FIGS. 2A-2E depict a proximal end 102 of a staple cartridge configured to secure at least one suture. In some examples, the staple cartridge further comprises a pan 114. The pan 114 may provide further support for the elongate body 120 of the staple cartridge. In some examples, a portion of the pan 114, at the proximal end 102 of the cartridge, comprises hooks 116 for securing at least one suture 400 at the proximal end 102 of the staple cartridge. As depicted in FIG. 2A, the ends 402 of a suture 400 may be knotted, and hooks 116 may be sized such that the knotted end 402 of the suture is retained by the hooks 116. In some examples, the hooks 116 are crimped metal. The hooks 116 may be approximately .050″ long.

As depicted in FIGS. 2A and 2B, two sutures 400 or two ends of a single suture may be provided through the longitudinal groove 304 of the implantable adjunct 300, according to some examples. The hooks 116, may bias each of the two sutures or two ends of a single suture toward the outside of the longitudinal slot 105 of the staple cartridge 100 to provide a space for a knife to pass between when passing though the longitudinal slot 105 during a cutting operation. As discussed above, the adjunct 300 may comprise a mesh 302 which the sutures rest on to tension the adjunct down onto the deck of the cartridge. As contemplated above, a single suture or single portion of a suture may be provided through the longitudinal grove groove 304 of the implantable adjunct 300, as opposed to two sutures or two portions of a suture. The other end or ends of the suture 400 may be secured to the distal end of the cartridge, as discussed herein. Alternatively, as depicted in FIG. 2C, a Y-shaped suture, or two sutures with an intertwined middle portion, may be utilized with a single strand running through the longitudinal groove (not shown) of the implantable adjunct.

As depicted in FIGS. 2A, 2B, 2D, and 2E, the proximal end 102 of the elongate body may further comprise a suture guide 132 directing the at least one suture 400 into the longitudinal groove 304 of the implantable adjunct 300. In some examples, the suture guides 132 comprises a bottom surface 134 angled relative to the deck 108 at an angle θ (see FIG. 2E). In some examples, the bottom surface 134 is angled relative to the deck 108 at an angle θ of approximately 0 degrees to approximately 20 degrees. In some examples, the downward angle of the suture guides 132 positions the sutures below the deck 108, such that the sutures maintain a downward tension on the adjunct 300 towards the deck 108.

With reference to FIG. 3, in some examples, a suture 400 comprises a sleeve 410 attached to at least one end of the suture 400. The sleeve 410 may comprise a metal or another suitable material which can be crimped onto the suture 400. The sleeve 410 can provide a feature for securing the suture to a portion of the elongate body 120 of the cartridge 100. FIGS. 4A-6B depict a proximal end 102 of an elongate body 120 of a staple cartridge having recesses 144 to retain a sleeve 410 attached to an end of a suture 400.

FIGS. 4A and 4B, depict a recess 144 provided in a top surface of the distal end 102 of the elongate body of the staple cartridge. In some examples, the recess 144 is sized to form a press-fit or an interference fit with the sleeve 410. In some examples, recess 144 is provided at an angle @ relative to a length of the longitudinal slot 105 (i.e., angle relative to the longitudinal axis 106, as depicted in FIG. 1C, along which the longitudinal slot 105 is provided). In some examples, the angle @ is approximately 30 to 60 degrees. As depicted in FIG. 4B when sleeve 410 is provided within the recess 144, the suture 400 extends into a suture recess 146 sized to fit the suture (smaller than the recess 144 sized for the sleeve) and around corner 148, such that the suture is biased to one side of the longitudinal slot 105. In some examples, the recess 144 is provided below the deck 108, such that the suture 400 will be positioned to tension the adjunct 300 (not shown in FIGS. 4A and 4B) downward on to the deck when the suture is provided through the longitudinal groove and on top of the mesh layer of the adjunct.

FIGS. 5A and 5B, depict a recess 144 provided through top surface of the distal end 102 of the elongate body of the staple cartridge. In some examples, the recess 144 is sized to form a press-fit with the sleeve 410. In some examples, recess 144 is provided orthogonal to a length of the longitudinal slot 105, extending from the top surface of the elongate body toward a bottom surface of the elongate body. As depicted in FIG. 5B when sleeve 410 is provided within the recess 144, the suture 400 extends into a suture recess 146, such that the suture is biased to one side of the longitudinal slot 105. In some examples, the bottom surface of the suture recess 146 is provided below the deck 108, such that the suture 400 will tension the adjunct (not shown in FIGS. 5A and 5B) downward on to the deck when the suture is provided through the longitudinal groove and on top of the mesh layer of the adjunct.

FIGS. 6A and 6B, depict a recess 144 provided at the proximal end 102 of the elongate body of the staple cartridge. In some examples, the recess 144 is sized to form an interference or press-fit with the sleeve 410. In some examples, recess 144 is provided perpendicular to a length of the longitudinal slot 105, extending across the proximal end 102 of the elongate body. As depicted in FIG. 6B when sleeve 410 is provided within the recess 144, the suture 400 extends into a suture recess 146, such that the suture is biased to one side of the longitudinal slot 105. In some examples, the recess 144 is provided below the deck 108, such that the suture 400 will tension the adjunct (not shown in FIGS. 6A and 6B) downward on to the deck when the suture is provided through the longitudinal groove and on top of the mesh layer of the adjunct.

