Patent Description:
<CIT> discloses an anvil for a surgical end effector which has a staple-forming surface having a plurality of pockets defined therein. The pockets are nested. A first pocket includes a proximal cup, a distal cup, and a pocket axis which extends between the proximal cup and the distal cup. The pocket is asymmetric relative to the pocket axis. A central axis transects the pocket between the proximal cup and the distal cup. The pocket is also asymmetric relative to the central axis. The pockets are obliquely oriented relative to a longitudinal axis of the anvil. <CIT> discloses an end effector and a staple cartridge. The staple cartridge includes an array of staples in which at least one staple is angularly-oriented relative to the longitudinal axis of the staple cartridge. The angled staple(s) provide longitudinal flexibility to the stapled tissue. Additionally, the staple cartridge and/or the end effector are configured to provide variable degrees of compression to tissue. For example, the compression of tissue before, during and/or after stapling can be optimized.

The present invention provides a surgical stapling assembly as recited in claim <NUM>. Optional features are recited in the dependent claims.

The various aspects described herein, both as to organization and methods of operation, together with further objects and advantages thereof, may best be understood by reference to the following description, taken in conjunction with the accompanying drawings as follows.

Corresponding reference characters indicate corresponding parts throughout the several views.

Certain exemplary assemblies will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these exemplary assemblies are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting and that the scope of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary assembly may be combined with the features of other exemplary assemblies.

The terms "comprise" (and any form of comprise, such as "comprises" and "comprising"), "have" (and any form of have, such as "has" and "having"), "include" (and any form of include, such as "includes" and "including") and "contain" (and any form of contain, such as "contains" and "containing") are open-ended linking verbs. As a result, a surgical system, device, or apparatus that "comprises," "has," "includes" or "contains" one or more elements possesses those one or more elements, but is not limited to possessing only those one or more elements. Likewise, an element of a system, device, or apparatus that "comprises," "has," "includes" or "contains" one or more features possesses those one or more features, but is not limited to possessing only those one or more features.

The terms "proximal" and "distal" are used herein with reference to a clinician manipulating the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the clinician and the term "distal" refers to the portion located away from the clinician. It will be further appreciated that, for convenience and clarity, spatial terms such as "vertical", "horizontal", "up", and "down" may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily appreciate that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present Detailed Description proceeds, the reader will further appreciate that the various instruments disclosed herein can be inserted into a body in any way, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device that has a working channel through which the end effector and elongate shaft of a surgical instrument can be advanced.

A surgical stapling system can comprise a shaft and an end effector extending from the shaft. The end effector comprises a first jaw and a second jaw. The first jaw comprises a staple cartridge. The staple cartridge is insertable into and removable from the first jaw; however, other embodiments are envisioned in which a staple cartridge is not removable from, or at least readily replaceable from, the first jaw. The second jaw comprises an anvil configured to deform staples ejected from the staple cartridge. The second jaw is pivotable relative to the first jaw about a closure axis; however, other embodiments are envisioned in which the first jaw is pivotable relative to the second jaw. The surgical stapling system further comprises an articulation joint configured to permit the end effector to be rotated, or articulated, relative to the shaft. The end effector is rotatable about an articulation axis extending through the articulation joint. Other embodiments are envisioned which do not include an articulation joint.

The staple cartridge comprises a cartridge body. The cartridge body includes a proximal end, a distal end, and a deck extending between the proximal end and the distal end. In use, the staple cartridge is positioned on a first side of the tissue to be stapled and the anvil is positioned on a second side of the tissue. The anvil is moved toward the staple cartridge to compress and clamp the tissue against the deck. Thereafter, staples removably stored in the cartridge body can be deployed into the tissue. The cartridge body includes staple cavities defined therein wherein staples are removably stored in the staple cavities. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of a longitudinal slot and three rows of staple cavities are positioned on a second side of the longitudinal slot. Other arrangements of staple cavities and staples may be possible.

The staples are supported by staple drivers in the cartridge body. The drivers are movable between a first, or unfired position, and a second, or fired, position to eject the staples from the staple cavities. The drivers are retained in the cartridge body by a retainer which extends around the bottom of the cartridge body and includes resilient members configured to grip the cartridge body and hold the retainer to the cartridge body. The drivers are movable between their unfired positions and their fired positions by a sled. The sled is movable between a proximal position adjacent the proximal end of the cartridge body and a distal position adjacent the distal end of the cartridge body. The sled comprises a plurality of ramped surfaces configured to slide under the drivers and lift the drivers, and the staples supported thereon, toward the anvil.

Further to the above, the sled is moved distally by a firing member. The firing member is configured to contact the sled and push the sled toward the distal end. The longitudinal slot defined in the cartridge body is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member further comprises a first cam which engages the first jaw and a second cam which engages the second jaw. As the firing member is advanced distally, the first cam and the second cam can control the distance, or tissue gap, between the deck of the staple cartridge and the anvil. The firing member also comprises a knife configured to incise the tissue captured intermediate the staple cartridge and the anvil. It is desirable for the knife to be positioned at least partially proximal to the ramped surfaces such that the staples are ejected ahead of the knife.

Firing a surgical stapling assembly can involve advancing a firing member in a first direction to move the fasteners in a second direction. For example, a firing member can be advanced distally along a longitudinal axis of a fastener cartridge during a firing stroke. The firing member, or sled, can include longitudinal rails, which are configured to engage corresponding ramped surfaces on staple-supporting drivers. Movement of the rails along the ramped surfaces can convert the longitudinal movement of the firing member to a transverse, lifting movement of the drivers. As the drivers are lifted vertically in the fastener cartridge, the fasteners can be pushed upward and out of the fastener cartridge.

The firing member is configured to transmit significant forces to the drivers during the firing stroke. These forces are sufficient to eject the fasteners from cavities in the fastener cartridge and into tissue clamped between jaws of a surgical end effector. The geometry of the drivers relative to the cartridge body can facilitate a smooth firing motion. Conversely, ill-fitting drivers relative to the cartridge body can be prone to torqueing or twisting during the firing motion, which can result in misfired fasteners and/or jamming of the surgical end effector.

The arrangement of the staples in a resultant staple line is also an important consideration. Certain staple line geometries can better accommodate stretching or movement of the stapled tissue. For example, staple lines having obliquely-oriented staples relative to a centerline, or cutline, can better facilitate tissue extension in certain instances. For example, the stapled tissue may be able to stretch and flex more when the staple line includes obliquely-oriented staples. However, obliquely-oriented staples present additional challenges regarding nesting obliquely-oriented staples in a fastener cartridge, nesting obliquely-oriented forming pockets in an anvil that aligned with the obliquely-oriented staples, balancing the torque during a firing stroke, and supporting the staple during the firing motion, and among other things.

In certain aspects of the present disclosure, a resultant staple line can include staples oriented at increasing angles outward from the centerline. For example, staples in an intermediate staple row can be positioned at a greater angle relative to the centerline than staples in an inner staple row and at a lesser angle relative to the centerline than staples in an outer staple row. Additionally or alternatively, the resultant staple line can include a space between adjacent staples in the same row that increases outward from the centerline. For examples, staples in an intermediate row can be spaced apart more than staples in the inner staple row and less than staples in the outer staple row.

In certain instances, the resultant staple line can include both longitudinally-oriented staples and obliquely-oriented staples. For example, a first row can include longitudinally-oriented staples, and a second row can include obliquely-oriented staples. Longitudinally-oriented staples can be parallel to the longitudinal axis and/or firing path through the cartridge body. In various instances, the longitudinally-oriented staples can be positioned adjacent to the cutline, which can advance sealing and hemostasis along the cutline. For example, the innermost row of staples (on one or both sides of the cutline) can include longitudinally-oriented staples, and the outer row or rows of staples (on one or both sides of the cutline) can include obliquely-oriented staples.

Additionally or alternatively, the resultant staple line can also include both planar staples (e.g. <NUM>-D staples) and non-planar staples (e.g. <NUM>-D staples). For example, a first row can include planar staples, and a second row can include non-planar staples. Non-planar staples can form a modified B-shape in which the staple legs diverge away from the centerline and base of the staple. In various instances, the planar staples can be positioned adjacent to the cutline, which can advance sealing and hemostasis along the cutline. For example, the innermost row of staples (on one or both sides of the cutline) can include planar staples, and the outer row or rows of staples (on one or both sides of the cutline) can include non-planar staples. In certain instances, the planar staples can be aligned with the longitudinal axis and the non-planar staples can be obliquely-oriented relative to the longitudinal axis.

The improved fastener cartridges and staple patterns further described herein can better balance the staple drivers, prevent driver roll, assure tight fits between the drivers and the cavities, preserve the wall thicknesses of the cartridge body and/or protect the integrity of the driver ramps against the sled in certain instances. These improvements and others are further described herein.

<FIG> depicts a surgical stapling assembly <NUM> in an open configuration. More specifically, the surgical stapling assembly includes a first jaw <NUM> and a second jaw <NUM> configured to move between the open position and a closed position. In the closed position, the jaws <NUM> and <NUM> can close on tissue to grip, clamp, manipulate, and otherwise effect the tissue. The first jaw <NUM> is configured to pivot relative to the second jaw <NUM>. In other instances, the second jaw <NUM> can be configured to pivot relative to the first jaw <NUM>. One jaw <NUM> or <NUM> can be fixed and the other jaw <NUM> or <NUM> can pivot in certain instances. In other instances, both jaws <NUM> and <NUM> can pivot to move the surgical stapling assembly between the open configuration and the closed configuration.

The surgical stapling assembly <NUM> further includes an elongate channel <NUM> and an anvil <NUM>. The elongate channel <NUM> is configured to receive a fastener cartridge assembly <NUM>. The fastener cartridge assembly <NUM> can be removably positioned in the elongate channel <NUM>. For example, the surgical stapling assembly <NUM> can be a reusable component and the fastener cartridge assembly <NUM> can be a replaceable component, which can be replaced with another fastener cartridge assembly <NUM> for a subsequent firing and/or subsequent use. An anvil <NUM> opposes the fastener cartridge assembly <NUM>. The anvil is configured to form fasteners ejected from the fastener cartridge assembly during a firing stroke.

