Abstract:
A surgical apparatus comprises a surgical staple for treating tissues of a patient in a surgical procedure. The surgical staple is deformable from a first configuration (e.g., an undeployed configuration) to a second configuration (e.g., a deployed configuration) in accordance with embodiments of the present invention. The surgical staple includes a first leg and a second leg, wherein said surgical staple substantially resembles a V-shape or a suture needle in the first configuration and substantially forms a D-shape in the second configuration in accordance with embodiments of the present invention.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This patent application is a continuation application of U.S. patent application Ser. No. 13/746,449 (Attorney Docket No. 360) filed on Jan. 22, 2013, which is a continuation application of U.S. patent application Ser. No. 13/282,759 (Attorney Docket No. 339) filed on Oct. 27, 2011, which is a divisional application of U.S. patent application Ser. No. 12/477,834 (Attorney Docket No. 277) filed on Jun. 3, 2009, now U.S. Pat. No. 8,056,789 that was issued on Nov. 15, 2011. U.S. patent application Ser. No. 13/746,449 (Attorney Docket No. 360) is also continuation application of U.S. patent application Ser. No. 13/090,168 (Attorney Docket No. 321) filed on Apr. 19, 2011, now U.S. Pat. No. 8,365,973 that was issued on Feb. 5, 2013, which is a continuation application of U.S. patent application Ser. No. 12/477,834 filed on Jun. 3, 2009, now U.S. Pat. No. 8,056,789 that was issued on Nov. 15, 2011. The contents of the aforementioned related applications are incorporated herein by reference in their entireties. 
     
    
     FIELD OF THE INVENTION 
       [0002]    The invention generally relates to surgical staplers and stapling. 
       BACKGROUND 
       [0003]    An endocutter is a surgical tool that staples and cuts tissue to transect that tissue while leaving the cut ends hemostatic. An endocutter is small enough in diameter for use in minimally invasive surgery, where access to a surgical site is obtained through a trocar, port, or small incision in the body. A linear cutter is a larger version of an endocutter, and is used to transect portions of the gastrointestinal tract. A typical endocutter receives at its distal end a disposable single-use cartridge with several rows of staples, and includes an anvil opposed to the cartridge. During actuation of an endocutter, the cartridge fires all of the staples that it holds. In order to deploy more staples, the endocutter must be moved away from the surgical site and removed from the patient, after which the old cartridge is exchanged for a new cartridge. The endocutter is then reinserted into the patient. However, it can be difficult and/or time-consuming to located the surgical site after reinsertion. Further, the process of removing the endocutter from the patient after each use, replacing the cartridge, and then finding the surgical site again is tedious, inconvenient and time-consuming, particularly where a surgical procedure requires multiple uses of the endocutter. That inconvenience may discourage surgeons from using the endocutter for procedures in which use of an endocutter may benefit the patient. Similar inconveniences may accompany the use of surgical staplers other than endocutters. 
       SUMMARY OF THE INVENTION 
       [0004]    A surgical apparatus is configured to deploy a surgical staple, wherein the surgical staple is deformable from a first configuration (e.g., an un-deployed configuration) to a second deployed configuration in accordance with embodiments of the present invention. The surgical staple of this surgical apparatus includes a first leg and a second leg, wherein said surgical staple forms a substantially D-shape in said second deployed configuration. 
         [0005]    The surgical apparatus is further configured to include a feeder belt to which at least one end of said first leg of the surgical staple may be frangibly affixed to said feeder belt, whereas one end of said second leg of the staple may be free (e.g., unattached or un-affixed to the feeder belt). 
         [0006]    The surgical apparatus, in said second configuration, the ends of the staple as described may be closer to one another in the second configuration than in the first configuration. 
         [0007]    The surgical apparatus, in said second configuration, the ends of the staple as described may contact one another. 
         [0008]    The surgical apparatus, as deploying the surgical staple, the surgical staple may be plastically deformable from the first configuration to the second configuration. 
         [0009]    The surgical apparatus, in the first configuration of the un-deployed surgical staple, the first leg of the surgical staple may be substantially straight and the second leg of the surgical staple may be at least partially curved. 
