Circular stapler including buttress

A surgical stapling device for joining tissue portions includes a handle assembly, and a tubular body portion having a staple cartridge assembly containing a plurality of surgical staples in an annular array. The surgical stapling device includes an anvil assembly having a shaft for removably connecting the anvil assembly to the tubular body portion. The anvil assembly and the tubular body portion are juxtaposed with respect to one another along the shaft and are arranged so as to be approximated with respect to one another. The surgical stapling device includes a buttress material supported by the tubular body portion and disposed between the anvil assembly and the staple cartridge assembly. The surgical stapling device includes a suture material that is adapted for engagement with the tubular body portion and the buttress material to secure the buttress material to the tubular body portion.

BACKGROUND

Technical Field

The present disclosure relates to surgical stapling devices and buttress materials for use with said surgical stapling device and, more particularly, to structures and methods for attaching a buttress material to a surgical stapling device for use in anastomosis procedures.

Background of Related Art

Staples have traditionally been used to replace suturing when joining or anastomosing various body structures such as, for example, the bowel or bronchus. The surgical stapling devices employed to apply these staples are generally designed to simultaneously cut and seal an extended segment of tissue in a patient, thus vastly reducing the time and risks of such procedures.

Linear or annular surgical stapling devices are employed by surgeons to sequentially or simultaneously apply one or more linear rows of surgical fasteners, e.g., staples or two-part fasteners, to body tissue for the purpose of joining segments of body tissue together and/or for the creation of anastomoses. Linear surgical stapling devices generally include a pair of jaws or finger-like structures between which body tissue to be joined is placed. When the surgical stapling device is actuated and/or “fired”, firing bars move longitudinally and contact staple drive members in one of the jaws, and surgical staples are pushed through the body tissue and into/against an anvil in the opposite jaw thereby crimping the staples closed. A knife blade may be provided to cut between the rows/lines of staples. Examples of such surgical stapling devices are described in U.S. Pat. Nos. 4,354,628, 5,014,899 and 5,040,715, the entirety of each of which is incorporated herein by reference.

Annular surgical stapling devices generally include an annular staple cartridge assembly including a plurality of annular rows of staples, typically two, an anvil assembly operatively associated with the annular cartridge assembly, and an annular blade disposed internal of the rows of staples. Examples of such annular surgical stapling devices are described in U.S. Pat. Nos. 5,799,857 and 5,915,616 to Robertson et al., the entirety of each of which is incorporated herein by reference.

In general, an end-to-end anastomosis stapler typically places an array of staples into the approximated sections of a patient's bowels or other tubular organs. The resulting anastomosis contains an inverted section of bowel which contains numerous “B” shaped staples to maintain a secure connection between the approximated sections of bowel.

For most procedures, the use of bare staples, with the staples in direct contact with the patient's tissue, is generally acceptable. The integrity of the tissue will normally serve to prevent the staples from tearing out of the tissue and compromising the sealing before healing has occurred. However, in some surgical operations, surgical supports, e.g., meshes or buttress materials, are employed by surgeons in combination with linear stapling devices to bridge, repair and/or reinforce tissue defects within a patient, especially those occurring in the abdominal wall, chest wall, diaphragm, and other musculo-aponeurotic areas of the body. Examples of suitable surgical supports are disclosed in U.S. Pat. Nos. 3,054,406, 3,124,136, 4,347,847, 4,655,221, 4,838,884, 5,002,551, and 7,942,890, the entirety of each of which is incorporated herein by reference.

When the staples are applied in surgical procedures utilizing surgical supports (i.e., reinforcing material), the legs of the staple typically pass from the cartridge jaw through a layer of the surgical support, and through the patient's tissue before encountering the anvil jaw.

While the surgical supports described above are used in conjunction with linear surgical stapling devices, the need exists for annular support structures for use in conjunction with annular or circular surgical stapling devices, for example, an end-to-end anastomosis stapler such as a Model “EEA™” instrument available from United States Surgical, a Division of Tyco Health-Care Group, LP, Norwalk, Conn. and disclosed in U.S. Pat. No. 5,392,979 to Green et al.