Referring primarily to <FIG>, the fastener cartridge assembly <NUM> includes a cartridge body <NUM> having a longitudinal knife slot <NUM> defined at least partially through the cartridge body <NUM> from a proximal end <NUM> of the cartridge body <NUM> toward the distal end <NUM> of the cartridge body <NUM>. The longitudinal knife slot <NUM> is configured to receive a firing member therethrough. An upright portion of the firing member can include a cutting edge. In certain instances, the cutting edge is configured to translate through the fastener cartridge assembly <NUM> during a firing stroke to sever tissue clamped between the jaws <NUM> and <NUM>.

The cartridge body <NUM> further includes a tissue-supporting deck <NUM>. Cavities <NUM> are defined into the tissue-supporting deck <NUM> forming openings therein. The cavities <NUM> are configured to receive fasteners and guide the fasteners toward and into tissue during a firing motion. The cavities <NUM> are arranged in a plurality of rows <NUM>.

Referring primarily to <FIG>, the cartridge body <NUM> includes three rows <NUM> on both sides of the longitudinal knife slot <NUM>. The rows includes an inner row 216a comprised of inner cavities 214a, an intermediate row 216b comprised of intermediate cavities 214b, and an outer row 216c comprised of outer cavities 214c.

In other instances, the cartridge body <NUM> can include additional rows of cavities or fewer rows of cavities on one or both sides of the longitudinal knife slot <NUM>. In certain instances, the fastener cartridge assembly <NUM> can be symmetrical about a longitudinal axis A and the rows of cavities can be symmetrical about the longitudinal axis A. In other instances, the rows of cavities can be asymmetrical about the longitudinal axis A.

The inner cavities 214a in cartridge body <NUM> are longitudinally-oriented relative to the longitudinal axis A. The intermediate cavities 214b and the outer cavities 214c are obliquely-oriented relative to the longitudinal axis A. The intermediate cavities 214b are angled away from the longitudinal axis A, and the outer cavities are angled toward the longitudinal axis A. In such instances, the longitudinal alignment of the inner cavities 214a and the angled orientations of the intermediate cavities 214b and the outer cavities 214c allow the intermediate cavities to nest closely between the inner cavities 214a and the outer cavities 214c. The nested arrangement of staple cavities positioned at different angular orientations can provide a compact arrangement of staple cavities and corresponding staples. Various exemplary dimensions, which enable to the array of drivers, staples, forming-pockets, and so on to fit within the small form factor of a fastener cartridge assembly for minimally-invasive surgeries, for example.

Referring primarily to <FIG>, the fastener cartridge assembly <NUM> further comprises a cartridge pan <NUM> configured to encase a portion of the cartridge body <NUM>. Staples <NUM> are removably positioned in the cavities <NUM> in the cartridge body <NUM>. The staples <NUM> can be V-shaped staples having a linear base, a first leg extending from a first end of the linear base, and a second leg extending from the second end of the linear base. The first leg and the second leg splay laterally outward to engage the inside walls of the cavities <NUM>. The staples <NUM> can be held in the cavities <NUM> prior to a firing stroke with a friction-fit connection between the legs and the inside walls of the cavities <NUM>.

The staples <NUM> are movably supported by drivers <NUM>, <NUM> in the cartridge body <NUM>. The drivers <NUM>, <NUM> are triple drivers. Each driver <NUM>, <NUM> includes three cradles and is configured to support a staple <NUM> in the inner row 216a, a staple <NUM> in the intermediate row 216b, and a staple <NUM> in the outer row 216c. To support the staples <NUM> oriented at different angles across multiple rows <NUM>, the triple drivers <NUM>, <NUM> include support columns comprising cradles oriented at different angles, connectors between the support columns, and ramps <NUM> (i.e. inner ramps 228a and outer ramps 228b) (<FIG>) on the underside configured to be driven by a (<NUM> during the firing stroke. The drivers <NUM>, <NUM> are first drivers <NUM> on a first side (e.g. right side) of the cartridge body <NUM>, and second drivers <NUM> on a second side (e.g. left side) of the cartridge body <NUM>. The first driver <NUM> is a mirror image of the second driver <NUM> owing to the symmetrical arrangement of the cavities <NUM> and the staples <NUM> on either side of the longitudinal axis A. The cartridge pan <NUM> is configured to retain the drivers <NUM>, <NUM> in the cartridge body <NUM>.

The fastener cartridge assembly <NUM> also includes the sled <NUM> configured to translate distally during a firing motion to engage the drivers <NUM>, <NUM> and lift the drivers <NUM>, <NUM> to eject the fasteners <NUM> from the cartridge body <NUM>. Referring primarily to <FIG>, the sled <NUM> is a four-rail sled having a connecting flange <NUM>, a central upright <NUM> configured to move through the longitudinal knife slot <NUM>, a pair of inner rails <NUM>, and a pair of outer rails <NUM>. An inner rail <NUM> and an outer rail <NUM> are configured to driving engage an inner ramp 228a and an outer ramp 228b, respectively, of each driver <NUM>, <NUM> to lift the drivers <NUM>, <NUM> toward the deck <NUM>.

As further described herein, the sled <NUM> can be comprised of metal, which can enable the inner rails <NUM> and the outer rails <NUM> to be narrower while transmitting sufficient forcesto the drivers <NUM>, <NUM> without buckling or otherwise deforming under the load. Narrower rails correspond to narrower rail channels through the cartridge body <NUM> such that the cartridge body walls can be widened to better guide the drivers <NUM>, <NUM> and staples <NUM> thereon during the firing stroke.

<FIG> and <FIG> depict the fastener cartridge assembly <NUM> in which the sled <NUM> is advanced distally from a proximal-most position to an intermediate position mid-firing stroke. The inner rails <NUM> and the outer rails <NUM> are engaged with multiple adjacent drivers <NUM>, <NUM> during the firing stroke and the proximal-most drivers <NUM>, <NUM> have already been driven upward through the cavities <NUM> to fire the proximal-most staples <NUM> out of the cartridge body <NUM>. The drivers <NUM>, <NUM> and the staples <NUM> supported thereon are progressively driven and fired from the proximal end <NUM> to the distal end <NUM> of the cartridge body <NUM> during the firing stroke. The reader will appreciate that the sequential proximal-to-distal driving of drivers <NUM>, <NUM> and firing of staples <NUM> is configured to seal tissue adjacent to a cutline in close proximity to the cutting. For example, the staples <NUM> can be configured to engage and seal tissue as the cutting edge transects the intermediate tissue. In certain instances, transection can immediately following stapling.

Upon completion of the firing stroke, the drivers <NUM>, <NUM> can be driven upward in the cavities <NUM> to lift the staples <NUM> out of the cartridge body <NUM>. Referring primarily to <FIG>, the drivers <NUM> have been lifted to their fully fired positions in which the staple-supporting cradles thereof are positioned outside the cartridge body <NUM>. In such instances, the drivers <NUM> have been overdriven. Overdrive of the drivers <NUM> allows the bases of the staples <NUM> to clear the deck <NUM> and completely disengage the fastener cartridge assembly <NUM> during the firing stroke.

Referring now to <FIG> and <FIG>, a proximal portion of the fastener cartridge assembly <NUM> is shown with the sled <NUM> in an unfired, proximal position. The rows <NUM> of cavities <NUM> are symmetric about the longitudinal knife slot <NUM>. Each cavity <NUM> includes a proximal end <NUM> and a distal end <NUM>. The first cavities ( in the first rows 216a (and the deck openings thereof) are longitudinally-oriented relative to the longitudinal axis A. For example, each first cavities 214a can define a first proximal-to-distal axis PD1 between its proximal end <NUM> and its distal end <NUM>. The first proximal-to-distal axes PD1 are parallel to the longitudinal axis A. The first cavities 214a are longitudinally-spaced apart a first length L1. The first length L1 is defined in a longitudinal direction from the distal end <NUM> of one first cavity214a to the proximal end <NUM> of the adjacent first cavity 214a in the first row 216a.

The second cavities 214b in the second rows 216b (and the deck openings thereof) are obliquely-oriented relative to the longitudinal axis A. For example, each second cavity 214b can define a second proximal-to-distal axis PD2 between its proximal end <NUM> and its distal end <NUM>. The second proximal-to-distal axes PD2 are obliquely-oriented relative to the longitudinal axis A at a second cavity angle θ2. The second proximal-to-distal axes PD2 are angled away from the longitudinal axis A. The second cavities 214b are longitudinally-spaced apart a second length L2. The second length L2 is defined in a longitudinal direction from the distal end <NUM> of one second cavity 214b to the proximal end <NUM> of the adjacent second cavity 214b in the second row 216b.

The third cavities 214c in the third rows 216c (and the deck openings thereof) are obliquely-oriented relative to the longitudinal axis A. For example, each third cavity 214c can define a third proximal-to-distal axis PD3 between its proximal end <NUM> and its distal end <NUM>. The third proximal-to-distal axes PD3 are obliquely-oriented relative to the longitudinal axis A at a third cavity angle θ3. The third proximal-to-distal axes PD3 are angled toward the longitudinal axis A. The third cavities 214c are longitudinally-spaced apart a third length L3. The third length L3 is defined in a longitudinal direction from the distal end <NUM> of one third cavity 214c to the proximal end <NUM> of the adjacent third cavity 214c in the third row 216c.

The third cavity angle θ3 is greater than the second cavity angle θ2. For example, the second cavity angle θ2 can be approximately <NUM> degrees, and the third cavity angle θ3 can be approximately <NUM> degrees. Both the second and third cavities angles θ2, θ3 are greater than the angle at which the first cavities 214a are oriented relative to the longitudinal axis. For example, where the first cavities 214a are parallel to the longitudinal axis A, the angle of the first cavities 214a relative to the longitudinal axis A can be zero. In various instances, the angular orientation of the staple cavities <NUM> can define an increasing gradient from the centerline outbound toward the lateral sides of the cartridge body <NUM>. For example, where the fastener cartridge assembly <NUM> includes a fourth row <NUM> of cavities <NUM> on one (or both) sides of the longitudinal knife slot <NUM>, the fourth row <NUM> could be oriented at a greater angle than second cavity angles θ3, for example.

