Abstract: A staple cartridge assembly comprising a tissue thickness compensator is disclosed. The tissue thickness compensator comprises a first fibrous, woven material and a second fibrous, woven material. The first fibrous, woven material comprises a density which is different than the density of the second fibrous, woven material. The tissue thickness compensator is configured to expand upon contact with a fluid in order to apply a compressive force to tissue captured within staples.

Abstract: A staple cartridge assembly comprising a tissue thickness compensator is disclosed. The tissue thickness compensator comprises a first fibrous, woven material and a second fibrous, woven material. The first fibrous, woven material comprises a density which is different than the density of the second fibrous, woven material. The tissue thickness compensator is configured to expand upon contact with a fluid in order to apply a compressive force to tissue captured within staples.

Abstract: A staple cartridge assembly comprising a tissue thickness compensator is disclosed. The tissue thickness compensator comprises a first fibrous, woven material and a second fibrous, woven material. The first fibrous, woven material comprises a density which is different than the density of the second fibrous, woven material. The tissue thickness compensator is configured to expand upon contact with a fluid in order to apply a compressive force to tissue captured within staples.

Abstract: A fastener cartridge assembly includes a plurality of fasteners and a layer configured to be captured by the fasteners. In addition, the layer includes a tissue contacting surface which includes a plurality of cleats, and/or any other suitable structures, configured to reduce slippage between the layer and the patient tissue. In various embodiments, the layer can include traction features extending therefrom.

Abstract: A tissue thickness compensator may generally comprise a first layer comprising a first biocompatible material sealingly enclosed in a water impermeable material and a second layer comprising a second biocompatible material comprising at least one encapsulation, wherein the first biocompatible material expands when contacted with a fluid. The tissue thickness compensator may comprise a haemostatic agent, an anti-inflammatory agent, an antibiotic agent, anti-microbial agent, an anti-adhesion agent, an anti-coagulant agent, a medicament, and/or pharmaceutically active agent. The encapsulation may comprise a biodegradable material to degrade in vivo and/or in situ. The tissue thickness compensator may comprise a hydrogel. The reaction product may comprise a fluid-swellable composition. Articles of manufacture comprising the tissue thickness compensator and methods of making and using the tissue thickness compensator are also described.

Abstract: A two-part tissue thickness compensator assembly can include a first tissue thickness compensator configured to be positioned relative to an anvil of a surgical stapler, a second tissue thickness compensator configured to be positioned relative to a staple cartridge of the surgical stapler, and a hinge connecting the first tissue thickness compensator to the second tissue thickness compensator. The first and/or second tissue thickness compensators may include additional engagement features, such as a raised ridge that engages a slot in the anvil and/or the staple cartridge. In certain embodiments, the first and/or second tissue thickness compensators may include an encasement that contains a suitable biologic agent. An end effector assembly may be provided for attachment to a surgical instrument that includes, for example, a staple cartridge, an anvil, a first tissue thickness compensator positioned on the anvil, and a second tissue thickness compensator positioned on the staple cartridge.

Abstract: A cutting blade for a surgical cutting and stapling instrument is disclosed therein. The cutting blade can include one or more features to direct or displace substances released from within the tissue thickness compensators used with the surgical instrument. The cutting blade may include a textured surface that can cause substances from the tissue thickness compensator to spread across the blade surface.

Abstract: A two-part tissue thickness compensator assembly can include a first tissue thickness compensator configured to be positioned relative to an anvil of a surgical stapler, a second tissue thickness compensator configured to be positioned relative to a staple cartridge of the surgical stapler, and a hinge connecting the first tissue thickness compensator to the second tissue thickness compensator. The first and/or second tissue thickness compensators may include additional engagement features, such as a raised ridge that engages a slot in the anvil and/or the staple cartridge. In certain embodiments, the first and/or second tissue thickness compensators may include an encasement that contains a suitable biologic agent. An end effector assembly may be provided for attachment to a surgical instrument that includes, for example, a staple cartridge, an anvil, a first tissue thickness compensator positioned on the anvil, and a second tissue thickness compensator positioned on the staple cartridge.

Abstract: A tissue thickness compensator may generally comprise a biocompatible material, a first component, and a second component, wherein the first component and second component form a reaction product to expand the tissue thickness compensator. The first component may comprise a first hydrogel precursor, the second component may comprise a second hydrogel precursor, and the reaction product may comprise a hydrogel. The reaction product may be formed in vivo and/or in situ by contacting the first component and the second component. The first component and/or second component may be encapsulated and configured to release the components when ruptured. The reaction product may comprise a fluid-swellable composition. Articles of manufacture comprising the tissue thickness compensator and methods of making and using the tissue thickness compensator are also described.

