Patent Publication Number: US-2022211376-A1

Title: Surgical buttress loading and attaching/detaching assemblies

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of U.S. patent application Ser. No. 16/387,951, filed Apr. 18, 2019 (now U.S. Pat. No. 11,284,896), which claims the benefit of, and priority to, U.S. Provisional Patent Application Ser. No. 62/789,580, filed Jan. 8, 2019, U.S. Provisional Patent Application Ser. No. 62/725,327, filed Aug. 31, 2018, U.S. Provisional Patent Application Ser. No. 62/668,851, filed May 9, 2018, and U.S. Provisional Patent Application Ser. No. 62/668,858, filed May 9, 2018, the entire contents of each of which being hereby incorporated herein by reference. 
    
    
     TECHNICAL FIELD 
     The present application relates to surgical buttresses for use with surgical stapling apparatus and more particularly, to surgical buttress loading and attaching/detaching assemblies for releasably securing the surgical buttress to a surgical stapling apparatus. 
     BACKGROUND 
     Surgical stapling apparatus are employed by surgeons to sequentially or simultaneously apply one or more rows of fasteners, e.g., staples or two-part fasteners, to body tissue for the purpose of joining segments of body tissue together and/or creating anastomoses. 
     Linear surgical stapling apparatus generally include a pair of jaws or finger-like structures between which the body tissue to be joined is placed. When the surgical stapling apparatus is actuated, or “fired”, longitudinally moving firing bars contact staple drive members in one of the jaws. The staple drive members push the surgical staples through the body tissue and into an anvil in the opposite jaw which forms the staples. If body tissue is to be removed or separated, a knife blade can be provided in one of the jaws of the apparatus to cut the body tissue between the lines of staples. 
     Annular surgical stapling apparatus generally include a staple cartridge assembly including annular rows of staples, an anvil assembly operatively associated with the staple cartridge assembly, and an annular blade disposed internal to the annular rows of staples. In use, during an end-to-end circular anastomosis procedure, two ends of hollow tissue sections (e.g., bowels, intestines, or other tubular organs) are positioned between the anvil and staple cartridge assemblies and are joined by clamping the two ends together and driving the annular rows of staples through the clamped tissue sections. During firing of the staples, the annular blade is advanced to cut portions of the tissue sections extending inside the staple lines, thereby establishing a passage through the two stapled tissue sections. 
     Surgical supports, e.g., meshes or buttress materials, may be used in combination with surgical stapling apparatus to bridge, repair, and/or reinforce tissue defects within a patient such as those occurring, for example, in the abdominal wall, chest wall, diaphragm, or musculo-aponeurotic areas of the body. The buttress material reinforces the staple line as well as covers the juncture of the tissues to reduce leakage prior to healing. The buttress material can help promote proper staple formation while reducing twisting/malformation caused by any misalignment of tissue and/or unusual or non-uniform tissue. The buttress material can also provide support to weakened tissue, or help address differences in the thickness of tissues. 
     Accordingly, buttress materials provide clinical benefits. Nonetheless, improvements are desired, for example, to reduce the complexity of manufacture and/or application of the buttress materials onto surgical stapling apparatus or into tissue, or to expand the range of application for use of the buttress materials. 
     SUMMARY 
     In an aspect of the present disclosure, a surgical buttress loading assembly for use with a surgical stapling apparatus includes a surgical buttress and a surgical buttress applicator. The surgical buttress includes a tubular body and an elongate member extending from the tubular body. The surgical buttress applicator includes a base and a handle releasably engaged with the base. The elongate member is disposed within and extends through the handle, and the tubular body of the surgical buttress is positioned within a cavity of the base. 
     The base of the surgical buttress applicator may include an elongate body having a proximal end defining an opening into the cavity, and a closed distal end. In embodiments, a tab extends proximally from the proximal end of the elongate body of the base and between the handle and the cavity of the base, and is positioned through an aperture defined in the elongate member of the surgical buttress. In some embodiments, a tab extends proximally from the proximal end of the elongate body of the base, and is positioned through an aperture defined in the tubular body of the surgical buttress. 
     The base of the surgical buttress applicator may include a fin having a concave wall defining an arcuate cut-out configured to receive the handle therein. The handle of the surgical buttress applicator may include an outer wall defining a groove therein that is configured to receive the concave wall of the base therein to releasably retain the handle within the arcuate cut-out of the base. 
     The handle of the surgical buttress application may include an outer handle housing including an outer wall and an inner wall defining an annular cavity therebetween. The elongate member of the surgical buttress may be disposed within the annular cavity of the outer handle housing. In embodiments, the outer wall of the outer handle housing includes a slot defined therethrough that is in fluid communication with the annular cavity, and the elongate member of the surgical buttress extends through the slot. 
     In embodiments, the handle of the surgical buttress application includes an inner handle housing rotatably disposed within the annular cavity of the outer handle housing, and the elongate member of the surgical buttress is wrapped around the inner handle housing. In some embodiments, the inner wall of the outer handle housing includes flexible wall segments extending radially around a central opening defined in the outer handle housing. At least one of the flexible wall segments may include a lip extending therefrom to aid in retaining the inner handle housing within the annular cavity of the outer handle housing. In some embodiments, the inner handle housing includes an annular base including an inner surface configured to engage and be rotatably mounted on the inner wall of the outer handle housing. The inner handle housing may include annular flanges extending from opposed sides of the annular base to aid in retaining the elongate member of the surgical buttress on an outer surface of the annular base. 
     In another aspect of the present disclosure, a surgical stapling system includes a surgical stapling apparatus and a surgical buttress loading assembly. The surgical stapling apparatus includes a handle assembly, an elongate tubular body portion extending distally from the handle assembly, and an end effector extending distally from the elongate tubular body portion. The end effector includes an anvil assembly and a staple cartridge assembly. The surgical buttress loading assembly includes a surgical buttress and a surgical buttress applicator. The surgical buttress includes a tubular body and an elongate member extending from the tubular body. The surgical buttress applicator includes a base and a handle releasably engaged with the base. The elongate member is disposed within and extends through the handle, and the tubular body of the surgical buttress is positioned within a cavity of the base. The cavity of the base is sized and shaped to slidably receive at least one of the anvil assembly or the staple cartridge assembly of the surgical stapling apparatus therein. 
     In embodiments, the tubular body of the surgical buttress includes a buttress portion and a folded portion, and the base of the surgical buttress applicator includes a first wall portion configured to extend over a tissue facing surface of the anvil or the staple cartridge assembly and a second wall portion configured to extend around the anvil or the staple cartridge assembly and over an outwardly facing surface of the anvil or staple cartridge assembly. The buttress portion of the surgical buttress is positioned adjacent to the first wall portion and the folded portion is positioned adjacent to the second wall portion such that the tubular body of the surgical buttress is open to receive the anvil or staple cartridge assembly therein. 
     The handle of the surgical buttress applicator may include a pair of fingers extending from an outer wall thereof that are configured to releasably engage the elongate tubular body portion of the surgical stapling apparatus. 
     In yet another aspect of the present disclosure, a method of using a surgical buttress loading assembly with a surgical stapling apparatus includes: sliding a surgical buttress loading assembly onto an anvil assembly or a staple cartridge assembly of a surgical stapling apparatus to dispose the anvil or staple cartridge assembly within a tubular body of the surgical buttress, the surgical buttress loading assembly including: a surgical buttress including a tubular body and an elongate member extending from the tubular body; and a surgical buttress applicator including a base and a handle releasably engaged with the base, the elongate member disposed within and extending through the handle, and the tubular body of the surgical buttress positioned within a cavity of the base. 
     The method may further include detaching the handle of the surgical buttress applicator from the base; and sliding the base of the surgical buttress applicator off of the anvil or staple cartridge assembly, leaving the tubular body of the surgical buttress disposed over the anvil or staple cartridge assembly. 