One possible side effect of any end-to-end bowel anastomosis is its tendency to undergo stenosis over time, which can decrease the diameter of the lumen over time. Accordingly, the need exists for an annular surgical structure which operates in conjunction with any end-to-end, annular, or circular anastomosis or stapling device and assists in keeping open the lumen of the anastomosed bowel or other tubular organ over time.

A need also exists for an annular support structure which operates in conjunction with any end-to-end, annular or circular stapling device to reduce the trauma suffered by the patient, reduce the instances of leakage, reduce the instances of bleeding, and create a relatively strong bond between adjacent body tissues.

SUMMARY

In one aspect of the present disclosure, a surgical stapling device for joining tissue portions includes a handle assembly and a tubular body portion supported on a distal end of the handle assembly. The tubular body portion has a staple cartridge assembly containing a plurality of surgical staples in an annular array and includes an inner surface and an outer surface. The surgical stapling device further includes an anvil assembly at a distal end of the surgical stapling device having a shaft for removably connecting the anvil assembly to the tubular body portion. The anvil assembly and the tubular body portion are juxtaposed with respect to one another along the shaft and are arranged so as to be approximated with respect to one another. The surgical stapling device further includes a buttress material supported by the tubular body portion and disposed between the anvil assembly and the staple cartridge assembly. The surgical stapling device further includes a suture material that is adapted for engagement with the tubular body portion and the buttress material to secure the buttress material to the tubular body portion. The suture material defines a first end and a second end.

In another aspect of the present disclosure, a distal portion of the tubular body portion includes at least one hole formed through at least one of the inner and outer surfaces and the suture material is adapted to engage the tubular body portion by insertion of at least one of the first and second ends thereof through the at least one hole.

In another aspect of the present disclosure, the first end of the suture material is inserted through a first hole of the tubular body portion and the second end of the suture material is inserted through a second hole of the tubular body portion.

In another aspect of the present disclosure, withdrawal of the suture material from the first and second holes of the tubular body portion is limited by knotting the first and second ends of the suture material together.

In another aspect of the present disclosure, withdrawal of the suture material from the first and second holes of the tubular body portion is limited by sealing the first and second ends of the suture material together.

In another aspect of the present disclosure, withdrawal of at least one of the first and second ends of the suture material from the at least one hole of the tubular body portion is limited by knotting, heat mushrooming, a stop member or a barb.

In another aspect of the present disclosure, a distal portion of the tubular body portion includes at least one attachment member disposed on at least one of the inner and outer surfaces where the suture material is adapted to engage the tubular body portion by engaging the attachment member.

In another aspect of the present disclosure, the at least one hole of the tubular body portion is filled with a gel.

In another aspect of the present disclosure, at least one of the first and second ends of the suture material includes a stop member adapted to limit removal of the at least one of the first and second ends from the at least one hole of the tubular member when inserted therethrough.

In another aspect of the present disclosure, the other of the first and second ends includes a barb.

In another aspect of the present disclosure, the tubular body portion supports a knife blade that is actuatable upon actuation of the handle assembly, the suture material being severable by the knife blade to release the buttress material during firing of the surgical stapling device.

In another aspect of the present disclosure, a surgical stapling device for joining tissue portions includes a handle assembly and a tubular body portion supported on a distal end of the handle assembly. The tubular body portion has a staple cartridge assembly containing a plurality of surgical staples in an annular array. The surgical stapling device further includes an anvil assembly at a distal end of the surgical stapling device having shaft for removably connecting the anvil assembly to the tubular body portion. The anvil assembly and the tubular body portion are juxtaposed with respect to one another along the shaft and are arranged so as to be approximated with respect to one another. The surgical stapling device further includes a buttress material supported by the anvil assembly and disposed between the anvil assembly and the staple cartridge assembly. The surgical stapling device further includes a suture material extending through the buttress material to engage the anvil assembly and adapted to secure the buttress material to the anvil assembly.