Abstract: An apparatus is operable to secure suture fasteners to sutures to eliminate the need to tie knots in the sutures. The apparatus comprises a shaft, an end effector disposed at the distal end of the shaft, and a suture fastener removably secured to the end effector. The end effector may include a pivoting jaw or a suture cutter. The suture fastener may be secured to one, two, or more strands of suture. The apparatus may include several suture fasteners and may secure those fasteners to one or more sutures in a serial fashion without having to remove the apparatus from the patient for reloading. A plurality of fasteners may be arranged within the apparatus in an end-to-end configuration. The suture fastener may include an inner fastener member and an outer fastener member, and may capture one or more strands of suture between the inner and outer fastener members.

Abstract: In various embodiments, a tissue thickness compensator can comprise a film body formed from a continuous extruded shape and, in addition, a fibrous medicament core.

Abstract: A two-part tissue thickness compensator assembly can include a first tissue thickness compensator configured to be positioned relative to an anvil of a surgical stapler, a second tissue thickness compensator configured to be positioned relative to a staple cartridge of the surgical stapler, and a hinge connecting the first tissue thickness compensator to the second tissue thickness compensator. The first and/or second tissue thickness compensators may include additional engagement features, such as a raised ridge that engages a slot in the anvil and/or the staple cartridge. In certain embodiments, the first and/or second tissue thickness compensators may include an encasement that contains a suitable biologic agent. An end effector assembly may be provided for attachment to a surgical instrument that includes, for example, a staple cartridge, an anvil, a first tissue thickness compensator positioned on the anvil, and a second tissue thickness compensator positioned on the staple cartridge.

Abstract: A retainer for assembling tissue thickness compensators to a surgical stapler can comprise a grip, a first surface for supporting a first tissue thickness compensator, a second surface for supporting a second tissue thickness compensator, and clips for aligning and attaching the retainer to the surgical stapler. The clips may align and attach the retainer to a staple cartridge of the surgical instrument. The clips may align the retainer with an anvil of the surgical instrument. An insertion tool may be used in combination with the retainer to insert the retainer into the surgical stapler and to push the tissue thickness compensators against the anvil and/or the staple cartridge of the surgical instrument.

Abstract: A device for loading a surgical knotting element on an applicator tool. One embodiment of the device includes a channel dimensioned to receive an applicator tool comprising a coupling. A surgical knotting element comprises a coupling complementary to the coupling of an applicator tool and a suture path. A carriage receives the surgical knotting element. The carriage is moveable in a transverse direction relative the channel between a first position where the knotting element is misaligned with the channel and a second position where the couplings are engaged with one another.

Abstract: Drive shaft assemblies for a surgical instrument. Various forms include a plurality of movably interlocking joint segments that are interconnected to form a flexible hollow tube. A flexible secondary constraining member is configured in flexible constraining engagement with the plurality of movably interlocking joint segments to retain the interlocking joint segments in movable interlocking engagement while facilitating flexing of the drive shaft assembly.

Abstract: A flexible endoscopic device including an elongate flexible member having opposite ends, an effector assembly mounted on one of the opposite ends of the flexible member, and a handle mounted on the end of the flexible member opposite the effector assembly. The handle includes a fastener for receiving a portion of the flexible member spaced from the end of the member opposite the effector assembly. The device also includes an actuator assembly extending through the flexible member and operatively connected to the effector assembly for actuating the effector.

Abstract: Drive shaft assemblies for a surgical instrument. Various forms include a plurality of movably interlocking joint segments that are interconnected to form a flexible hollow tube. A flexible secondary constraining member is configured in flexible constraining engagement with the plurality of movably interlocking joint segments to retain the interlocking joint segments in movable interlocking engagement while facilitating flexing of the drive shaft assembly.

Abstract: Surgical stapling instruments are disclosed. At least one embodiment includes a first jaw that supports a plurality of surgical staples and a second jaw that is movable relative to the first jaw. Various arrangements include a tissue thickness compensator that is configured to be captured within the surgical staples and assume different compressed heights within different surgical staples upon application of a firing motion to the surgical staples. Various attachment protrusion arrangements are disclosed to mechanically removably attach the tissue thickness compensator to the first or second jaw.

Abstract: In various embodiments, a tissue thickness compensator can comprise a film body formed from a continuous extruded shape and, in addition, a fibrous medicament core.

Abstract: A fastener cartridge assembly includes a plurality of fasteners and a layer configured to be captured by the fasteners. In addition, the layer includes a tissue contacting surface which includes a plurality of cleats, and/or any other suitable structures, configured to reduce slippage between the layer and the patient tissue. In various embodiments, the layer can include traction features extending therefrom.