     In embodiments, the method further includes attaching the handle of the surgical buttress applicator to the elongate tubular body portion of the surgical stapling apparatus. In some embodiments, the method further includes: firing the surgical stapling apparatus to drive fasteners through a buttress portion of the tubular body of the surgical buttress; and pulling the handle of the surgical buttress applicator away from the buttress portion to separate the elongate member and a folded portion of the tubular body of the surgical buttress from the buttress portion. 
     In an aspect of the present disclosure, a surgical stapling system includes a surgical stapling apparatus and a staple cartridge surgical buttress assembly. The surgical stapling apparatus includes a handle assembly, an elongate tubular body extending distally from the handle assembly, and an end effector extending distally from the elongate tubular body. The end effector includes an anvil assembly and a staple cartridge assembly. The staple cartridge surgical buttress assembly includes a surgical buttress and a leash. The surgical buttress includes a body having an annular configuration and legs extending from the body. The body is positioned against a tissue facing surface of the staple cartridge assembly and the legs are positioned against a housing of the staple cartridge assembly. The leash is threaded through at least one of the legs and extends proximally from the surgical buttress towards the handle assembly. 
     Each of the legs of the surgical buttress may include at least one opening or cutout defined therein. The legs of the surgical buttress may alternate between including at least one opening and at least one cutout defined therein. In embodiments, a central portion of the leash is looped through a pair of openings defined in a first leg of the legs of the surgical buttress, and first and second elongated portions of the leash are passed around the housing of the staple cartridge assembly and through an opening defined in a second leg of the legs of the surgical buttress that is opposed to the first leg. In some embodiments, third and fourth legs of the legs of the surgical buttress each include a pair of opposed cutouts defined therein, and the first and second elongated portions of the leash respectively extend under the pair of opposed cutouts. 
     Free ends of the legs of the surgical buttress may be secured to the housing of the staple cartridge assembly. A sleeve tube may be positioned around the housing of the staple cartridge assembly and over free ends of the legs of the surgical buttress to retain the legs against the staple cartridge assembly. 
     In embodiments, the surgical stapling system further includes an anvil surgical buttress assembly. The anvil surgical buttress assembly includes a surgical buttress and an anvil cap. The surgical buttress includes a body having an annular configuration and legs extending from the body. The body is positioned against a tissue facing surface of the anvil assembly and the legs are positioned against a distal surface of a housing of the anvil assembly. The anvil cap is coupled to the housing of the anvil assembly. The anvil cap is movable between an approximated position in which the legs of the surgical buttress are captured between the anvil cap and the housing of the anvil assembly and an unapproximated position in which the anvil cap is spaced from the housing and the legs of the surgical buttress are released. 
     In embodiments, the anvil cap includes a cap body supported on the distal surface of the housing and pegs extending proximally from the cap body. The pegs are positioned through openings defined in the housing. In some embodiments, the pegs of the anvil cap have flanged ends. In certain embodiments, each of the pegs of the anvil cap has a split body including first and second legs terminating at the flanged ends, the first and second legs deflectable inwardly and outwardly relative to each other. 
     In another aspect of the present disclosure, a staple cartridge assembly includes a housing, a staple guide, a surgical buttress, and a leash. The staple guide is supported within the housing and includes a tissue facing surface having staple receiving slots defined therein. Each of the staple receiving slots houses a staple therein. The surgical buttress includes a body having an annular configuration and legs extending from the body. The body is positioned against the tissue facing surface of the staple guide and the legs are positioned against the housing. The leash is threaded through at least one of the legs and extends proximally from the surgical buttress. 
     Each of the legs of the surgical buttress may include at least one opening or cutout defined therein. The legs of the surgical buttress may alternate between including at least one opening and at least one cutout defined therein. In embodiments, a central portion of the leash is looped through a pair of openings defined in a first leg of the legs of the surgical buttress, and first and second elongated portions of the leash are passed around the housing and through an opening defined in a second leg of the legs of the surgical buttress that is opposed to the first leg. In some embodiments, third and fourth legs of the legs of the surgical buttress each include a pair of opposed cutouts defined therein, and the first and second elongated portions of the leash respectively extend under the pair of opposed cutouts. 
     Free ends of the legs of the surgical buttress may be secured to the housing. A sleeve tube may be positioned around the housing and over free ends of the legs of the surgical buttress to retain the legs against the housing. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above and other aspects, features, and advantages of the present 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: 
         FIG. 1  is a perspective view of a surgical stapling apparatus having a surgical buttress disposed thereon in accordance with an embodiment of the present disclosure; 
         FIG. 2  is an exploded, perspective view of anvil and staple cartridge assemblies of an end effector of the surgical stapling apparatus of  FIG. 1 ; 
         FIG. 3  is a perspective view of an end effector of the surgical stapling apparatus of  FIG. 1 , showing the surgical buttress disposed thereon; 
         FIG. 4  is a side view of the surgical buttress of  FIG. 1 , separated from the surgical stapling apparatus; 
         FIG. 5  is a plan view of the surgical buttress of  FIG. 4 , in an unfolded condition in accordance with an embodiment of the present disclosure; 
         FIG. 6  is a side, perspective view of a surgical buttress loading assembly including a surgical buttress applicator and a surgical buttress in a loaded configuration in accordance with an embodiment of the present disclosure; 
         FIG. 7  is an end, perspective view of a base of the surgical buttress applicator of  FIG. 6 ; 
         FIG. 8  is a perspective view, with parts separated, of the surgical buttress loading assembly of  FIG. 6 ; 
         FIG. 9  is a side view of the surgical stapling apparatus of  FIG. 1  including the surgical buttress loading assembly of  FIG. 6  disposed thereon; 
         FIG. 10  is a side view of a surgical stapling apparatus including the surgical buttress loading assembly of  FIG. 9 , illustrating a handle of the surgical buttress applicator separated from a base of the surgical buttress applicator; 
         FIG. 11  is a perspective view of anvil and cartridge buttresses in accordance with another embodiment of the present disclosure; 
         FIG. 12  is a cross-sectional view of the anvil buttress of  FIG. 11 ; 
         FIG. 13  is a perspective view of an end effector having the anvil and cartridge buttresses of  FIG. 11  disposed thereon in accordance with an embodiment of the present disclosure 
         FIG. 14  is a perspective view of a surgical stapling apparatus having surgical buttresses disposed thereon in accordance with an embodiment of the present disclosure; 
         FIG. 15  is an exploded, perspective view of an anvil assembly of an end effector of the surgical stapling apparatus of  FIG. 14 ; 
         FIG. 16  is a cross-sectional, close-up view of an anvil head of the anvil assembly of  FIG. 15 , illustrating an anvil cap in an approximated position securing a surgical buttress to the anvil head; 
         FIG. 17  is a cross-sectional, close-up view of the anvil head of  FIG. 16 , illustrating the anvil cap in an unapproximated position releasing the surgical buttress from the anvil head; 
         FIG. 18  is an exploded, perspective view of a staple cartridge assembly of an end effector of the surgical stapling apparatus of  FIG. 14 ; 
         FIG. 19  is a plan view of a surgical buttress of the surgical stapling apparatus of  FIG. 14  in accordance with an embodiment of the present disclosure; 
         FIG. 20  is a perspective view of a staple cartridge assembly of the surgical stapling apparatus of  FIG. 14  including the surgical buttress of  FIG. 19  and a leash, illustrating a step-by-step release of the surgical buttress from the staple cartridge assembly in accordance with an embodiment of the present disclosure; 
         FIG. 21  is a perspective view of a surgical stapling apparatus in accordance with another embodiment of the present disclosure; and 
         FIG. 22  is a perspective view of a surgical stapling apparatus in accordance with yet another embodiment of the present disclosure. 