In another aspect of the present disclosure, the buttress material includes a flange on an inner portion thereof. The suture material is threaded through the flange and through a lumen extending through the shaft of the anvil assembly to secure the buttress material to the anvil assembly.

In another aspect of the present disclosure, the suture material is annularly stitched through the buttress material about the shaft of the anvil assembly and is transitionable between a first configuration and a second configuration, the second configuration defining a smaller diameter than the first configuration for securing the buttress material to the shaft of the anvil assembly.

In another aspect of the present disclosure, a method of using a buttress material with a surgical stapling device includes the steps of positioning the buttress material at least partially between an anvil assembly and a cartridge assembly of the surgical stapling device, securing the buttress material to the surgical stapling device by engaging a suture material with the buttress material and engaging the suture material with the surgical stapling device, receiving body tissue between the anvil assembly and the cartridge assembly, grasping the body tissue between the anvil assembly and the cartridge assembly, firing the surgical stapling device to drive a plurality of staples from the cartridge assembly through the buttress material and the body tissue, and releasing the suture material from the surgical stapling device to release the buttress material from the surgical stapling device.

In another aspect of the present disclosure, the step of securing the buttress material to the surgical stapling device includes the step of inserting at least one end of the suture material through at least one hole of one of the anvil assembly and the tubular body portion.

In another aspect of the present disclosure, the step of securing the buttress material to the surgical stapling device includes the step of attaching first and second ends of the suture material together after the first and second ends of the suture material have been inserted through the at least one hole.

In another aspect of the present disclosure, the step of releasing the suture material includes the step of severing the suture material with a knife blade disposed in the tubular body portion and movable relative to the tubular body portion.

In another aspect of the present disclosure, the step of securing the buttress material to the surgical stapling device includes the step of removably attaching the suture material to an attachment member of the surgical stapling device.

In another aspect of the present disclosure, the step of releasing the suture material includes the step of releasing the suture material from the attachment member of the surgical stapling device.

Any of the above aspects of the present disclosure described may be combined with any other aspect of the present disclosure without departing from the scope of the present disclosure.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the presently disclosed annular surgical stapling device will now be described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. As used herein and as is traditional, the term “distal” refers to that portion which is furthest from the user while the term “proximal” refers to that portion which is closest to the user.

Referring initially toFIGS. 1 and 3, an annular surgical stapling device for use with a buttress material is disclosed herein and is generally designated as10. Surgical stapling device10includes a handle assembly12having at least one pivotable actuating handle member14, and an advancing member16. Extending from handle member12, there is provided a tubular body portion100which may be constructed so as to have a curved shape along its length. Body portion100terminates in a staple cartridge assembly102defining an inner surface108and an outer surface110. Staple cartridge assembly102includes at least one annular array of staple receiving slots104disposed at a distal end and a staple116disposed in each of staple receiving slots104. For example, staple cartridge assembly102may include one, two, or more than two annular arrays of staple receiving slots104. Staple receiving slots104extend through a tissue contacting surface106of the distal end of the staple cartridge assembly102.

Staple cartridge assembly102may be fixedly connected to the distal end of tubular body portion100or may be configured to concentrically fit within the distal end of tubular body portion100. Typically, staple cartridge assembly102includes a staple pusher (not shown) including a proximal portion having a generally frusto-conical shape and a distal portion defining two concentric rings of peripherally spaced fingers (not shown), each one of which is received within one of the respective staple receiving slots104.

Typically, a knife118(seeFIG. 8), substantially in the form of an open cup with the rim thereof defining a knife edge, is disposed within staple cartridge assembly102and mounted to a distal surface of a staple pusher (not shown). The knife edge is disposed radially inward of the pair of annular arrays of staples. Accordingly, in use, as the staple pusher is advanced, the knife118is also advanced axially outward.

Positioned distally of staple cartridge assembly102there is provided an anvil assembly200including an anvil member202and a shaft204operatively associated therewith for removably connecting anvil assembly200to a distal end portion of stapling device10. Inner wall108forms an opening112in the distal end of staple cartridge assembly102and tubular body portion100includes a central shaft114extending through opening112for engagement with shaft204of anvil assembly200.