The third cavity angle θ3 can be sufficiently angled such that the sled <NUM> can pass completely under the staples <NUM> in the outer row 216c while still providing sufficient space for a cartridge outside wall to vertically support the outside portion of the driver <NUM>, <NUM> and the staple <NUM> thereon. For example, the third cavity angle θ3 can be greater than or less than <NUM> degrees in certain instances while still maintaining a minimum outside wall thickness that is sufficient for vertical support and suitable for injection molding (e.g. around a <NUM> inch (<NUM>) minimum wall thickness).

The third length L3 is greater than the second length L2 and the first length L1. In various instances, the first length L1 is less than the second length L2 such that the longitudinal lengths between adjacent cavities <NUM> increases laterally outboard from the longitudinal axis A. Stated differently, as the angular orientation of the cavities <NUM> increases, the longitudinal length between adjacent cavities <NUM> also increases.

Referring primarily now to <FIG>, the end-to-end distance between each staple cavity corresponds to a staple gap between the distal end of one staple <NUM> and the proximal end of an adjacent staple in the same row. The inner cavities 214a define a first gap G1, the intermediate cavities 214b define a second gap G2, and the outer cavities 214c define a third gap G3. The third gap G3 is greater than the second gap G2 and the first gap G1. In various instances, the first gap G1 is less than the second gap G2 such that gaps between adjacent staples <NUM> in a staple line increase laterally outboard from the longitudinal axis A. Stated differently, as the angular orientation of the staples <NUM> increases, the staple gaps between adjacent staples <NUM> also increase. For example, the first gap G1 can be approximately <NUM> inches (). <NUM>), the second gap G2 can be approximately <NUM> inches (<NUM>), and the third gap G3 can be approximately <NUM> inches (<NUM>).

Referring primarily now to <FIG>, the third proximal-to-distal axis PD3 for the outer row 216c intersects the longitudinal axis A along with the outer sled rail <NUM> translated at the geometric center 263c of the support column 261c in the outer cavity 214c. In other words, the outer rail <NUM> passes through the proximal-to-distal axis PD3 at the geometric center 263c and the channel slot <NUM> through the cartridge body <NUM> for receiving and guiding the outer rail <NUM> is positioned far enough inward away from the outside face <NUM> of the cartridge body <NUM> to maintain the minimum wall thickness between the outer cavity 214c and the outside face <NUM> and around the vertical portions (e.g. the staple legs) of the staple <NUM> in the outer cavity 214c. In such instances, the vertical portion of the staple (e.g. the staple legs) can be sufficiently supported during the firing motion.

Referring still primarily to <FIG>, various dimensional relationships between walls in the cartridge body <NUM> are shown. Despite the compact arrangement of drivers and staples thereof, the cartridge body <NUM> can maintain a minimum wall thickness between the various cavities and channels therethrough. For examples, the cartridge body <NUM> can define minimum widths W3 (the minimum distance between an inner cavity 214a and an adjacent intermediate cavity 214b), W4 (the minimum distance between an intermediate cavity 214b and an adjacent outer cavity 214c), W5 (the minimum distance between the distal end <NUM> of the outercavity 214c and the outer channel slot <NUM>), and W6 (the minimum distance between the proximal end <NUM> of the outer cavity 214c and the outer rail channel). The minimum widths W3, W4, W5, and W6 can be at least <NUM> inches (<NUM>) to ensure sufficient driver/staple support and/or injection molding flow paths. For example, the minimum widths W3, W4, W5, and W6 can be designed to be optimized at or around <NUM> inches (<NUM>) by shifting the arrangement of drivers and staples to ensure the minimum width is maintained throughout the cartridge body <NUM>. In other instances, at least one of the minimum widths W3, W4, W5, and W6 can be between <NUM> inches (<NUM>) and <NUM> inches (<NUM>).

Referring primarily to <FIG>, the compact array of nested drivers <NUM>, <NUM> in the fastener cartridge assembly <NUM> provides a sufficiently tight staple line to seal the tissue while still allowing extendability and stretching of the stapled tissue. Exemplary distances are depicted in <FIG> in which illustrative tangent lines T1 and T2 are depicted. The tangent line T1 is the closest tangent line from a staple <NUM> in an intermediate cavity 214b to a staple <NUM> in an inner cavity 214a. The tangent line T2 is the closest tangent line from a staple <NUM> in an outer cavity 214c to a staple <NUM> in an intermediate cavity 214b. In various instances, the tangential distance TD from the tangent lines T1, T2 to the centerline of the adjacent row's tangency line can be the same row-to-row. For example, a first tangential distance TD1 from the tangent line T1 to the centerline of the staple <NUM> in the inner row 216a along the PD1 axis can be equal to, or substantially equal to, a second tangential distance TD2 from the tangent line T2 to the centerline of the staple <NUM> in the intermediate row 216b along the PD2 axis. In various aspects of the present disclosure, the tangential distances TD1 and TD2 can be less than <NUM> inches (<NUM>), and can be between <NUM> inches (<NUM>) and <NUM> inches (<NUM>) in certain instances. For example, the tangential distances TD1 and TD2 can be <NUM> inches (<NUM>). In other instances, the tangential distances TD1 and TD2 can be different.

Referring now to <FIG>, the arrangement of nested drivers <NUM>, <NUM> in the fastener cartridge assembly <NUM> provides differing parallel offsets between staples <NUM> in each row <NUM>. For example, the staples <NUM> in the intermediate row 216b extend along PD2 axes, which are substantially parallel and offset by a first parallel offset distance PO1, and staples <NUM> in the outer row 216c extend along PD3 axes, which are substantially parallel and offset by a second parallel offset distance PO2. The second parallel offset distance PO2 is approximately double the first parallel offset distance PO1. For example, in instances in which the drivers <NUM>, <NUM> are longitudinally spaced apart by a longitudinal length LL of <NUM> inches (<NUM>), the first parallel offset distance PO1 can be <NUM> inches (<NUM>), and the second parallel offset distance PO2 can be <NUM> inches (<NUM>). The reader will appreciate that if the longitudinal length LL is increased, the first parallel offset distance PO1 and the second parallel offset distance PO2 would also increase.

Referring again to <FIG>, the intermediate cavities 214b are nested and positioned laterally between first cavities 214a and third cavities 214c. More specifically, an intermediate cavity 214b is positioned between proximally-positioned inner and outer cavities 214a, 214c and between distally-positioned inner and outer cavities 214a, 214c. The cavities <NUM> in the cartridge body <NUM> are positioned to form repeating patterns of cavity end clusters. For example, the cavities <NUM> form longitudinally-repeating high-density clusters <NUM> of cavity ends <NUM>, <NUM> and longitudinally-repeating low-density clusters <NUM> of cavity ends <NUM>, <NUM>. The cavity ends <NUM>, <NUM> correspond to staple legs when the staples <NUM> are installed in the cavities <NUM>. Therefore, the arrangement of cavities corresponds to an arrangement of fasteners that are positioned to form longitudinally-repeating high-density clusters of fastener legs and longitudinally-repeating low-density clusters of fastener legs.

Referring still to <FIG>, each high-density cluster <NUM> comprises three staple ends <NUM>, <NUM>, and each low-density cluster <NUM> comprises three staple ends. More specifically, each high-density cluster <NUM> includes an end <NUM> or <NUM> from an inner cavity 214a, an end <NUM> or <NUM> from an intermediate cavity 214b, and an end <NUM> or <NUM> from an outer cavity 214c. In such instances, each cluster of fastener legs comprises the leg of a fastener from an inner cavity 214a, an intermediate cavity 214b, and an outer cavity 214c. For example, the high-density clusters <NUM> include a distal end <NUM> of both an inner cavity 214a and an outer cavity 214c and a proximal end <NUM> of an intermediate cavity 214b. The low-density clusters <NUM> include a proximal end <NUM> of both an inner cavity 214a and an outer cavity 214c and a distal end <NUM> of an intermediate cavity 214b. Each cavity <NUM> includes one end <NUM> or <NUM> in a high-density cluster <NUM> and the opposite end <NUM> or <NUM> in a low-density cluster <NUM>. Consequently, the high-density clusters <NUM> and the low-density clusters <NUM> form an alternating pattern along the longitudinal axis A.

The underside of the cartridge body <NUM> is depicted in <FIG>, in which the sled <NUM> is in the proximal, unfired position at the proximal end <NUM> of the cartridge body <NUM>. The sled can include upright rails that driving engage the underside of ramped surfaces on the drivers <NUM>, <NUM> (<FIG>) to drive the drivers <NUM>, <NUM> toward the deck <NUM> (<FIG>). The outer rails <NUM> are configured to engage outer ramps 228b (<FIG>) and the inner rails <NUM> are configured to engage the inner ramps 228a (<FIG>) of the drivers <NUM>, <NUM>. An inner rail <NUM> and an outer rail <NUM> on a first side of the longitudinal knife slot <NUM> are configured to simultaneously drive the inner ramp 228a and the outer ramp 228b, respectively, of a driver <NUM>, <NUM>. More specifically, the inner rail <NUM> and the outer rail <NUM> are longitudinally aligned, and the inner ramp 228a and the outer ramp 228b are longitudinally aligned. Moreover, the inner rail <NUM> and the outer rail <NUM> engage both ramps 228a and 228b at the same time and complete the upward pushing motion on the ramps 228a, 228b at the same time.

In various instances, the sled <NUM> and rails <NUM>, <NUM> thereof are comprised of metal. For example, the sled <NUM> can be formed from (e.g. cast) from metal such that the rails <NUM>, <NUM> can be narrower than conventional sled rails, which requires narrower channels through the cartridge body <NUM> and more material (i.e. thicker cavity walls) in the cartridge body <NUM>. The narrower sled rails <NUM>, <NUM> and passages therefor also accommodate the consolidated array of staple cavities <NUM> at the row-to-row gradient of cavity angles/orientations relative to the longitudinal axis. For example, to accommodate the consolidated array of staple cavities <NUM>, the outer rails <NUM> can be positioned to move along outer axes L2 that are laterally aligned with the cavities <NUM> and openings thereof, while the inner rails <NUM> are positioned to move along inner axes L1 that are positioned laterally inward from the inner cavities 214a. Referring primarily to <FIG>, the outer cavities 214c define an outside outer row boundary and the inner cavities 214a define an inside inner row boundary. Each outer axes L2 can extend longitudinally between the outer outside row boundary and the inner inside row boundary.