         [0010]    The surgical apparatus, in the second deployed configuration, the surgical staple may form a completely closed D-shape. 
         [0011]    The surgical apparatus, in the first configuration (e.g., un-deployed configuration), the surgical staple may be in a generally V-shaped form. 
         [0012]    The surgical apparatus, in the first configuration (e.g., un-deployed configuration), the surgical staple may include a continuously curved segment. 
         [0013]    A surgical apparatus for treating tissue in a surgical procedure comprises a surgical staple that includes a first leg and a second leg, wherein the surgical staple is configured to be deployed by deforming only the second leg. After deployment, the surgical staple substantially resembles a D-shape after the second leg is deformed. 
         [0014]    A surgical apparatus for treating tissue in a surgical procedure comprises a surgical staple that includes a first leg and a second leg, wherein the surgical staple is configured to be deployed from a first configuration substantially resembling a V-shape to a second configuration substantially resembling a D-shape. 
         [0015]    A surgical apparatus for treating tissue in a surgical procedure comprises a surgical staple that includes a first leg and a second leg, wherein the surgical staple is configured to be deployed by deforming the second leg only during deployment from a first configuration to a second configuration. The surgical staple is configured to substantially resemble a V-shape in the first configuration. The surgical staple is configured to substantially resemble a D-shape after deployment in the second configuration. 
         [0016]    A surgical apparatus for treating tissue comprises a surgical staple that includes a first leg and a second leg, wherein deployment of said surgical staple by said surgical apparatus involves deforming only the second leg of said surgical staple. Deployment of said surgical staple by said surgical apparatus involves deforming said staple from a first configuration substantially resembling a V-shape or a suture needle to a second configuration substantially resembling a D-shape. 
         [0017]    A surgical apparatus for treating tissues comprising a surgical staple that includes a first leg and a second leg, wherein deployment of said surgical staple by said surgical apparatus includes deforming said staple from a first configuration to a second configuration, wherein deforming said surgical staple involves only deforming said second leg of said surgical staple. In the first configuration, the first leg of the surgical staple is substantially straight and the second leg of the surgical staple is substantially curved. Furthermore, in the first configuration, the first leg and the second leg of the surgical staple forms s substantially V-shape configuration. Alternatively or similarly, in the first configuration, the first leg and second leg of the surgical staple is in a configuration or shape substantially resembling a suture needle. In the second configuration, the first leg and the second leg of the surgical staple form a substantially D-shape configuration. 
         [0018]    A surgical apparatus for treating tissues comprises a surgical staple that includes a first leg and a second leg, wherein deployment of said surgical staple by said surgical apparatus includes deforming said surgical staple from a first configuration to a second configuration, wherein deforming said surgical staple involves only deforming said second leg of said surgical staple to form a substantially D-shape in said second configuration. In the first configuration, the first leg and the second leg of the surgical staple form a substantially V-shape. In the first configuration, the first leg of the surgical staple is substantially straight and the second leg of the surgical staple is substantially curved. In the second configuration, the first leg of the surgical staple remains substantially straight and the second leg of the surgical staple remains substantially curved. 
         [0019]    A method of treat tissue using an exemplary surgical apparatus, which involves urging a surgical staple into tissue, while the surgical staple is in a first shape, and deforming the surgical staple from the first shape into a second shape that is substantially a D-shaped. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0020]      FIG. 1  is a perspective view of an exemplary feeder belt with staples affixed thereto. 
           [0021]      FIG. 2  is a perspective view of a carrier with staples affixed thereto. 
           [0022]      FIG. 3  is a top view of carriers and staples of  FIG. 2  attached to an exemplary feeder belt. 
           [0023]      FIG. 4  is a perspective view of an exemplary wedge. 
           [0024]      FIG. 5  is a perspective view of another exemplary carrier with staples affixed thereto, prior to deployment. 
           [0025]      FIG. 6  is the perspective view of  FIG. 5 , after deployment. 
           [0026]      FIG. 7  is a side view of an exemplary staple in a first state. 