Reference may be made to U.S. Pat. No. 5,915,616 to Viola et al., the entire contents of which are incorporated herein by reference, for a detailed discussion of the construction and operation of annular stapling device10.

Referring now toFIG. 2, a buttress material300is generally annular in shape and includes an inner portion302, a middle portion304, and an outer portion306. A substantially centrally located aperture308, defined by the inner circumference of inner portion302is formed through buttress material300. Buttress material300may be any shape sufficient to provide support for anastomosis of tissue after surgical stapling device10has been fired including, for example, a square, a circle, an oval, a triangle or any other polygonal or other shape.

As illustrated inFIGS. 4A-4C, buttress material300is sized such that when buttress material300is positioned over tissue contacting surface106, inner portion302and outer portion306of buttress material300are substantially axially aligned with inner surface108and outer surface110of staple cartridge assembly102, respectively. Aperture308of buttress material300is sized to at least receive shaft204of anvil assembly200and central shaft114of tubular body portion100therethrough and, in certain embodiments, may be substantially the same size as opening112. It is also contemplated that buttress material300may extend radially beyond inner and outer surfaces108,110, respectively.

Each portion302,304, and306of buttress material300may be fabricated from surgical grade, biocompatible, non-absorbable material (i.e. permanent) or absorbable material (i.e. non-permanent) mesh or material desirably impregnated with an adhesive, sealant and/or other medicament. It is also contemplated that each portion may be a composite of both a non-absorbable and an absorbable material. Suitable materials for the fabrication of buttress material300and suitable adhesives, sealants, and/or medicaments for impregnation in or application to buttress material300may be found, for example, in U.S. Pat. No. 7,942,890, referenced above.

Buttress material300may be secured to staple cartridge assembly102through the use of one or more sutures500, as illustrated inFIGS. 4A-4C, 5A-5D, 6A-6C and 7A-7C. Generally, each suture500includes a leading end502, a trailing end504and a body portion506extending between the leading and trailing ends502,504, as will be described in the embodiments to follow.

Similar to buttress material300, sutures500may be fabricated from surgical grade, biocompatible, non-absorbable material (i.e. permanent) or absorbable material (i.e. non-permanent) or material desirably impregnated with an adhesive, sealant and/or other medicament. It is also contemplated that sutures500may be a composite of both a non-absorbable and an absorbable material. Suitable materials are described above with reference to buttress material300.

In one embodiment, with reference toFIGS. 4A-4C, cartridge assembly102includes a plurality of attachment points400disposed on or about inner and outer surfaces108,110for attaching or securing a length of suture500thereto. Although attachment points400are illustrated as cleats402inFIGS. 4A-4C, attachment points400may also be in the form of buttons, knobs, holes or other similar mechanisms for receiving and securing suture500thereto.

Each cleat402includes an opening or depression404extending into the inner or outer surface108,110of the staple cartridge assembly102defining a substantially arcuate or U-shape profile having a substantially linear distal edge408. Each cleat402includes a tab406extending from the distal edge408into opening404and includes a base portion410and a tip portion412. Tip portion412is dimensioned to allow body portion506of suture500to be inserted between tip portion412and opening404of cleat402. Base portion410forms wedge points414with opening404for securing body portion506of suture500to cleat402. It is contemplated that opening404may define other shapes such as, for example squares, rectangles, triangles, or other shapes suitable for receiving and securing a portion of suture500therein. Although illustrated as being substantially triangular in shape, tab406may alternatively include a rounded tip portion412, a squared off tip portion412, or another suitably shaped tip portion412so long as the portion of suture500is insertable between tip portion412and opening404and securable by wedge points414.

