ANVIL BUTTRESS LOADING FOR A SURGICAL STAPLING APPARATUS

Abstract

A buttress attachment assembly includes a buttress and a buttress loader. The buttress includes a buttress body and buttress wings secured to the buttress body. The buttress body defines first openings. The buttress wings define second openings. The buttress loader includes first tabs that are receivable through the first openings of the buttress body and second tabs that are receivable through the second openings defined in the buttress wings. The first and second tabs support the buttress on the buttress loader.

Claims

1-20. (canceled)

21. An anvil buttress attachment assembly of a surgical stapling system, the anvil buttress attachment assembly comprising: an anvil buttress including a buttress body that extends between a proximal end portion and a distal end portion of the anvil buttress, the proximal end portion of the buttress body including buttress wings disposed on opposite sides of the buttress body, the buttress wings configured to fold relative to one another and relative to the buttress body, the buttress wings defining proximal openings, the distal end portion of the buttress body defining distal openings; and an anvil buttress loader configured to load the anvil buttress onto a surgical stapling apparatus of the surgical stapling system, the anvil buttress loader including distal tabs that are receivable through the distal openings of the anvil buttress and proximal tabs that are receivable through the proximal openings defined in the buttress wings, the distal and proximal tabs supporting the anvil buttress on the anvil buttress loader when the anvil buttress is received within the anvil buttress loader.

22. The anvil buttress attachment assembly of claim 21, further comprising a strap that extends between and connects the buttress wings together at a location proximal to the buttress body.

23. The anvil buttress attachment assembly of claim 22, wherein the strap is separated from a proximal end of the buttress body.

24. The anvil buttress attachment assembly of claim 23, further comprising tab openings that extend between outer side surfaces of the buttress body and inner side surfaces of the buttress wings.

25. The anvil buttress attachment assembly of claim 24, wherein the proximal tabs of the anvil buttress loader include upper proximal tabs and lower proximal tabs that are offset from the upper proximal tabs, the upper proximal tabs configured to be received within the proximal openings of the wings, the lower proximal tabs configured to be received within the tab openings between the outer side surfaces of the buttress body and the inner side surfaces of the wings.

26. The anvil buttress attachment assembly of claim 25, wherein the anvil buttress loader includes a loader body that defines a distal buttress opening, the distal tabs extending proximally into the distal buttress opening.

27. The anvil buttress attachment assembly of claim 26, wherein the loader body has a tubular configuration that defines a receiving pocket for supporting the anvil buttress within the loader body.

28. The anvil buttress attachment assembly of claim 21, wherein the distal end portion of the anvil buttress further defines a finger aperture that is configured to secure to the surgical stapling apparatus.

29. The anvil buttress attachment assembly of claim 28, wherein the distal end portion of the anvil buttress includes a distal flap, the distal openings defined through the distal flap at a location distal to the finger aperture.

30. The anvil buttress attachment assembly of claim 29, wherein the distal flap is secured to the distal end portion of the buttress body by a transverse fold segment extending along opposite sides of the finger aperture to enable the distal flap to fold relative to the buttress body for securing the distal tabs of the anvil buttress loader to the distal openings defined in the distal flap of the anvil buttress.

31. A buttress attachment assembly for a surgical system, the buttress attachment assembly comprising: a buttress including a buttress body that extends between a proximal end portion and a distal end portion of the buttress, the proximal end portion of the buttress including buttress wings defining proximal openings, the distal end portion of the buttress defining distal openings; and a buttress loader including distal tabs that are receivable through the distal openings of the buttress and proximal tabs that are receivable through the proximal openings defined in the buttress wings, the distal and proximal tabs supporting the buttress on the buttress loader when the buttress is received within the buttress loader.

32. The buttress attachment assembly of claim 31, further comprising a strap that extends between and connects the buttress wings together at a location proximal to the buttress body.

33. The buttress attachment assembly of claim 32, wherein the strap is separated from a proximal end of the buttress body.