With references to FIGS. 7A and 7B, the proximal end 102 of the elongate body 120 comprises a cavity 154 to receive a collet 420, according to some examples. The collet 420 may comprise a first opening 422 to receive the at least one suture 400 therethrough allowing the suture to be pulled through (in direction 1) when the collet 420 is moved away from the longitudinal slot (in direction 2). In some examples, the cavity 154 tapers inward toward the longitudinal slot 105 such that the first opening 422 of the collet 420 clamps onto the at least one suture 400 as the collet 420 moves toward the longitudinal slot 105 (in the direction 3) under tension of the suture and restricts the suture 400 from sliding back through the first opening 422, thereby providing a self-tensioning mechanism. The suture 400 may enter the cavity through a first aperture 152 from the longitudinal slot 105 and exit through a second aperture 156 to an outer surface of the elongate body. The first aperture 152 may be angle relative to the longitudinal slot such that the suture is biased to one side of the longitudinal slot 105. In some examples, the first aperture 152 is provided below the deck such that the suture 400 will tension the adjunct (not shown in FIGS. 7A and 7B) downward on to the deck when the suture is provided through the longitudinal groove and on top of the mesh layer of the adjunct.

FIGS. 8A-10B depict a distal end 102 of an elongate body 120 of a staple cartridge configured to secure a suture 400. As depicted in FIGS. 8A, 9B, and 10B, in some examples, the distal end 104 comprises a cutting slot 117 on an underside 107 of the elongate body 120. The cutting slot may be formed by bridging the suture 400 over a portion of the underside of the elongate body thereby forming a space between the underside 107 of the elongate body 120 and the at least one suture 400 to accommodate a cutting instrument. The cutting slot 117 may provide space for a cutting instrument, such as a scalpel or scissors, to cut the suture 400, if needed.

With reference to FIGS. 8A and 8B, in some examples, the distal end 104 of the staple cartridge comprises two through holes 124 extending from a topside 109 to the underside 107 of the elongate body 120. A suture 400 may be looped through the two through holes and across the cutting slot 117 on the underside 107 of the elongate body 120. On the topside 109 of the distal end 104, the two through holes may be provided below the deck 108 such that the suture 400 will tension the adjunct (not shown in FIGS. 8A and 8B) downward on to the deck 108 when the suture is provided through the longitudinal groove and on top of the mesh layer of the adjunct. The distal end 104 may further comprise guide ledges 136 to guide the suture 400 into the longitudinal groove of the adjunct.

With reference to FIGS. 9A and 9B, in some examples, the distal end 104 of the elongate body 120 comprises two side grooves 126. In some examples, the suture 400 is looped around the two side grooves 126 to secure the at least one suture 400 to the distal end 104 of the elongate body 120. The suture 400 may extend over cutting slot 117 on the underside 107 of the elongate body 120. On the topside 109 of the distal end 104, the suture 400 may enter the two side grooves below the deck 108 such that the suture 400 will tension the adjunct (not shown in FIGS. 9A and 9B) downward on to the deck 108 when the suture is provided through the longitudinal groove and on top of the mesh layer of the adjunct. The distal end 104 may further comprise guide ledges 136 to guide the suture 400 into the longitudinal groove of the adjunct.

With reference to FIGS. 10A and 10B, in some examples, the distal end 104 of the elongate body 120 comprises two side grooves 126 and a post 128 provided distal to the side grooves 126 to secure the suture 400 to the distal end of the staple cartridge. On the underside 107 of the distal end, the suture 400 may extend over cutting slot 117 provided between the two side grooves 126. In some examples, the post 128 centers the ends of the suture such that the suture 400 and is centered when extending into the longitudinal groove of the implantable adjunct (not shown in FIGS. 10A and 10B) from the post. In some examples, the two side groove 126 comprise an additional notch 127 to further secure the suture as it is wrapped toward the over the topside 109 and toward the post 128. In some examples, the post 128 is lower than the deck 108 such that the suture 400 will tension the adjunct (not shown in FIGS. 10A and 10B) downward on to the deck 108 when the suture is provided through the longitudinal groove and on top of the mesh layer of the adjunct.

FIGS. 11 and 12A-12G depict a routing method for securing a suture 400 having a first end 402 and a second end 404. The routing method may be carried out by a user (such as an assembler) or a pair of robotic arms, each arm manipulating one of the ends of the suture.

With reference to FIGS. 12A-12G, in some examples, a method for securing a suture 400 to a distal end 104 of the elongate body 120 comprises a first step of wrapping the suture 400 around an underside of the distal end 104 of the elongate body 120, such that the suture 400 extends over a cutting slot (e.g., cutting slot 117 depicted in FIGS. 8A, 9B, and 10B provided on the underside of the distal end 104 of the elongate body), advancing a first end 402 of the suture 400 through a first side groove 126a, and advancing a second end 404 of the suture 400 through a second side groove 126b, as depicted in FIG. 12A. A second step, according to some examples, comprises bringing the first end 402 of the suture 400 to post 128, as depicted in FIG. 12B. A third step, according to some examples, comprises wrapping the first end 402 of the suture 400 around post 128, as depicted in FIG. 12C. A fourth step, according to some examples, comprises positioning the first end 402 of the suture 400 through the longitudinal groove and onto the mesh layer of the implantable adjunct (not shown in FIGS. 12A-12G), as depicted in FIG. 12D. A fifth step, according to some examples, comprises bringing the second end 404 of the suture 400 to post 128, as depicted in FIG. 12E. A sixth step, according to some examples, comprises wrapping the second end 404 of the suture 400 around post 128, as depicted in FIG. 12F. A seventh step, according to some examples, comprises positioning the second end 404 of the suture 400 through the longitudinal groove and onto the mesh layer of the implantable adjunct (not shown in