           [0027]      FIG. 8  is a side view of the exemplary staple of  FIG. 7  in a second state. 
           [0028]      FIG. 9  is a side view of the exemplary staple of  FIG. 7  in a third state. 
           [0029]      FIG. 10  is a side view of the exemplary staple of  FIG. 7  in a fourth, deployed state. 
           [0030]      FIG. 11  is a perspective view of an exemplary feeder belt with groups of staples affixed thereto. 
           [0031]      FIG. 12  is a side view of an exemplary feeder belt from which differently-sized staples extend. 
           [0032]      FIG. 13  is a side view of an exemplary surgical instrument with an anvil and staple holder. 
           [0033]      FIG. 14  is a bottom view of an exemplary anvil. 
           [0034]      FIG. 15  is a side cross-section view of an anvil with non-homogeneous staple pockets defined therein. 
           [0035]      FIG. 16  is a perspective view of a first group of staples extending from a corresponding feeder belt. 
           [0036]      FIG. 17  is a perspective view of a second group of staples extending from the feeder belt of  FIG. 16 . 
           [0037]      FIG. 18  is a perspective view of a third group of staples extending from the feeder belt of  FIG. 16 . 
           [0038]      FIG. 19  is a side view of an exemplary variable-thickness staple in a first configuration. 
           [0039]      FIG. 20  is a side view of the staple of  FIG. 19  in a second configuration. 
           [0040]      FIG. 21  is a side view of the staple of  FIG. 19  in a third configuration. 
           [0041]      FIG. 22  is a perspective view of two exemplary feeder belts configured to deliver collectively three rows of staples. 
           [0042]      FIG. 23  is an end view of the feeder belts of  FIG. 22 . 
           [0043]      FIG. 24  is a perspective view of an exemplary feeder belt from which three rows of staples extend. 
           [0044]      FIG. 25  is an end of an exemplary feeder belt assembly from which three rows of staples extend. 
           [0045]      FIG. 26  is an end of another exemplary feeder belt assembly from which three rows of staples extend. 
       
    
    
       [0046]    The use of the same reference symbols in different figures indicates similar or identical items. 
       DETAILED DESCRIPTION 
       [0047]    U.S. patent application Ser. No. 12/263,171, filed on Oct. 31, 2008 (the “Endocutter Document”), is hereby incorporated by reference herein in its entirety. The Endocutter Document describes exemplary feeder belts used in a surgical stapler. Referring to  FIG. 1 , a feeder belt  2  may be a long, narrow, thin strip of material from which one or more staples  4  extend. The feeder belt  2  and staples  4  of the present document may be substantially as set forth in the Endocutter Document, with the exception of the inventive features set forth in the present document. Each staple  4  may have a free end  6 , and an opposite end  8  that is connected to the feeder belt  2 . Advantageously, the staples  4  are frangibly affixed to the feeder belt  2 , such that they are sheared off from the feeder belt  2  during deployment. However, the staples  4  may be connected to the feeder belt  2  in any suitable manner. One or more rows  10  of staples  4  may be connected to the feeder belt  2 . Each row  10  of staples  4  is the group of staples  4  positioned at substantially the same lateral location relative to the longitudinal centerline of the feeder belt  2 , and each row  10  of staples  4  may be oriented generally longitudinally. After deployment, each staple  4  may form substantially a D-shape. As seen in  FIG. 1 , an exemplary feeder belt  2  may be a generally flat and generally linear piece of material that carries a plurality of staples  4 . The feeder belt  2  may lie substantially in a single plane. The feeder belt  2  may be flexible, or instead may be rigid. 