As illustrated inFIGS. 4A-4C, cleats402are disposed on both inner and outer surfaces108,110of staple cartridge assembly102such that one or more lengths of suture500can be alternately secured to cleats402on the inner surface108and the outer surface110of staple cartridge assembly102to secure buttress material300to the tissue contacting surface106of staple cartridge assembly102. For example, a single suture500may be wound through a first of cleats402on the outer surface110of staple cartridge assembly102and then drawn distally over buttress material300to engage buttress material300before being wound through a second of cleats402on the inner surface108of staple cartridge assembly102, thereby securing buttress material300to tissue contacting surface106of staple cartridge assembly102. Each pair of inner and outer cleats402may receive a separate suture500or a single suture500may be wound continuously through each of cleats402. Alternatively a single suture500may be secured to any number of cleats402where, for example, one, two or more sutures500may be included.

The first cleat402on the inner surface108of staple cartridge assembly102and the second cleat402on the outer surface110of staple cartridge assembly102may be substantially radially aligned with respect to one another or may be radially offset with respect to one another (SeeFIGS. 4A-4C), for example, to facilitate weaving suture500between more than one pair of cleats402.

It is contemplated that attachment points400may alternatively be holes (not shown) where, for example, one or more sutures500are inserted through one or more holes on outer surface110, are being wound over buttress material300in a similar manner as described above for cleats402, and are further inserted through holes (not shown) on inner surface120. Suture500may be wound back and forth over buttress material300between the holes (not shown) in outer and inner surfaces110,120to secure buttress material300to staple cartridge assembly102.

Sutures500are configured to break free from staple cartridge assembly102, or to be severed, upon firing of the annular surgical stapling device10to allow buttress material300to separate from tissue contacting surface106of staple cartridge assembly102after anastomosis has occurred. For, example, suture500may be configured to break free upon release of anastomized tissue from between the staple cartridge assembly102and the anvil assembly200or after the firing procedure is complete as the surgical stapling device10is withdrawn from the surgical site.

Suture500may also include weakened portions or sections along body portion506or at leading and trailing ends502,504at which suture500may break or sever upon application of force along its length.

Suture500may also or alternatively, as mentioned above, be configured to be cut or severed by knife118as the knife118is actuated during the firing process where, for example, the portion of suture500disposed radially inward of inner surface108may be severed by knife118during firing of surgical stapling device10. The surgeon may also manipulate suture500to release suture500from staple cartridge assembly102.

In another embodiment, as illustrated inFIGS. 5A-5D and 6A-6Cattachment points1400include openings1404extending through outer surface110of staple cartridge assembly102. In this embodiment, sutures500are inserted through mesh300and through the tissue contacting surface106of staple cartridge assembly102. For example, leading and trailing ends502,504of sutures500are inserted through staple receiving slots104. Sutures500are inserted through staple cartridge assembly102and through openings1404in outer surface110of staple cartridge assembly102. Each of leading and trailing ends502,504of suture500may extend through a different opening1404(SeeFIGS. 5B and 6B) or both of leading and trailing ends502,504may extend through the same opening1404. As illustrated inFIG. 5D, sutures500are drawn through openings1404until body portion506engages buttress material300to secure buttress material300to tissue contacting surface106of staple cartridge assembly102.

As illustrated inFIGS. 5A-5C, each of leading and trailing ends502,504of sutures500are secured in place through the use of knotting, heat mushrooming, buttons, stop members or other similar methods which will limit or prevent leading and trailing ends502,504of sutures500from being withdrawn through openings1404.

Alternatively, as illustrated inFIGS. 6A-6C, leading and trailing ends502,504of sutures500may be joined together through knotting, fusing, or other similar methods of combining or attaching leading and trailing ends502,504of sutures500together to limit or prevent leading and trailing ends502,504of sutures500from being withdrawn through openings1404. It is contemplated that openings1404may alternatively or additionally extend through inner surface108of staple cartridge assembly102.