In one aspect of the present disclosure, the inner axes L2 are positioned laterally inward from the inner cavities 214a between the inner row 216a and the longitudinal axis A on each side of the cartridge body <NUM>. Moreover, the outer rails <NUM> can be configured to pass under the obliquely-oriented fasteners <NUM> of the outer cavities 214c in the outer rows 216c. For example, each fastener <NUM> in the obliquely-oriented outer cavities 214c can include an outside leg and an inside leg, and the outer axes L2 can be positioned between the outside leg and the inside leg of the fasteners <NUM> in the outer cavities 214c.

The compact arrangement of staple cavities <NUM> in the cartridge body <NUM> can optimize the small footprint of the fastener cartridge assembly <NUM> to fit three rows of staples at different angular orientations for each row. Moreover, the thickness of the cavity walls is limited by manufacturing processes (e.g. injection molded components require a minimum width for sufficient flow of the injected material in the mold). The cavity walls also must sufficiently support the drivers <NUM>, <NUM> and staples <NUM> during a firing motion to ensure the drivers <NUM>, <NUM> do not torque or become jammed in the cavities. Bowing or other deformation of the cavities walls can result in misfiring of the fastener cartridge assembly <NUM>.

Referring still to <FIG> and also <FIG>, the inside wall of the cartridge body <NUM> defines a minimum width W1 between the channel for the inner rail <NUM> of the sled <NUM> and the longitudinal knife slot <NUM>. The outside wall of the cartridge body <NUM> defines a minimum width W2 between the proximal ends <NUM> of the outer cavities 214c and the outside face <NUM> of the cartridge body <NUM>. The minimum widths W1 and W2 can be at least <NUM> inches (<NUM>) to ensure sufficient driver/staple support and/or injection molding flow paths. In various instances, the minimum widths W1 can be between <NUM> inches (<NUM>) and <NUM> inches (<NUM>). For example, the minimum width W1 can be <NUM> inches (<NUM>), and the minimum width W2 can be <NUM> inches (<NUM>).

Referring primarily now to <FIG>, drivers <NUM>, <NUM> are shown. The drivers <NUM>, <NUM> include columns <NUM> supporting cradles <NUM>. More specifically, the drivers <NUM>, <NUM> are triple drivers, each having three columns 261a, 261b, and 261c and each column terminating in a cradle 260a, 260b, and 260c, respectively. The columns <NUM> are configured to move through the cavities <NUM> during a firing stroke. The sidewalls of the cavities <NUM> guide the columns <NUM> toward the cartridge deck <NUM> during the firing stroke to eject the staples <NUM> supported on the cradles 260a, 260b, and 260c. The cradles 260a, 260b, and 260c are configured to be overdriven with respect to the cartridge body <NUM> as further described herein. Each cradle 260a, 260b, and 260c defines a proximal-to-distal axis PD1, PD2, and PD3, respectively, that corresponds to the proximal-to-distal axis of the staple cavity in which it is positioned. More specifically, the inner cradles 260a are oriented along the first proximal-to-distal axes PD1, the intermediate cradles 260b are oriented along the second proximal-to-distal axes PD2, and the outer cradles 260c are oriented along the third proximal-to-distal axes PD3. PD1 is oriented at a first angle relative to the longitudinal axis A, PD2 is oriented at a second angle (θ2) relative to the longitudinal axis A, and PD3 is oriented at a third angle (θ3) relative to the longitudinal axis A.

In various instances, the first angle is zero and the PD1 axis is oriented parallel, or substantially parallel to the longitudinal axis A. Longitudinal alignment of an inner row of staples can help provide a robust seal along the cutline. The PD2 axis is angled away from the longitudinal axis A and cutline there along. Angling the intermediate cradle 260b, which is in the intermediate row and adjacent to the inner row, can increase the spacing between adjacent staple legs in the same row to improve pressure distribution, for example. Moreover, angling the intermediate cradle 260b (and staple thereon) away from the longitudinal axis A can facilitate tissue flow away from the cutline during the firing stroke. Tissue flow outward away from the cutline and innermost row can create a tighter staple line and improve hemostasis in certain instances. In certain instances, the second angle (θ2) is between <NUM> and <NUM> degrees, and can be <NUM> degrees, for example. The second angle (θ2) is greater than the first angle, which is zero in the drivers <NUM>, <NUM>. PD3 is angled toward the longitudinal axis A and cutline there along. Angling the third cradle 260c, which is in the outermost row, can increase spacing between adjacent staple legs in the same row, which can improve pressure distribution in the stapled tissue, for example. Moreover, angling the third cradle 260c (and staple thereon) toward the longitudinal axis A can consolidate the staple line and allow nesting of adjacent proximal-to-distal drivers <NUM>, <NUM> and staples thereon to minimize space between the staples and improve hemostasis. In certain instances, the third angle (θ3) is between <NUM> and <NUM> degrees, and can be <NUM> degrees, for example. The third angle (θ3) is greater than the first angle and the second angle (θ2) in the drivers <NUM>, <NUM>.

Referring primarily to <FIG>, each cradle 260a, 260b, and 260c includes a geometric center 263a, 263b, and 263c, respectively, through which the proximal-to-distal axes (PD1, PD2, and PD3, respectively) pass through. On each driver <NUM>, <NUM>, the first geometric center 263a of the inner cradle 260a is longitudinally-aligned with the third geometric center 263c of the outer cradle 260b. Moreover, the third geometric center 263c is laterally offset from the first geometric center 263a by an inner-to-outer lateral offset Y1. Owing to the compact staple and driver arrangement, the inner-to-outer lateral offset Y1 can be minimized to less than <NUM> inches (<NUM>), and can be <NUM> inches (<NUM>), for example. In other instances, the inner-to-outer lateral offset Y1 can be between <NUM> inches (<NUM>. 778mmm) and <NUM> inches (<NUM>), for example. Furthermore, on each driver <NUM>, <NUM>, the second geometric center 263b of the intermediate cradle 260b is longitudinally offset from the first geometric center 263a and the third geometric center 263c by a longitudinal stagger X. Moreover, the second geometric center 263b is laterally offset from the first geometric center 263a by an inner-to-intermediate lateral offset Y2. Owing to the compact staple and driver arrangement, the longitudinal stagger X can be minimized to less than <NUM> inches (<NUM>), and can be <NUM> inches (<NUM>), for example. In other instances, the longitudinal stagger X can be between <NUM> inches (<NUM>) and <NUM> inches (<NUM>), for example. Additionally, the inner-to-intermediate lateral offset Y2 can be minimized to less than <NUM> inches (<NUM>), and can be <NUM> inches (<NUM>), for example. In other instances, the inner-to-intermediate lateral offset Y2 can be between <NUM> inches (<NUM>) and <NUM> inches (<NUM>), for example.

The drivers <NUM>, <NUM> include an inner bridge <NUM> extending between the inner column 261a and the intermediate column 261b and also include an outer bridge <NUM> extending between the intermediate column 261b and the outer column 261c. The bridges <NUM>, <NUM> connect the columns <NUM> to form a triple driver spanning three rows of cavities. The drivers <NUM>, <NUM> also include an inside flange <NUM> extending laterally inward from the inner column 261a and an outside flange <NUM> extending distally and laterally outward from the outside column 261c. The inside and outside flanges <NUM>, <NUM> movably engage the wedge-shaped inner and outer rails <NUM>, <NUM>, respectively, during the firing stroke. For example, the underside of the inside flange <NUM> includes the inner ramp 228a, and the underside outside flange <NUM> includes the outer ramp 228b. The rails <NUM>, <NUM> are configured to move along the undersides of the flanges <NUM>, <NUM> and/or along the ramps 228a, 228b, respectively, during a firing motion. Referring primarily to <FIG>, as further described herein, the inner rails <NUM> (<FIG>) are configured to move along first longitudinal axes L1, and the inner flange <NUM> extends laterally inward from the inner column 261a to position the inner ramp 228a in alignment with the first longitudinal axes L1. Moreover, the outer rails <NUM> (<FIG>) are configured to move along second longitudinal axes L2, and the outer flange <NUM> extends laterally outward from the outer column 261c to extend the engagement surface between the outer rails <NUM> and the respective driver <NUM>, <NUM> distal to the outer ramp 228b.

The drivers <NUM>, <NUM> further include at least one upright rib <NUM>, which is configured to be received in a recess in the cartridge body <NUM>. Engagement between the rib <NUM> and the recess further guides the drivers <NUM>, <NUM> during the firing motion and prevents rotation and jamming of the drivers <NUM>, <NUM> in the cavities <NUM>.

Referring primarily to <FIG>, the drivers <NUM>, <NUM> further include a center of mass ("CoM") between the inner column 261a and the intermediate column 261b. The ramps 228a, 228b each include a leading distal edge <NUM> and a trailing proximal edge <NUM>. The CoM of the drivers <NUM>, <NUM> is positioned proximal to the trailing proximal edges <NUM> thereof. More specifically, the CoM is longitudinally offset from the trailing proximal edges <NUM> in the proximal direction by a distance Z in <FIG>. In certain instances, the distance Z can be less than <NUM> inches (<NUM>). In certain instances, the distance Z can be between <NUM> inches (<NUM>) and <NUM> inches (<NUM>). For example, the distance Z is <NUM> inches (<NUM>) in various aspects of the present disclosure. The three-dimensional position of the CoM is adjusted by adjusting the geometry of the inner bridge <NUM> and outer bridge <NUM>. For example, by extending the inner bridge <NUM> distally, the CoM of the drivers <NUM>, <NUM> shifts distally. In such instances, the length of the inner bridge <NUM>, for example, can by adjusted to ensure the CoM is distally beyond the trailing proximal edges <NUM>, which can prevent driver roll during a firing motion in certain instances.

