method of applying a buttress to a surgically cut and stapled site uses an end effector with a buttress applier cartridge assembly to load one or more buttress assemblies to the end effector. The buttress assemblies each include a buttress to support a staple formed therein as well an adhesive for adhering to the end effector. The adhesive of the buttress assemblies can include a pattern to assist in both attachment to the end effector and release from the end effector after cutting and stapling a tissue site. The buttress applier cartridge can include features that accommodate end effectors having various tip configurations, including straight tips and curved or bent tips.

A tissue monitoring system includes a sensor, a sensor reader, and at least one computing device. The sensor is releasably coupled to a staple by a tether and is configured to measure a physiological parameter of tissue and convert the measurement into a signal. The sensor reader is configured to receive the signal from the sensor and the at least one computing device is configured to receive the signal from the sensor reader and process the signal into physiological data. The sensor is implanted in tissue by the staple.

The present disclosure includes a surgical buttress or reinforcement for a surgical stapler assembly. The surgical stapler includes an anvil with a tissue contacting surface and a staple cartridge with a tissue contacting surface. The surgical buttress, in either one or two pieces, is releasably secured to the tissue contacting surfaces. The staples are delivered through the surgical buttress to provide a reinforcement for the staples.