Sutures500are configured to break free or be severed from staple cartridge assembly102upon firing of the annular surgical stapling device10to allow buttress material300to separate from tissue contacting surface106of staple cartridge assembly102after anastomosis has occurred. For example, as a staple116is driven through one of the staple receiving slots104through which a suture500extends, the staple116may pierce, puncture or otherwise tear the suture500to release buttress material300from staple cartridge assembly102. The suture500may also or alternatively be configured to break upon release of anastomized tissue from between the staple cartridge assembly102and the anvil assembly200or after the firing procedure is complete as the surgical stapling device10is withdrawn from the surgical site. For example, the suture500may include weakened portions or sections along body portion506or at leading and trailing ends502,504of suture500at which suture500may break or sever upon application of force along its length. The surgeon may also manipulate the suture500to release suture500from staple cartridge assembly102. The knife118may also be used to sever a portion of suture500extending through the openings1404in inner surface108of staple cartridge assembly102during firing of surgical stapling device10.

In another embodiment, as illustrated inFIGS. 7A-7C, attachment points2400are openings2404extending through inner surface108of staple cartridge assembly102. In this embodiment, leading end502of suture500includes a barbed tip508such as, for example a unidirectional barb, single barb, composite barb or other suitable barb, and trailing end504of suture500includes a stop member510. Barbed tip508may also extend along at least a portion of body portion506. Stop member510may include a button, knob, or other similar element which is suitable for preventing or limiting advancement of trailing end504through openings2404. Stop member510may also or alternatively be formed by heat mushrooming at trailing end504and may have a transverse dimension that is greater than a transverse dimension of openings2404. Initially leading end502is inserted through a first of openings2404through the tissue contacting surface106of staple cartridge assembly102and through a first portion of the buttress material300until stop member510engages the first of openings2404to limit further advancement of suture500through the first opening2404. Leading end502is then inserted through a second portion of the buttress material300, through tissue contacting surface106, and through a second of openings2404until body portion506engages buttress material300to secure buttress material300to tissue contacting surface106of staple cartridge assembly102. Suture500may also extend through one or more of staple receiving slots104.

In an embodiment, it is contemplated that openings2404may include a silicon or gel like material for engaging barbed tip508to limit withdrawal of suture500from openings2404. Openings2404may also or alternatively extend through outer surface110of staple cartridge assembly102.

As described above, sutures500are configured to break free or be severed from staple cartridge assembly102upon firing of the annular surgical stapling device10. The suture500may also be configured to be cut or severed by the knife118as the knife118is actuated to sever tissue “T” where, for example, one or both of barbed tip508and stop member510may be severed by the knife118during firing of surgical stapling device10. The surgeon may also manipulate the suture500to release suture500from staple cartridge assembly102during or after firing of annular surgical stapling device10.

Turning now toFIGS. 8 and 9, there is illustrated the use of annular surgical stapling device10and detachable anvil assembly200in an anastomosis procedure to effect joining of intestinal sections20and22. The anastomosis procedure is typically performed using minimally invasive surgical techniques including laparoscopic means and instrumentation. At the point in the procedure shown inFIG. 9, a diseased intestinal section has been previously removed, anvil assembly200has been applied to the operative site either through a surgical incision or transanally and positioned within intestinal section22, and tubular body portion100of annular surgical stapling device10has been inserted transanally into intestinal section20. Intestinal sections20and22are also shown temporarily secured about their respective components (e.g., shaft204of anvil assembly200, and the central shaft114of tubular body portion100by a purse-string suture or the like).

According to one method, with reference toFIGS. 4A-4C, 5A-5D, 6A-6C, 7A-7C, and as seen inFIGS. 8 and 9, buttress material300may be positioned and secured to the tissue contacting surface106of tubular body portion100by sutures500prior to the coupling of anvil assembly200to the central shaft114of tubular body portion100. Tubular body portion100may come with buttress material300pre-positioned and secured to tissue contacting surface106by sutures500. Alternatively the surgeon may secure buttress material300to tissue contacting surface106prior to use. With buttress material300secured in place, the surgeon maneuvers anvil assembly200until the proximal end of shaft204is inserted into the central shaft114of tubular body portion100. Central shaft114is now engaged to shaft204with intestinal sections20and22disposed between anvil assembly200and staple cartridge assembly102. As seen inFIG. 9, for example, buttress material300is disposed between cartridge assembly102and intestinal sections20and22.