Referring now to <FIG>, portions of the cartridge body <NUM> are shown with drivers <NUM>, <NUM> removably positioned in the cavities <NUM> thereof. The cartridge body <NUM> includes an outside wall supporting the outside edge of the drivers <NUM>, <NUM>, and an inside wall supporting the inside edge of the drivers <NUM>, <NUM> adjacent to the longitudinal knife slot <NUM>. The inside contoured walls of the cartridge body <NUM> between the outside wall and the inside wall form an island <NUM> defining the cavities <NUM>, upright cavities and tracks for receiving (and guiding) the drivers <NUM>, <NUM> and staples <NUM>, and channel slots <NUM>, <NUM> (<FIG>) for receiving (and guiding) the rails <NUM>, <NUM> of the sled <NUM> during the firing stroke. Owing to the compressed arrangement of staple cavities <NUM> in the cartridge body <NUM>, the island <NUM> can be separated from the outside wall and the inside wall by narrow channel slots <NUM>, <NUM> along which the narrow rails <NUM>, <NUM>, respectively, of the sled <NUM> are configured to pass during the firing stroke.

The island <NUM> defines stand up features in the cartridge body <NUM>, which are supported by opposing ribs <NUM> extending down from the deck <NUM> and forming a thicker portion of the deck <NUM> than the adjacent portions of the deck <NUM>. The increased thickness provided by the opposing ribs <NUM> is further shown in <FIG>, for example. The opposing ribs <NUM> can be dimensioned to substantially fill the longitudinal space between consecutive drivers <NUM>, <NUM> and the vertical space from the deck <NUM> to the longitudinal channel for the rails <NUM>, <NUM>. The clearance between the top of the sled <NUM> and the opposing ribs <NUM> can be minimized to sufficiently support the island <NUM> and prevent bending or twisting of the islands <NUM> during the firing stroke. For example, significant firing forces during a firing stroke can exert a torque on the islands <NUM>. Without sufficient support, the islands <NUM> are prone to bending forward in certain instances. The opposing ribs <NUM> support the islands <NUM> and provide a flow path for plastic resin, for example, to flow into each island <NUM>. The deck <NUM> alone is too thin in various instances to permit sufficient flow into the islands during the molding process.

Referring primarily now to <FIG>, a portion of the fastener cartridge assembly <NUM> is shown. The inner rails <NUM> of the sled <NUM> are configured to move along the first longitudinal axis L1, and the outer rails <NUM> of the sled <NUM> are configured to move along the second longitudinal axis L2. The second longitudinal axis L2 defines a channel slot <NUM> (<FIG>) in the cartridge body <NUM> through which the outer rail <NUM> translates during the firing stroke. The outer support column 261c of the driver <NUM> extends into the channel slot <NUM>, and is lifted out of the channel slot <NUM> when the outer rail <NUM> engages the outer ramp 228b on the underside of the driver <NUM> and along the underside of outer support column 261c and outer flange, or tail, <NUM>. The inner longitudinal axis L1 defines a channel <NUM> (<FIG>) in the cartridge body <NUM> through which the inner rail <NUM> translates during a firing stroke. The rails <NUM>, <NUM> can be comprised of metal to be sufficiently robust even when reduced to a narrowed width to fit in the narrowed channel slots <NUM>, <NUM>. The outside surface of the inner rail <NUM> is positioned a minimum width W7 from the inner edge of the inner cavity 214a where the cartridge body <NUM> forms the track at the end of the inner cavity 214a for supporting the vertical portion (e.g. the staple legs) of the staple <NUM> during a firing stroke. In various instances, the minimum width W7 can be approximately <NUM> inches (<NUM>) or less than <NUM> inches (<NUM>). For example, the minimum width W7 can be <NUM> inches (<NUM>), which can be the limit for plastic injection molded components. By reducing the minimum width W7 to the minimum manufacturable dimension, the width of the fastener cartridge assembly <NUM> can be minimized to maintain a small footprint for minimally-invasive surgical procedures, for example. At the minimum width W7, the cartridge body <NUM> can have enough material, i.e. wall thickness, to hold the staple <NUM> upright in the inner cavity 214a as the staple <NUM> is fired from the inner cavity 214a and into tissue.

Minimum widths W1 and W2 (<FIG>); W3, W4, W5 and W6 (<FIG>); and W7 (<FIG>) are further described herein, as well as the angular orientation of the proximal-to-distal axes PD1, PD2, and PD3 (e.g. angles θ2 and θ3) (<FIG> and <FIG>); longitudinal lengths L1, L2, and L3 (<FIG>); longitudinal stagger X (<FIG>); lateral offsets Y1 and Y2 (<FIG>); and staple gaps G1, G2, and G3 (<FIG>); tangential distances TD1 and TD2 (<FIG>); and parallel offset distances PO1 and PO2 (<FIG>); for example. Certain exemplary dimensional relationships for the fastener cartridge assembly <NUM> are also shown in <FIG>. For example, the minimum wall thickness for plastic flow in injection molded components is minimum width W3, which is <NUM> inches (<NUM>), in various aspects of the present disclosure.

Referring still to <FIG>, the minimum width W15 of the cartridge wall between the longitudinal knife slot <NUM> and the inner rail <NUM> (<FIG>) of the sled <NUM> can be limited by manufacturing limitations for injection molded components, for example. The minimum width W15 can be less than <NUM> inches (<NUM>), and is <NUM> inches (<NUM>)in various aspects of the present disclosure. In other instances, the minimum width W15 can be <NUM> inches (<NUM>), for example. The minimum width W8 of the channel slot <NUM> for the inner rail <NUM> can also be reduced to fit a narrower metal rail, such as the inner rail <NUM>. For example, the minimum width W8 of the channel slot <NUM> (and channel slot <NUM>) can be less than <NUM> inches (<NUM>), and is <NUM> inches (<NUM>) in various aspects of the present disclosure. In other instances (where the sled rails are less than <NUM> inches (<NUM>)), the minimum width W15 can be <NUM> inches (<NUM>).

<FIG> further depicts edge dimensions for capturing the vertical portion (e.g. the staple legs) of the staple <NUM> during a firing motion. For example, edge widths W9, W10, W11, W12, and W13 are configured to support the staple legs during firing motions thereof. In various instances, the staples <NUM> can be V-shaped staples, for example, with outward splaying legs, as further described herein. The proximal and/or distal edges of the cartridge body around the staple cavities are configured to engage the staple legs and support the staple legs as the drivers <NUM>, <NUM> lift the staple bases toward the cartridge deck. Though not a complete wall in the cartridge body <NUM> (which are subject to different size limitations further described herein), these edges or extensions around the cavities <NUM> define a key limitation on the compact array of cavities <NUM>, drivers <NUM>, <NUM>, and staples <NUM> thereon. Manufacturing limitations and material strength limitations, for example, can compel a minimum edge width, which can be less than <NUM> inches (<NUM>), for example. The edge widths W9, W10, W11, W12, and W13 are approximately <NUM> inches (<NUM>) in various aspects of the present disclosure. In certain instances, referring to edge widths W9, W12, W13 (around the obliquely-oriented cavities <NUM>, support columns <NUM>, and staples <NUM> in the intermediate row 216b and outer row 216c) the edge widths can be on an angle and the minimum edge width along the angled cavity where the vertical portions of the staple are supported is compelled by the manufacturing and material limitations of the cartridge body <NUM>.

In various instances, a compact arrangement of staple cavities and staples therein can be effected by the geometry and arrangement of staple forming pockets in the anvil. For example, the forming pockets can include a pair of cups, and each cup can be configured to receive one staple leg. The cups are configured to catch the tips of the staple legs and deform the staple legs along a predefined trajectory toward their formed configurations. In order to catch the tips of the staple legs, which are subjected to tissue flow and associated forces during a firing stroke, each forming pocket can be larger than the target contact area for the tips of the staple legs. The staple forming pockets and cups thereof can take up a larger footprint on the anvil than the footprint of the corresponding staple cavity in the fastener cartridge assembly. Consequently, the limitations on staple cavity arrangements described herein can be further limited by the nestability of the forming pockets proximal-to-distal and row-to-row.

In various instances, the available space for forming pockets on the forming surface of an anvil is further reduced proximal to a tissue stop, which can take up real estate along the outside edge of the forming surface. The placement of forming pockets proximal to a tissue stop can improve sealing and/ hemostasis by further extending the stapling line for the associated transection. For the fastener cartridge assembly <NUM>, for example, the arrangement of forming pockets can extend proximally beyond a tissue stop plane defined by the tissue stops, which enables proximal extension of the staple line.

Referring primarily to <FIG>, the anvil <NUM> includes an anvil forming surface <NUM> with a longitudinal slot <NUM> and forming pockets <NUM> defined therein. The forming pockets <NUM> are arranged in multiple rows <NUM> on either side of the longitudinal slot <NUM>. The forming pockets <NUM> are configured to receive the legs of the fasteners and the guide the fastener legs along a predefined curvature into a formed configuration.

Referring primarily to <FIG>, the cartridge body <NUM> includes three rows <NUM> on both sides of the longitudinal slot <NUM>. The rows includes an inner row 286a comprised of inner forming pockets 284a, an intermediate row 286b comprised of intermediate forming pockets 284b, and an outer row 286c comprised of outer forming pockets 284c.

In other instances, the forming surface <NUM> can include additional rows of forming pockets or fewer rows of forming pockets on one or both sides of the longitudinal slot <NUM>. In certain instances, the forming surface <NUM> can be symmetrical about a longitudinal axis A and the rows of forming pockets can be symmetrical about the longitudinal axis A. In other instances, the rows of forming pockets can be asymmetrical about the longitudinal axis A.