34. The buttress attachment assembly of claim 33, further comprising tab openings that extend between outer side surfaces of the buttress body and inner side surfaces of the buttress wings.

35. The buttress attachment assembly of claim 34, wherein the proximal tabs of the buttress loader include upper proximal tabs and lower proximal tabs that are offset from the upper proximal tabs, the upper proximal tabs configured to be received within the proximal openings of the wings, the lower proximal tabs configured to be received within the tab openings between the outer side surfaces of the buttress body and the inner side surfaces of the wings.

36. The buttress attachment assembly of claim 35, wherein the buttress loader includes a loader body that defines a distal buttress opening, the distal tabs extending proximally into the distal buttress opening.

37. The buttress attachment assembly of claim 36, wherein the loader body has a tubular configuration that defines a receiving pocket for supporting the buttress within the loader body.

38. The buttress attachment assembly of claim 31, wherein the distal end portion of the buttress further defines a finger aperture.

39. The buttress attachment assembly of claim 38, wherein the distal end portion of the buttress includes a distal flap, the distal openings defined through the distal flap at a location distal to the finger aperture.

40. A buttress attachment assembly, comprising: a buttress including a buttress body and buttress wings secured to the buttress body, the buttress body defining first openings, the buttress wings defining second openings; and a buttress loader including first tabs that are receivable through the first openings of the buttress body and second tabs that are receivable through the second openings defined in the buttress wings, the first and second tabs supporting the buttress on the buttress loader.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0018] The above and other aspects, features, and advantages of this disclosure will be apparent in light of the following detailed description when taken in conjunction with the accompanying drawings, which are incorporated in and constitute a part of this specification, wherein:

[0019] FIG. 1 is a perspective view of a surgical stapling apparatus in accordance with the principles of this disclosure;

[0020] FIG. 2 is an enlarged view of the indicated area of detail shown in FIG. 1;

[0021] FIG. 3 is a perspective view of an anvil buttress of the surgical stapling apparatus of FIG. 1;

[0022] FIG. 4 is a top plan view of the anvil buttress of FIG. 3;

[0023] FIG. 5 is a perspective view, with parts separated, of an anvil buttress attachment assembly of a surgical stapling system including the surgical stapling apparatus of FIG. 1, the anvil buttress attachment assembly including the anvil buttress of FIG. 3 and an anvil buttress loader;

[0024] FIG. 6 is a perspective view of the anvil buttress loader of FIG. 5;

[0025] FIG. 7 is an enlarged, perspective view of the anvil buttress attachment assembly of FIG. 5;

[0026] FIG. 8 is an enlarged view of the indicated area of detail shown in FIG. 7;

[0027] FIG. 9 is an enlarged, perspective view of a leading end portion of the anvil buttress loader of FIG. 6;

[0028] FIGS. 10-12 are progressive views illustrating the anvil buttress loading unit of FIG. 5 mounting the anvil buttress thereof on an end effector of the surgical stapling apparatus of FIG. 1;

[0029] FIG. 13 is an enlarged, side view of a portion of the end effector of the surgical stapling apparatus of FIG. 1 with the anvil buttress of FIG. 3 mounted thereon;

[0030] FIGS. 14 and 15 are progressive views of a portion of an end effector of the surgical stapling apparatus of FIG. 1 illustrating the anvil buttress of FIG. 3 being mounted thereon;

[0031] FIG. 16 is an enlarged, side view of a portion of an end effector of the surgical stapling apparatus of FIG. 1 with the anvil buttress of FIG. 3 mounted thereon;

[0032] FIG. 17 is an enlarged, side view of an end effector of the surgical stapling apparatus of FIG. 1 with the anvil buttress of FIG. 3 mounted thereon;

[0033] FIG. 18 is an enlarged, side view of a portion of an end effector of the surgical stapling apparatus of FIG. 1 with the anvil buttress of FIG. 3 mounted thereon;

[0034] FIG. 19 is a perspective view of a portion of an anvil assembly of the end effector of FIG. 18;

[0035] FIG. 20 is an enlarged, side view of a portion of an end effector of the surgical stapling apparatus of FIG. 1 with the anvil buttress of FIG. 3 mounted thereon; and

[0036] FIG. 21 is a side, perspective view of a portion of the end effector of FIG. 20 with the anvil buttress of FIG. 3 mounted thereon.