         [0048]    Referring also to  FIGS. 2-3 , at least two staples  4  may be generally D-shaped, and may extend from a carrier  16 . This configuration of staples  4  may be referred to as the “double-D configuration.” The end  8  of each staple  4  that is connected to the carrier  16  may be fixed to that carrier  16  such that the staples  4  are not frangibly separable from the carrier  16 . Instead, the carrier  16  may itself be fixed to and frangibly separable from the feeder belt  2 . In this way, the carrier  16  is implanted in tissue along with the attached staples  4 . The connection between the carrier  16  and the feeder belt  2  may be coined or otherwise fabricated to facilitate frangible separation from the feeder belt  2 . Such a connection may be made in the same or similar manner as between a staple  4  and the feeder belt  2  as set forth in the Endocutter Document, or in a different manner. As shown in  FIG. 2 , staples  4  that are attached to a carrier  16  may be substantially in the same plane as one another, such that the staples  4  all extend from the same side of the carrier  16 . Further, those staples  4  may be oriented in substantially the same direction as one another, such that the free end  6  of each staple  4  is located at the proximal end or at the distal end of each staple  4 . Alternately, at least one staple  4  attached to a carrier  16  may be oriented in a different direction relative to a least one other staple  4 . At least one carrier  16  may be in substantially the same plane as the feeder belt  2 , and positioned lateral to the feeder belt  2 . 
         [0049]    Referring also to  FIG. 4 , the wedge  20  used to form the staples  4  and then shear the carrier  16  from the feeder belt  2  may have a three-dimensional form. That is, the wedge  20  may include two separate ramps  22 ,  24 , where the first ramp  22  is configured to deform staples  4  and the second ramp  24  is configured to shear the carriers  16  from the feeder belt  2 . The wedge  20  may be actuated substantially as described in the Endocutter Document, with the following differences. The first ramp  22  may be located laterally outboard relative to the second ramp  24 . As the wedge  20  slides relative to the feeder belt  2 , the first ramp  22  sequentially engages staples  4 , deforming them upward into contact with an anvil which causes further deformation. The first ramp  22  is shaped to facilitate that deformation, such as set forth in the Endocutter Document. The second ramp  24  may be located laterally inboard relative to the first ramp  22 . The second ramp  24  is shaped such that, after the staples  4  attached to a carrier  16  have been deformed by contact with the first ramp  22 , the second ramp  24  contacts and exerts a force on the carrier  16  and/or the junction between the feeder belt  2  and that carrier  16  in order to shear off or otherwise separate the carrier  16  from the feeder belt  2 . Alternately, instead of a three-dimensional wedge  20  with two separate ramps  22 ,  24 , two separate wedges  20  may be utilized, where one wedge  20  deforms staples  4  and the other wedge  20  shears carriers  16  from the feeder belt  2 . 
         [0050]    Alternately, at least one staple  4  that is attached to a carrier  16  may be out of plane relative to at least one other staple  4  that is attached to that carrier  16 . Referring also to  FIG. 5 , a carrier  16  may have two or more staples  4  extending therefrom, where at least one staple  4  extends from a different side of the carrier  16  than at least one other staple  4 . At least one staple  4  may be oriented in a different direction from at least one other staple  4 . For example, as shown in  FIG. 5 , two staples  4  may be attached to a carrier  16 , where the free end  6  of one staple  4  is located at the proximal end of that staple  4 , and the free end  6  of the other staple  4  is located at the distal end of that staple  4 . This configuration of the staples  4  may be referred to as the “B configuration.” Two separate wedges  20  may be utilized in conjunction with the staples  4  and carrier  16 . Those two wedges  20  may move in opposite directions relative to one another, referring also to  FIG. 6 , to deform the staples  4 . One of the wedges  20  may be configured substantially as shown in  FIG. 4  such that the wedge  20  can both deform one or more staples  4  and shear the carrier  16  from the feeder belt  2 . The resultant combination of the deformed staples  4  and carrier  16  may form generally a B-shape. Alternately, both wedges  20  may be configured as set forth in the Endocutter Document, and the staples  4  may be connected to the feeder belt  2  directly instead of to a carrier  16 . 
