# US 2017/0281177 A1 · Surgical stapling system configured to apply annular rows of staples having different heights

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- Number: US 2017/0281177 A1
- Document ID: US20170281177A1
- Status: Published application
- Kind: A1
- Application number: 15/089,253
- Filed: 2016-04-01
- Published: 2017-10-05
- Earliest claimed: 2016-04-01
- Assignees: Ethicon Endo-Surgery, Inc.
- Applicants: Ethicon Endo-Surgery, LLC
- Inventors: Jason L. Harris; Frederick E. Shelton, IV; Anil K. Nalagatla; Thomas E. Adams; Christopher C. Miller
- Web page: https://patentgrep.com/patent/US20170281177A1

## CPC

- A61B 17/07207: {the staples being applied sequentially}
- A61B 17/0644: {penetrating the tissue, deformable to closed position}
- A61B 17/068: Surgical staplers {, e.g. containing multiple staples or clamps}({staplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105;} for performing anastomosis A61B17/115; {staplers in general B25C5/00})
- A61B 17/0686: {having a forming anvil staying below the tissue during stapling}
- A61B 17/072: for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B 17/105: {Wound clamp magazines (for packaging sharps A61B50/3001)}
- A61B 17/1155: {Circular staplers comprising a plurality of staples}
- A61B 17/07292: {Reinforcements for staple line, e.g. pledgets}
- A61B 2017/00017: {Electrical control of surgical instruments}
- A61B 2017/00115: {with audible or visual output}
- A61B 2017/00367: {Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like}
- A61B 2017/0038: {Simultaneous actuation of two tools by pushing one button or the like}
- A61B 2017/00393: {with means for switching between functions}
- A61B 2017/00398: {using powered actuators, e.g. stepper motors, solenoids}
- A61B 2017/00407: {Ratchet means}
- A61B 2017/00424: {ergonomic, e.g. fitting in fist}
- A61B 2017/0046: {with a releasable handle; with handle and operating part separable}
- A61B 2017/00464: {for use with different instruments}
- A61B 2017/00473: {Distal part, e.g. tip or head (A61B2017/00464 takes precedence)}
- A61B 2017/00477: {Coupling (A61B2017/0046 takes precedence)}
- A61B 2017/00734: {battery operated}
- A61B 2017/07221: {curved}
- A61B 2017/07228: {Arrangement of the staples}
- A61B 2017/07235: {containing different staples, e.g. staples of different shapes, sizes or materials}
- A61B 2017/07242: {achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes}
- A61B 2017/0725: {with settable gap between anvil and cartridge, e.g. for different staple heights at different shots}
- A61B 2017/07264: {characterised by its staple forming cavities, e.g. geometry or material}
- A61B 2017/07271: {characterised by its cartridge}
- A61B 2017/07278: {characterised by its sled or its staple holder}
- A61B 2017/07285: {characterised by its cutter}
- A61B 2017/2903: {transferring rotary motion}
- A61B 2017/2908: {Multiple segments connected by articulations}
- A61B 2017/291: {the position of the handle being adjustable with respect to the shaft}
- A61B 2017/2912: {transmission of forces to actuating rod or piston}
- A61B 2017/2922: {toggle linkages}
- A61B 2017/2923: {Toothed members, e.g. rack and pinion}
- A61B 2017/2927: {the angular position of the head being adjustable with respect to the shaft}
- A61B 2017/293: {with means preventing relative rotation between the shaft and the actuating rod}
- A61B 2017/2932: {Transmission of forces to jaw members}
- A61B 2090/034: {abutting on parts of the device itself}
- A61B 2090/0808: {for indicating correct assembly of components, e.g. of the surgical apparatus}
- A61B 2090/0811: {for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Circular and curved surgical stapling instruments are disclosed comprising circular and curved stapling configurations. A circular staple cartridge comprises a plurality of staples arranged in an inner row, an intermediate row, and an outer row. Staples in certain rows can have different unformed heights. Some arrangements include deck features that protrude from the staple cartridge deck. Various anvil arrangements are also disclosed to attain staples having different formed heights.

## Claims

### Claim 1

A surgical circular stapler, comprising:
a staple cartridge, comprising:
a cartridge body defining an annular deck surface;
a plurality of deck features protruding from said annular deck surface;
an inner annular row of staple cavities in said cartridge body;
at least one first staple positioned within each staple cavity in said inner annular row, wherein each said first staple comprises a first crown and a pair of first legs extending from the first crown and defining a first unformed height;
an outer annular row of staple cavities positioned radially outward with respect to the inner annular row of staple cavities; and
at least one second staple positioned within each staple cavity in said outer annular row, wherein each said second staple comprises a second staple crown and a pair of second legs extending from the second crown and defining a second unformed height that is equal to said first unformed height and wherein said surgical circular stapler further comprises:
an anvil movably supportable relative to said staple cartridge and comprising:
a first staple forming portion located a first forming distance from said annular deck surface; and
a second staple forming portion located a second forming distance from said annular deck surface that differs from said first forming distance.

### Claim 2 (depends on 1)

The surgical circular stapler of claim 1, wherein said second forming distance is greater than said first forming distance.