DETAILED DESCRIPTION

[0037] Aspects of this disclosure will now be described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. Throughout this description, the term “proximal” refers to a portion of a structure, or component thereof, that is closer to a user, and the term “distal” refers to a portion of the structure, or component thereof, that is farther from the user. Directional reference terms, such as “top,” “bottom,” “side,” and the like, are used to ease description of the aspects and are not intended to have any limiting effect on the ultimate orientation of a structure or any part thereof. In the following description, well-known functions or constructions are not described in detail to avoid obscuring this disclosure in unnecessary detail.

[0038] Referring now to FIGS. 1-13, a surgical stapling system, in accordance with this disclosure, includes a surgical stapling apparatus or surgical stapler 10 and an anvil buttress attachment assembly 100 for use in stapling tissue and applying one or more anvil and/or cartridge buttress materials or surgical buttresses 200, 300 to the tissue. The surgical stapling apparatus 10 generally includes a handle assembly 12 and an elongated tubular body portion 14 that extends distally from the handle assembly 12, which may be in the form of an adapter assembly that is selectively removable from handle assembly 12. The elongated tubular body portion 14 may include a surgical loading unit 16 that is selectively attachable to the elongated tubular body portion 14. An end effector or jaw assembly 18 extends distally from the elongated tubular body portion 14 (e.g., a distal end portion of the surgical loading unit 16). The jaw assembly 18 includes an anvil assembly 20 and a staple cartridge assembly 22. The jaw assembly 18 may be permanently affixed to the elongated tubular body portion 14 or may be detachable with respect to the elongated tubular body portion 14 and thus, replaceable with a new jaw assembly 18. The anvil assembly 20 and/or the staple cartridge assembly 22 is pivotable with respect to the elongated tubular body portion 14 such that the anvil and/or staple cartridge assemblies 20, 22 is/are movable between an open position in which the anvil and staple cartridge assemblies 20, 22 are spaced apart with respect to each other (FIG. 2) and a closed position (not shown) in which the anvil and staple cartridge assemblies 20, 22 are substantially adjacent each other.

[0039] The handle assembly 12 of the surgical stapling apparatus 10 includes any number of actuators 12a, 12b, 12c to facilitate a firing of jaw assembly 18, an articulation and/or rotation of the jaw assembly 18 relative to handle assembly 12, and/or an opening and/or closing of anvil and/or cartridge assemblies 20, 22 to clamp tissue therebetween. Jaw assembly 18 is configured to apply lines of staples (not shown) to tissue captured between the anvil and staple cartridge assemblies 20, 22 when fired.

[0040] For a detailed description of the structure and function of exemplary surgical stapling apparatus, one or more components of which may be included, or modified for use with the disclosed aspects, reference may be made to U.S. Pat. Nos. 8,256,656, 7,819,896, and 7,128,253 as well as U.S. Pat. Application Serial No. 16/387,882, filed Apr. 18, 2019, the entire contents of each of which is incorporated herein by reference. It should be appreciated that principles of this disclosure are equally applicable to surgical stapling apparatus having other configurations such as, for example, the types described in U.S. Pat. Nos., 7,334,717, 5,964,394, and 5,915,616, the entire contents of each of which is incorporated herein by reference. Accordingly, it should be understood that a variety of surgical stapling apparatus may be utilized with the surgical buttresses and/or surgical buttress applicators or loaders of this disclosure such as, for example, laparoscopic staplers, open staplers, transverse anastomosis staplers, and end-to-end anastomosis staplers having a circular staple cartridge and anvil, as well as staple cartridge assemblies housing surgical fasteners other than staples.