     
    
    
     DETAILED DESCRIPTION OF EMBODIMENTS 
     Embodiments of the present 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 embodiments 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 the present disclosure in unnecessary detail. 
     Referring now to  FIG. 1 , an exemplary surgical stapling apparatus or surgical stapler  1  in the form of a linear surgical stapling device is shown for use in stapling tissue and applying one or more buttress materials or surgical buttresses to the tissue. The surgical stapling apparatus  1  generally includes a handle assembly  10 , an elongate tubular body portion  20  extending distally from the handle assembly  10 , and an end effector or jaw assembly  30  extending distally from the elongate tubular body portion  20 . The jaw assembly  30  includes an anvil assembly  40  and a staple cartridge assembly  50 . The jaw assembly  30  may be permanently affixed to the elongate tubular body portion  20  or may be detachable with respect to the elongate tubular body portion  20  and thus, replaceable with a new jaw assembly  30 . The anvil assembly  40  and/or the staple cartridge assembly  50  is pivotable with respect to the elongate tubular body portion  20  such that the anvil and/or staple cartridge assemblies  40 ,  50  is movable between an open position in which the anvil and staple cartridge assemblies  40 ,  50  are spaced apart with respect to each other and a closed position in which the anvil and staple cartridge assemblies  40 ,  50  are substantially adjacent each other. 
     The handle assembly  10  includes a stationary handle member  12   a , a movable handle member  12   b , and a barrel portion  14 . An articulation lever  16  is mounted on the forward end of the barrel portion  14  to facilitate articulation of the jaw assembly  30 . A rotatable member  18  is also mounted on the forward end of the barrel portion  14 , adjacent the articulation lever  16 . Rotation of the rotatable member  18  relative to the barrel portion  14  rotates the elongate tubular body portion  20  and the jaw assembly  30  relative to the handle assembly  10  so as to properly orient the anvil and staple cartridge assemblies  40 ,  50  relative to tissue to be stapled. A knob  19  is movably positionable along the barrel portion  14 . The knob  19  is advanced distally to approximate or close the anvil and staple cartridge assemblies  40 ,  50 , relative to each other, and retracted proximally to unapproximate or open the anvil and staple cartridge assemblies  40 ,  50 , with respect to each other. Actuation of the movable handle member  12   b  applies lines of staples  58  ( FIG. 2 ) to tissue captured between the anvil and staple cartridge assemblies  40 ,  50 . 
     As shown in  FIG. 2 , the anvil assembly  40  includes an anvil plate  42  having a central longitudinal slot  41  formed therein, and a cover plate  44  secured over the anvil plate  42  such that the cover plate  44  defines a top or outwardly facing surface  46  of the anvil assembly  40 . The anvil plate  42  may include a plurality of staple forming pockets/cavities (not shown) defined in an inwardly or tissue facing surface  48  thereof. 
     The staple cartridge assembly  50  includes a cartridge carrier  52  defining an elongated support channel  51  configured and dimensioned to selectively receive a staple cartridge  54  therein. The cartridge carrier  52  also defines a bottom or outwardly facing surface  53  of the staple cartridge assembly  50 . The staple cartridge  54  is removable and replaceable in the cartridge carrier  52  of the staple cartridge assembly  50 . The staple cartridge  54  includes an inwardly or tissue facing surface  56  defining staple pockets or retention slots  55  formed therein for receiving a plurality of fasteners or staples  58  and staple pushers  60 . A central longitudinal slot  57  is formed in and extends along a substantial length of the staple cartridge  54  to facilitate passage of a knife blade  62  of a drive bar  64  therethrough. During operation of the surgical stapler  1 , an actuation sled  66  translates through the staple cartridge  54  to advance cam wedges  68  of the actuation sled  66  into sequential contact with the staple pushers  60 , to cause the staple pushers  60  to translate vertically within the staple pockets  55  and urge the staples  58  from the staple pockets  55  towards the tissue facing surface  48  of the anvil plate  42  of the anvil assembly  40 . 
     For a detailed description of the structure and function of exemplary surgical stapling apparatus, reference may be made to U.S. Pat. Nos. 8,256,656, 7,819,896, and 7,128,253, the entire content of each of which is incorporated herein by reference. It should be appreciated that principles of the present 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 content 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 of the present 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. 
     With reference again to  FIG. 1 , a surgical buttress  100  is shown releasably coupled to the anvil assembly  40  of the surgical stapler  1 . The surgical buttress  100  is 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 buttress  100 . The surgical buttress  100  may be biodegradable (e.g., formed from bioabsorbable and bioresorable materials) such that the surgical buttress  100  decomposes or is 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 buttress  100  may be formed from the same material or different materials. 
     In embodiments, at least a portion of the surgical buttress  100  is 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 embodiments, at least a portion of the surgical buttress  100  is 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. 
     The surgical buttress  100  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 buttress  100 , 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 buttress  100 , 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. 
     As shown in  FIGS. 3 and 4 , the surgical buttress  100  includes an elongate member  102 , a folded portion  104 , and a buttress portion  106 . The elongate member  102  is coupled to the folded portion  104 , and the folded portion  104  is coupled to the buttress portion  106  and is separable therefrom by perforations  108 . Together, the folded portion  104  and the buttress portion  106  form a tubular body  110  that is sized and shaped to facilitate the reception of the anvil assembly  40  and/or the staple cartridge assembly  50  therethrough. 
     The elongate member  102  is secured to the folded portion  104  of the surgical buttress  100  and extends proximally therefrom. The elongate member  102  is of a sufficient length to be accessible outside of a patient&#39;s body and may extend the length of the elongate tubular body portion  20  of the surgical stapler  1 . The elongate member  102  may be a band, a cord, a rope, a strap, a suture, among other elongate structures tethered to or integrally formed with the folded portion  104  of the surgical buttress  100 . In some embodiments, the elongate member  102  may include two or more elongate sections such as, for example, a suture attached to a strip of material that extends proximally from the folded portion  104  of the surgical buttress  100 . 
     When the elongate member  102  is pulled away from the tubular body  110  (e.g., proximally towards a user), the folded portion  104  and the elongate member  102  separate from the buttress portion  106  along the perforations  108 . It should be understood, however, that the perforations  108  may be omitted from the surgical buttress  100 . For example, the juncture between the folded portion  104  and the buttress portion  106  may be formed or otherwise secured to one another to facilitate separation of the folded portion  104  from the buttress portion  106  upon application of a force to the elongate member  102 . 
     The folded portion  104  can include one or more sections of material, and can be made from the same material as the buttress portion  106 , or from a different material, as discussed above. The folded portion  104  can be secured to itself to form the tubular body  110  and/or the buttress portion  106  can be attached to the folded portion  104  or itself. The folded portion  104  and/or the buttress portion  106 , or sections thereof, may be integrally formed or secured together via any suitable attachment features within the purview of those skilled in the art, such as, mechanical attachment features (e.g., sutures, pins), chemical attachment features (e.g., adhesives), and/or attachment methods (e.g., welding). 
     The folded portion  104  can include first and second sections  112 ,  114  secured to one another. In embodiments, the first and second sections  112 ,  114  are welded to each other. The elongate member  102  can be unitary with the folded portion  104  and/or may be permanently secured to the folded portion  104 . As seen in  FIG. 4 , the elongate member  102  can be integrally formed with the first section  112  of the folded portion  104  and attached to the second section  114  by welding at an attachment region  113 . The elongate member  102  can include one or more elongate sections, as discussed above, and can be made from the same material, or different material, as the folded and/or buttress portions  104 ,  106 . 
     With continued reference to  FIG. 3 , the surgical buttress  100  is disposed on the anvil assembly  40  of the stapler  1  with the buttress portion  106  positioned over the tissue facing surface  48  of the anvil assembly  40 , the folded portion  104  positioned over the outwardly facing surface  46  of the anvil assembly  40 , and the elongate member  102  extending proximally along the elongate tubular body portion  20  of the surgical stapler  1 . The perforations  108  are positioned adjacent side surfaces  49  of the anvil assembly  40  that interconnect the outwardly and tissue facing surfaces  46 ,  48  of the anvil assembly  40 . 