The inner forming pockets 284a in the anvil <NUM> are longitudinally-aligned with the longitudinal axis A, i.e. extend along a first proximal-to-distal axis PD1, or pocket centerline, that is parallel, or substantially parallel, to the longitudinal axis A. Each inner forming pocket 284a comprises individual cups 287a, 287b. The intermediate forming pockets 284b and the outer forming pockets 284c are obliquely-oriented relative to the longitudinal axis A. The intermediate forming pockets 284b each define a second proximal-to-distal axis PD2, or pocket centerline, from the proximal end to the distal end thereof, and the second proximal-to-distal axes PD2 are angled away from the longitudinal axis A. Though the PD2 axes of each intermediate forming pocket 284b (defined by both cups 288a, 288b of the intermediate forming pockets 284b) is angled away from the longitudinal axis, the individual cups 288a, 288b forming the intermediate forming pockets 284b are oriented parallel to the longitudinal axis A and are laterally offset from each other, which results in the oblique orientation of the PD2 axes.

The outer forming pockets 284c each define a third proximal-to-distal axis PD3, or pocket centerline, from the proximal end to the distal end thereof, and the PD3 axes are angled toward the longitudinal axis A. Each cup 289a, 289b of the outer forming pockets 284c are also oriented at an oblique angle with respect to the longitudinal axis A. The longitudinal alignment of the inner forming pockets 284a and the angled orientations of the intermediate forming pockets 284b and the outer forming pockets 284c allow the intermediate forming pockets 284b to nest closely between the inner forming pockets 284a and the outer forming pockets 284c. The nested arrangement of forming pockets positioned at different angular orientations can provide a compact arrangement of forming pockets and a correspondingly tight staple line, while still allowing sufficient stretch to accommodate movement of the stapled tissue. Various exemplary dimensions are further described herein, which enable the array of drivers, staples, forming-pockets, and so on to fit within the small form factor of a fastener cartridge assembly for minimally-invasive surgeries such as minimally-invasive thoracic surgery, for example.

The second proximal-to-distal axes PD2 are oriented at a second pocket angle θ2 relative to the longitudinal axis A, and the third proximal-to-distal axes PD3 are oriented at a third pocket angle θ3 relative to the longitudinal axis A. The third pocket angle θ3 is greater than the second pocket angle θ2. For example, the second pocket angle θ2 can be between <NUM> degrees and <NUM> degrees (e.g. approximately <NUM> degrees), and the third pocket angle θ3 can be between <NUM> degrees and <NUM> degrees (e.g. approximately <NUM> degrees). In various instances, the angle of the proximal-to-distal axes PD1, PD2, PD3 of the forming pockets can match or be equal to the angle of the proximal-to-distal axes PD1, PD2, PD3 of the staple cavities <NUM> (and staples <NUM> therein). Both the second and third pocket angles θ2, <NUM> are greater than the angle at which the first forming pockets 284a are oriented relative to the longitudinal axis. For example, where the first forming pockets 284a are parallel to the longitudinal axis A, the angle of the first forming pockets 284a relative to the longitudinal axis A can be zero. In various instances, the angular orientation of proximal-to-distal axes defined between ends of the forming pockets <NUM> can define an increasing gradient from the longitudinal centerline outbound toward the lateral sides of the anvil <NUM>.

Referring primarily to <FIG>, each forming pocket includes a pair of forming cups 287a, 287b, 288a, 288b, 289a, 289b configured to receive the staple legs. More specifically, the inner forming pockets 284a include an inner proximal cup 287a and an inner distal cup 287b, which are aligned and connected. Moreover, the inner cups 287a, 287b are aligned with a central inner axis C1 (<FIG>), which is collinear with the PD1 axes. The inner proximal cup 287a is configured to receive a proximal staple leg and the inner distal cup 287b is configured to receive a distal staple leg of the same staple. The staple legs can be directed along the entry ramp of each inner cup 287a, 287b toward the first proximal-to-distal axis PD1 thereof, can bend at the apex of each inner cup 287a, 287b, and be further deformed by an exit ramp of the cup 287a, 287b back toward the fastener cartridge assembly <NUM> (<FIG>) and along the proximal-to-distal axis PD1 thereof. The inner forming pockets 284a are structured to deform the staples into a planar, or substantially planar, configuration, in which the staple legs and base are aligned with a plane through the first proximal-to-distal axis PD1 thereof.

The intermediate forming pockets 284b include an intermediate proximal cup 288a and an intermediate distal cup 288b, which are independent. The intermediate cups 288a, 288b are each oriented longitudinally, i.e. parallel to the longitudinal axis A and to each other; and are laterally offset and disconnected from each other. Moreover, the intermediate cups 288a, 288b are equilaterally-spaced apart from a central intermediate axis C2 (<FIG>) that defines the intermediate row 286b and is oriented parallel to the longitudinal axis A. The intermediate proximal cup 288a is configured to receive a proximal staple leg and the intermediate distal cup 288b is configured to receive a distal staple leg. The staple legs can be directed along the entry ramp of each intermediate cup 288a, 288b, can bend at the apex of each intermediate cup 288a, 288b, and be further deformed by an exit ramp of the cup 288a, 288b to back toward the fastener cartridge assembly <NUM> (<FIG>) but diverging away from the second proximal-to-distal axis PD2 thereof. The intermediate forming pockets 284b are structured to deform the staples <NUM> into a non-planar configuration, in which the staple legs and base are deformed out of alignment with each other and out of alignment with a plane through the second proximal-to-distal axes PD2 thereof.

The outer forming pockets 284c include an outer proximal cup 289a and an outer distal cup 289b, which are disconnected. The outer cups 289a, 289b are each obliquely-oriented relative to the longitudinal axis A and parallel to each other, but offset and independent of each other and from a central outer axis C3 (<FIG>) that defines the outer row 286c. The outer proximal cup 289a is configured to receive a proximal staple leg and the outer distal cup 289b is configured to receive a distal staple leg. The staple legs can be directed along the entry ramp of each outer cup 289a, 289b, can bend at the apex of each outer cup 289a, 289b, and be further deformed by an exit ramp of the cups 289a, 289b back toward the fastener cartridge assembly <NUM> (<FIG>) but diverging from the third proximal-to-distal axis PD3 thereof. The outer forming pockets 284c are structured to deform the staples into a non-planar configuration, in which the staple legs and base are deformed out of alignment with each other and out of alignment with a plane through the third proximal-to-distal axes PD3 thereof.

Planar and non-planar staples and anvils for forming the same are further described in <CIT>.

The inner cups 287a, 287b of the inner forming pocket 284a are connected; however, the intermediate cups 288a, 288b of the intermediate forming pocket 284b and the outer cups 289a, 289b of the outer forming pockets <NUM> are discrete and independent cups.

In various instances, the distance between the central inner axis C1 and the central intermediate axis C2 can be less than the distance between the central intermediate axis C2 and the central outer axis C3. For example, the distance between the central inner axis C1 and the central intermediate axis C2 can be less than the width of the forming pockets. Additionally or alternatively, the distance between the central intermediate axis C2 and the central outer axis C3 can be greater than the width of the forming pockets <NUM>.

In various aspects of the present disclosure, the portion of the forming surface <NUM> filled with forming pockets <NUM> is maximized within the constraints imposed by how close the forming pockets can be made during a manufacturing process. In certain instances, <NUM>% to <NUM>% of the total tissue-contacting surface of the forming surface <NUM> can be within the boundaries of a forming pocket. For example, the total area of the forming surface <NUM> within the boundaries of forming pockets <NUM> divided by the total area of the forming surface <NUM> is <NUM>% in the anvil <NUM> in <FIG>. In the foregoing example, the total area of the forming surface can be <NUM> square inches (<NUM> square mm), and the total area of the forming surface <NUM> within the boundaries of the forming pockets <NUM> can be <NUM> square inches (<NUM> square mm).

The anvil <NUM> further comprises tissue stops <NUM> projecting away from the forming surface <NUM>. Each tissue stop <NUM> can include an upright distal-facing edge <NUM>. The distal-facing edges <NUM> define a tissue stop plane P, which blocks tissue from protruding proximally beyond the pivot point between the jaws <NUM>, <NUM> (<FIG>). If tissue was positioned past the tissue stop plane P, the surgical stapling assembly <NUM> may be unable to sufficiently close and clamp onto tissue, for example. Referring primarily to <FIG>, one whole inner forming pocket 284a, one whole intermediate forming pocket 284b, and one whole outer forming pocket 284c are positioned proximal to the tissue stop plane P. Moreover, in such instances, at least one longitudinally-oriented staple pocket 284a and two obliquely-oriented staple pockets 284b, 284c are positioned proximal to the tissue stop plane P. In various aspects of the present disclosure, at least one forming pocket configured to form planar staples (e.g. inner forming pocket 284a) and at least one forming pocket configured to form non-planar staples (e.g. intermediate forming pocket 284b and outer forming pocket 284c) are positioned proximal to the tissue stop plane P.

In various aspects of the present disclosure, a staple <NUM> fired from an inner row 214a can be formed proximal to the tissue stop plane P, a staple <NUM> fired from an intermediate row 214b can be formed proximal to the tissue stop plane P, and a staple <NUM> fired from an outer row 214c can be formed proximal to the tissue stop plane P. Moreover, in such instances, at least one longitudinally-aligned staple <NUM> (formed by a first forming pocket 284a) and at least one obliquely-oriented staple <NUM> (from by a second forming pocket 284b or a third forming pocket 284c) in a staple line can be proximal to the tissue stop plane P. In various aspects of the present disclosure, at least one planar formed staple <NUM> (formed by a first forming pocket 284a) and at least one non-planar formed staple <NUM> (from by a second forming pocket 284b or a third forming pocket 284c) in a staple line can be proximal to the tissue stop plane P.

Second and third forming pockets 284b and 284c are three-dimensional forming pockets. The structure of the three-dimensional forming pockets can be adjusted to fit the anvil geometry constraints and/or to maximum staple leg crossover. With respect to non-planar staples, staple leg crossover can improve homeostasis in certain instances. The three-dimensional forming pockets (e.g. 284b and 284c) are dimensioned with varying splay angles between the staple base, or crown, and the staple legs, and with varying pocket radii to fit in the footprint limitation of the anvil <NUM> while maximizing staple leg cross over.