### Claim 3 (depends on 1)

The surgical circular stapler of claim 1, wherein at least one said second leg of each said second staple has an end portion that extends inwardly toward the other second leg of said second staple.

### Claim 4 (depends on 3)

The surgical circular stapler of claim 3, wherein the second legs of each said second staple each has an inwardly extending end portion.

### Claim 5 (depends on 1)

The surgical circular stapler of claim 1, wherein said deck surface defines a centrally disposed knife opening and wherein said plurality of deck features are located around said centrally disposed knife opening and adjacent thereto.

### Claim 6 (depends on 1)

The surgical circular stapler of claim 1, wherein said plurality of deck features are associated with at least some of the staple cavities in one of the inner annular row and the outer annular row of staple cavities.

### Claim 7 (depends on 6)

The surgical circular stapler of claim 6, wherein said plurality of deck features are associated with every other staple cavity in said annular outer row.

### Claim 8 (depends on 1)

The surgical circular stapler of claim 1, wherein said first and second staples comprise a same diameter.

### Claim 9 (depends on 1)

The surgical circular stapler of claim 1, further comprising an upstanding outer annular rim extending upward from said annular deck surface.

### Claim 10

A surgical staple cartridge for use with a circular stapler, the surgical staple cartridge comprising:
a cartridge body defining an annular deck surface;
a plurality of deck features protruding from said annular deck surface;
an inner annular row of staple cavities in said cartridge body;
at least one first staple positioned within each staple cavity in said inner annular row, wherein each said first staple comprises a first crown and a pair of first legs extending from the first crown and defining a first unformed height;
an outer annular row of staple cavities positioned radially outward with respect to the inner annular row of staple cavities; and
at least one second staple positioned within each staple cavity in said outer annular row, wherein each said second staple comprises a second staple crown and a pair of second legs extending from the second crown and defining a second unformed height that differs from said first unformed height.

### Claim 11 (depends on 10)

The surgical staple cartridge of claim 10, wherein said second unformed height is greater than said first unformed height.

### Claim 12 (depends on 10)

The surgical staple cartridge of claim 10, wherein at least one said second leg of each said second staple has an end portion that extends inwardly toward the other second leg of said second staple.

### Claim 13 (depends on 12)

The surgical staple cartridge of claim 12, wherein the second legs of each said second staple each has an inwardly extending end portion.

### Claim 14 (depends on 10)

The surgical staple cartridge of claim 10, wherein said plurality of deck features are associated with at least some of the staple cavities in at least one of the inner annular row and the outer annular row of staple cavities.

### Claim 15 (depends on 14)

The surgical staple cartridge of claim 14, wherein said plurality of deck features are associated with every staple cavity in said outer annular row.

### Claim 16 (depends on 15)

The surgical staple cartridge of claim 15, wherein said plurality of deck features are associated with every other staple cavity in said inner annular row.

### Claim 17 (depends on 10)

The surgical staple cartridge of claim 10, further comprising:
an intermediate annular row of staple cavities positioned radially outward with respect to the inner annular row of staple cavities and radially inwardly with respect to said outer annular row of staple cavities; and
at least one third staple positioned within each staple cavity in said intermediate annular row, wherein each said third staple comprises a third staple crown and a pair of third legs extending from the third crown and defining a third unformed height that differs from said first and second unformed heights.

### Claim 18 (depends on 17)

The surgical staple cartridge of claim 17, wherein said first unformed height is less than said third unformed height and said second unformed height is greater than said third unformed height.

### Claim 19

A surgical circular stapler, comprising:
a staple cartridge, comprising:
a cartridge body defining an annular deck surface;
an inner annular row of staple cavities in said cartridge body;
at least one first staple positioned within each staple cavity in said inner annular row, wherein each said first staple comprises a first crown and a pair of first legs extending from the first crown and defining a first unformed height;
an intermediate annular row of staple cavities positioned radially outward with respect to the inner annular row of staple cavities; and
at least one second staple positioned within each staple cavity in said intermediate annular row, wherein each said second staple comprises a second staple crown and a pair of second legs extending from the second crown and defining a second unformed height that differs from said first unformed height;
an outer annular row of staple cavities positioned radially outward with respect to the inner annular row of staple cavities, wherein said intermediate annular row of staples cavities is positioned radially inwardly with respect to said outer annular row of staple cavities; and
at least one third staple positioned within each staple cavity in said outer annular row, wherein each said third staple comprises a third staple crown and a pair of third legs extending from the third crown and defining a third unformed height that differs from said second unformed height;
a tissue thickness compensator supported in at least some staple cavities and wherein said surgical circular stapler further comprises:
an anvil movably supportable relative to said staple cartridge and comprising:
a first staple forming portion located a first forming distance from said annular deck surface;
a second staple forming portion located a second forming distance from said annular deck surface that differs from said first forming distance; and
a third staple forming portion located a third forming distance from said annular deck surface that differs from said first and second forming distances.

### Claim 20 (depends on 19)

The surgical circular stapler of claim 19, wherein said first crown defines a first crown width and said second crown defines a second crown width that differs from said first crown width and wherein said third crown defines a third crown width that differs from said first and second crown widths.