Anvil assembly200and tubular body portion100are then approximated to approximate intestinal sections20,22and capture buttress material300between intestinal section20and tissue contacting surface106of staple cartridge assembly102. Surgical stapling device10is then fired to staple buttress material300and intestinal sections20,22together and the knife118is actuated to cut the portion of tissue and any portion of buttress material300and any portion of suture500disposed radially inward of knife118or extending across knife118, to complete the anastomosis. The staples116which are driven or fired through staple receiving slots104may sever or break any portion of suture500disposed or extending through staple receiving slots104during the firing process. Once anastomosis is complete anvil assembly200and tubular body portion100are unapproximated to release intestinal sections20,22and buttress material300. Sutures500may break or sever upon release of intestinal sections20,22or as described above, may be released by the surgeon or severed by the knife118.

In another embodiment, referring now toFIGS. 10 and 11, buttress material300may be secured to the anvil assembly200instead of staple cartridge assembly102. In this embodiment, aperture308of buttress material300is dimensioned to receive shaft204of anvil assembly200such that inner portion302of buttress material300abuts or is proximate to shaft204. Buttress material300further includes flanges or tabs310extending from inner portion302of buttress material300with flanges310extending axially from inner portion302of buttress material300along shaft204.

As illustrated inFIG. 10, shaft204includes a lumen206extending therethrough between opposite flanges310of buttress material300. Leading end502of suture500is inserted through a first of flanges310, through lumen206, and through a second of flanges310on an opposite side of shaft204. Similar to the above embodiments, leading and trailing ends502,504of suture500may include buttons, knobs, stop members, barbs or other similar mechanisms for limiting advancement or withdrawal of suture500through flanges310and lumen206. Leading and trailing ends502,504may also be heat mushroomed or sealed after insertion. Additional flanges310and/or lumens206may be included about the circumference of inner portion302of buttress material300and of shaft204respectively to further secure buttress material300to anvil assembly200. Although illustrated as substantially linearly extending through shaft204, lumens206may also or alternatively define arcuate or angled paths through shaft204where, for example, adjacent flanges310may be aligned with a single lumen206instead of opposite flanges310. For example, lumens206may define a ninety degree angle through shaft204or may define a larger or smaller angle through shaft204. Lumen206may also or alternatively define a curved or arcuate path through shaft204. Leading end502of suture500may be inserted through flanges310by piercing flanges310or flanges310may, for example, include one or more holes312for receiving sutures500therethrough.

In another embodiment, as illustrated inFIG. 11, suture500may instead be threaded through flanges310to encircle or surround shaft204and form a purse string. For example, suture500may be annularly stitched through flanges310or buttress300about shaft204of anvil assembly200. The annularly stitched suture500is transitionable between a first configuration defining a first diameter which is larger than the outer diameter of shaft204and a second configuration which is substantially the same as the outer diameter of shaft204. As suture500is transitioned to the second configuration and tightened about shaft204, flanges310press against shaft204to secure buttress material300in place against shaft204. Buttress material300may be released from anvil assembly200in a manner similar to those described above in previous embodiments. Suture500may alternatively be annularly threaded or inserted through inner portion302of buttress material300instead of flanges310.

In both of the above embodiments, buttress material300may be separated from anvil assembly as described above through breakage or slippage. For example, the surgeon may manipulate suture500to release buttress material300or suture500may be adapted or configured to break or sever after firing of surgical stapling device10. Alternatively, during firing, actuation of knife118may sever the portion of buttress material300disposed radially inward of the inner surface108of staple cartridge assembly102, and may sever suture500, from the portion of buttress material300disposed on the staple cartridge assembly102such that only the anastomized portion of buttress material300remains attached to the intestinal sections20,22. In this way the remaining portion of buttress material300remains secured to the anvil assembly200for removal from the patient's body.

Although the illustrative embodiments of the present disclosure have been described herein with reference to the accompanying drawings, the above description, disclosure, and figures should not be construed as limiting, but merely as exemplifications of particular embodiments. It is to be understood, therefore, that the disclosure is not limited to the precise embodiments described herein, 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 present disclosure.