Referring primarily to <FIG>, a first splay angle θS1 is defined between the PD2 axis and an axis defined by the proximal leg of the formed staple <NUM>", and a second splay angle θS2 is defined between the PD2 axis and an axis defined by the distal leg of the formed staple <NUM>". The first splay angle θS1 and the second splay angle θS2 are the same in <FIG>. For example, both splay angles θS1 and θS2 can be nine degrees. The splay angles θS1 and θS2 can be between five and fifteen degrees, in various aspects of the present disclosure. In certain instances, the first splay angle θS1 and the second splay angle θS2 can be different.

A third splay angle θS3 is defined between the PD3 axis and an axis defined by the proximal leg of the staple <NUM>‴, and a fourth splay angle θS4 is defined between the PD3 axis and an axis defined by the distal leg of the staple <NUM>‴. The third splay angle θS3 and the fourth splay angle θS4 are the same in <FIG>. For example, both splay angles θS3 and θS4 can be eight degrees. The splay angles θS3 and θS4 can be between five and fifteen degrees, in various aspects of the present disclosure. In certain instances, the third splay angle θS3 and the fourth splay angle θS4 can be different.

The intermediate forming pockets 284b can also have pocket radii of <NUM> inches (<NUM>) and the outer forming pockets 284c can have a pocket radii of <NUM> inches (<NUM>), for example. In other instances, the splay angles and/or pocket radii of non-planar staples formed in different rows can be the same.

The staple leg crossover can also vary between non-planar staples in the same staple line. For example, in <FIG>, the formed staple <NUM>" (formed by the intermediate forming pocket 284b) can have a first overlap O1 (<FIG>) between the tips of the crossed staple legs, and the formed staple <NUM>‴ (formed by the outer forming pocket 284c) can have a second overlap O2 (<FIG>) between the tips of the crossed staple legs. The formed staple <NUM>' (formed by the inner forming pocket 284a) can define a space S (<FIG>) between the tips of the staple legs rather than an overlap. <FIG> depicts the different formed staple geometries for formed staples <NUM>', <NUM>", and <NUM>‴ formed by different forming pockets <NUM>. Notably, the unformed staples <NUM> can be identical in various aspects of the present disclosure. The formed height of the staples <NUM>' (<FIG>), <NUM>" (<FIG>), and <NUM>‴ (<FIG>) can be the same height. Nonetheless, the staples have assumed different formed geometries-the formed staple <NUM>' forming a planar staple with a space S between the tips of the staple legs, the formed staple <NUM>" forming a non-planar staple with an overlap O1 between the tips of the staple legs, and the formed staple <NUM>‴ forming a non-planar staple with an overlap O2, which is different than the overlap O1, between the tips of the staple legs. Referring to <FIG>, the first overlap O1 is <NUM> inches (<NUM>) and the second overlap O2 is <NUM> inches (<NUM>), for example.

In other instances, the formed heights of the staples <NUM>', <NUM>", and <NUM>‴ can vary row-to-row. Additionally or alternatively, the unformed staples can vary row-to-row. For example, to better fit within a compact footprint, the staples can have different crown lengths in the different rows on the same side of the cartridge body <NUM> and/or different leg lengths.

Example pressure distributions <NUM>, <NUM> in different staple lines are shown in <FIG>. The pressure distribution <NUM> in <FIG> results from three adjacent rows of longitudinally-aligned, planar staples, and the pressure distribution <NUM> results from the combination of longitudinally-aligned, planar staples with obliquely-oriented, non-planar staples formed with the surgical stapling assembly <NUM> (<FIG>), for example. By optimizing the forming pocket geometries, angular orientations of the forming pockets and staples, widths of the staple crowns and splay of the non-planar staple legs with the geometric constraints of the anvil <NUM> and entire surgical stapling assembly <NUM>, a wider pressure distribution can be achieved. More specifically, a wider band of desirable pressure is achieved spanning between the inner and outer staple rows in the pressure distribution <NUM> compared to the speckled array of higher pressure and lower pressure regions in the pressure distribution <NUM>.

Example strain contour plots <NUM>, <NUM> for different staple lines are shown in <FIG>. The strain contour plot <NUM> in <FIG> results from three adjacent rows of longitudinally-aligned, planar staples, and the pressure distribution <NUM> results from the combination of longitudinally-aligned, planar staples with obliquely-oriented, non-planar staples formed with the surgical stapling assembly <NUM> (<FIG>), for example. While optimizing the staple line for an improved compressive profile, as shown in <FIG>, for example, obliquely-oriented staples can also improve staple line stretch, flexibility, or compliance. A more compliant staple line can be less likely to result in an air leak at puncture sites, such as in the lung during a thoracic surgical procedure, for example. More specifically, the global stretch along the staple line in plot <NUM> can be greater than the global stretch along the staple line in plot <NUM>. Under pressure and stretch loading conditions during a test, the staple line of plot <NUM> achieved global stretch along the staple line of <NUM>% and the staple line of plot <NUM> achieved global stretch along the staple line of <NUM>%, for example.

Referring primarily to <FIG>, <FIG>, an anvil <NUM> is depicted. The anvil <NUM> is similar in many aspects to the anvil <NUM> and various differences are further described herein. The anvil <NUM> can be used in the surgical stapling assembly <NUM> (<FIG>) and can deform staples ejected from the fastener cartridge assembly <NUM> in various instances. The anvil <NUM> includes an anvil forming surface <NUM> with a longitudinal slot <NUM> and forming pockets <NUM> defined therein. The forming pockets <NUM> are arranged in multiple rows <NUM> (i.e. inner forming pockets 384a in an inner row 386a, intermediate forming pockets 384b in an intermediate row 386b, and outer forming pockets 384c in an outer row 386c) on either side of the longitudinal slot <NUM>. The longitudinal slot <NUM> is adapted to receive an upright portion of a firing member, such as an upper portion and upper pins or flanges on an I-beam firing member, for example. The forming pockets <NUM> are configured to receive the legs of the fasteners and the guide the fastener legs along a predefined curvature into a formed configuration.

In other instances, the forming surface <NUM> can indude additional rows of forming pockets or fewer rows of forming pockets on one or both sides of the longitudinal slot <NUM>. In certain instances, the forming surface <NUM> can be symmetrical about a longitudinal axis A and the rows of forming pockets can be symmetrical about the longitudinal axis A. In other instances, the rows of forming pockets can be asymmetrical about the longitudinal axis A.

The inner forming pockets 384a in the anvil <NUM> are longitudinally-aligned with the longitudinal axis A, i.e. extend along a first proximal-to-distal axis PD1, or pocket centerline, that is parallel, or substantially parallel, to the longitudinal axis A. The intermediate forming pockets 384b and the outer forming pockets 384c are obliquely-oriented relative to the longitudinal axis A. The intermediate forming pockets 384b each define a second proximal-to-distal axis PD2, or pocket centerline, from the proximal end to the distal end thereof, and the second proximal-to-distal axes PD2 are angled away from the longitudinal axis A. The outer forming pockets 384c each define a third proximal-to-distal axis PD3, or pocket centerline, from the proximal end to the distal end thereof, and the PD3 axes are angled toward the longitudinal axis A. The longitudinal alignment of the inner forming pockets 384a and the angled orientations of the intermediate forming pockets 384b and the outer forming pockets 384c allow the intermediate forming pockets 384b to nest closely between the inner forming pockets 384a and the outer forming pockets 384c. The nested arrangement of forming pockets <NUM> positioned at different angular orientations can provide a compact arrangement of forming pockets and a correspondingly tight staple line, while still allowing sufficient stretch to accommodate movement of the stapled tissue. Various exemplary dimensions are further described herein, which enable the array of drivers, staples, forming-pockets, and so on to fit within the small form factor of a fastener cartridge assembly for minimally-invasive surgeries such as minimally-invasive thoracic surgery, for example.

The second proximal-to-distal axes PD2 are oriented at a second pocket angle θ2 relative to the longitudinal axis A, and the third proximal-to-distal axes PD3 are oriented at a third pocket angle θ3 relative to the longitudinal axis A. The third pocket angle θ3 is greater than the second pocket angle θ2. For example, the second pocket angle θ2 can be between <NUM> degrees and <NUM> degrees (e.g. approximately <NUM> degrees), and the third pocket angle θ3 can be between <NUM> degrees and <NUM> degrees (e.g. approximately <NUM> degrees). In various instances, the angle of the proximal-to-distal axes PD1, PD2, PD3 of the forming pockets <NUM> can match or be equal to the angle of the proximal-to-distal axes PD1, PD2, PD3 of the staple cavities <NUM> (and staples <NUM> therein). Both the second and third pocket angles θ2, θ3 are greater than the angle at which the first forming pockets 384a are oriented relative to the longitudinal axis. For example, where the first forming pockets 384a are parallel to the longitudinal axis A, the angle of the first forming pockets 384a relative to the longitudinal axis A can be zero. In various instances, the angular orientation of proximal-to-distal axes defined between proximal and distal end <NUM>, <NUM> (<FIG>) of the forming pockets <NUM> can define an increasing gradient from the longitudinal centerline outbound toward the lateral sides of the anvil <NUM>.

A central axis defines each row <NUM> of forming pockets <NUM>. The central axes extend through a pocket center <NUM> of each forming pocket <NUM> in the respective row. More specifically, an inner central axis C1 extends through the pocket centers <NUM> of each inner forming pocket 384a. The inner central axis C1 is collinear with the first proximal-to-distal axes PD1. An intermediate central axis C2 extends through the pocket centers <NUM> of each intermediate forming pocket 384b. The intermediate central axis C2 is parallel to the longitudinal axis A and transects the second proximal-to-distal axes PD2 at the angle θ2. An outer central axis C3 extends through the pocket centers <NUM> of each outer forming pocket 384c. The outer central axis C3 is parallel to the longitudinal axis A and transects the third proximal-to-distal axes PD3 at the angle θ3.