     The perforations  108  can be any size and shape, such as small pin-holes or larger openings such as, for example, the elongated openings shown in  FIG. 3 , or the perforations  108  can be a single feature, such as a line of weakness in the buttress material or materials forming the folded and buttress portions  104 ,  106 . The perforations  108  may be formed using laser cutting, knife cutting, press cutting, scoring, etching, among other methods within the purview of those skilled in the art. In some embodiments, the surgical buttress  100  is formed from a non-woven polyglycolide material that is laser cut to form the perforations  108 . 
     As shown in  FIG. 5 , the entire surgical buttress  100  may be formed from a single sheet of material  120 . The surgical buttress  100  is cut from the single sheet of material  120  and the perforations  108  are formed therein. The single sheet of material  120  is cut such that the surgical buttress  100  includes the elongate member  102 , the folded portion  104  including first and second sections  112 ,  114 , and the buttress portion  106 . The first and second sections  112 ,  114  of the folded portion  104  can be folded and attached to one another before the surgical buttress  100  is disposed on or around the anvil assembly  40  of the surgical stapler  1  (e.g., prior to loading the surgical buttress  100  into a surgical buttress applicator  200  ( FIG. 6 )), or as the surgical buttress  100  is applied to the anvil assembly  40 . As discussed above, the first and second sections  112 ,  114  of the folded portion  104  can be attached to one other by, for example, welding, using adhesives, tying sutures, etc. 
     Turning now to  FIG. 6 , a surgical buttress loading assembly  201  is shown. The surgical buttress loading assembly  201  includes a surgical buttress applicator  200  configured for positioning the surgical buttress  100  onto a surgical stapler  1  ( FIG. 1 ) and/or removing the elongate member  102  and the folded portion  104  ( FIG. 1 ) of the surgical buttress  100  from a surgical site. The surgical buttress applicator  200  includes a base  210  sized and shaped to releasably retain the tubular body  110  ( FIG. 3 ) of the surgical buttress  100  therein, and a handle  220  configured to retain the elongate member  102  of the surgical buttress  100  therein. 
     As shown in  FIGS. 7 and 8 , the base  210  includes an elongate body  212  having a proximal end  212   a  and a distal end  212   b , and defines a cavity  213  therein. The cavity  213  is sized and shaped to slidably receive at least one of the anvil or staple cartridge assembly  40 ,  50  ( FIG. 1 ) of the surgical stapler  1  therein. The elongate body  212  includes a first or substantially flat wall section  214   a  corresponding to the tissue facing surface  48 ,  56  ( FIG. 2 ) of the anvil or staple cartridge assembly  40 ,  50  of the surgical stapler  1 , and a second or rounded wall section  214   b  configured to extend around the anvil or staple cartridge assembly  40 ,  50  and over the outwardly facing surface  46 ,  53  ( FIG. 2 ) of the anvil or staple cartridge assembly  40 ,  50 . 
     The proximal end  212   a  of the elongate body  212  defines an opening into the cavity  213  of the base  210 , and the distal end  212   b  is closed by a distal wall section  214   c . It is envisioned, however, that the distal end  212   b  of the elongate body  212  may be open. The proximal end  212   a  further includes first and second tabs  216   a ,  216   b  extending proximally and axially from the respective first and second wall sections  214   a ,  214   b  of the elongate body  212  in opposed relation relative to each other. The first and second tabs  216   a ,  216   b  are configured to engage the surgical buttress  100 . 
     The base  210  of the surgical buttress applicator  200  further includes a fin  218 . The fin  218  extends from the second wall section  214   b  of the elongate body  212 . The fin  218  includes a concave wall  218   a  defining an arcuate cut-out  219  configured to receive the handle  220  therein. 
     With reference now to  FIGS. 6 and 8 , the handle  220  includes an outer handle housing  230  and an inner handle housing  240  rotatably disposed within the outer handle housing  230 . The elongate member  102  of the surgical buttress  100  is spooled, wound or rolled around the inner handle housing  240  and extends through a slot  237  defined through the outer handle housing  230  such that the tubular body  110  of the surgical buttress  100  is positionable within the cavity  213  of the base  210 . 
     The outer handle housing  230  includes an outer wall  232  and an inner wall  234  defining an annular cavity  233  therebetween. The outer wall  232  includes a groove  235  defined therein that corresponds with, and is configured to frictionally engage, the concave wall  218   a  of the fin  218  of the base  210  to releasably retain the handle  220  within the arcuate cut-out  219  of the base  210 . The outer handle housing  230  further includes a pair of fingers  236  extending from the outer wall  232  that are configured to releasably engage the elongate tubular body portion  20  ( FIG. 1 ) of the surgical stapler  1 , and a slot  237  defined through the outer wall  232  that is sized and shaped for passage of the elongate member  102  of the surgical buttress  100  therethrough. 
     The inner wall  234  of the outer handle housing  230  includes flexible wall segments  238  extending radially around a central opening  239  defined in the outer handle housing  230 . The flexible wall segments  238  are movable to allow a user to insert or remove the inner handle housing  240  into or out of the annular cavity  233  of the outer housing  230 . At least one of the flexible wall segments  238  includes a lip  238   a  extending towards the outer wall  232  to help retain the inner handle housing  240  within the annular cavity  233 . In embodiments, at least two flexible wall segments  238  (e.g., opposed flexible wall segments  238 ) may each include a lip  238   a  extending therefrom and, in some embodiments, alternating flexible wall segments  238  may each include a lip  238   a  extending therefrom. 
     The inner handle housing  240  is concentric with and configured to be received within the annular cavity  233  of the outer handle housing  230 . The inner handle housing  240  includes an annular base  242  having an inner surface  242   a  configured to engage the inner wall  234  of the outer handle housing  230  and to be rotatably mounted thereon. The arcuate base  242  also includes an outer surface  242   b  that is configured to receive the elongate member  102  of the surgical buttress  100  therearound. Annular flanges  244   a ,  244   b  extend from opposed sides of the annular base  242  adjacent respective sides of the elongate member  102  when the elongate member  102  is wrapped around the annular base  242 . 
     In a method of assembling the handle  220 , the elongate member  102  of the surgical buttress  100  is wrapped around the outer surface  242   b  of the annular base  242  of the inner handle housing  240  such that the elongate member  102  conforms to the contour of the annular base  242 . The elongate member  102  is wound around the annular base  242  such that a majority of the elongate member  102  is wound around the inner handle housing  240 , and the tubular body  110  of the surgical buttress  100  freely extends therefrom. In embodiments, a terminal end of the elongate member  102  may be secured to the inner handle housing  240  and/or to itself (e.g., the terminal end may form a closed loop  107   a  ( FIG. 13 ) around the inner handle housing) to secure the elongate member  102  to the inner handle housing  240 . The tubular body  110  is passed through the slot  237  of the outer handle housing  230  and pulled therethrough, and the inner handle housing  240  is inserted into the annular cavity  233  of the outer handle housing  230 . 
     In a method of assembling the surgical buttress loading assembly  201 , the assembled handle  220  is positioned within the arcuate cut-out  219  of the base  210  of the surgical buttress applicator  200 , and the tubular body  110  of the surgical buttress  100 , which includes the folded and buttress portions  104 ,  106  of the surgical buttress  100 , is positioned within the cavity  213  of the base  210  of the surgical buttress applicator  200 . The folded portion  104  of the surgical buttress  100  is positioned adjacent to the second wall section  214   b  of the base  210  and the buttress portion  106  is disposed adjacent to the first wall section  214   a  of the base  210  such that the tubular body  110  is open to receive the anvil or staple cartridge assembly  40 ,  50  therein. 
