Adjunct materials and methods of using same in surgical methods for tissue sealing

Abstract

Surgical methods involving cutting and sealing tissue include affixing a first adjunct material to tissue at a treatment site, such as by stapling the adjunct to tissue. A second adjunct material is applied to at least a portion of the first adjunct material such that the second adjunct material interacts with the first adjunct material to form a seal in an area of the tissue covered by at least one of the first and the second adjunct material. The resulting tissue sealing structure, which includes a combination of the two adjuncts, is believed to be superior to the sealing properties of either adjunct alone.

1 .- 19 . (canceled) 
     
     
         20 . A method for forming an adjunct, comprising:
 weaving first fibers together to form a first layer; and   interlocking or knotting second fibers with the first woven fibers to form a second layer that is connected to the first layer,   wherein the adjunct is configured to be elastically deformable, to be releasably retained on a stapling body, and to allow a plurality of staples disposed within the stapling body to pass therethrough such that the adjunct can be attached to tissue by the plurality of staples.   
     
     
         21 . The method of  claim 20 , wherein at least one of the first layer and the second layer are configured to releasably couple to the stapling body. 
     
     
         22 . The method of  claim 20 , wherein the first fibers are made of a first bioabsorbable polymer and the second fibers are made of a second bioabsorbable polymer that is different than the first bioabsorbable polymer. 
     
     
         23 . The method of  claim 20 , further comprising interlocking or knotting third fibers with the second fibers to form a third layer, wherein the second layer is positioned between the first and third layers. 
     
     
         24 . The method of  claim 23 , wherein the second fibers extend from the first layer to the second layer, wherein at least a portion of the second fibers within the second layer are oriented in a different direction compared to an orientation of at least one of the first fibers and third fibers. 
     
     
         25 . The method of  claim 23 , wherein the at least one of the first fibers and third fibers are formed of a first bioabsorbable polymer, and the second fibers are made of a second bioabsorbable polymer that is different than the first bioabsorbable polymer 
     
     
         26 . The method of  claim 20 , wherein the first layer has a first weave density and the second layer has a second weave density that is different that the first weave density. 
     
     
         27 . The method of  claim 20 , wherein the adjunct is configured to apply a pressure of at least 3 gf/mm 2  to the captured tissue for at least 3 days when the adjunct is stapled thereto. 
     
     
         28 . The method of  claim 20 , wherein the first fibers are multifilament fibers and the second fibers are monofilament fibers. 
     
     
         29 . The method of  claim 20 , wherein at least one of the first fibers and the second fibers include oxidized regenerated cellulose fibers. 
     
     
         30 . The method of  claim 20 , wherein at least one of the first fibers and the second fibers have a fiber diameter of about 0.024 mm to 0.3 mm. 
     
     
         31 . The method of  claim 20 , further comprising weaving third fibers into the first layer, wherein the first fibers are formed of a first bioabsorbable polymer and the third fibers are formed of a third bioabsorbable polymer that degrades at a rate greater than that of the first bioabsorbable polymer. 
     
     
         32 . The method of  claim 20 , wherein the first fibers are formed of a first bioabsorbable polymer, and wherein the first bioabsorbable polymer is formed of at least one of poly-L-lactic acid, a copolymer of glycolide and L-lactide, a copolymer of glycolic acid and lactic acid, poly(lactic-co-glycolic acid), poly(lactic acid), polyglycolide, and a copolymer of glycolide, caprolactone, trimethylene carbonate, and lactide. 
     
     
         33 . The method of  claim 20 , wherein the second fibers are formed of a second bioabsorbable polymer, and wherein the second absorbable bioabsorbable polymer is formed of at least one of polydioxanone, a copolymer of polydioxanone and polyglycolide, a copolymer of lactide and polycaprolactone), a copolymer of glycolide, dioxanone, and trimethylene carbonate, polyhydroxyalkanoate, and polyglyconate.