Methods and devices for reinforcing a staple line
Adjunct material and methods of using adjunct material to reinforce tissue in proximity to a staple line are provided herein. In general, the adjunct material can be used to maintain a seal in tissue, such as lung tissue, and prevent stapled tissue from tearing. This adjunct material can be coupled to a jaw of a surgical stapler, and can be deployed into tissue along with the staples. In some embodiments, the adjunct material can comprise an outer material encompassing an inner, hydrophilic swellable material. The outer material can be selectively dissolvable and/or absorbable. When the outer material is punctured by staples or otherwise penetrated, moisture is passed to the inner material which then swells and expands to transition to a predetermined shape to seal the tissue and prevent leaks from forming in the tissue. Portions of the inner material around the staple line can transition to a large radius.
1. A staple cartridge assembly for use with a surgical stapler, comprising:
a cartridge body having a plurality of staple cavities configured to seat staples therein; and
a tissue reinforcement construct removably attached to the cartridge body and configured to be delivered to tissue by deployment of the staples in the cartridge body, the tissue reinforcement construct comprising a first, dissolvable material encompassing a swellable, hydrophilic second material such that the second material is maintained within the first material in a constrained configuration, wherein the second material has a preconfigured shape such that, in an unconstrained configuration, the second material is adapted to expand to the preconfigured shape in which a peripheral edge portion of the second material has a thickness that is greater than a central portion of the second material.
2. The assembly of claim 1 , wherein at least a portion of the first material is less hydrophilic than the second material.
3. The assembly of claim 1 , wherein the first material is brittle.
4. The assembly of claim 1 , wherein the second material comprises a foam material.
5. The assembly of claim 1 , wherein the first material is selectively dissolvable such that portions of the first material encompassing the peripheral edge portions of the second material are configured to dissolve at a faster rate than portions of the first material encompassing the central portion of the second material.
6. The assembly of claim 1 , wherein the first material comprises at least one first portion and at least one second portion, and the first material is selectively dissolvable such that the at least one first portion is configured to dissolve at a faster rate than the at least one second portion.
7. The assembly of claim 1 , wherein the first material is selectively absorbable such that portions of the first material encompassing the peripheral edge portions of the second material are configured to absorb at a faster rate than portions of the first material encompassing the central portion of the second material.
8. The assembly of claim 1 , wherein the first material comprises at least one first portion and at least one second portion, and the first material is selectively absorbable such that the at least one first portion is configured to absorb at a faster rate than the at least one second portion.
9. The assembly of claim 1 , wherein the first material is selected from the group consisting of polydioxanon, polyhydroxyalkanoate (PHA), polyglycerol sebacate (PGS), polyglycolic acid, polylactic acid (PLA), poliglecaprone 25, polyglactin 910, poly glyconate, polyglycolide-(PGA), polyglycolide-trimethylene carbonate (PGA/TMC), polyhydroxybutyrate (PHB), poly(vinyl pyrrolidone) (PVP), poly(vinyl alcohol) (PVA), absorbable polyurethanes, a blend thereof, and a copolymer thereof.
10. The assembly of claim 1 , wherein the second material is selected from the group consisting of polydioxanon, polyhydroxyalkanoate (PHA), Polyglycerol sebacate (PGS), polyglycolic acid, polylactic acid (PLA), poliglecaprone 25, polyglactin 910, poly glyconate, polyglycolide (PGA), polyglycolide-trimethylene carbonate (PGA/TMC), polyhydroxybutyrate (PHB), poly(vinyl pyrrolidone) (PVP), poly(vinyl alcohol) (PVA), absorbable polyurethanes, a blend thereof, and a copolymer thereof.
11. The assembly of claim 1 , further comprising at least one therapeutic agent incorporated into at least one of the first material and the second material, the at least one therapeutic agent being effective to be released upon one of absorption of the first material and expansion of the second material upon exposure to moisture.
12. The assembly of claim 1 , wherein the tissue reinforcement construct is shaped such that a cross-section of the peripheral edge portion of the tissue reinforcement construct is larger than a cross-section of the central portion of the tissue reinforcement construct, the central portion being closer to a longitudinal axis of the tissue reinforcement construct than the peripheral edge portion.
13. The assembly of claim 12 , wherein the preconfigured shape is such that the central portion of the second material transitions to a large radius at the peripheral edge.
14. A staple cartridge assembly for use with a surgical stapler, comprising:
a cartridge body having a plurality of staple cavities configured to seat staples therein; and an adjunct material releasably retained on the cartridge body and configured to be delivered to tissue by deployment of the staples in the cartridge body, the adjunct material comprising a first material encompassing a second material, wherein:
the adjunct material is configured to be penetrated by the staples being delivered to the tissue such that the first material is penetrated so as to expose the second material to moisture; and
the second material is configured to expand to form a seal around at least one staple of the staples inserted therethrough upon the exposure to moisture, wherein the seal is formed such that a peripheral portion of the second material transitions to a large radius than a remainder of the second material.
15. The staple cartridge assembly of claim 14 , wherein the adjunct material is positioned on the cartridge body such that at least a portion of the adjunct material extends beyond the cartridge body.
16. A method for joining tissue, comprising:
engaging tissue between a cartridge assembly and an anvil of a surgical stapler at a surgical site, at least one of the cartridge assembly and the anvil having an adjunct material releasably retained thereon, the adjunct material comprising a first material, at least a portion of which is configured to dissolve when exposed to bodily fluid, and a second material constrained within the first material in a constrained form; and
actuating the surgical stapler to eject staples from the cartridge into the tissue such that at least one staple from the staples extends through the adjunct material to maintain the material at the surgical site, wherein the second material is configured to transition to a predetermined shape upon dissolution of the first material such that at least a peripheral edge portion of the adjunct material has a thickness greater than a central portion of the adjunct material.