Method for treating tissue
Methods for treating tissue are provided. In one embodiment, an adjunct material, when secured to tissue, can receive at least one physiological element released from the tissue during healing progression of the tissue, and can exhibit first and second stiffnesses in compression that are approximately constant during first and second time periods from contact with the tissue, with the second stiffness decreasing with time as a function of at least one of oxidation, enzyme-catalyzed hydrolysis, and change of pH resulting from interaction with the at least one physiological element. In another embodiment, the adjunct can receive a unit volume of fluid that causes first and second portions of the adjunct to expand according to first and second expansion behaviors that differ from one another to apply different pressures to the tissue.
1. A method for treating tissue, comprising:
securing, by one or more staples, a biocompatible porous polymer adjunct material to tissue, the adjunct material receiving at least one physiological element released from the tissue during healing progression of the tissue, and the adjunct material exhibiting a first stiffness in compression that is approximately constant during a first time period from contact with the tissue and exhibiting a second stiffness in compression during a second time period following the first time period, the second stiffness being less than the first stiffness and decreasing with time as a function of at least one of oxidation, enzyme-catalyzed hydrolysis, and change of pH resulting from interaction with the at least one physiological element.
2. The method of claim 1 , wherein the adjunct material adopts the second stiffness in response to oxidation of the adjunct due to reaction with the at least one physiological element comprising a reactive oxygen species.
3. The method of claim 2 , wherein the reactive oxygen species is at least one of an oxygen containing enzyme, a free radical, a superoxide, or a peroxide.
4. The method of claim 2 , wherein the reactive oxygen species is at least one of O 2− , H 2 O 2 , NO, and HOCl.
5. The method of claim 1 , wherein the adjunct material oxidizes in response to reaction with the at least one physiological element comprising a reactive oxygen species released by at least one of a mature blood cell, a fybrocyte, and an inflammatory cell.
6. The method of claim 3 , wherein the inflammatory cell is at least one of a leukocyte and a macrophage.
7. The method of claim 1 , wherein the adjunct material adopts the second stiffness in response to hydrolysis catalyzed by an enzyme.
8. The method of claim 7 , wherein the enzyme comprises a lysozyme.
9. The method of claim 1 , wherein the adjunct adopts the second stiffness in response to a decrease in pH resulting from the presence of the at least one physiological element.
10. A surgical method, comprising:
clamping tissue and a biocompatible porous polymer adjunct between opposed first and second jaws;
firing a plurality of staples from one of the first and second jaws, through the adjunct, and into the tissue to thereby staple the adjunct to the tissue;
wherein the adjunct, after being stapled to the tissue, receives a unit volume of fluid that causes at least one first portion of the adjunct to expand according to a first expansion behavior to thereby apply a first pressure to the tissue, and that causes at least one second portion of the adjunct to expand according to a second expansion behavior that is different from the first expansion behavior to thereby apply a second pressure to the tissue that is different than the first pressure.
11. The method of claim 10 , wherein one of the first and second jaws includes a staple cartridge having a knife slot, and where the at least one first portion of the adjunct is positioned adjacent to the knife slot, and the at least one second portion of the adjunct is spaced apart from the knife slot.
12. The method of claim 10 , wherein the one or more second portions of the adjunct comprise a swellable material, different from the adjunct material, positioned at the one or more second portions.
13. The method of claim 12 , wherein the swellable material comprises a hydrogel.
14. The method of claim 12 , wherein the swellable material comprises a porous, solid material and wherein the swellable material is housed in a compressed state within a fluid-soluble capsule.
15. The method of claim 14 , wherein the capsule releases the swellable material after a predetermined time period from contact with the fluid.
16. The method of claim 10 , wherein the amount of expansion of the adjunct is sufficient to provide hemostasis when the tissue is cut.
17. The method of claim 10 , wherein the amount of expansion of the adjunct is sufficient to seals holes created by staples when ejected therethrough.
18. The method of claim 17 , wherein at least one staple of the plurality of staples comprises at least one leg including a plurality of barbs, and wherein, when the plurality of staples are ejected into the adjunct and tissue, the barbs permit expansion of adjunct in a first direction towards the tissue and inhibit retraction of the adjunct in a second direction, opposite the first direction.
19. The method of claim 10 , wherein the at least one second portion of the adjunct comprises a film overlying a surface of the adjunct.
20. The method of claim 10 , wherein the adjunct further comprises a color transition dye and the method further comprises changing, by the dye, the color of the adjunct during expansion.