     The inner handle member  240  may then be rotated relative to the outer handle member  230  to wind or unwind the elongate member  102  around the inner handle member  240  so that the elongate member  102  is made taut as shown in  FIG. 6 . In the loaded configuration shown in  FIG. 6 , the portion of the elongate member  102  extending between the base  210  and the handle  220  of the surgical buttress applicator  200  is secured to the second tab  216   b  of the base  210  to help retain the tubular body  110  of the surgical buttress  100  within the base  210 . The second tab  216   b  is positioned through an aperture  103  defined through the elongate member  102 . The aperture  103  may be formed during assembly of the surgical buttress  100  into the surgical buttress applicator  200 , or the aperture  103  may be pre-formed in the surgical buttress  100  prior to assembly. In some embodiments, the first tab  216   a  of the base  210  of the surgical buttress applicator  200  may be engaged with an aperture  105  ( FIG. 13 ) defined in the buttress portion  106  of the surgical buttress  100  to further help retain the tubular body  110  within the base  210  in an open configuration for receiving the anvil or staple cartridge assembly  40 ,  50  therein. 
     In a method of loading the surgical buttress  100  onto the surgical stapler  1 , as shown in  FIG. 9 , the surgical buttress loading assembly  201  is applied to the anvil assembly  40  of the surgical stapler  1 . A user grasps the handle  220  of the surgical buttress applicator  200  and manipulates the surgical buttress loading assembly  201  onto the anvil assembly  40  by aligning the cavity  213  ( FIG. 7 ) of the base  210  with the distal end of the anvil assembly  40  and sliding the surgical buttress applicator  200  proximally over the anvil assembly  40  until the anvil assembly  40  abuts the distal wall section  214   c  ( FIG. 7 ) of the base  210 . As discussed above, the shape (e.g., a transverse cross-sectional shape/profile) of the cavity  213  of the base  210  corresponds to the shape (e.g., a transverse cross-sectional shape/profile) of the anvil assembly  40  (or the staple cartridge assembly  50 ) for ease of application of the surgical buttress  100  thereon. 
     With the surgical buttress loading assembly  201  applied onto the anvil assembly  40  such that the anvil assembly  40  is received within the tubular body  110  of the surgical buttress  100  as well as within the base  210  of the surgical buttress applicator  200 , the handle  220  of the surgical buttress applicator  200  is detached from the base  210  and pulled proximally towards the user, thereby unrolling the elongate member  102  from within the handle  220  of the surgical buttress applicator  200 , as shown in  FIG. 10 . The handle  220  is secured to the elongate tubular body portion  20  of the surgical stapler  1  via the pair of fingers  236  of the outer handle housing  230  at a position proximal of the end effector  30 , such as adjacent to the handle assembly  10  ( FIG. 1 ) of the surgical stapler  1 , and/or at least at a location outside of a patient&#39;s body during a surgical procedure. The user can then grasp the base  210  of the surgical buttress applicator  200  and slide it distally off of the anvil assembly  40 . The base  210  may be removed from the anvil assembly  40  either prior to, or after, attaching the handle  220  to the surgical stapler  1 . As the base  210  is slid distally, the surgical buttress  100  disengages from the second tab  216   b  of the base  210  such that the surgical buttress  100  is left loaded on the anvil assembly  40 . The surgical stapler  1  is now ready for use. 
     In a method of use, the loaded surgical stapler  1  is introduced to a surgical site through a trocar or other access device. The surgical stapler  1  is operated within methods known by those skilled in the art. Once the anvil and staple cartridge assemblies  40 ,  50  are clamped onto tissue, the surgical stapler  1  is fired. In firing the surgical stapler  1 , the drive bar  64  ( FIG. 2 ) is advanced distally through the jaw assembly  30  urging the staple pushers  60  upwardly which, in turn, drive the staples  58  out of the staple pockets  55  and through the buttress portion  106  of the surgical buttress  100  as well as the captured tissue, thereby stapling the buttress portion  106  to the tissue. During firing, the knife blade  62  of the drive bar  64  travels distally while substantially simultaneously cutting and dividing the tissue as well as the buttress portion  106  of the surgical buttress  100  disposed between the rows of now formed staples  58 . 
     The folded portion  104  and the elongate member  102  of the surgical buttress  100  can then be detached from the now-stapled buttress portion  106  by pulling the handle  220  proximally to tear the folded portion  104  from the buttress portion  106  via the perforations  108 . The handle  220  may be pulled separately from the surgical stapler  1  by detaching the handle  220  from the elongate tubular body portion  20  of the surgical stapler  1 , or the handle  220  may be pulled when the surgical stapler  1  is pulled proximally away from the surgical site. Alternatively, the user may grasp an exposed portion of the elongate member  102  and pull the elongate member  102  directly. 
     It should be understood that additionally or alternatively, a surgical buttress loading assembly may be applied to the staple cartridge assembly of the surgical stapler and/or either the anvil assembly or the staple cartridge assembly can include a buttress material pre-loaded thereon. For example, in surgical stapling apparatus having staple cartridge assemblies that are removable and replaceable, the staple cartridge assembly may have a buttress pre-loaded onto it by the manufacturer. In these circumstances, the user can utilize a surgical buttress loading assembly that is ready for installation on the anvil assembly, as discussed above. In embodiments, the surgical stapling apparatus can be re-used on the same patient by reloading it with a staple cartridge assembly having a fresh set of staples ready to be fired and a fresh buttress material. A new surgical buttress loading assembly may be applied to the anvil assembly, as discussed above, or a fresh surgical buttress may be installed into the surgical buttress applicator, as also discussed above. 
     Further, the surgical buttress loading assembly can be sized and shaped to correspond to a particular jaw onto which it is to be assembled. For example, a first surgical buttress loading assembly may have a shape corresponding to the shape of the anvil assembly and a second surgical buttress loading assembly may have a shape corresponding to the staple cartridge assembly. As shown in  FIG. 1 , the anvil assembly  40  has a lower profile and is more curved in shape than the staple cartridge assembly  50 , which is deeper and may be rounded or more rectangular in shape. Accordingly, the surgical buttress and the surgical buttress applicator of the present disclosure may be any size and/or shape to accommodate a variety of surgical stapler sizes and/or configurations. 
     As shown, for example, in  FIGS. 11-13 , surgical buttresses, shown as anvil and cartridge buttresses  100   a ,  100   b , are respectively configured for use with the anvil and staple cartridge assemblies  40 ,  50  of the end effector  30  of the surgical stapler  1  ( FIG. 1 ) and likewise, surgical buttress applicators (not shown) are configured for use with the anvil and cartridge buttresses  100   a ,  100   b . The anvil and cartridge buttresses  100   a ,  100   b  each include an elongate member  102   a ,  102   b , a folded portion  104   a ,  104   b , and a buttress portion  106   a ,  106   b . Perforations  108   a ,  108   b  are disposed between the folded portion  104   a ,  104   b  and the buttress portion  106   a ,  106   b  of the respective anvil and cartridge buttress  100   a ,  100   b , and are optimized to allow for sequential detachment of the folded portion  104   a ,  104   b  from the buttress portion  106   a ,  106   b  when the elongate member  102   a ,  102   b  is pulled. The folded portion  106   a ,  106   b  and the buttress portion  106   a ,  106   b  are formed from a single sheet of material having the perforations  108   a ,  108   b  formed therein, and the elongate member  102   a ,  102   b  is attached to the respective folded portion  106   a ,  106   b . Loops  107   a ,  107   b  are disposed at terminal ends of the respective elongate member  102   a ,  102   b  and are configured for positioning around the inner handle housing of the respective surgical buttress applicator with which the anvil and cartridge buttresses  100   a ,  100   b  are utilized. 