[0041] As seen in FIGS. 2, 10, 12 and 13, anvil assembly 20 of jaw assembly 18 of surgical stapling apparatus 10 includes an anvil body 20a having a proximal end portion including a tissue stop 20x configured to prevent proximal tissue migration. The tissue stop 20x having a pair of tissue stop wings 20b, 20c that extends outwardly and downwardly from opposite side surfaces of anvil body 20a. The pair of tissue stop wings 20b is positioned to extend over and cover a proximal end portion of staple cartridge assembly 22. Each wing of the pair of tissue stop wings 20b, 20c defines a buttress slot 20d that extends partially therethrough such that buttress slots 20d of the pair of tissue stop wings 20b, 20c may be disposed in mirrored relation with one another. For example, as seen in FIG. 10, buttress slot 20d of wing 20b extends proximally from a distal end face 20e of tissue stop wing 20b. Buttress slot 20d includes a receiving channel 20f for receiving a proximal portion of anvil buttress 200 and a retention cavity 20g that is disposed proximal to, and in registration with, receiving channel 20f for retaining a proximal portion of anvil buttress 200 within retention cavity 20g. A strap lock 20h, in the form of a proximally-extending retention tooth, is disposed between receiving channel 20f and retention cavity 20g to capture anvil buttress 200 within retention cavity 20g.

[0042] Anvil assembly 20 of jaw assembly 18 further includes a distal end portion having a distal finger 20i supported between a pair of buttress stops 20j, 20k. The buttress stops 20j, 20k are disposed proximal to distal finger 20i.

[0043] With reference to FIGS. 3-5, anvil buttress attachment assembly 100 of surgical stapling system includes an anvil buttress 200 and an anvil buttress loader 101 for loading anvil buttress 200 onto surgical stapling apparatus 10. Anvil buttress 200 includes a buttress body 202 having a proximal end portion including a pair of buttress wings 204, 206 disposed on opposite sides of buttress body 202. Wings 204, 206 are coupled to buttress body 202 by wing folding segments 204a, 206a that enable wings 204, 206 to fold toward/away from one another and relative to buttress body 202. Wings 204, 206 define an upper tab opening 208 through a proximal end portion thereof. Wings 204, 206 further include a transverse strap 210 that extends between inner side surfaces of wings 204, 206 to connect wings 204, 206 together. Strap 210 is separated from a proximal end of buttress body 202 and includes strap folding segments 211 on opposite ends thereof that enable wings 204, 206 to fold relative to strap 210 as wings 204, 206 fold relative to buttress body 202. The proximal end portion of buttress body 202 also defines lower tab openings 212 that extend between outer side surfaces of buttress body 202 and the inner side surfaces of wings 204, 206.

[0044] Anvil buttress 200 has a distal end portion defining a finger aperture 214 configured to receive distal finger 20i of anvil assembly 20 therethrough for supporting anvil buttress 200 on anvil assembly 20 of jaw assembly 18. Distal end portion of anvil buttress 200 further includes a distal flap 216 secured to a distal end of anvil buttress 200 by a transverse fold segment 218 extending along opposite sides of finger aperture 214 to enable distal flap 216 to fold relative to buttress body 202. Distal flap 216 defines distal tab apertures 216a, 216b therethrough.

[0045] Referring now to FIGS. 5-9, anvil buttress loader 101 of anvil buttress attachment assembly 100 includes a loader body 102 with a tubular configuration. Loader body 102 defines a receiving pocket 104 therein for supporting anvil buttress 200 and receiving anvil assembly 20 therein. Loader body 102 has a proximal end portion having upper proximal tabs 106 and lower proximal tabs 108 that extend proximally from lower body 102. Loader body 102 includes a distal end portion defining a distal buttress opening 110 through an upper surface of loader body 102. Loader body 102 further includes distal tabs 112 that extend proximally from loader body 102 into distal buttress opening 110.