         [0051]    Referring also to  FIGS. 7-10 , staples  4  may be formed into a B-configuration with a wedge  20  moving in a single direction. Such staples  4  may be attached to a carrier  16  substantially coplanar with one another, similar to the configuration of  FIG. 2 . As another example, at least two staples  4  may be attached to a carrier  16  out of plane relative to one another, similar to the configuration of  FIG. 5 . As seen in  FIG. 7 , at least one staple  4  may be oriented relative to a wedge  20  such that the free end  6  is longitudinally closer to the wedge  20  as it approaches the staple  4  than the opposite end  8 . The surface of the wedge  20  that contacts that staple  4 , and the staple  4  itself, are shaped such that contact therebetween as the wedge  20  slides relative to the staple  4  urges the free end  6  of the staple  4  upward, referring also to  FIG. 8 . As the wedge  20  continues to slide relative to the staples  4 , the wedge  20  encounters the next longitudinally-successive staple  4 , and urges that staple  4  upward as well, referring also to  FIG. 9 . Optionally, two wedges  20  may be used where at least two staples  4  attached to a carrier  16  are out of plane relative to each other. After the wedge  20  has deformed both staples  4 , the staples  4  are in the B-configuration, as shown in  FIG. 10 . The carrier  16  may then be separated from the feeder belt  2  by the wedge  20 . Optionally, the three-dimensional wedge  20  of  FIG. 4  may be utilized in order to first form the staples  4  and then separate the carrier  16  from the feeder belt  2 . 
         [0052]    The staples  4  may be grouped together along the feeder belt  2  in any suitable manner. As one example, referring also to  FIG. 11 , the staples  4  may be organized into two or more groups  22  longitudinally spaced apart from one another by blank space  24  along the feeder belt  2 . The blank space  24  may have any suitable length. Advantageously, no staples  4  extend from the feeder belt  2  along a blank space  24  on the feeder belt  2 . At least one staple  4  may be deployable to a different closed shape than at least one other staple  4 . As one example, referring also to  FIG. 12 , the staples  4  within a group  22  need not be homogeneous. For example, one or more staples  4  may extend downward from the feeder belt  2  a distance greater than one or more other staples  4 . A staple  4   a  may extend downward from the feeder belt  2  a first distance  26 . Another staple  4   b  may extend downward from the feeder belt  2  a second distance  28  greater than the first distance  26 . Yet another staple  4   c  may extend downward from the feeder belt  2  a third distance  30  greater than the second distance  28  The staple  4   c  may be larger than the staples  4   a,    4   b.  The staples  4   a,    4   b,    4   c  may be positioned longitudinally relative to one another in any suitable manner. Advantageously, non-homogeneous staples  4  are positioned longitudinally relative to one another, and differ from one another, in a manner related to a specific surgical procedure to be performed. For example, staple  4   a  is positioned proximal to staple  4   b,  which in turn is positioned proximal to staple  4   c.  In this way, tissue that varies in thickness in a known way may be stapled effectively, where the tissue becomes thicker from the proximal to the distal direction. A staple  4  that extends further downward from the feeder belt  2  may rotate about its attached end  8  substantially the same amount rotationally as a staple  4  extends a lesser distance downward from the feeder belt  2 . As a result, the free end of  6  a staple  4   c  that extends a third distance  30  downward from the feeder belt  2  will swipe through tissue at a height above the feeder belt  2  that is above the height through which the free end of a staple  4   a  extends a first distance  26  downward from the feeder belt  2  can swipe, where the first distance  26  is less than the third distance  30 . As another example, one or more staples  4  may be shaped differently from one or more other staples  4 , whether or not a subset of those staples  4  extends downward a different distance from the feeder belt  2  than a different subset of those staples  4 . As another example, one or more staples  4  within a group  22  may have a D-configuration after formation and shearing, and one or more staples  4  within the same group  22  may have a B-configuration, a double-D configuration, and/or any other suitable configuration. One or more staples  4  within a group  22  may vary from one or more other staples  4  within the same group  22  in any other suitable matter. Alternately, all of the staples  4  within at least one group  22  may be substantially homogeneous. 