     The surgical buttress may be provided and/or sold as part of the surgical buttress loading assembly that includes the surgical buttress and the surgical buttress applicator. Alternatively, the surgical buttress and the surgical buttress applicator may be provided and/or sold separately and assembled by the user. In embodiments, one or more surgical buttresses and one or more surgical buttress applicators are provided in a kit. In some embodiments, the kit further includes one or more end effectors and, in certain embodiments, the kit further includes a surgical stapler. 
     With reference now to  FIG. 14 , a surgical stapling apparatus or surgical stapler  2  in the form of an annular surgical stapling device is shown for use in stapling tissue and applying one or more buttress materials or surgical buttresses to tissue. The surgical stapler  2  generally includes a handle assembly  310 , an elongate tubular body  320  extending distally from the handle assembly  310 , and an end effector  330  extending distally from the elongate tubular body  320 . The end effector  330  includes an anvil assembly  332  and a staple cartridge assembly  334 . The anvil assembly  332  is releasably coupled to a distal end portion  322  of the elongate tubular body  320 , and the staple cartridge assembly  334  is disposed at the distal end portion  322  of the elongate tubular body  320 . 
     The handle assembly  310  includes at least one movable handle member  312  for actuating the firing of staples  410  ( FIG. 18 ) from the staple cartridge assembly  334  and the cutting of tissue secured between the anvil and staple cartridge assemblies  332 ,  334 . The handle assembly  310  further includes an advancing member  314  for moving the anvil assembly  332  between an open or spaced apart position and a closed or approximated position relative to the staple cartridge assembly  334 . 
     The elongate tubular body  320  may be flexible or rigid, and/or straight or curved along a portion or the entirety thereof. It should be understood that the elongate tubular body  320  may be otherwise configured (e.g., shaped and/or dimensioned) depending on, for example, the surgical application or procedure of use as is within the purview of those skilled in the art. The staple cartridge assembly  334  may be fixedly connected to the distal end portion  322  of the elongate tubular body  320  or may be configured to concentrically fit within, or be otherwise connected to, the distal end portion  322  of the elongate tubular body  320  such that the staple cartridge assembly  334  is removable and replaceable. 
     For a detailed description of the structure and function of exemplary surgical stapling apparatus, reference may be made to U.S. Pat. Nos. 4,473,077; 4,576,167; 5,005,749; 5,119,983; 5,588,579; 5,915,616; and 6,053,390, the entire contents of each of which are incorporated herein by reference. It should be understood that a variety of annular surgical stapling apparatus may be utilized with the surgical buttress assemblies of the present disclosure. 
     As shown in  FIGS. 14 and 15 , the anvil assembly  332  includes a head assembly  350  and a center rod assembly  360  pivotally secured to the head assembly  350 . The head assembly  350  includes a central post or connector  351 , a housing or anvil head  352 , a backup plate  353 , a cut ring assembly  354 , an anvil plate  356 , and a spacer  358 . The connector  351  extends proximally from the housing  352  and is dimensioned to operatively couple to a first end portion  362   a  of a center rod  362  of the center rod assembly  360 . The connector  351  may be substantially centrally positioned through a bore (not shown) defined in the housing  352 , or the connector  351  may be integrally or monolithically formed with the housing  352 . One or more openings  352   a  (e.g., pressure relief openings) are defined through the housing  352 , and the housing  352  includes an inner annular recess  352   b  and an outer annular recess  352   c  supporting the backup plate  353 , the cut ring assembly  354 , the anvil plate  356 , and the spacer  358  therein. 
     The anvil plate  356  is supported in the outer annular recess  352   c  of the housing  352  and includes a tissue facing surface  357  having a plurality of staple forming pockets  357   a  for receiving and deforming staples. The anvil plate  356  may include at least one tab  356   a  extending radially outwardly form the anvil plate  356  that is received within a cutout  352   d  formed in an outer rim of the housing  352 . The tab  356   a  and the cutout  352   d  function to align and/or properly locate and retain the anvil plate  356  within the outer annular recess  352   c  of the housing  352 . 
     The inner annular recess  352   b  is located between the connector  351  and the outer annular recess  352   c . The backup plate  353  includes a substantially centrally located opening  353   a  positioned and slidably mounted about the connector  351  within the inner annular recess  352   b . The backup plate  353  includes a raised center platform  353   b  and a pair of inwardly extending fingers  353   c , although other configurations are envisioned. 
     The cut ring assembly  354  includes a body  354   a  and a cover  354   b . The body  354   a  includes an opening  355   a  having an inner configuration substantially the same as the platform  353   b  of the backup plate  353  to facilitate positioning of the cut ring assembly  354  about the platform  353   b . The cover  354   b  includes a substantially centrally located opening  355   b  for receiving the connector  351  and is secured to an outwardly facing or proximal surface of the body  354   a . The cut ring assembly  354  may be fixedly secured or otherwise fastened to the backup plate  353 . 
     The spacer  358  is positioned in the inner annular recess  352   b  of the housing  352  between the backup plate  353  and an inner or proximally facing surface  352   e  of the housing  352 . The spacer  358  is annular and may include deformable tabs  358   a  which engage a distally facing surface of the backup plate  353 . The spacer  358  prevents the backup plate  353  and the cut ring assembly  354  from moving or being pushed into the inner annular recess  352   b  of the housing  352  until a predetermined force sufficient to deform the tabs  358   a  has been applied to the backup plate  353  and the cut ring assembly  354 . The predetermined force may be, for example, close to but less than the force applied by an annular knife  420  ( FIG. 18 ) of the staple cartridge assembly  334  to the cut ring assembly  354  as the surgical stapler  2  is fired. When the predetermined force is reached, e.g., during cutting of tissue, the backup plate  353  and the cut ring assembly  354  will move into the inner annular recess  352   b  of the housing  252  and compress the spacer  358 . It is envisioned that other crushable, deformable, collapsible, and/or movable spacing members may be used to retain the backup plate  353  and the cut ring assembly  354  in a fixed position until the predetermined force has been applied to the backup plate  353  and the cut ring assembly  354 . 
     In embodiments, the backup plate  353  may be omitted and the cut ring assembly  354  may be configured for positioning about the connector  351  within the housing  352  with the spacer  358  positioned in the inner annular recess  352   b  of the housing  352  between the cutting ring assembly  354  and the inner surface  352   e  of the housing  352 . 
     The center rod assembly  360  includes a center rod or anvil shaft  362 , a plunger  364 , and a plunger spring  365 . A pivot pin  366  pivotably secures the connector  351  of the head assembly  350  to the center rod  362  via throughbores  367  such that the head assembly  350  is pivotably mounted to the center rod assembly  360 . 
     The plunger  364  is slidably positioned in a bore  363   a  formed in a first end portion  362   a  of the center rod  362 . The plunger  364  includes an engagement finger  364   a  biased into engagement with the connector  351  by the plunger spring  365  to urge the head assembly  350  from a non-tilted or operative position to a pivoted or tilted position on the center rod  362 . In a preferred position, the fingers  353   c  formed on the backup plate  353  engage a top surface  362   b  of the center rod  362  to prevent the head assembly  350  from pivoting about the pivot pin  366 . When the anvil assembly  332  is attached to a surgical stapler  2  and the surgical stapler  2  is fired, the backup plate  353  and the cut ring assembly  354  are pushed into the inner annular recess  352   b  of the housing  352  about the connector  351  by the annular knife  420  ( FIG. 18 ) to move the fingers  353   c  of the backup plate  353  out of engagement with the top surface  362   b  of the center rod  362  and to permit the plunger  364  to pivot the head assembly  350  about the pivot pin  366 . The spacer  358  prevents inadvertent or premature movement of the backup plate  353  and the cut ring assembly  354  to prevent premature or inadvertent tilting of the head assembly  350 . 