[0046] With reference to FIGS. 10-12, with anvil buttress 200 mounted to anvil buttress loader 101 (e.g., slip-fit via tabs 106, 108, and 112), anvil buttress loader 101 is advanced over anvil assembly 20 so that strap 208 cams through receiving channel 20f of buttress slot 20d along strap lock 20h until strap 208 of anvil buttress 200 is disposed proximal of strap lock 20h and captured within retention cavity 20g of buttress slot 20d by strap lock 20h so that the proximal end portion of anvil buttress 200 is secured to anvil assembly 20. As strap 210 of anvil buttress 200 cams through buttress slot 20d, distal finger 20i of anvil assembly 20 extends through finger aperture 214 of anvil assembly 20 so that distal flap 216 of anvil buttress 200 abuts against stops 20j, 20k of anvil assembly 20 to secure the distal end portion of anvil buttress 200 to the distal end portion of anvil assembly 20. When anvil buttress 200 is secured to anvil assembly 20, wings 204, 206 and distal flap 216 of anvil buttress 200 remain folded upwardly so that wings 204, 206 and distal flap 216 extend transverse (e.g., perpendicular) to buttress body 202 to facilitate retention of anvil buttress 200 on anvil assembly 20. Once the proximal and distal end portions of anvil buttress 200 are secured to anvil assembly 20, anvil buttress loader 101 can be drawn distally away from anvil assembly 20 so that anvil buttress 200 slides off anvil buttress loader 101 and remains attached to anvil assembly 20. Surgical stapling apparatus 10 can then be used to secure buttress to tissue upon a firing of surgical stapling apparatus 10. As can be appreciated by persons of ordinary skill in the art, a knife assembly (not shown) cuts through strap 210 (and buttress body 202) upon firing of surgical stapling apparatus so that anvil buttress 200 can slide off anvil assembly 20 as surgical stapling apparatus 10 is drawn proximally away from anvil buttress 200.

[0047] Turning now to FIGS. 14 and 15, one aspect of an anvil assembly, generally referred to as anvil assembly 520 includes a strap lock in the form of a leaf spring 522 that is configured to flex, from an initial, unflexed position, to a flexed position as strap 210 cams therealong, as indicated by arrow “A.” Leaf spring 522 is also configured to snap back to the unflexed position, from the flexed position, as indicated by arrows “B” when the strap 210 passes proximally past leaf spring 522 and into retention cavity 20g. Leaf spring 522 can be angled to reduce an amount of bending or flexing thereof for enabling strap 210 to be received within retention cavity 20g.

[0048] As seen in FIGS. 16-19, the leaf spring can be provided in any suitable configuration such as leaf spring 622, leaf spring 722, and leaf spring 822. In aspects, any of these leaf springs can be configured to act like a pawl and can be provided in any suitable arrangement, for example, to enable inward and/or outward flexing of such leaf springs.

[0049] With reference to FIGS. 20 and 21, in some aspects of anvil assembly 20, anvil assembly 20 can include any suitable arrangement of buttress slots such a single buttress slot 900. Buttress slot 900 extends from a bottom surface of one of tissue stop wings 20b through a curvilinear receiving channel 902 that guides strap 210 of anvil buttress 200 upwardly and proximally into retention cavity 904. Buttress slot 900 can be positioned to cause strap 210 to cam and stretch along contours of tissue stop wings 20b, 20c of anvil assembly 20 for guiding strap 210 into buttress slot 900.

[0050] The surgical buttresses of this disclosure may be fabricated from biocompatible materials which are bioabsorbable or non-absorbable, natural or synthetic materials. It should be understood that any combination of natural, synthetic, bioabsorbable, and/or non-bioabsorbable materials may be used to form the surgical buttresses. The surgical buttresses may be biodegradable (e.g., formed from bioabsorbable and bioresorable materials) such that the surgical buttresses decompose or are broken down (physically or chemically) under physiological conditions in the body, and the degradation products are excretable or absorbable by the body. Components or portions of the surgical buttresses may be formed from the same material or different materials.