         [0053]    Referring also to  FIGS. 13-14 , as set forth in the Endocutter Document, a surgical instrument that deploys staples  4  from the feeder belt  2  may include an end effector  40  that includes a staple holder  42  and an anvil  44 . One or more feeder belts  2  may extend through a shaft  46  proximal to and connected to the end effector  40 , into the staple holder  42 . An inner surface  48  of the anvil  44 , which is the surface of the anvil  44  oriented generally toward the staple holder  42 , may include staple forming pockets  50  defined therein. As the staples  4  are deployed, the free end  6  of each staple  4  may be forced into a corresponding staple forming pocket  50 , whereby contact between the free end  6  of that staple  4  and the staple forming pocket  50  causes that staple  4  to close. Each staple forming pocket  50  may be shaped in any suitable manner. 
         [0054]    Referring also to  FIG. 15 , the staple forming pockets  50  need not be homogeneous. As one example, one or more staple forming pockets  50  may extend further into the inner surface  48  of the anvil  44  then one or more other staple forming pockets  50 . One anvil forming pocket  50   a  may extend a first distance  52  above the inner surface  48  of the anvil  44 . Another anvil forming pocket  50   b  may extend a second distance  54  above the inner surface  48  of the anvil  44 , where the second distance  54  may be less than the first distance  52 . Another anvil forming pocket  50   c  may extend a third distance  56  above the inner surface  48  of the anvil  44 , where the third distance  56  may be less than the second distance  54 . As another example, at least one staple forming pocket  50  may be curved or shaped in a different manner than at least one other staple forming pocket  50 . For example, one staple forming pocket  50  may have a tighter radius of curvature than a different staple forming pocket  50 . As another example, one staple forming pocket  50  may have a complex shape, and another staple forming pocket  50  may simply be arcuate. In this way, different anvil forming pockets  50   a,    50   b,    50   c  may form corresponding staples  4  differently. Non-homogeneous anvil forming pockets  50  may be utilized with a feeder belt  2  that utilizes at least one group  22  of staples  4  that is homogeneous, such that different degrees of bending and forming may be applied across a variety of staples  4  that are substantially the same in order to obtain the result of closed staples  4  that are differentially formed. As another example, non-homogeneous anvil forming pockets  50  may be utilized with non homogeneous staples  4 , such as those described above, where particular staples  4  are positioned for deployment into particular, corresponding anvil forming pockets  50 . 
         [0055]    As another example, the inner surface  48  of the anvil  44  need not be flat, such that different anvil forming pockets  50  may be located at a different distance away from the staple holder  42  when the end effector  40  is closed. In this way, staples  4  of different heights may be accommodated. As another example, the gap between the inner surface  48  of the anvil  44  and the staple holder  42  may be adjustable, whether the inner surface  48  is substantially flat or not. In this way, the degree of deformation of the staples  4  within a particular tissue structure held between the anvil  44  and the staple holder  42  may be controlled. The gap may be adjustable in any suitable manner, such as by mechanisms, structures, or methods set forth in co-pending U.S. patent application Ser. No. 12/477,302, filed on Jun. 3, 2009, which is hereby incorporated by reference in its entirety. 
         [0056]    Referring also to  FIGS. 16-18 , staples  4  on a feeder belt  2  may form longitudinally-successive groups  22  in which at least one group  22  may have a different number or configuration of staples  4  than at least one other group  22 . Such an organization of staples  4  may be advantageous for particular surgical procedures. Referring to  FIG. 16 , a first group  22   a  of staples  4  may be connected to a feeder belt  2 . Referring to  FIG. 17 , a second group  22   b  of staples  4  may be connected to the feeder belt  2  proximal to the first group  22   a.  The first group  22   a  of staples  4  may include a different number of staples  4  than the second group  22   b.  Referring to  FIG. 18 , a third group  22   c  of staples  4  may be connected to the feeder belt  2  proximal to the second group  22   b.  The third group  22   c  of staples  4  may include a different number of staples  4  than the first group  22   a  and/or the second group  22   b.  The first group  22   a  is deployed before the second group  22   b,  which in turn is deployed before the third group  22   c.  Where each group  22   a,    22   b,    22   c  includes successively fewer staples  4  than the previous one, that configuration of feeder belt  2  may be suitable for a surgical procedure in which tissue structures of increasingly narrow widths are treated with the feeder belt  2 . 