     A retaining clip  368  is positioned in a transverse slot  351   a  formed in the connector  351  and is operatively engaged with the pivot pin  366 . After the backup plate  353  has been pushed into the inner annular recess  252   b  of the housing  252  by the annular knife  420  of the surgical stapler  2 , the retaining clip  368  is configured to prevent the backup plate  353  and the cut ring assembly  354  from sticking to the annular knife  420  when the anvil assembly  332  is moved away from the staple cartridge assembly  334 . 
     A second end portion  362   c  of the center rod  362  includes a bore  363   b  defined by flexible arms  362   d . The flexible arms  362   d  are configured and dimensioned to releasably secure a trocar (not shown) of the surgical stapler  2  to the center rod  362  of the anvil assembly  332 . A plurality of splines  362   e  are formed about the center rod  362  to align the anvil assembly  332  with the staple cartridge assembly  334  of the surgical stapler  2 , and a recessed portion  362   f  of the center rod  362  facilitates grasping of the anvil assembly  332  by a user (e.g., with a grasper). 
     With continued reference to  FIGS. 14 and 15 , a surgical buttress  370  is releasably coupled to the anvil assembly  332  of the surgical stapler  2  via an anvil cap  380 . The surgical buttress  370  may be fabricated from biocompatible materials which are bioabsorbable or non-absorbable, natural or synthetic materials, or combinations thereof, and may be porous, non-porous, or combinations thereof, as described above with respect to the surgical buttress  100 ,  200 . 
     The surgical buttress  370  includes a body or buttress portion  372  and a plurality of legs  374  extending radially outwardly from the body portion  372 . The body portion  372  has a generally circular or annular configuration defining a central aperture  373  therethrough. The body portion  372  is sized and dimensioned to extend over (e.g., completely cover) the tissue facing surface  357  of the anvil assembly  332 . The central aperture  373  is sized and dimensioned to allow passage of the center rod  362  of the anvil assembly  332  therethrough. In embodiments, the central aperture  373  has a diameter that is larger than the diameter of the center rod  362  of the anvil assembly  332  and, in some embodiments, the central aperture  373  has a diameter that is about the same as or smaller than the diameter of the center rod  362  such that the center rod  362  frictionally engages the surgical buttress  370 . The legs  374  of the surgical buttress  370  extend from the body portion  372  radially beyond the tissue facing surface  357  of the anvil assembly  332  such that the legs  374  can be wrapped around the housing  352  of the anvil assembly  332 . While the legs  374  are shown extending linearly and uniformly from the body portion  372 , other configurations of the legs  374  are envisioned. 
     The surgical buttress  370  is disposed on the anvil assembly  332  of the surgical stapler  2  with the body portion  372  selectively supported on and positioned over the tissue facing surface  357  of the anvil plate  356  and the legs  374  selectively positioned around the housing  352  such that free ends  374   a  of the legs  374  are adjacent an outer or distal surface  352   f  of the housing  352 . The legs  374  are releasably secured against the distal surface  352   f  of the housing  352  by the anvil cap  380 . 
     The anvil cap  380  includes a cap body  382  supported on the distal surface  352   f  of the housing  352 . The cap body  382  includes one or more pegs  384  extending proximally from an inner or proximal wall  382   a  of the cap body  382 . Each peg  384  has a split body including first and second legs  384   a ,  384   b  terminating at flanged ends  384   c . The first and second legs  384   a ,  384   b  are deflectable inwardly and outwardly relative to each other. The pegs  384  are positionable through the openings  352   a  defined in the housing  352  to facilitate securement of the anvil cap  380  to the housing  352  and to permit the anvil cap  380  to move relative to the housing  352  between an approximated or closed position and an unapproximated or open position, as described in further detail below. 
     The anvil cap  380  is utilized to releasably attach the surgical buttress  370  to the anvil assembly  332 . In the approximated position, as shown in  FIG. 16 , the pegs  384  of the anvil cap  380  are positioned through the openings  352   a  of the housing  352  of the anvil assembly  332  such that the proximal wall  382   a  of the anvil cap  380  abuts the distal surface  352   f  of the housing  352 , and engages and holds the legs  374  of the surgical buttress  370  therebetween. In embodiments, the legs  374  of the surgical buttress  370  are retained between a curved rim  382   b  of the body  382  of the anvil cap  380  and the distal surface  352   f  of the housing  352 . The flanged ends  384   c  of the pegs  384  of the anvil cap  380  are positioned adjacent to (e.g., against) the backup plate  353  of the anvil assembly  332 . Upon firing of the surgical stapler  2 , the cutting ring assembly  354  and the backup plate  353  are moved towards and into engagement with the pegs  384  to move the anvil cap  380  to the unapproximated position, as shown in  FIG. 17 . In the unapproximated position, the pegs  384  and thus, the anvil cap  380  are moved distally or axially away from the housing  352  to create a gap “G” between the housing  352  and the anvil cap  380  such that the legs  374  of the surgical buttress  370  can be released from the anvil assembly  332  and the surgical buttress  370  can separate from the anvil assembly  332 . The flanged ends  384   c  of the pegs  384  act as self-locking features to ensure that the anvil cap  380  remains attached to, and does not pop off the housing  352  when moved between the approximated and unapproximated positions. 
     In a method of assembling the surgical buttress  370  to the stapler  2 , the body portion  372  of the surgical buttress  370  is position adjacent to the tissue facing surface  357  of the anvil plate  356  and the legs  374  are wrapped around the housing  352  of the anvil assembly  332  such that the free ends  374   a  of the legs  370  of the surgical buttress  374  are positioned adjacent the distal surface  352   f  of the housing  352 . The anvil cap  380  is then attached to the housing  352  by aligning the pegs  384  with the openings  352   a  defined in the housing  352  and axially pushing the anvil cap  380  towards the housing  352  and into the approximated position such that the legs  374  of the surgical buttress  370  are trapped between the anvil cap  380  and the housing  352 . During movement of the anvil cap  380  towards the housing  352 , the first and second legs  384   a ,  384   b  of each of the pegs  384  are deflected towards each other as the flanged ends  384   c  are compressed into the opening  352   a  of the housing  352  and then return to their biased position such that the flanged ends  384   c  of the pegs  384  are slidably retained within the housing  352 . The anvil assembly  332 , with loaded surgical buttress  370 , is ready for use with the surgical stapler  2  according to methods within the purview of those skilled in the art. 
     With reference now to  FIG. 18 , in conjunction with  FIG. 14 , the staple cartridge assembly  334  is disposed at the distal end portion  322  of the elongate tubular body  320  of the surgical stapler  2  and is configured to fire and form an annular array of surgical fasteners or staples, and to sever a ring of tissue. The staple cartridge assembly  334  includes a housing  390  having a staple guide  400 , a plurality of staples  410 , an annular knife  420 , and a staple pusher  430  disposed therein. The staple guide  400  includes a tissue facing surface  402  defining at least one annular array of staple receiving slots  404  therein. The plurality of staples  410  are disposed, one each, in each of the staple receiving slots  404 . The staple pusher  430  includes a proximal portion  430   a  having a generally frusto-conical shape and a distal portion  430   b  defining at least one concentric ring of peripherally spaced fingers  432 , each of which is received within one of the respective staple receiving slots  404  of the staple guide  400 . The annular knife  420  is mounted to the staple pusher  430  and is substantially in the form of an open cup with a rim thereof defining a knife edge  422 . The annular knife  420  is disposed radially inward of the staples  410  and the staple receiving slots  404  of the staple guide  400  such that, in use, as the staple pusher  430  is advanced, the annular knife  420  is also advanced axially in a linear direction. 