Referring primarily to <FIG>, each forming pocket <NUM> includes a pair of cups (e.g. a proximal cup 387a and a distal cup 387b) configured to receive the staple legs. The inner forming pockets 384a, the intermediate forming pockets 384b, and the outer forming pockets 384c define the same geometry, but are oriented at different angles row-to-row. Consequently, the proximal cups 387a define the same geometry (but different orientations row-to-row) and the distal cup 387b define the same geometry (but different orientations row-to-row). Moreover, each proximal cup 387a is a mirror image reflection of the distal cup 387b across a plane bisecting the forming pocket <NUM> at the pocket center <NUM>. The geometry of an inner forming pocket 384a is further described herein, but the reader will appreciate the following description of inner forming pocket 384a applies to intermediate forming pockets 384b and 384c, as well. In other aspects of the present disclosure, at least one row of forming pockets can define a different geometry, such as the forming pockets 284b and 284c (<FIG>) configured to form non-planar staples, for example.

The proximal cup 387a and the distal cup 387b of each forming pocket <NUM> are aligned with the proximal-to-distal axis, or pocket axis, of that forming pocket <NUM>. Moreover, the proximal cup 387a and the distal cup 387b of each forming pocket <NUM> are connected at a centrally-located neck which defines the pocket center <NUM>. The proximal-to-distal axes PD1, PD2, PD3 extend through the pocket center <NUM> of each forming pocket <NUM> and bisect each cup 387a, 387b of the forming pocket <NUM>.

Referring primarily to <FIG>, the inner forming pocket 384a includes the proximal cup 387a, which is configured to receive a proximal staple leg, and the distal cup 387b, which is configured to receive a distal staple leg of the same staple. The staple legs can be directed along the entry ramp of each inner cup 387a, 387b, which converge toward the pocket center <NUM>, and along the first proximal-to-distal axis PD1 thereof. The inner forming pocket 384a is structured to bend the staple legs at the apex of each proximal and distal cup 387a, 387b, and an exit ramp of each proximal and distal cup 387a, 387b is structured to further deform the staple legs back toward the fastener cartridge assembly <NUM> (<FIG>) and along the first proximal-to-distal axis PD1 thereof. The inner forming pockets 384a are structured to deform the staples into a planar, or substantially planar, configuration, in which the staple legs and base are aligned with a plane through the first proximal-to-distal axis PD1 thereof.

The proximal cup and distal cup 387a, 387b define a teardrop shape extending away from the pocket center <NUM>. More specifically, the boundary of the forming pocket 384a defines a contoured boundary line where the proximal cups 387a is widest near the proximal end <NUM> and the distal cup 387b is widest near the distal end <NUM>. The cups 387a, 387b taper inward toward the neck (i.e., the pocket center <NUM>) at which the cups 387a, 387b define their narrowest width. Referring now to the cross-sectional views in <FIG>, the proximal cup 387a is shallowest near the proximal end <NUM> and the distal cup 387b is shallowest near the distal end <NUM>. From the shallow basin geometry shown in <FIG>, the proximal and distal cups 387a, 387b become deeper and the walls transition to a straighter, less contoured shape toward the pocket center <NUM> as shown in <FIG>. The walls of the inner forming pocket 384a at the intermediate location shown in <FIG> define a modified V-shape channel with a flat bottom. Further toward the pocket center <NUM>, referring now to <FIG>, the walls of the inner forming pocket 384a transition to a more upright orientation as the cups 387a, 387b continue to narrow at the neck connecting the proximal and distal cups 387a, 387b.

In various aspects of the present disclosure, the foregoing description of the inner forming pocket 384a can also apply to the inner forming pocket 284a (<FIG>), for example. Notably, both forming pockets 284a and 384a include connected cups that are symmetrical about the proximal-to-distal axis and a transverse axis that bisects the proximal-to-distal axis at the pocket center.

Referring again to <FIG>, in various instances, the distance between the central inner axis C1 and the central intermediate axis C2 can be less than the distance between the central intermediate axis C2 and the central outer axis C3. For example, the distance between the central inner axis C1 and the central intermediate axis C2 can be less than the width of the forming pockets. Additionally or alternatively, the distance between the central intermediate axis C2 and the central outer axis C3 can be greater than the width of the forming pockets <NUM>.

In various aspects of the present disclosure, the portion of the forming surface <NUM> filled with forming pockets <NUM> is maximized within the constraints imposed by how close the forming pockets can be made during a manufacturing process. For example, as further described herein with respect to anvil <NUM>, <NUM>% to <NUM>% of the total tissue-contacting surface of the forming surface <NUM> can be within the boundaries of a forming pocket.

Referring again to <FIG> and <FIG>, the anvil <NUM> further comprises tissue stops <NUM> projecting away from the forming surface <NUM>. Each tissue stop <NUM> can include an upright distal-facing edge <NUM> defining a tissue stop plane P, as further described herein. Referring primarily to <FIG>, one whole inner forming pocket 384a, one whole intermediate forming pocket 384b, and one whole outer forming pocket 384c are positioned proximal to the tissue stop plane P. Moreover, in such instances, at least one longitudinally-oriented staple pocket 384a and two obliquely-oriented staple pockets 384b, 384c are positioned proximal to the tissue stop plane P. In various aspects of the present disclosure, at least one longitudinally-aligned staple <NUM> (formed by a first forming pocket 384a) and at least one obliquely-oriented staple <NUM> (formed by a second forming pocket 384b or a third forming pocket 384c) in a staple line can be proximal to the tissue stop plane P.

In various aspects of the present disclosure, a fastener cartridge assembly can utilize different arrangements of staple cavities, drivers, and staples. Moreover, different arrangements of staple cavities, drivers, and staples can necessitate a different arrangement of forming pockets in the anvil opposing the fastener cartridge assembly. Alternatives are further described herein. The reader will appreciate that modifications to the fastener cartridge assembly can necessitate corresponding changes to the anvil.

In various aspects of the present disclosure, a fastener cartridge assembly includes obliquely-oriented fasteners that are sequentially-fired from a linear fastener cartridge during a longitudinal firing stroke, as further described herein. In various instances, the obliquely-oriented fasteners can be supported by obliquely-oriented cradles, which are structured and positioned to nest row-to-row and/or proximal-to-distal to consolidate the staple line and provide a tight seal in the stapled tissue. Obliquely-oriented fasteners can improve the stretchability of the stapled tissue, for example, and correspond to a more compliant staple line. In certain instances, obliquely-oriented fasteners can be positioned in an overlapping and crisscrossed arrangement in which one staple base crosses over another staple base. In various instances, overlapping fasteners can provide a tight staple line and prevent air leaks while permitting expansion and contraction of the staple line. Compliant staple lines can be especially important in certain surgical procedures, such as a thoracic transection where the lung repeated inflates and deflates while the tissue heals, for example.

The fastener cartridge assemblies and anvils described herein can be incorporated into a handheld surgical instrument and/or a robotic surgical tool. In various instances, the fastener cartridge assemblies can incorporated into an interchangeable surgical tool assembly, for example, that is operably coupled to a motor driven handle assembly. The tool assembly may also be effectively employed with a tool drive assembly of a robotically controlled or automated surgical system. For example, the surgical tool assemblies disclosed herein may be employed with various robotic systems, instruments, components and methods such as, but not limited to, those disclosed in <CIT>. The handle assembly, as well as the tool drive assembly of a robotic system may also be referred to herein as "control systems" or "control units".

Many of the surgical instrument systems described herein are motivated by an electric motor; however, the surgical instrument systems described herein can be motivated in any suitable manner. In various instances, the surgical instrument systems described herein can be motivated by a manually-operated trigger, for example. In certain instances, the motors disclosed herein may comprise a portion or portions of a robotically controlled system. Moreover, any of the end effectors and/or tool assemblies disclosed herein can be utilized with a robotic surgical instrument system. <CIT>, for example, discloses several examples of a robotic surgical instrument system in greater detail.

The surgical instrument systems described herein have been described in connection with the deployment and deformation of staples; however, the embodiments described herein are not so limited. Various embodiments are envisioned which deploy fasteners other than staples, such as clamps or tacks, for example. Moreover, various embodiments are envisioned which utilize any suitable means for sealing tissue. For instance, an end effector in accordance with various embodiments can comprise electrodes configured to heat and seal the tissue. Also, for instance, an end effector in accordance with certain embodiments can apply vibrational energy to seal the tissue.

Various embodiments described herein are described in the context of linear end effectors and/or linear fastener cartridges. Such embodiments, and the teachings thereof, can be applied to non-linear end effectors and/or non-linear fastener cartridges, such as, for example, circular and/or contoured end effectors. For example, various end effectors, including non-linear end effectors, are disclosed in <CIT>.

Although various devices have been described herein in connection with certain embodiments, modifications and variations to those embodiments may be implemented. Particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or characteristics illustrated or described in connection with one embodiment may be combined in whole or in part, with the features, structures or characteristics of one or more other embodiments without limitation. Also, where materials are disclosed for certain components, other materials may be used. Furthermore, according to various embodiments, a single component may be replaced by multiple components, and multiple components may be replaced by a single component, to perform a given function or functions. The foregoing description and following claims are intended to cover all such modification and variations.

The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, a device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps including, but not limited to, the disassembly of the device, followed by cleaning or replacement of particular pieces of the device, and subsequent reassembly of the device. In particular, a reconditioning facility and/or surgical team can disassemble a device and, after cleaning and/or replacing particular parts of the device, the device can be reassembled for subsequent use. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly.

Claim 1:
A surgical stapling assembly, comprising:
a cartridge body (<NUM>) defining a longitudinal axis (A) and comprising a deck (<NUM>),
wherein cavities (<NUM>) are defined in the cartridge body (<NUM>) and form a pattern of openings in the deck (<NUM>); and
fasteners removably positioned in the cavities (<NUM>);
wherein the pattern of openings comprise openings on a first side of the cartridge body (<NUM>), and wherein the openings on the first side of the cartridge body (<NUM>) comprise:
inner openings each defining an inner proximal-to-distal axis (PD1) oriented parallel to the longitudinal axis (A);
outer openings each defining an outer proximal-to-distal axis (PD3) obliquely-oriented relative to the longitudinal axis (A) at an outer angle (θ3); and
intermediate openings each defining an intermediate proximal-to-distal axis (PD2) obliquely-oriented relative to the longitudinal axis (A) at an intermediate angle (θ2),
wherein the intermediate openings are nested between the inner openings and the outer openings, and wherein the intermediate angle (θ2) is different than the outer angle (θ3).