         [0057]    Where a variable gap between the anvil  44  and staple holder  42  in the closed position of the end effector  40  is provided, the staples  4  may be configured in any manner to take advantage of that variable gap. As one example, referring also to  FIGS. 19-21 , at least one staple  4  may be configured to be closed through a variety of degrees. Referring to  FIG. 19 , a staple  4  may be closed to a first degree in which both sides of the staple  4  are closed to a first distance  60   a.  That first distance  60   a  may result from a first gap between the anvil  44  and the staple holder  42 . Referring also to  FIG. 20 , a staple  4  may be closed to a second degree in which both sides of the staple  4  are closed to a second distance  60   b,  which may be less than the first distance  60   a,  and which may result from a second gap between the anvil  44  and the staple holder  42  that is less than the first gap. Referring also to  FIG. 21 , a staple  4  may be closed to a third degree in which both sides of the staple  4  are closed to a third distance  60   c,  which may be less than the first distance  60   a  and the second distance  60   b,  and which may result from a third gap between the anvil  44  and the staple holder  42  that is less than the first gap and the second gap. 
         [0058]    The staple  4  may be configured in any manner to close through a variety of tightnesses  60   a,    60   b,    60   c  without causing interference between the free end  6  of the staple  4  and a remainder of the staple  4 . As one example, at least one staple  4  may include a notch  62  at or near the end  8  of the staple  4  that is fixed to the feeder belt  2 . Such a notch  62  reduces the thickness of the staple  4 , such that the free end  6  of the staple  4  can travel within that notch as the staple  4  is closed to a degree in which the free end  6  would otherwise collide and interfere with the staple  4  in the vicinity of the end  8 . As another example, at least one staple  4  may be curved laterally such that contact between the free end  6  and a staple-forming pocket causes the free end  6  of the staple  4  to move laterally to and swipe past the other end  8  of the staple  8  as a consequence of the shape of the staple  4 . As another example, the shape of at least one staple forming pocket  50  actively deflects the free end  6  of at least one staple  4  laterally, allowing it to swipe past the opposite end  8  of the staple  4  as a consequence of the shape of the staple forming pocket  50 . Such a staple-forming pocket  50  alternately may be used in conjunction with a laterally-curved staple  4  such as described immediately above. As another example, the free end  6  of the staple  4  and/or a remainder of the staple  4  may be shaped such that contact between the free end  6  and a remainder of the staple  4  causes the free end  6  to deflect laterally and prevent interference therebetween. To that end, the free end  6  may be conical or otherwise curved, as may a remainder of the staple  4 . 
         [0059]    Multiple feeder belts  2  may be utilized in the staple holder  42  in order to provide any suitable number of rows  10  of staples  4  on each side of a knife held by the staple holder  42  that is used for transection or other incision in tissue made by the end effector  40 . Referring also to  FIGS. 22-23 , two feeder belts  2  may be utilized on one or both sides of a transection, where one feeder belt  2   a  includes two rows  10  of staples  4  such as described above with regard to FIG.  1 . The other feeder belt  2   b  may include a single row  10  of staples  4  configured in any suitable manner. As one example, for ease of fabrication, the feeder belt  2   a  may be configured in substantially the same way as the feeder belt  2   b,  where fabrication of a second row  10  of staples  4  is simply omitted from the feeder belt  2   b.  Alternately, the feeder belt  2   b  may have any other configuration of staples  4 . For example, the staples  4  extending from feeder belt  2   b  need not be positioned in a row  10 , and instead may be laterally staggered relative to one another. Alternately, two feeder belts  2  each may include two rows  10  of staples  4 , such that four rows  10  of staples  4  may be deployed on each side of the transection. In this way, fabrication of the feeder belts  2  may be simplified, because the same feeder belt  2  may be utilized multiple times without the need to fabricate a different configuration of feeder belt  2 . 