     A surgical buttress assembly  440  is releasably coupled to the staple cartridge assembly  334  of the surgical stapler  2 . The surgical buttress assembly  440  includes a surgical buttress  450  and an elongate member, tether or leash  460 . The surgical buttress  450  may be fabricated from biocompatible materials which are bioabsorbable or non-absorbable, natural or synthetic materials, or combinations thereof, and may be porous, non-porous, or combinations thereof, as described above with respect to the surgical buttress  100 ,  200 ,  370 . 
     As seen in  FIGS. 14 and 19 , the surgical buttress  450  is substantially the same as surgical buttress  370  and includes a body or buttress portion  452  and a plurality of legs  454  extending radially outwardly from the body  452 . The body  452  has a generally circular or annular configuration defining a central aperture  453  therethrough. The body  452  is sized and dimensioned to extend over (e.g., completely cover) the tissue facing surface  402  of the staple cartridge assembly  334 . The central aperture  453  is sized and dimensioned to allow passage of the center rod  362  of the anvil assembly  332  therethrough. The legs  454  of the surgical buttress  450  extend from the body  452  radially beyond the tissue facing surface  402  of the staple cartridge assembly  334 . Together, the body  452  and the legs  454  are sized and shaped to be positioned over the staple cartridge assembly  334 . 
     The elongate member  460  is secured to the legs  454  of the surgical buttress  450  and extends proximally therefrom. The elongate member  460  is of a sufficient length to be accessible outside of a patient&#39;s body and may extend the length of the elongate tubular body  320  of the surgical stapler  2  (e.g., at least to or beyond the handle assembly  310 ). As seen in  FIG. 14 , the elongate member  460  may be wrapped or loosely tied along the length of the elongate tubular body  320 , or the elongate member  460  may extend freely along the length thereof. The elongate member  460  may be a band, a cord, a rope, a strap, a suture, among other elongate structures tethered to the legs  454  of the surgical buttress  450 . 
     As shown in  FIG. 19 , the legs  454  of the surgical buttress  450  are disposed equidistantly around the body  452 . Each of the legs  374  is configured to include at least one opening or cutout disposed in a portion of the leg  454  adjacent the body  452  that will be aligned with the elongate member  460  ( FIG. 14 ). For example, a first leg  454   a  includes a pair of openings  455  defined therein, a second leg  454   b  disposed in opposed relation relative to the first leg  454   a  defines an elongated opening or slot  456  therein, and third and fourth legs  454   c ,  454   d  each include a pair of opposed cutouts  457  (e.g., recesses or notches) defined therein. 
     With reference again to  FIGS. 14 and 19 , a central portion  460   a  of the elongate member  460  is looped through the pair of openings  455  defined in the second leg  454   a , and first and second elongated portions  460   b ,  460   c  of the elongate member  460  are passed under the second and third legs  454   c ,  454   d , respectively, such that the elongate member  460  is aligned with and positioned beneath the opposed cutouts  457  defined in the third and fourth legs  454   c ,  454   d . The first and second elongated portions  460   b ,  460   c  are then passed through the elongated opening  456  of the second leg  454   b  and guided proximally along the elongate tubular body  320  of the surgical stapler  2 . In embodiments, a sleeve tube  480  is utilized to hold free ends  454   e  of the legs  454  against the housing  390  of the staple cartridge assembly  334 . Alternatively, the free ends  454   e  of the legs  454  may be secured to the staple cartridge assembly  334  via any suitable attachment features within the purview of those skilled in the art, such as, mechanical attachment features (e.g., sutures, pins), chemical attachment features (e.g., adhesives), and/or attachment methods (e.g., welding). 
     When the elongate member  460  is pulled away from the elongate tubular body  320  (e.g., proximally towards a user), the elongate member  460  breaks (e.g., cuts or tears) through the legs  454  of the surgical buttress  450  as shown in  FIG. 20 . From an initial stage, the elongate member  460  first tears through the second leg  454   b  of the surgical buttress  450 , then through the third and fourth legs  454   c ,  454   d , and finally through the first leg  454   a  thus separating the legs  454  from the body  452  so that the body  452  is free and the legs  454  remain secured to the staple cartridge assembly  334 . Other configurations of the legs  454  of the surgical buttress  450  are also envisioned that are suitable for separating the legs  454  from the body  452  of the surgical buttress  450  (e.g., weakened, perforated, and/or thinner regions of the legs) via the elongate member  460 . 
     In a method of use, the loaded surgical stapler  2  is introduced to a surgical site. Specifically, the surgical stapler  2  and detachable anvil assembly  332  are used in an anastomosis procedure to effect joining of tissue sections (e.g., intestinal or other tubular organ sections). The surgical stapler  2  is operated within methods known by those skilled in the art. Once the anvil and staple cartridge assemblies  332 ,  334  are positioned in the tissue sections and the anvil assembly  332  has been connected to the elongated tubular body  320  of the surgical stapler  2 , the anvil assembly  332  is approximated towards the elongated tubular body  320  (e.g., via the advancing member  314  of the handle assembly  310 ) to approximate the tissue sections and the surgical stapler  2  is fired (e.g., via movable handle members  312 ) to fire the staples  410  from the staple cartridge assembly  334  towards the housing  352  of the anvil assembly  332  to effect stapling of the tissue sections to one another, as well as the surgical buttresses  370 ,  450  to the tissue sections. During firing, the annular knife  420  cuts the stapled tissue sections, as well as any portion of the surgical buttresses  370 ,  450  extending radially inwardly of the annular knife  420  to complete the anastomosis. 
     During actuation of the surgical stapler  2 , the cut ring assembly  334  is pushed axially such that the anvil cap  380  is moved distally away from the anvil assembly  332  from the approximated position to the unapproximated position, as described above, so that the legs  374  of the surgical buttress  370  associated with the anvil assembly  332  are free to release the now-stapled surgical buttress  370  therefrom. The surgical buttress  450  associated with the staple cartridge assembly  334  can then be detached from the now-stapled body  452  of the surgical buttress  450  by pulling the elongate member  460  proximally to separate the legs  454  from the body  452 , as described above. 
     In any of the embodiments disclosed herein, the surgical buttress can include, or be used with, brachytherapy, chemotherapy, other medical materials or pharmaceuticals. The buttress portion or body 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 or body 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 applied as part of a suture or suture or other feature. 
     It should be understood that the surgical buttresses, surgical buttress loading assemblies, and/or surgical buttress assemblies described herein may be used with other surgical apparatus, such as electromechanical surgical devices as described, for example, in U.S. Patent Appl. Pub. Nos. 2015/0157320 and 2015/0157321, and U.S. patent application Ser. No. 15/972,606, filed on May 7, 2018, the entire contents of each of which are incorporated herein by reference. 
     For example, as shown in  FIG. 21 , a surgical device  500  is in the form of a powered handheld electromechanical instrument. The surgical device  500  includes a handle assembly  510  configured for selective connection with an adapter assembly  520  and, in turn, the adapter assembly  200  is configured for selective connection with an end effector  530 . Surgical buttresses  100 ,  100   a ,  100   b  and/or surgical buttress loading assembly  201  may be configured for use with the end effector  530  of the surgical device  500 . As another example, as shown in  FIG. 22 , a surgical device  600 , also in the form of a powered handheld electromechanical instrument, includes the handle assembly  510  configured for selective connection with an adapter assembly  620  and, in turn, the adapter assembly  620  is configured for selective connection with an end effector  630 . Surgical buttress assemblies including the surgical buttress  370  and the anvil cap  380 , and/or the surgical buttress  450  and the elongate member  460  may be configured for use with the end effector  630  of the surgical device  600 . 
     While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. It is to be understood, therefore, that the present disclosure is not limited to the precise embodiments 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, the elements and features shown and described in connection with certain embodiments may be combined with the elements and features of certain other embodiments without departing from the scope of the present disclosure, and that such modifications and variation are also included within the scope of the present disclosure. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Thus the scope of the embodiments should be determined by the appended claims and their legal equivalents, rather than by the examples given.