[0051] In aspects, at least a portion of the surgical buttresses are made from biodegradable materials selected from the following group: natural collagenous materials, cat gut, and synthetic resins including those derived from alkylene carbonates, trimethylene carbonate, tetramethylene carbonate, caprolactone, valerolactone, dioxanone, polyanhydrides, polyesters, polyacrylates, polymethylmethacrylates, polyurethanes, glycolic acid, lactic acid, glycolide, lactide, polyhydroxy butyrates, polyorthoester, polyhydroxy alkanoates, homopolymers thereof, and copolymers thereof. In aspects, at least a portion of the surgical buttresses may be made from non-biodegradable materials selected from the following group: polyolefins, polyethylene, polydimethylsiloxane, polypropylene, copolymers of polyethylene and polypropylene, blends of polyethylene and polypropylene, ultra high molecular weight polyethylene, polyamides, polyesters, polyethylene terephthalate, polytetrafluoroethylene, polyether-esters, polybutester, polytetramethylene ether glycol, 1,4-butanediol, and polyurethanes.

[0052] The surgical buttresses may be porous, non-porous, or combinations thereof. Suitable porous structures include, for example, fibrous structures (e.g., knitted structures, woven structures, and non-woven structures) and/or foams (e.g., open or closed cell foams). Suitable non-porous structures include, for example, films. The surgical buttresses, or portions thereof, may be a non-woven structure formed by melt-blown or melt-spun methods, a mesh material, a braid material, and/or a molded or extruded sheet. The surgical buttresses, or portions thereof, may be a single porous or non-porous layer, or include a plurality of layers including any combination of porous and/or non-porous layers.

[0053] The surgical buttresses may be provided and/or sold as part of the buttress loader and/or loading unit. Alternatively, the surgical buttress(es), the buttress loader, and/or the loading units may be provided and/or sold separately and assembled by the user. In aspects, one or more surgical buttresses, one or more buttress loaders, and/or loading units are provided in a kit. In some aspects, the kit further includes one or more end effectors (and/or surgical loading units) and, in certain aspects, the kit further includes a surgical stapler.

[0054] In any of the aspects disclosed herein, the surgical buttresses can include, or be used with, brachytherapy, chemotherapy, other medical materials or pharmaceuticals. The buttress portion of the surgical buttress can have pockets, apertures, or other features for retaining brachytherapy seeds with the buttress portion, or brachytherapy seeds or materials can be incorporated into a suture or sutures that are threaded into or through the buttress portion or otherwise attached thereto. A coating having brachytherapy materials can be applied to a buttress portion of a surgical buttress by spraying or dipping. Chemotherapy pharmaceuticals or agents can be incorporated into the buttress portion of the surgical buttress, coated thereon, or otherwise applied as part of a suture or other feature secured to the buttress portion.

[0055] As can be appreciated, securement of any of the components of the presently disclosed apparatus can be effectuated using known securement techniques such welding, crimping, gluing, fastening, etc.

[0056] The various aspects disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the clinician and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the clinician during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.

[0057] The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of clinicians may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another clinician (or group of clinicians) remotely controls the instruments via the robotic surgical system. As can be appreciated, a highly skilled clinician may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients. For a detailed description of exemplary medical work stations and/or components thereof, reference may be made to U.S. Pat. No. 8,828,023, and PCT Application Publication No. WO2016/025132, the entire contents of each of which are incorporated by reference herein.

[0058] Persons skilled in the art will understand that the structures and methods specifically described herein and illustrated in the accompanying figures are non-limiting exemplary aspects, and that the description, disclosure, and figures should be construed merely as exemplary of particular aspects. It is to be understood, therefore, that the present disclosure is not limited to the precise aspects described, and that various other changes and modifications may be effected by one skilled in the art without departing from the scope or spirit of the disclosure. Additionally, it is envisioned that the elements and features illustrated or described in connection with one exemplary aspect may be combined with the elements and features of another without departing from the scope of the present disclosure, and that such modifications and variations are also intended to be included within the scope of the present disclosure. Indeed, any combination of any of the presently disclosed elements and features is within the scope of the present disclosure. Accordingly, the subject matter of the present disclosure is not to be limited by what has been particularly shown and described.