         [0060]    Alternately, three or more rows  10  of staples  4  may be attached to a single feeder belt  2 . Referring also to  FIG. 24 , two rows  10  of staples  4  may be attached to the feeder belt  2  substantially as described in the Endocutter Document. A third row  10  may be provided by attaching staples  4  to the feeder belt  2  individually with extension arms  64 . At least one extension arm  64  may extend generally laterally to the feeder belt  2 , in a direction that may be substantially perpendicular to the longitudinal centerline of that feeder belt. At least one extension arm  64  may be substantially in the same plane as the corresponding feeder belt  2 . Alternately, at least one extension arm  64  may be oriented or configured differently relative to the feeder belt  2 . The staple  4  may be configured to be sheared off or otherwise separated from a lateral end  66  of the extension arm  64 , such as by the three-dimensional wedge  20  of  FIG. 4 . Alternately, at least one extension arm  64  may be sheared off from or otherwise separated from the feeder belt  2 , and may remain fixed to the staple  2 . Advantageously, each extension arm  64  is connected to one corresponding staple  4 . Alternately, at least one extension arm  64  may have two or more staples  4  connected thereto and extending therefrom. A staple  4  fixed to a corresponding extension arm  64  may be spaced laterally apart from the feeder belt  2 . 
         [0061]    Alternately, a feeder belt  2  having three or more rows  10  of staples  4  attached to a single feeder belt  2  may be fabricated differently. As one example, referring to  FIG. 25 , a feeder belt  2   a  may be provided, along with a feeder belt  2   b,  such as described above with regard to  FIG. 23 . The feeder belt  2   b  may be generally L-shaped as viewed from the end. The feeder belt  2   a  may include a plurality of apertures therethrough. The feeder belt  2   b  may be fastened to an upper surface of the feeder belt  2   a,  such that the staples  4   b  of the feeder belt  2   b  extend through the apertures in the feeder belt  2   a  and beneath the feeder belt  2   a.  The feeder belt  2   b  may be fastened to the upper surface of the feeder belt  2   a  by laser welding or in any other suitable manner. Alternately, referring to  FIG. 26 , a master belt  70  may be provided, where one or more L-shaped feeder belts  2   b  are attached to the underside thereof by laser welding or in any other suitable manner. The master belt  70  need not have staples  4  extending therefrom, and may simply carry one or more L-shaped feeder belts  2   b.  Alternately, the master belt  70  may be fastened to one or more two-row feeder belts  2   a.  Alternately, the master belt  70  may include a plurality of apertures therethrough. At least one feeder belt  2   b  may be fastened to an upper surface of the master belt  70 , such that the staples  4   b  of the feeder belt  2   b  extend through the apertures in the master belt  70  and beneath the feeder belt  70 . 
         [0062]    The feeder belts  2  described herein may be actuated such as described in this document, in the Endocutter Document, or in any other suitable manner. As another example, two-phase deployment may be used to deploy one or more staples  4 . One or more wedges  20  or other deployment mechanisms may slide relative to one or more of the staples  4  in a first pass generally along one longitudinal direction. During the first pass, the one or more wedges  20  may deploy one or more staples  4  in part or in full. Those wedges  20  or other deployment mechanisms then may slide relative to one or more of the staples  4  in a second pass generally along the opposite longitudinal direction. During the second pass, the one or more wedges  20  may complete the deployment of any partially-deployed staples  4 . Alternately, the first pass of the wedges  20  deforms the staples  4 , and the second pass of the wedges shears the staples  4  from the feeder belt  2 . 
         [0063]    While the invention has been described in detail, it will be apparent to one skilled in the art that various changes and modifications can be made and equivalents employed, without departing from the present invention. It is to be understood that the invention is not limited to the details of construction, the arrangements of components, and/or the method set forth in the above description or illustrated in the drawings. Statements in the abstract of this document, and any summary statements in this document, are merely exemplary; they are not, and cannot be interpreted as, limiting the scope of the claims. Further, the figures are merely exemplary and not limiting. Topical headings and subheadings are for the convenience of the reader only. They should not and cannot be construed to have any substantive significance, meaning or interpretation, and should not and cannot be deemed to indicate that all of the information relating to any particular topic is to be found under or limited to any particular heading or subheading. Therefore, the invention is not to be restricted or limited except in accordance with the following claims and their legal equivalents.